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【生物医学】第14章埃希菌属问题◼大肠埃希菌与人类健康的关系如何？◼肠道杆菌的共同特征？DepartmentofMicrobiology,HarbinMedicalUniversity形态染色◼0.4-0.7µm1-3µm◼短杆菌◼革兰

染色阴性◼有鞭毛◼有菌毛DepartmentofMicrobiology,HarbinMedicalUniversityDepartmentofMicrobiology,HarbinMedicalUni

versity培养特性与生化反应◼兼性厌氧◼营养要求不高◼生化反应活泼，发酵多种糖类◼绝大多数发酵乳糖◼IMViC试验结果为++--DepartmentofMicrobiology,HarbinMedic

alUniversity大肠埃希菌于普通营养平板培养生长的菌落DepartmentofMicrobiology,HarbinMedicalUniversity抗原结构◼O抗原：菌体抗原◼H抗原：鞭毛抗原◼K

抗原：荚膜抗原◼O111：K58：H2DepartmentofMicrobiology,HarbinMedicalUniversity复杂的抗原构造DepartmentofMicrobiology,HarbinMedicalUniversity致病物质◼菌毛、定居因子抗原◼K抗原◆与侵袭力有关◆抗

吞噬与抗补体的溶菌◼外毒素◆肠毒素及溶血毒素◼内毒素◆与感染特征和严重程度有关DepartmentofMicrobiology,HarbinMedicalUniversity所致疾病◼肠道外感染◆泌尿道感染最多见◆化脓性感染◼腹泻Departmen

tofMicrobiology,HarbinMedicalUniversity引起腹泻的大肠埃希菌◼肠产毒型大肠埃希菌enterotoxigenicE.coliETEC◼肠侵袭型大肠埃希菌enteroinvasiveE.coliEIEC◼肠致病型大肠埃希菌enteropathogenicE.c

oliEPEC◼肠出血型大肠埃希菌enterohemorrhagicE.coliEHEC◼肠集聚型大肠埃希菌enteroaggregativeE.coliEAggECDepartmentofMicrobiology,HarbinMedicalUniversity肠产毒素型大肠埃希

菌（ETEC）◼致病物质◆肠毒素◆菌毛粘附素◆内毒素◆K抗原◼所致疾病◆5岁以下婴幼儿腹泻◆旅游者腹泻DepartmentofMicrobiology,HarbinMedicalUniversityDep

artmentofMicrobiology,HarbinMedicalUniversityDepartmentofMicrobiology,HarbinMedicalUniversityDepartmentofMicrob

iology,HarbinMedicalUniversity肠侵袭型大肠埃希菌（EIEC）◼致病物质◆不产肠毒素，侵袭结肠粘膜上皮细胞◼所致疾病◆主要侵犯较大儿童和成人◆腹泻呈脓血便，有里急后重诊断◆EIEC无动力、生化反应和抗原结构DepartmentofMi

crobiology,HarbinMedicalUniversityDepartmentofMicrobiology,HarbinMedicalUniversity肠致病型大肠埃希菌（EPEC）◼致病物质◆不产生肠毒素及其他外毒素◆无侵袭力◼

所致疾病◆婴幼儿腹泻DepartmentofMicrobiology,HarbinMedicalUniversity肠出血型大肠埃希菌（EHEC）◼亦称为vero毒素大肠埃希菌◼致病物质◆菌毛：粘附作用◆毒素：vero毒素◼所致疾病◆出血性结肠炎◆溶血性尿毒综合征Dep

artmentofMicrobiology,HarbinMedicalUniversityIntimateAdherenceofEHECtoEpithelialCellsDepartmentofMicrobiology,HarbinMedicalUniversityThe“

lifecycle”ofE.coliO157:H75-10%prevalenceinanimals40%prevalenceinfarmsDepartmentofMicrobiology,HarbinMedicalUniversity肠集聚型大肠埃

希菌EAggEC◼致病物质◆毒素◆粘附素◼所致疾病◆引起婴儿持续性腹泻，脱水，偶有血便DepartmentofMicrobiology,HarbinMedicalUniversity肺泡巨噬细胞吞噬大肠埃希菌DepartmentofMicrobi

ology,HarbinMedicalUniversity微生物学检查法◼标本◼分离培养与鉴定◆肠道外感染◆肠道内感染DepartmentofMicrobiology,HarbinMedicalUniversity卫生细菌学检查◼大肠菌

群指数◆每1000(g)ml水中大肠菌群数◆大肠菌群◼细菌总数◆每1ml(g)样品中细菌总数◼我国卫生标准◆大肠菌群◆细菌总数DepartmentofMicrobiology,HarbinMedicalUniversity防治原则◼疫苗◼抗生素的抗性质粒

，耐药性非常普遍DepartmentofMicrobiology,HarbinMedicalUniversity小结◼肠道杆菌的共同特征及分类◼致病性大肠埃希菌的种类和致病机制◼大肠埃希菌的微生物学检查法◼大肠埃希菌的卫生细菌学检查及其意义Departmen

tofMicrobiology,HarbinMedicalUniversity