上海交通大学：《医学微生物》课程教学资源（PPT课件讲稿）英文版 Treponema, Borrelia and Leptospira

SPIROCHETES Treponema, Borrelia and Leptospira

SPIROCHETES Treponema, Borrelia and Leptospira

Spirochetes Gram negative Long, thin, helical, motile axial filaments locomotion between peptidoglycan layer/outer membrane runs parallel

Spirochetes • Gram negative • Long, thin, helical, motile • axial filaments – locomotion – between peptidoglycan layer/outer membrane * runs parallel

Spirochete spirochaetaceae leptospiraceae I: cristispira 5 leptonema T serpulina 5 leptospira T spirochaeta r treponema r borrelia

Spirochete ◼ spirochaetaceae leptospiraceae cristispira leptonema serpulina leptospira spirochaeta treponema borrelia

Treponema Tpallidum T carateum T subsp,pa∥idum T subsp. endemicum T: subsp. pertenue

Treponema T.pallidum T.carateum subsp.pallidum subsp.endemicum subsp.pertenue

Histology: Trepphema pallidum testis infected rabbit

Histology: Treponema pallidum - testis infected rabbit

Treponema pallidum 0.1-02X6-15um;8-14 small regular spirals; actively motile transmission genital/genital in utero or during birth

Treponema pallidum • transmission – genital/genital – in utero or during birth ◼ 0.1-0.2 x 6-15um; 8-14 small, regular spirals; actively motile

syphilis After initial infection, a primary chancre(an area of ulceration/inflammation) is seen in genital areas or elsewhere within 10-60 days. The organism, meantime, has penetrated and systemically spread The patient has flu-like symptoms with secondary lesions particularly affecting the skin. These occur 2-10 Weeks later. The final stage(if untreated) is tertiary syphilis (several years later) In primary and secondary syphilis organisms are often present in large numbers. However, as the disease progresses immunity controls bacterial replication and fewer organisms are seen. It is extremely difficult to detect spirochetes in tertiary syphilis. The systemic lesions of skin, central nervous system and elsewhere are suggestive of a delayed hypersensitivity reaction

syphilis ◼ After initial infection, a primary chancre (an area of ulceration/inflammation) is seen in genital areas or elsewhere within 10-60 days. The organism, meantime, has penetrated and systemically spread. ◼ The patient has flu-like symptoms with secondary lesions particularly affecting the skin . These occur 2-10 weeks later. ◼ The final stage (if untreated) is tertiary syphilis (several years later). In primary and secondary syphilis organisms are often present in large numbers. However, as the disease progresses immunity controls bacterial replication and fewer organisms are seen. It is extremely difficult to detect spirochetes in tertiary syphilis. The systemic lesions of skin, central nervous system and elsewhere are suggestive of a delayed hypersensitivity reaction

Syphilis Primary stage chronic 10 to 60 days 3w slowly progressive primary lesion- chancre area of ulceration/inflammation many organisms a predom in ance of m phocytes and plasm a cells hard chan cre硬下疳 in fectious highly heal spontaneously Tn(MeR tnr eml Secondary stage Tertiary stage 2y Secondary (2-10 Tertial weeks after primary several years later system flu-like symptoms central nervous system skin, particularly delayed hypersen sitivity many organIsms few organisms rich in Tp control by immune a red maculopapular response rash any where on the 3-5 vears after infection few Tp infectious highly anulom atous lesions in subside spontaneously kin bone, and liver degenerative changes in the central nervous cardiovascular lesions

3w 2y

Congenital syphilis Interstitial keratitis角膜炎 Hutchinson's teeth ■ Saddlenosema马鞍鼻 Periostitis骨膜炎 A variety of central nervous system anomalies

Congenital syphilis ◼ Interstitial keratitis角膜炎 ◼ Hutchinson’s teeth ◼ Saddlenosema马鞍鼻 ◼ Periostitis骨膜炎 ◼ A variety of central nervous system anomalies

Microbiological diagnosis not culturable dark field microscopy screening g method actively motile ■ antibodies to organisms cardiolipin brightly lit against specific diagnosis dark backdrop antibodies to light shines at an treponemal antigen angle fluorescence microscopy reflected from thin antibody staining organisms conventional light PCR microscopy light shines through NoT visualized

Microbiological diagnosis • not culturable • dark field microscopy – actively motile organisms – brightly lit against dark backdrop – light shines at an angle – reflected from thin organisms • conventional light microscopy – light shines through – NOT visualized screening method antibodies to cardiolipin specific diagnosis antibodies to treponemal antigen fluorescence microscopy antibody staining PCR