螺杆菌和弯曲菌.ppt

Helicobacter and campylobacter螺杆菌和弯曲菌 Campylobacter jejuni空肠弯曲菌 Helicobacter pylori幽门螺杆菌 Helicobacter螺杆菌属 幽门螺杆菌 （H. pylori） Typical Organisms Ｇ- rods with comma，S，or “gull-wing” shapes 革兰阴性细长，呈弧形、S形或海鸥状 flagella at pole and is actively motile 丛毛菌 ，运动活泼 culture microaerophilic environment 微需氧环境 Selective media 选择培养基 菌落：细小、针尖、半透明 strong producer of urease 产生大量的尿素（脲）酶 致病性与免疫性 幽门螺杆菌与疾病 antral gastritis胃窦胃炎 duodenal（peptic）ulcer十二指肠（消化性）溃疡 gastric ulcer胃溃疡 gastric carcinoma and lymphoma胃癌和胃淋巴瘤 致病因子 鞭毛 尿素酶 菌毛/粘附素 VacA CagA 多种胞外酶及蛋白 致病假说 漏屋学说 胃泌素联系学说 ? Campylobacter 弯曲菌属 gram-negative rods with comma，S，or “gull-wing” shapes 形态细长，呈弧形、螺旋形、S形或海鸥状 motile，with polar flagellum 单鞭毛，运动活泼 microaerophilic微需氧 5% O2with added 10% CO2 42℃能生长，营养要求高 抵抗力较弱 Pathogenesis致病性 The infection is acquired by the oral route 经口感染 Minimum infectious inoculum ~104 organisms enteritis细菌性肠炎（食物中毒） Incubation period ~ 2-4 days. Diarrhea, sometimes with blood. The diarrhea is self-limited in most cases, but fluid losses can be fatal for infants and elderly. Patients with AIDS and other immunosuppressed states may have chronic diarrhea. * * 最适温度：37℃ 不能生长：42 ℃，25 ℃ Barry Marshall, M.D. ? Helicobacter pylori is specific for humans other primates. Other mammals have their own Helicobacter species. ? Route of transmission is primarily person-to-person rather than water contamination污染. ? Infections cluster in families. Helicobacter pylori transmission ? H. pylori infection: 60-70% prevalence流行率overall in the world. ? Higher prevalence in developing than developed countries. ? Within a country there is inverse relationship between infection and socioeconomic status社会经济地位. % prevalence of H. pylori infection Gastric adenocarcinoma Endoscopic view Diagnostic laboratory tests Gastric biopsy specimens 胃活检标本 histological examination 组织学检查 culture 细菌培养 stains can show the curved or spiraled organisms 染色找到典型细菌 detect serum specific antibodie