Chapter9

Vibrio

p.141本章重點及難點掌握霍亂腸毒素的作用機制熟悉霍亂弧菌的主要生物學特性、所致疾病、免疫性和防治原則熟悉副溶血弧菌的主要生物學特性、所致疾病、診斷與防治了解霍亂弧菌的微生物學檢查法1.Concept:morethan56species,of12relatedtohumaninfection.2.History1817-1923:1st-6th,IndiaandBengal,O-1Classicalbiotype

1961:7th,Indonesia,O-1ElTorbiotype

1992:8th?

IndiaandBengal,O-139Classicalbiotype

wasisolatedin1883ElTorbiotypewasisolatedin1905

VibrioCholerae

p.142

(Classicalbiotype

and

ElTorbiotype)

I.BasicProperties

1.Morphology:Shortandfine,Curvedrod,G－,

Singleflagella,activemotility2.Culture:Aerobic,pH9,TCBSagar3.Resistance:Lowerresistanttoheat,acid,anddrying.V.CholeraemorphologyGenometsucture:2circledchromsomeslarge---2.91Mb,G+C46.9%small---1.072Mb,G+C47.7%4.Antigenicstructuresandclassification

1).Oantigen:morethan155,mainlyO1andO139

serogroups:O1andO139non-O1/non-O139

O1canbedivided3serotypes2).Classification:

Claasicbiotype:1817~1923(1st~6th)ElTorbiotype:in1961(7th)O139serotype:from1992(8th?)

{II.PathogenesisandImmunity

V.Choleraehabitatonlyadherencetotheintestinalepithelialcellularsurface,notenterintocellsandblood;multiplythereandreleaseCholeratoxin

(CT)

andendotoxin.pathogenicityonlyforhuman

Choleraenterotoxin(CT)

BSubunitASubunit(A1、A2)↓↓A1throughbindtothereceptorCellmembraneofmucous(GM1)↓activationATP↓cAMP↑↓

oversecretionand

severediarrheaGprotein---GsCTactivitymechanismClinicalfindings:

nausea,vomiting,diarrhea

“ricewater”stoolrapidlossfluidandelectrolytes

mortalityrate:60%withouttreatment

<1%withtreatment

Immunity:

gastricacid

anti-toxin:verystrong,reinfectionisrare!Mortalratewasveryhigh,60％,withouttreatment.“ricewater”

III.Diagnosticlaboratorytest.1.rapiddiagnosis

1).Smearandstaining2).Immobilizetest3).FluorescinbacteriaballtestSPAcoagglutination:fortoxins2.Cultures

37℃PeptonebrothSmearpH8-96-8h

37℃Smearagarplate(TCBS)ColonypH8-910-24hidentification.IV.PreventionandTreatment

1.Prevention

separatethepatients.4f,water,personalhygiene

Vaccine:imonlyfor6monthsstudyonoralvaccine,subunitvaccine

2.Treatment

supplementoffluid,electrolytesantibiotics:tetracyclineV.parahaemolyticusMaincharacter:halophilic---35%NaClDisease:foodpoisoningTreatment:gentamycinorSMZ復習思考題哪些霍亂弧菌可以引起霍亂？霍亂是如何傳播的？其臨床表現和預后如何？霍亂弧菌的主要致病物質是什么？其作用機理是什么？副溶血性弧菌可以引起何種疾病？如何預防？Vibrio弧菌屬V.cholerae霍亂弧菌V.paraheomlyticus副溶血性弧菌Cholera

toxin霍亂腸毒素Kanagawaphenomenon神奈川現象關鍵詞課外閱讀資料目錄[1]FarmerP.,etal.Meetingcholera'schallengetoHaitiandtheworld:ajointstatementoncholerapreventionandcare.PLoSNeglTropDis.2011;5(5):e