双语09-衣原体.ppt

第1７章其他原核细胞微生物Sction 3 chlamydiae 衣原体 -is a prokaryote --is an obligate intracellular parasite --has a distinctive developmental cycle --can pass through bacterial filters (0.45μm).一类严格细胞内寄生，有独特发育周期，能通过细菌滤器的原核细 胞型微生物 . bacterial filterbacterial filter共同特征( common features) G-,round or elliptical)革兰阴性，圆形或椭圆形 the outer cell wall resembles the cell wall of G- bacteria)具有细胞壁，其组成与革兰阴性菌相似； a distinctive developmental cycle and division by binary fission ) 有独特的发育周期，行二分裂方式繁殖； contain prokaryotic ribosomes and complex enzymes,are obligate intracellular parasites because they can not produce ATP and must depend on the host cell for energy requirement,and are sensitive to certain antibiotics.)n有核糖体和较复杂的酶类，但缺乏供代谢所需的能量 来源，营专性细胞内寄生,对多种抗生素敏感1生物学性状 (biological characteristics )（1） developmental cycle(发育周期) elementary body（EB ）原体initial body（始体） or reticulate body，RB（网状体）原体（elementary body, EB）始体（initial body） [网状体（reticulate body, RB）]小 0.2-0.4μm大 0.8-1.0 μm有致密的类核结构，有胞壁，发育成熟电子密度较低，无胞壁Giemsa 紫色，Macchiavello 红色Macchiavello 蓝色高度感染性无感染性无繁殖能力代谢活泼，二分裂方式繁殖胞外稳定性强胞外稳定性弱receptor-mediated endocytosis or pinocytosis包涵体(inclusion body) 易感 细胞内含繁殖的始体和子代 原体的空泡(vacuole)receptor-mediated endocytosis or pinocytosis包涵体(inclusion body) 易感 细胞内含繁殖的始体和子代 原体的空泡(vacuole)（2）培养特点(culture characteristics)————专性细胞内寄生(obligate intracellular parasites)a.鸡胚培养(embryonated egg yolksac inoculation)b.动物接种（ animal inoculation）如，小鼠（mouse) c.细胞培养(Hela 299,McCoy等) (cell culture--------- Hela 299,McCoy cell lines)汤飞凡(1897-1958)，1955,首次分离出沙眼衣原体 (Professor Feifan Tang isolated Chlamydia trachomatis for the first time in 1955)（3）resistancesusceptible to heat;disinfectants;certain antibiotics, such as erythromycin and tetracycline. resistant to hypothermia n对热敏感n对消毒剂敏感n耐低温n对抗生素敏感 2 致病性与免疫性 (Pathogenicity and immunity ) （1）致病性n内毒素样物质(endotoxin-like substance, ELS)--------抑制细胞代谢，破坏细胞(inhibit metabolism and cause lysis of host cells)n主要外膜蛋白(major outer member protein, MOMP）-------与吸附、侵入及阻止吞噬体和溶酶体融合有 关(related to adsorption ,invasion and inhibit the fusion of phagosomes and lysosomes) nⅣ型超敏反应(delayed-type hypersensitivity)n人类衣原体病:沙眼、包涵体结膜炎、泌尿生殖道感染（非淋菌性 尿道炎、宫颈炎等）、性病淋巴肉芽肿、肺炎（2）immunitythe immunity to chlamydia is weak. The host is liable to persistent infection and recurrent infection of chlamydiae) 免疫力不强，易造成持续感染和反复感染3. Main pathogenic chlamydia主要致病性衣原体（1）Chlamydia trachomatis 沙眼衣原体a.沙眼（trachoma） n传染源(source of infection)：人n传播途径：眼---眼，眼---手--- 眼: (route of transmission:eye-hand- eye ; eye-eye)n沙眼亚种A、B、Ba和C血清型 (Cause: Biovar trachoma A, B, Ba and C )感染眼结膜上皮细胞 (chlamydial infections of the conjunctival epithelium→ 增殖，包涵体proliferation, Inclusion bodies 局部炎症local inflammation 早期流泪、有粘液脓性分泌物、结膜充血及滤泡增生 (lacrimation,mucopurulent discharge ,conjunctival hyperemia,and follicular hypertrophy 后期结膜瘢痕、眼睑内翻、倒睫以及角膜血管翳引起的角 膜损害→conjunctival scar,eyelid deformities(entropion,trichiasis),pannus 影响视力或致盲 (→blurred vision ,even blindness.)b.包涵体结膜炎(inclusion conjunctivitis）n由沙眼亚种B、Ba、D、Da、E、F、G、H 、I 、Ia、J、及K血清型引起 (Cause: Biovar trachoma B、Ba、D、Da、E、F、G、H 、I 、Ia、J、,K)n婴儿—产道传染(infants -------infection via birth canal) n成人(adults)由性接触经手传染至眼(sexual contacts)通过游泳池水传染至眼(contaminated water → eye)n inclusion conjuncticitis has similar symptoms to trachoma except for corneal pannus and scar,and can heals spontaneously over several weeks or months n症状类似沙眼，但不出现角膜血管翳，不形成结膜 斑痕，一般经数周或数月可痊愈。

inclusion conjunctivitis 包涵体性结膜炎c.c. urogenitalurogenital tract infectiontract infection 泌尿生殖道感染泌尿生殖道感染—— ——non-gonococcalnon-gonococcal urethritisurethritis，，NGU(NGU(非淋菌性尿道炎非淋菌性尿道炎））sexualsexual contacts contacts ( (性接触性接触) )malemale：： urethritis urethritis 尿道炎尿道炎femalefemale：尿道炎、宫颈炎：尿道炎、宫颈炎cervisitiscervisitis、、输卵管炎输卵管炎salpingitissalpingitis、、 盆腔感染盆腔感染pelvic infectionpelvic infection等 尿道炎尿道炎宫颈炎宫颈炎输卵管炎输卵管炎盆腔感染盆腔感染immunityshort duration of antibodyn抗体持续时间短weak immunity,predisposing to re-infection)n免疫力不强，易再受感染微生物学检查法 microbiological diagnosis scrapings of pathological site →Giemsa,iodine, fluorescent antibody staining →look for inclusion bodies in the epithelia cell)n病变部位刮片→ Giemsa、碘液或荧光抗体染色镜检，检查上 皮细胞内有无包涵体 (isolation: embryonated egg yolk sac or continuous cell line)n分离培养 接种鸡胚卵黄囊或传代细胞 Nucleic acid testing:PCR , etc. with high sensitivity and specificity ) 核酸检测 PCR等核酸扩增技术，敏感度高，特异性强。

包涵体含糖原(glycogen)，被碘液染为棕褐色(brown)EBFluorescent inclusion body of C trachomatis in epithelial Cell(conjunctival scraping)防治原则 prevention and treatment预防－－－无特异预防方法 (prevention-------no specific prevention methodsa.注意个人卫生，不用公共毛巾、脸盆等pay attention to sanitation, not share towels and basin)b.注意自我防护，提倡健康性行为(pay attention to self-protection and advocate safe sex) 治疗：磺胺类、大环内酯类、喹诺酮类 (treatment: sulfonamides, macrolides, quinolones,etc.)（２）性病淋巴肉芽肿亚种biovar lymphogranuloma venereum,LGVn血清型（L1、L2、L2a及L3）n致病性(pathogenecity)传染源(source of infection)：人传播途径(route of transmission)：性接触(sexual contacts )侵犯淋巴组织(involvement of lymphatic tissues) 男性→腹股沟淋巴结→化脓性淋巴结炎 和慢性淋巴肉芽。