微生物精品教学（汕头大学）B Infection and Immunity 2012.pptVIP

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Carrier I had my first talk with Mary in the kitchen of this house. . . . I was as diplomatic as possible, but I had to say I suspected her of making people sick and that I wanted specimens of her urine, feces and blood. It did not take Mary long to react to this suggestion. She seized a carving fork and advanced in my direction. I passed rapidly down the long narrow hall, through the tall iron gate, . . . and so to the sidewalk. I felt rather lucky to escape……….. Hospital Infection Hospital Infection 医院感染：指住院病人在医院内获得的感染，包括在住院期间发生的感染和在医院内获得出院后发生的感染，但不包括入院前已开始或者入院时已处于潜伏期的感染。医院工作人员在医院内获得的感染也属医院感染。 Hospital Infection 说明： 一、下列情况属于医院感染 1．无明确潜伏期的感染，规定入院48小时后发生的感染为医院感染；有明确潜伏期的感染，自入院时起超过平均潜伏期后发生的感染为医院感染。 2．本次感染直接与上次住院有关。 3．在原有感染基础上出现其它部位新的感染(除外脓毒血症迁徙灶)，或在原感染已知病原体基础上又分离出新的病原体(排除污染和原来的混合感染)的感染。 4．新生儿在分娩过程中和产后获得的感染。 5．由于诊疗措施激活的潜在性感染，如疱疹病毒、结核杆菌等的感染。 6．医务人员在医院工作期间获得的感染。 二、下列情况不属于医院感染 1．皮肤粘膜开放性伤口只有细菌定植而无炎症表现。 2．由于创伤或非生物性因子刺激而产生的炎症表现。 3．新生儿经胎盘获得(出生后48小时内发病)的感染，如单纯疱疹、弓形体病、 水痘等。 4．患者原有的慢性感染在医院内急性发作。 Hospital Infection ? Category Endogenous infection Exogenous infection (cross infection; environmental infection) Hospital Infection Characters Opportunistic pathogen Antibiotic resistance Evolution and adaption * * * * * * * * * * * * * * * * * * * * * * * * * Invasive substances Invasin For penetration epithelium and spread Invasive Enzymes Coagulase Streptokinase; streptodornase; hyaluronidase IgA proteases Etc. Penetration and spread Vibrio cholerae 霍乱弧菌 Salmonella enteritidis 伤寒肠炎菌 Salmonella typhi 伤寒沙门菌 Epithelium Gut lumen Blood stream Bacterial biofilm A structured community of microorganisms encapsulated within a self-developed polymeric matrix and adherent to a living or inert surface. characterized by surface attachment, structural heterogeneity, genetic diversity, complex community interactions, and an extracellular matrix of polymeric substances. Integri