細(xì)菌感染的檢測(cè)方法與防治原則-課件

細(xì)菌感染的檢測(cè)方法與防治原則PPT細(xì)菌感染的檢測(cè)方法與防治原則PPTMedicalmicrobiologyNursingSchoolofSiasInternationalUniversityLaboratoryDiagnosisandPreventionofBacterialInfectionsContents2

細(xì)菌感染的檢查方法1

細(xì)菌感染的防治原則2MedicalmicrobiologyNursingSc2MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌學(xué)檢查血清學(xué)檢查01細(xì)菌感染的檢查方法LaboratoryDiagnosisandPreventionofBacterialInfectionsMedicalmicrobiologyNursingSc3MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌標(biāo)本的采集與運(yùn)送

無(wú)菌：采集標(biāo)本時(shí)應(yīng)注意無(wú)菌操作

部位：應(yīng)根據(jù)不同病變采集不同標(biāo)本

時(shí)間：采集標(biāo)本應(yīng)在使用抗生素之前運(yùn)送：標(biāo)本采集后應(yīng)及時(shí)送檢

處理：特殊標(biāo)本要特殊處理（如腦膜炎奈瑟氏菌）LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc4MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌學(xué)檢查的基本程序細(xì)菌標(biāo)本細(xì)菌形態(tài)與結(jié)構(gòu)檢查細(xì)菌分離與鑒定病原菌抗原檢測(cè)其他（動(dòng)物實(shí)驗(yàn)及藥敏實(shí)驗(yàn)）LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc5MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌形態(tài)與結(jié)構(gòu)的檢查

形態(tài)與結(jié)構(gòu)檢查：取標(biāo)本涂片、染色鏡檢。根據(jù)鏡下典型的形態(tài)、排列、染色性作出初步診斷。

顯微鏡放大法：光鏡、電鏡(TEM,SEM)染色法：菌細(xì)胞可與帶正電荷的堿性染色劑結(jié)合。最常用的是革蘭染色法。另有單染色法、抗酸染色法、特殊染色法（莢膜、鞭毛、芽胞等）。LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc6大家學(xué)習(xí)辛苦了，還是要堅(jiān)持繼續(xù)保持安靜大家學(xué)習(xí)辛苦了，還是要堅(jiān)持繼續(xù)保持安靜7MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌革蘭染色結(jié)晶紫碘液酒精復(fù)紅水洗水洗水洗細(xì)菌初染媒染脫色復(fù)染G+G?LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc8MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity葡萄球菌G(+)

E.coliG(-)細(xì)菌革蘭染色LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc9MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌的特殊染色莢膜染色LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc10MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity芽孢染色鞭毛染色細(xì)菌的特殊染色LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc11MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌的分離與鑒定①培養(yǎng)特征②形態(tài)特性③生化反應(yīng)

④血清學(xué)鑒定⑤動(dòng)物試驗(yàn)

⑥藥物敏感試驗(yàn)LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc12MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌的分離與鑒定LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc13MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌的分離與鑒定LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc14MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌的藥物敏感試驗(yàn)細(xì)菌的分離與鑒定LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc15MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity血清學(xué)檢查

血清學(xué)診斷：用已知抗原檢測(cè)病人血清或其他體液中未知抗體及其量的變化?？勺鳛檩o助診斷。

血清學(xué)診斷或血清學(xué)反應(yīng)常用的方法：直接凝集反應(yīng)、補(bǔ)體結(jié)合試驗(yàn)、乳膠凝集試驗(yàn)及ELISA。要注意患者血清效價(jià)的動(dòng)態(tài)變化抗體效價(jià)低時(shí)不要輕易否定LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc16MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity現(xiàn)代細(xì)菌學(xué)檢查技術(shù)酶免疫測(cè)定免疫熒光測(cè)定放射免疫測(cè)定聚合酶鏈反應(yīng)（PCR）DNA芯片技術(shù)LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc17MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity02細(xì)菌感染的防治原則LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌學(xué)感染的特異性預(yù)防細(xì)菌感染的治療MedicalmicrobiologyNursingSc18MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌感染的預(yù)防一般性預(yù)防：控制傳染源、切斷傳播途徑、提高免疫力特異性預(yù)防：應(yīng)用獲得性免疫的原理，給機(jī)體注射或服用病原微生物抗原（包括類毒素）或特異性抗體以達(dá)到預(yù)防和治療感染性疾病的目的。

人工主動(dòng)免疫

人工被動(dòng)免疫LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的防治原則MedicalmicrobiologyNursingSc19MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌感染的特異性預(yù)防

