6-肠杆菌科摘要.pptVIP

Virulence factors of V.cholerae O1 and O139 Virulence factor Biological effect Cholera toxin Hypersecretic of electrolytes and water Coregulated pilus Adherence to mucosal cells adhesin Accessory colonization factor adhesin Hemagglutin/ protease Releases bacteria from mucosal cells Flagellum Motility Siderophores铁载体 Iron sequestration 血凝素 Vibrio cholerae Pathogenesis Cholera toxin is the most important (Vibrio cholerae only) Increased cAMP→ massive secretion of of water and electrolytes into gut lumen→ Watery diarrhea → Dehydration and death Ingest 108-1010 organisms Non invasive infection of small intestine Immunity Strong immunity after recovery, sIgA Vibrio cholerae O1 (This is a specific powerful serotype) Mild diarrhea to severe deadly diarrhea Depends on how much toxin produced Abrupt onset of watery diarrhea and vomiting (onset 2-3 days after ingestion), Rice water stools Severe fluid and electrolyte loss---dehydration, metabolic acidosis, hypovolemic shock, renal failure.( Lose 10-25 liters a day, sometimes 1 liter/hour, Lose 50% of body weight during course of disease) Self-limiting, but have to replace fluids and electrolytes or high likelihood of eventual death---Death 60% if untreated, 1% if treated for fluid loss, Death within hours (renal failure and shock) Vibrio cholerae O139 (more potent serotype compare to O1 ) Severer dehydration and higher mortality Vibrio cholerae non01 and nonO139 (less potent serotype) Much milder diarrhea, not life-threatening Clinical Findings Bacteriological Diagnosis Specimens: stool, vomitus. Stained smear: Culture: alkaline peptone water of agar plate, and TCBS agar plate. Grows well on thiosulfate硫代硫酸盐-citrate柠檬酸盐-bile-sucrose (TCBS) agar, on which it produces yellow colonies that are readily visible against the dark-green background of the agar. Quick immunological methods: immunofluorescent “ball” test; PCR. Vibrio-Prevention and Control Improved sanitation Fluid and electrolyte replacement---- P