1. Spirochetes 04 口腔七年制

2. Introduction monocellular organism, flexible, helical,possess an axial filament (active motile) situs is between baterium and protozoa Gram-negative

3. Introduction Fontana silver stain sensitive to antibiotics(penicillin etc.)

4. Introduction classification non-pathogenic spirochete pathogenic spirochete Leptospira Treponema Borrelia

5. Leptospira 1 TaxonomyTaxonomy 2 Biological propertiesBiological properties 3 EpidemicologyEpidemicology 4 Pathogenicity and ImmunityPathogenicity and Immunity 5 Microbiological detectionMicrobiological detection 6 Treatment and preventationTreatment and preventation

6. Order: Spirochaetales Family: Leptospiraceae Genus: Leptospira L.interrogans pathogenic L.biflexa non-pathogenic

7. General structure outer envelope endoflagellum(6 kinds of protein) cytoplasmic cylinder

8. Morphology tightly coiled spiral,long(6-12 μ m) hooked in one or both ends active motility---rhythmic contraction of axial filament silver staining--brown

9. LMFontana

10. Culture aerobic Korthof substrate transparent, unregular,flat colony tempreture: 28 ℃ to 30 ℃ pH: 7.2 to 7.4

11. Genus-specific protein Ag serogroup-specific Ag serovar-specific Ag Ag

12. Resistance weak 60 ℃,1min,died exist in water or moist soil for several months sensitive to penicillin

13. Epidemicology Mainly a zoonotic disease –Transmitted to humans from a variety of wild and domesticated animal hosts –In USA most common reservoirs rodents (rats), dogs, farm animals and wild animals Transmitted through breaks in the skin or intact mucus membranes Indirect contact (soil, water, feed) with infected urine from an animal with leptospiruria Occupational disease of animal handling

14. Epidemicology Zoonoses

15. Invasiveness mechanism:adhension endocytosis inducing apoptosis or necrosis endosome

16. Pathogenic substance: Endotoxin-like component(ELS)---- cause fever,inflammation,necrosis(lower toxicity) Hemolysin---lysis RBC Cytotoxicity factor---muscle spasm and dyspnea Cytopathogenic effect substance(sensi- tive to heat,50 ℃,30min;sensitive to trypsin)

17. Route of infection organism infected animal discharge urine contaminant water/soil human skin blood stream leptospirosis recovery or fatality(30%)

18. Clinical type of diseases Jaundice---hemorrhage type Influenza---typhoid type Pulmonary---hemorrhage type Renal---failure type Meningoencephalitis type

21. Immunity Humoral immunity;after 2 weeks,specific Ab can be examed Specific Ab doesn't act efficiently on Leptospira in kidney. So they can multiply in patient's kidney and excrete through urine

22. Specimen: the first week, blood. the second week, urine meninigoirratation,cerebrospinal fluid

23. Etiologic diagnosis Dark-field microscopy Fontana silver stain--brown Animal test PCR Serology MAT TR/patoc(IgM) Indirect agglutination test

24. Treatment penicillin,tetracycline,streptomycin erythromycin(in large enough doses early in the infection) 赫氏反应 ---chill,fever,hypotension and even twitch,shock,breath and heartbeat pause.

25. Prevention rodent control vaccination of domestic animal