人工主動(dòng)免疫是指是通過(guò)人工接種抗原（疫苗）的方法，使機(jī)體自動(dòng)產(chǎn)生特異性免疫，從而預(yù)防感染的措施。人工主動(dòng)免疫（artificialactiveimmunization）LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的防治原則MedicalmicrobiologyNursingSc20MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity滅活疫苗霍亂疫苗百日咳疫苗狂犬疫苗乙腦疫苗減毒活疫苗BCG牛痘苗脊髓灰質(zhì)炎疫苗麻疹疫苗類毒素白喉類毒素破傷風(fēng)類毒素人工主動(dòng)免疫常用的生物制品細(xì)菌感染的特異性預(yù)防LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的防治原則MedicalmicrobiologyNursingSc21MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity死疫苗活疫苗

特性死活減毒或弱毒

保存易（4℃1年）不易（需冷藏）

接種劑量大小

接種次數(shù)多次一次

副反應(yīng)大小

應(yīng)答類型體液免疫體液免疫和細(xì)胞免疫

免疫效果差好持久死疫苗與活疫苗的區(qū)別細(xì)菌感染的特異性預(yù)防LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的防治原則MedicalmicrobiologyNursingSc22MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity人工被動(dòng)免疫（artificialpassiveimmunization）

人工被動(dòng)免疫是指通過(guò)人工方法給機(jī)體注射含特異性抗體的免疫血清或細(xì)胞因子等制劑，以治療或緊急預(yù)防感染的措施。細(xì)菌感染的特異性預(yù)防LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的防治原則MedicalmicrobiologyNursingSc23MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity?抗毒素（antitoxin）：破傷風(fēng)抗毒素、白喉抗毒素等?人免疫球蛋白制劑：從血漿或胎盤血中分離制備?細(xì)胞因子制劑：IFN-α、IFN-

、G-CSF、IL-2、GM-CSF?單克隆抗體制劑人工被動(dòng)免疫常用的生物制品細(xì)菌感染的特異性預(yù)防LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的防治原則MedicalmicrobiologyNursingSc24MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity人工主動(dòng)免疫人工被動(dòng)免疫

免疫物質(zhì)抗原抗體或細(xì)胞因子

免疫出現(xiàn)時(shí)間慢(2~4周)快立即

免疫維持時(shí)間長(zhǎng)(數(shù)月~數(shù)年)短(2~3周)

主要用途預(yù)防緊急預(yù)防或治療人工主動(dòng)免疫與人工被動(dòng)免疫的區(qū)別細(xì)菌感染的特異性預(yù)防LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的防治原則MedicalmicrobiologyNursingSc25MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity

主要采用抗菌藥物?？咕幬镏柑烊换蛉斯ず铣傻幕瘜W(xué)制劑。影響細(xì)胞壁的合成：如青霉素影響細(xì)胞膜的功能：如多粘菌素(G-＞G+）、兩性霉素B（真菌）影響蛋白質(zhì)的合成：如四環(huán)素、氯霉素、卡那霉素影響核酸代謝：如喹諾酮、利福平、磺胺類細(xì)菌感染的治療LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的防治原則MedicalmicrobiologyNursingSc26細(xì)菌感染的檢測(cè)方法與防治原則PPT細(xì)菌感染的檢測(cè)方法與防治原則PPTMedicalmicrobiologyNursingSchoolofSiasInternationalUniversityLaboratoryDiagnosisandPreventionofBacterialInfectionsContents2

細(xì)菌感染的檢查方法1

細(xì)菌感染的防治原則2MedicalmicrobiologyNursingSc28MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌學(xué)檢查血清學(xué)檢查01細(xì)菌感染的檢查方法LaboratoryDiagnosisandPreventionofBacterialInfectionsMedicalmicrobiologyNursingSc29MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌標(biāo)本的采集與運(yùn)送

無(wú)菌：采集標(biāo)本時(shí)應(yīng)注意無(wú)菌操作

部位：應(yīng)根據(jù)不同病變采集不同標(biāo)本

時(shí)間：采集標(biāo)本應(yīng)在使用抗生素之前運(yùn)送：標(biāo)本采集后應(yīng)及時(shí)送檢

處理：特殊標(biāo)本要特殊處理（如腦膜炎奈瑟氏菌）LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc30MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌學(xué)檢查的基本程序細(xì)菌標(biāo)本細(xì)菌形態(tài)與結(jié)構(gòu)檢查細(xì)菌分離與鑒定病原菌抗原檢測(cè)其他（動(dòng)物實(shí)驗(yàn)及藥敏實(shí)驗(yàn)）LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc31MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌形態(tài)與結(jié)構(gòu)的檢查

