微免其中
The Control of Microbial Growth, Mechanisms of Bacteria Pathogenesis
Glutaldehyde can inactivate enzyme by alkylation
戊二醛是烷化物,
透過將烷基轉移到官能基上使細菌體內酵素失去活性,
使用於不耐高溫的侵入性醫療器材
Glutaldehyde is more active under Alkaline
超臨界二氧化碳(Supercritical fluids of CO2)
常用來消毒食物或者是移植物
Detergents(洗滌劑) can disrupt bacterial cell membranes
rthroscopic surgery 是關節內視鏡手術,
問侵入性醫療器材的消毒方式,
醫療器材不耐高溫,
所以跟高溫有關的都不能選
看到 Glutaldehyde 和 plasma 類的
Plasma gas for sterilization is used 10-25% of hydrogen peroxide at 55-60°C
disadvantages of Ultra Violet light(UV)
The optimal method for sterilization operation room are HEPA filtration (High Efficiency Particular Air(高效率空氣微粒子過濾網))and UV light
格蘭氏陰性菌細胞壁構造
bacteria escaping host defenses
細胞內膜利用 porins 之類的蛋白質以管制小分子之通透
含內毒素(Endotoxin)主要是指 LPS
因具有細胞外膜因此對抗生素之耐藥性比革蘭氏陽性菌來得強
periplasmic space beta-lactamase 等抗生素分解酵素
periplasmic space 內含有許多如 protease,lipase 等水解酵素(Hydrolytic enzymes)
S. aureus can secret coagulase promoting the conversion of fibrinogen to fibrin
Staphylococcus produces catalase to break down H2O2
S.pyogenes can degrade C5a component of complements to limit the chemotaxis
S.pyogenes use hyaluronic-acid-made capsules to mimic human connective tissue
Incomplete sterilization
T-T dimers formation affects DNA translation
poor penetration through solid material radia
cause conjunctiva damage
Staphylococcus, Streptococcus & Enterococcus
Suppurative 是化膿的意思,
rheumatic fever跟acute glomerulonephritis
cause from M-protein(non-suppurative)
Catheter 是導管,
CoNS 大多會造成院內伺機性感染,
常見於感染裝導尿管患者
(CoNS:不會製造 Coagulase 的葡萄球菌,基本上就是非金黃色葡萄球菌的葡萄球菌)
The symptoms in scarlet fever are due to Pyrogenic toxin
coagulase test 是用在 Catalase (+)的菌種,
也就是葡萄球菌類的
Streptococcus pneumonia 肺炎鏈球菌與其他𝛼-hemolytic species 的方法有三
葡萄球菌大多分布在皮膚和黏膜,
然後鏈球菌大部分是在口咽
pairs between a disease and its infectious agent
看到 urine incontinence,代表泌尿道那邊被感染
然後對 vancomycin 有抗藥性、
是 catalase- negative,
看來看去,當然就是選腸球菌
化膿性鏈球菌主要造成的感染部位是喉嚨跟皮膚,
然後會藉由 M protein 產生
風溼熱(Rheumatic fever)
(”常見”於咽喉炎之非化膿性併發症)
以及急性腎小球腎炎(Acute glomerulonephritis)
(”常 見”於皮膚感染之併發症)
90%的 toxic shock syndrome (TSS) 是由 Staphylococcus aureus 金黃色葡萄球菌引起
Neonatal meningitis(新生兒腦膜炎)
—Streptococcus agalactiae 無乳鏈球菌
Bacterial pharyngitis(細菌造成的咽喉炎)
-Streptococcus pyogenes 化膿性鏈球菌
Subacute endocarditis(亞急性心內膜炎)
-Streptococcus mitis
Necrotizing fasciitis(壞死性筋膜炎)
—Streptococcus pyogenes 化膿性鏈球菌
Inulin fermentation--肺炎鏈球菌可以發酵 insulin
Optochin test--肺炎鏈球菌對 optochin 比較敏感
Bile solubility test--肺炎鏈球菌會被膽鹽溶解
Fungal Structure and Mycosis
白色念珠菌擁有酵母、假菌絲、菌絲共三態,
但這三型會同時在體溫環境存在,
沒有符合dimorphism 最標準的定義。
具有 Dimorphism 之性質
Candida albicans 是白色念珠菌
屬於出芽型酵母 budding yeast,
以 CHROMagar 培養的話會呈綠色,
長期培養後會產生厚膜孢子(chlamydospore)及芽生孢子(blastospore)。
若將一群念珠菌,以血清為培養基,白色念珠菌是唯一一個會長出 Germ-tube 的
Coenocytic hyphae 代表是接合菌亞門 Zygomycotina,
考他的無性階段
他有假根 rhizoids,上面可以長出囊孢柄 sporangiophores 和囊孢 sporangium,囊孢裡面有中軸 columella 跟上千顆的囊孢子 sporangiospore
Zygomycotina 之主要特徵為Coenocytic mycelium(hyphae)
擔子菌亞門:菌絲通常具有鎖狀聯合(Clamp-connection)的構造,會進行出芽生殖或塊
狀生殖,也會產生分生孢子,不過很少
真菌界的分裂順序是是否一直具有細胞壁、有無遊走孢子、有無有性世代、菌絲有無隔板、有性 孢子著生處,其中畫底線的,就是屬於 Amastigomycota 無鞭毛菌門的範圍
所謂 True fungi
子囊菌亞門:有隔菌絲長出分生孢子柄 conidiophore 和瓶狀孢子柄 phialides,瓶狀孢子柄
上面有分生孢子(或稱瓶孢子)conidia
PAS 染色法(Periodic Acid-Schiff stain)
在組織學上,主要用來檢測組織中的醣類,通常用於黴菌病檢體組織切片染色的方法
Aspergillus(麴菌)不屬於擔子菌綱(Basidiomycetes)
葉綠素(Achlorophyllous )
真菌毒素對人類的危害通常不包括致畸胎作用
真菌的基本組成包括細胞本身(yeast)和菌絲(hyphae)
白色念珠菌造成的疾病有以下:
鵝口瘡、尿布疹、陰道感染、全身感染、菌血症
不包括濕疹(過敏)
main components in the cell wall in fungi
