1. Chapter 5 Pathogenicity of B and Immunity against Bacterial Infections(Infection and Immunity)

2. §1. Normal Flora and opportunistic B (fig) 一.Normal flora : 1.Biological antagonism 2.Nutritional function 3.Induction of immune response 4.Growth and aging

3. 二.Opportunistic pathogens : 1.Change of normal habit 2.Endogenous infection 3.Dysbacteriosis 三.Hospital acquired infection (nosocomial infection) 1.Cross- infection : patients,doctors 2.Endogenous ~ : from patient himself 3.Iatrogenic ~ : (instrument)

4. §2 Mechanisms of Bacterial pathogenicity virulence : LD50, ID50 一.Bacterial virulence : ( 一 ) Invasiveness : 1. B surface structure (1)Adhesive factors: pili and lipoteichoic acid(LTA) (2)Capsule and microcapsule: M － pro, Vi － Ag. K － Ag. 2. Invasive enzyme coagulase, SK, SD,spreading factor.

5. ( 二 ) Toxin 1. Exotoxins: (1)G + produce. (2)Protein in nature (3)Specific (disease) (4)Lethal (5)Neuro ~, Cyto ~, Entero ~ (6)A : toxic B : non-toxic, binding to cells. 0.3~0.4 %formaldehyde (7) Exotoxin -----------------------  toxoid -----------  immunize animal  Antitoxin

6. 2.Endotoxins G －, LPS, heat stable. (1)Fever(pyrogens) (2)Leukocyte response (3)Hypotension and shock (4)DIC (5)Shwartzman’s phenomenon (6)etc a.active B, T, M Φ. b.induce TNF, IFN,CSF,IL-6 Endotoxin detect : Limulus test.

7. 表 6-4 外毒素与内毒素的主要区别 区别要点 外 毒 素 内 毒 素 来源 革兰阳性菌与部分革兰阴性菌 革兰阴性菌 存在部分 从活菌分泌出, 少数菌崩解后释出 细胞壁组分, 菌裂解后释出 化学成分 蛋白质 脂多糖 稳定性 60 ～ 80 ℃,30min 被破坏 160 ℃,2 ～ 4h 才被破坏 毒性作用 强, 对组织器官有选择性毒害效应, 较弱, 各菌的毒性效应大致 引起特殊临床表现 相同, 引起发热、白细胞增 多、微循环障碍、休克、 DIC 等 抗原性 强, 刺激机体产生抗毒素 ; 甲醛液处 弱, 刺激机体产生的中和抗 理脱毒形成类毒素 体作用弱 ; 甲醛液处理不 形成类毒素

8. 二.Number of Invading B 三.Portal of Entry

9. §3. Host Immunity against Bacterial Infections 一.Non-specific Immunity ( 一 )Barrier Structure 1.Skin and mucous membrane (1)mechanical factors (2)chemical factors (3)biological factors 2.Blood-Brain-Barrier 3.Placental Barrier

10. ( 二 ) Phagocyte 1. Process and Mechanisms of Phagocytosis (1)Chemotaxis and adherence (2)Ingestion (3)Intracellular killing a. Oxygen-dependent system MPO Non-MPO b. oxygen-independent system 2. Fate of B after phagocytosis (1)complete~ (2)incomplete~: TB

11. ( 三 )Anti-bacterial Substances in serum and body fluids 1.Complement 2.β-lysin 3. Lysozyme

12. 二.Specific Immunity Humoral ~ Cellular ~ 三.Immunity to extracellular bacterial infections 四. Immunity to intracellular bacterial infections(cellular immunity) 五.Immunity to exotoxins （ Anti-toxins ）

13. §4. Occuring and Developing of Infections 一.Origins of infections ( 一 )Exogenous infection 1.Patients 2.Carriers 3.Animals : suffering from disease (Carrying B) ( 二 )Endogenous infection

14. 二.Ways of infection transmission 1.Respiratory tract 2.Gastrointestinal tract 3.Wound / injury 4.Contact 5.Bites by insects 6. Multiple ways

15. ( 一 )No-infection ( 二 )Inapparent infection ( 三 )Latent infection ( 四 )Apparent 1.Acute infection 2.Chronic infection Infection Sites 1.Local infection 2.Systemic infection

16. (1)toxemia (2)bacteremia (3)septicemia (4)pyemia (5)endotoxemia ( 五 ) Carrier 四.Influence of Environment on Infection ( 一 )Natural environment ( 二 )Social environment

17. Chapter 6 Principles of Diagnosis, Prevention and Treatment for Bacterial Infections

18. §1. Diagnosis of B 一.Specimens 1.diseases and sites; 2.aseptic 3.before using antibiotics 4.from obvious diseased sites 5.fresh, quickly send to lab 6.cold 7.labeled

19. 二. Procedures of Diagnosis ( 一 ) Microscopy & stains ( 二 )Culture ( 三 )Biochemical reaction ( 四 )Serology ( 五 )Animal test ( 六 )Drug sensitivity ( 七 )etc 1.HPLC 2.PCR 3.Phage 4.Bacteriocin 5.Plasmid fingerprinting

20. ( 一 )Dead Vaccines ( 二 )Live Attenuated Vaccines ( 三 )Toxoid ( 四 )Polysaccharide ( 五 )Autovaccine

21. §4. Artificial Passive Immunization ( 一 )Anti-toxin ( 二 )Anti-Bacterial Serum ( 三 )Placental globulin, γ ~ ( 四 )Preparations for CI: TF,iRNA,IFN,IL,CTL,LAK,etc.