形態(tài)與結(jié)構(gòu)檢查：取標(biāo)本涂片、染色鏡檢。根據(jù)鏡下典型的形態(tài)、排列、染色性作出初步診斷。

顯微鏡放大法：光鏡、電鏡(TEM,SEM)染色法：菌細(xì)胞可與帶正電荷的堿性染色劑結(jié)合。最常用的是革蘭染色法。另有單染色法、抗酸染色法、特殊染色法（莢膜、鞭毛、芽胞等）。LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc32大家學(xué)習(xí)辛苦了，還是要堅(jiān)持繼續(xù)保持安靜大家學(xué)習(xí)辛苦了，還是要堅(jiān)持繼續(xù)保持安靜33MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌革蘭染色結(jié)晶紫碘液酒精復(fù)紅水洗水洗水洗細(xì)菌初染媒染脫色復(fù)染G+G?LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc34MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity葡萄球菌G(+)

E.coliG(-)細(xì)菌革蘭染色LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc35MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌的特殊染色莢膜染色LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc36MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity芽孢染色鞭毛染色細(xì)菌的特殊染色LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc37MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌的分離與鑒定①培養(yǎng)特征②形態(tài)特性③生化反應(yīng)

④血清學(xué)鑒定⑤動(dòng)物試驗(yàn)

⑥藥物敏感試驗(yàn)LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc38MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌的分離與鑒定LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc39MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌的分離與鑒定LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc40MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌的藥物敏感試驗(yàn)細(xì)菌的分離與鑒定LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc41MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity血清學(xué)檢查

血清學(xué)診斷：用已知抗原檢測(cè)病人血清或其他體液中未知抗體及其量的變化?？勺鳛檩o助診斷。

血清學(xué)診斷或血清學(xué)反應(yīng)常用的方法：直接凝集反應(yīng)、補(bǔ)體結(jié)合試驗(yàn)、乳膠凝集試驗(yàn)及ELISA。要注意患者血清效價(jià)的動(dòng)態(tài)變化抗體效價(jià)低時(shí)不要輕易否定LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc42MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity現(xiàn)代細(xì)菌學(xué)檢查技術(shù)酶免疫測(cè)定免疫熒光測(cè)定放射免疫測(cè)定聚合酶鏈反應(yīng)（PCR）DNA芯片技術(shù)LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的檢查方法MedicalmicrobiologyNursingSc43MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity02細(xì)菌感染的防治原則LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌學(xué)感染的特異性預(yù)防細(xì)菌感染的治療MedicalmicrobiologyNursingSc44MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌感染的預(yù)防一般性預(yù)防：控制傳染源、切斷傳播途徑、提高免疫力特異性預(yù)防：應(yīng)用獲得性免疫的原理，給機(jī)體注射或服用病原微生物抗原（包括類毒素）或特異性抗體以達(dá)到預(yù)防和治療感染性疾病的目的。

人工主動(dòng)免疫

人工被動(dòng)免疫LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的防治原則MedicalmicrobiologyNursingSc45MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity細(xì)菌感染的特異性預(yù)防

人工主動(dòng)免疫是指是通過(guò)人工接種抗原（疫苗）的方法，使機(jī)體自動(dòng)產(chǎn)生特異性免疫，從而預(yù)防感染的措施。人工主動(dòng)免疫（artificialactiveimmunization）LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的防治原則MedicalmicrobiologyNursingSc46MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity滅活疫苗霍亂疫苗百日咳疫苗狂犬疫苗乙腦疫苗減毒活疫苗BCG牛痘苗脊髓灰質(zhì)炎疫苗麻疹疫苗類毒素白喉類毒素破傷風(fēng)類毒素人工主動(dòng)免疫常用的生物制品細(xì)菌感染的特異性預(yù)防LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的防治原則MedicalmicrobiologyNursingSc47MedicalmicrobiologyNursingSchoolofSiasInternationalUniversity死疫苗活疫苗

特性死活減毒或弱毒

保存易（4℃1年）不易（需冷藏）

接種劑量大小

接種次數(shù)多次一次

副反應(yīng)大小

應(yīng)答類型體液免疫體液免疫和細(xì)胞免疫

免疫效果差好持久死疫苗與活疫苗的區(qū)別細(xì)菌感染的特異性預(yù)防LaboratoryDiagnosisandPreventionofBacterialInfections細(xì)菌感染的防治原則MedicalmicrobiologyNursingSc48MedicalmicrobiologyNursingSchoolofSiasInte