-Chitin and 1-3 β-glucan
真菌最適生長溫度不不不為 37°C
Terbinafine(Lamisil)是Allylamines的衍生物,可以抑制麥角固醇的合成
真菌中最常見的無性孢子是分生孢子
Which of the following antifungal drugs inhibited biosynthesis of 14-a-lanosterol(Lanosterol 是動物和真菌合成類固醇時的中間產物) demethylase in fungi? Imidazoles(Ketoconzole)(Imidazoles 可以抑制麥角固醇的合成)
真菌中毒症不具有傳染性
A “filamentous fungus(絲狀黴菌,泛指有菌絲的真菌)” means Related to fungus produce only hyphae
Candida albicans(白色鏈珠)
Sporothrix schenkil
histoplasma capsulatum莢膜胞漿
penicillium marneffei馬氏青黴
Amphotericin B 破壞真菌細胞的主要標的是細胞膜
(本藥在易感受黴菌細胞膜內與脂醇(sterols)結合,造成膜通透性的變化,導致細胞內成分的洩露)
白色念珠菌(Candida albicans)會造成鵝口瘡(oral thrush)、陰道炎、甚至食道炎或藉由 血流侵入各個器官
AIDS 病人的伺機性感染,最常見的是卡氏肺囊蟲(Pneumocystis carinii pneumonia)所造成的肺炎
沒有假菌絲是yeast-like菌的敘述
脂多醣層(lipopolysaccharide layer)陰性菌細胞壁才有喔
Lymphocutaneous sporotrichosis 是由 Sporothrix schenkii 一種皮下真菌感染,由淋巴管線轉移
Candidiasis 是 Candida spp.(spp 為種 species 的縮寫)的局部感染;
Candidemia 是 Candida spp.進入血液引起的菌血症
Bacillus, Corynebacteria, Listeria
典型 spore-forming bacteria 有兩種
對於炭疽桿菌,需要及時投以抗生素或是抗毒素才能有效治療,現行的治療方式為投與 ciprofloxacin 搭配一到兩種抗生素,或是服用口服盤尼西林(amoxicillin)
Listeria monocytogenes
Corynebacteria diphtheriae
Treating first giving antitoxin then antibiotic
The baby was born two months for the first vaccination
Tumbling motility at 20-25°C
Important pathogen in veterinary
Intracellular pathogen
humoral immunity is not important
Bacillus,屬於革蘭氏陽性嗜氧菌
Clostridium,屬於革蘭氏陽性厭氧菌
Enterobacteriacea
Proteus species are highly motile organisms that are found in the human colon and cause urinary tract infections.
造成血便的原因是其他毒素(例如:類志賀毒素),
而非腸毒素。
Klebsiella pneumoniae, although a cause of pneumonia, is part of the normal flora of the colon.
Vibrio cholera causes cholera by producing an enterotoxin that activates adenylate cyclase.
(霍亂毒素會活化腺苷酸環化酶(AC,EC 4.6.1.1),
打亂人體細胞調控。)
E. coli ferments lactose, whereas the enteric pathogens Shigella and Salmonella do not.
Escherichia coli enterotoxin activates adenylate cyclase, resulting diarrhea.
Escherichia coli is part of the normal flora of the colon; therefore, it does not cause diarrhea.
Bacillus cereus enterotoxin activates adenylate cyclase, resulting diarrhea.
大腸桿菌 ETEC 會分泌腸毒素,
但除非潰瘍,否則細菌本身不會穿入腸壁。
無運動性,故非沙門氏菌屬(Salmonella)。
MOST likely to involve invasion of the
intestinal mucosa?Shigella
傳染途徑為糞口傳染,故推斷為shigella or salmonella
鼠疫plague由鼠疫桿菌(Yersinia pestis)造成
耶氏菌雖然也有糞尿傳播的紀錄,但主要 傳播途徑是血液與接觸,特別是冰箱──它們喜歡 1-4°C的環境,恰好就是冷藏室的溫度。
Salmonella spp
More than 2500 unique serotypes
Salmonella typhi infection can be diagnosed by Widal’s test
peritrichous flagella
Associated with raw egg-induced food poisoning
(non-typhoid salmonellosis)
All Enterobacteriaceae share all of the following characteristics
ETEC 與 EHEC 等大腸桿菌引起的症狀不同,是因為產生的毒素不同,體表抗原可用來區分亞種, 但和致病機制無關。
Salmonella
click to edit
Shigella
click to edit
click to edit
Non-spore forming
Ferment glucose
) Rod-shaped(bacilli)
The most common sources of human infections are poultry, egg, dairy products and foods prepared on
contaminated work surfaces
They can colonize virtually all animals and cause
animal-to-animal spread
They can enter epithelial cell of intestinal tract from M cell
They are transmitted person to person
They can cross the epithelial cell membrane of intestinal tract, but can’t enter the lymphatic system
and blood stream
Shigellosis produces a smaller volume of feces(大便), but with blood, mucus and inflammatory cells
They can enter epithelial cell of intestinal tract from M cell