《非发酵革兰阴性杆菌》ppt课件.pptVIP

第十章非发酵革兰阴性杆菌 (nonfermenting bacilli, NFB) ;KEY POINTS;P. aeruginosa is the species most commonly associated with human disease among nonfermenting bacilli, followed by Acinetobacter baumannii and Stenotrophomonas maltophilia. P. aeruginosa is also a frequent cause of nosocomial infections such as pneumonia, urinary tract infections (UTIs), and bacteremia. Pseudomonal infections are complicated and can be life threatening. Pseudomonas spp. are aerobic, non-spore-forming, gram-negative rods which are straight or slightly curved. They are motile due to the presence of one or more polar flagella. Clinical isolates are oxidase positive (with of exception P. luteola and P. oryzihabitans) and catalase positive and grow on MacConkey agar, appearing as lactose nonfermenters. Most species degrade glucose oxidatively and convert nitrate to either nitrite or nitrogen gas. Certain species have distinctive colony morphologies or pigmentation. ;Acinetobacter spp. consists of strictly aerobic, gram-negative coccobacillary rods that are oxidase negative, non-motile, usually nitrate negative, and nonfermentative. They sometimes difficult to decolorize, and frequently arranged in pairs. Colonies are smooth, opaque, and slightly smaller than those of members of the family Enterobacteriaceae. Stenotrophomonas maltophilia are aerobic, non-spore-forming, gram-negative straight bacilli and tend to be slightly smaller. They are motile due to a tuft of polar flagella, oxidase negative, oxidation of glucose. They are nutritionally quite versatile, all grow on MacConkey agar and appear as nonfermenters. ;概 述;在分类学上分别属于不同的科、属和种，但表型特征较接近 非发酵菌广泛存在于水、土壤和空气中，有的是人体皮肤粘膜表面的正常菌群组成成分，一般是条件致病菌 铜绿假单胞菌、不动杆菌等在医院感染中有重要地位 以纯培养方式从正常无菌部位的标本中分离出非发酵菌，一定要进行鉴别和抗生素敏感试验 从非无菌性标本比如无临床体征或无肺炎症状的患者气管内标本培养物分离到非发酵菌，即使是优势生长，也没有必要进一步鉴定 [因为非发酵菌可表现对多种抗生素耐药，使用多种抗生素治疗的患者常出现非发酵菌定殖 ！];临床常见非发酵菌; 第一节 假 单 胞 菌 属 （Pseudomonas）;Pseudomonas分类;Natural Habitats;Clinical Significance;P. aeruginosa is a c