結(jié)核分枝桿菌王利沙MycobacteriumTuberculosis講解

結(jié)核分枝桿菌主講老師：王利沙MycobacteriumTuberculosisWeifangNursingVocationalCollege濰坊護(hù)理職業(yè)學(xué)院結(jié)核分枝桿菌MycobacteriumTuberculosis俗稱結(jié)核桿菌，引起人類結(jié)核病。Commonlyknownastuberclebacillus,itcauseshumantuberculosis.該菌可侵犯全身各組織器官，但以肺結(jié)核最為多見。

Thisbacteriumcaninvadevarioustissuesandorgansthroughoutthebody,buttuberculosisisthemostcommon.結(jié)核分枝桿菌MycobacteriumTuberculosis世界防治結(jié)核病日3月24日

WorldDaytoFighttuberculosis:March2401生物學(xué)性狀Biologicalcharacteristics生物學(xué)性狀Biologicalcharacteristics形態(tài)與染色

Morphologyandstaining結(jié)核桿菌細(xì)長(zhǎng)略彎曲呈單個(gè)或分枝狀排列

Mycobacteriumtuberculosisisslender,slightlycurved,

andarrangedinasingleorbranchedpattern.有莢膜，抗酸染色陽性Thereisacapsule,andtheacidresistantstainingispositive.生物學(xué)性狀Biologicalcharacteristics形態(tài)與染色

Morphologyandstaining抗酸染色法：以5％石炭酸復(fù)紅加溫染色，再用3％鹽酸酒精脫色，然后用美藍(lán)復(fù)染，則分枝桿菌呈紅色(+)，其他細(xì)菌和背景物質(zhì)為藍(lán)色(-)。Acidfaststainingmethod:Stainwith5%carbolicacidand

heating,thendecolorizewith3%hydrochloricacidandalcohol,andthencounterstainwithmethyleneblue.TheMycobacteriumwillappearred(+),whileotherbacteriaandbackgroundsubstanceswillappearblue(-).生物學(xué)性狀Biologicalcharacteristics培養(yǎng)特性

Cultivationcharacteristics專性需氧Specializedaerobic

液體培養(yǎng)基：底部顆粒狀，表面形成菌膜。

Liquidculturemedium:granularatthebottom,formingabacterialfilmonthesurface.營養(yǎng)要求較高--常用羅氏培養(yǎng)基

Highnutritionalrequirements-commonlyusedRocheculturemedium生長(zhǎng)慢

Slowgrowth固體培養(yǎng)基：菌落呈顆粒、花菜狀，乳白或米黃色，

不透明粗糙型菌落。

Solidculturemedium:Thecoloniesaregranular,cauliflowerlike,milky

whiteorbeigeincolor,opaqueandroughintexture.生物學(xué)性狀Biologicalcharacteristics抵抗力

Resistance四怕乙醇濕熱紫外線抗癆藥物（鏈霉素、異煙肼、利福平等）四不怕干燥酸（HCl或H2SO4)或

堿（4%NaOH)有抵抗力堿性染料青霉素等抗生素

生物學(xué)性狀Biologicalcharacteristics變異性

Variability形態(tài)、菌落、毒力及耐藥性等變異

Variationsinmorphology,bacterialcolonies,virulence,anddrugresistance毒力變異

Virulencevariation卡介苗BCG:減毒活疫苗株

BCG:attenuatedlivevaccinestrain

1908年，Calmette和Guerin將有毒的牛型結(jié)核分枝桿菌培養(yǎng)于含甘油、膽汁、馬鈴薯的培養(yǎng)基中，經(jīng)13年230次傳代使其毒力發(fā)生變異，成為對(duì)人無致病性，而仍保持良好免疫原性的疫苗菌株，稱為卡介苗（BCG）。1908,CalmetteandGuerinculturedthetoxicbovineMycobacteriumtuberculosisinamediumcontainingglycerol,bile,andpotatoes.After13yearsand230passages,thevirulenceofthestrainchanged,becomingavaccinestrainthatisnonpathogenictohumansbutstillmaintainsgoodimmunogenicity,calledBCGvaccine.02致病性Pathogenicity所致疾病Causingdiseases感染方式：呼吸道、消化道或皮膚、粘膜Infectionmode:respiratorytract,digestivetractorskin,mucosa致病性Pathogenicity致病物質(zhì)

Pathogenicsubstance脂質(zhì)、蛋白質(zhì)、莢膜

Lipids,proteins,capsules所致疾?。航Y(jié)核病----肺結(jié)核、肺外結(jié)核（多臟器受累）

Diseasecaused:tuberculosis----pulmonarytuberculosis,

extrapulmonarytuberculosis(multipleorgansinvolved)03免疫性Immunity免疫性Immunity機(jī)體對(duì)結(jié)核分枝桿菌具有一定的免疫力，由于其為胞內(nèi)寄生菌，其免疫主要是細(xì)胞免疫，同時(shí)也會(huì)發(fā)生遲發(fā)型超敏反應(yīng)。ThebodyhasacertainimmunitytoMycobacteriumtuberculosis,whichisanintracellularparasite.Itsimmunityismainlycellularimmunity,anddelayedtypehypersensitivityreactionsmayalsooccur.免疫性Immunity定義：應(yīng)用結(jié)核菌素測(cè)定機(jī)體對(duì)結(jié)核桿菌是否產(chǎn)生遲發(fā)型超敏反應(yīng)，以判斷有無免疫力的皮膚試驗(yàn)。

結(jié)核菌素試驗(yàn)

Tuberculintest試劑的種類：Typesofreagents:

舊結(jié)核菌素（OT）Oldtuberculin(OT)

純蛋白衍生物（PPD）Pureproteinderivative(PPD)Definition:Askintestthatusestuberculintodeterminewhetherthebodyhasadelayedtype

hypersensitivityreactiontoMycobacteriumtuberculosis,inordertodeterminethepresenceorabsenceofimmunity.試驗(yàn)方法：Testmethod:PPD皮內(nèi)注射，48～72h觀察結(jié)果。

PPDintradermalinjection,observationresultsfor48-72hours.