Microbiology 2012 12/13/2012 Department of Nursing Yu Chun-Keung Chapter 41 Spirochete Treponema Borrelia Leptospira Chapter 45 Rickettsia Orientia Chapter 46 Ehrlichia Coxiella
Chapter 41 Treponema Borrelia Leptospira
(Spirochete)
Order Spirochaetales Human disease Etiologic agent Treponema Syphilis T. pallidum Borrelia Bejel Yaws Pinta Relapsing fever Lyme disease Leptospira 鈎 Leptospirosis 鈎 3 genera cause human diseases T. endemicum T. pertenue T. carateum B. recurrentis B. burgdorferi L. interrogans
T. Pallidum! : n n 酶 hyaluronidase n fibronection! : Cell membrane, cell walls, outer envelope
T. pallidum Syphilis : syn - together philis love! (syphilis)!!
! ( ) (hard chancre) 2! ( 脚 )
! 2 3! (gummas) (80-85 ) (5-10 ) ( )! 30 30 ( )
!! ( ) ( ) ( )
! 1940!! (contagious) 30!!
! n n n! ( )
( ) Tp à à à à Ig Tp
non-treponemal tests! Cardiolipin ( )! ( ) IgG IgM 2-3 4-8 CSF!! VDRL (Venereal Disease Research Laboratory)
treponemal tests!!! fluorescent treponemal antibody (FTA) test! Micro-hemagglutination for T. pallidum (MHA-TP) test
Fluorescent Treponemal Antibody (FTA) test Ig Tp Tp
Microhemagglutination for T. pallidum (MHA-TP) test ( ) T. pallidum RBC U U RBC, Tp Tp
VDRL!! ( 6-18 VDRL )!! FTA/TPHA!! VDRL!!!
!!!
! Bejel (T. endemium)! Yaws (T. pertenue)! pinta (T. carateum) Bejel
Borrelia Borrelia recurrentis Relapsing fever ( ) Borrelia burgdorferi Lyme disease ( )
Relapsing fever ( )! 3 10!! 4 10!
保菌者 病媒 體蝨 流行性回歸熱 軟蜱 地區性回歸熱 硬蜱
! Giemsas Wright ( )! ( )!
Lyme disease! (Ixodes) Borrelia burgdorferi! Kenneth Todar University of Wisconsin-Madison Department of Bacteriology
! 3-30!! 4! 80! (...)! ( )
鈎 Leptospira! Leptospira interrogans! 鈎! ( )!!
Leptospirosis! 90 鈎 n n n! 鈎 n
! ( )! CSF!
! Penicillin! doxycycline!!
Wash Those Soda Cans This incident happened recently in North Texas. On Sunday, a woman went boating taking with her some cans of coke which she put into the refrigerator of the boat. On Monday she became ill and was taken to the hospital and placed in the Intensive Care Unit. She died on Wednesday. The autopsy concluded she died of Leptospirosis. This was traced to the can of coke she drank from, not using a glass. Tests showed that the can was infected by dried rat urine and hence the disease Leptospirosis. Rat urine contains toxic and deathly substances. It is highly recommended to thoroughly wash the upper part of soda cans before drinking out of them. The cans are typically stocked in warehouses and transported straight to the shops without being cleaned. A study at NYCU showed that the tops of soda cans are more contaminated than public toilets (i.e.).. full of germs and bacteria. So wash them with water before putting them to the mouth to avoid any kind of fatal accident.
Chapter 45 (Rickettsia) and Orientia Chapter 46 (Ehrlichia) and (Coxiella)
1. (0.3 1~2µm) G(-) ATP ( 蟎 )
Rickettsia! (R. rickettsii)! (R. prowazekii)! (R. typhi)! (Orienta tsutsugamushi)
!! (skin rash)! :
Riclettsial diseases
R. rickettsii 24-48 )
R. prowazekii 2-3
R. typhi
Orienta tsutsugamushi 蟎 蟎
蟎
< >
(IFA) R. rickettsii: R. prowazekii: R. typhi:
2. (Ehrlichia) (10 to 40%) doxycycline Ehrlichia inclusions (peripheral blood smear, Wright-Giemsa)
3. (Coxiella burnetii)
: Q
96.5.14
立克次體菌和歐立區菌在細 胞外迅速死亡 科克斯菌 對乾燥抵抗性強 可活數 月至數年 立克次體菌 寄生細胞質 (藉磷酸酶A破壞吞噬體膜) 歐立區菌 寄生空囊 (phagosoma 科克斯菌 寄生 phagolysosome Life cycle of Ehrlichia 生長週期 進入體 初 體 桑椹體