Teaching plan of bilingual teaching
双语教学教案
Gannan Medical College
Department of pathogenic Biology
Teacher
（教师）
Date
（日期）
Grade
（年级）
Speciality
专业
Lecture type
(授课类型)
Clinical medical
(临床医学)
chapters and sections
(授课章节)
Chapter 13 Respiratory Bacilli
Objective and request
教学目的和要求
1.
2.
3.
4.
Emphasis and difficulty
授课重点、难点
Reference teaching material
参考教材
Teaching aid
媒体与教具
Theory Course
(理论课)
Subject
（课程）
Class hour
（学时）
4 hours
Medical Microbiology
医学微生物学
Master the biological properties, pathogenicity and immunity of M.tuberculosis.
Master the following concepts : BCG; Tuberculin test.
Master the pathogenicity of Corynebacterium dophtheria.
Understand the biological properties of Corynebacterium dophtheria.
1. the biological properties, pathogenicity and immunity of M.tuberculosis
2. the pathogenicity of Corynebacterium dophtheria
1．周正任主编.《医学微生物学》第 6 版
2．Medical microbiology(21 edition, Jawetz, Melnick, and Adelberg)
Powerpoint
Teach contents（教学内容）
Chapter 13 Respiratory Bacilli
Section 1 M. tuberculosis
Ⅰ.Biological properties
 Shape and structure
----slender, curved rods
----acid-fast positive
----complex cell wall lipids: mycolic acid
----capsule
----non-motile; non- sporing
----L forms
 Cell Wall Structure
----Peptidoglycan
---- arabinogalactan layer
----high content lipid
Mycolic acids
1





Cord Factor
Wax-D
----polypeptide 多肽
Cultivation
----obligate aerobes
----slow growth: 18-24 hrs / 2-4 w
----fastidious: lowenstein-Jensen medium
Biochemical reactions
----carbohydrate fermentation “-”
---- heat Catalase test
M. tuberculosis“-”
Nontuberculosis mycobacteria: “+”
Sensitivity
---moist heat
----UV radiation
----alcohol
Resistance
----drying
----acid
----alkaline
----dyes: e.g., malachite green
Variation
----drug resistance variation
----virulent variation ------BCG (Bacliie Calmette-Guerin)
Ⅱ.Pathogenesis –virulence factor
neither endotoxin or exotoxin nor invasive enzyme intracellular pathogen
 Lipid
 Phosphatide
--- Stimulate monocytes proliferation---form tubercle
---Inhibit proteinase--- form caseous necrosis
 Mycolic acid
---A large fatty acid
----Associated with acid-fast property
 Cord factor
 Associated with virulence
 Inhibit migration of leukocyte to form chronic granuloma
 Bind to mitochondrial membranes, cause functional damage to respiration and oxidative
phosphorylation
 Wax D
 Act as an adjuvant
 Sulfatides
 Inhibit the fusion of phagosome and lysosome
 Protein: tuberculin
2


Polysaccharides
Capsule
Ⅲ.Pathogenesis – disease
 Pathogens
M. tuberculosis-- only human host
M. bovis-- human and cattle
 Transmission
respiratory route (main)
gastrointestinal route
impaired skin
 Clinical manifestations and types
----Lung infection (pulmonary tuberculosis )
primary type: acute and mild; primary complex
reactivation type: chronic and severe; caseation
----Infection outside lung
Ⅳ. Immunity
 Protective immunity
CMI
Infection immunity
 Tuberculin test
Ⅴ. Laboratory diagnosis
 Smears— acid-fast stain
 Culture
– Use to confirm diagnosis of TB
Ⅵ. Control
 Prevention
BCG, bacillus Calmette-Guerin
 Treatment
principle: early, sufficient, recombination
M. Leprae
Ⅰ. Biological properties
 Intracellular parasites
 Not grow on artificial media and cell culture
 Grow in footpads of mice , armadillo
 Optimal temperature: 30℃
Ⅱ.pathogenesis
 Transmission
Respiratory tract (main)
Contact
 Clinical types
lepromatous type
3
tuberculoid type
borderline form
indeterminate form
Ⅲ. Laboratory diagnosis
 Pathogen examination
 Lepromin test
Ⅳ. Prevention and control
 BCG prevention
 ulfone-diamino diphenyl sulfone (dapsone), rifampin
Section 2 C. diphtheriae
Ⅰ. Biological properties
 Shape and structure
----G+, “Club-shaped”, pleomorphic: V form; non- branching
----Non-sporing; non-motile; non-capsulate
----metachromatic granules within the rods (polar body)
 Culture
----Aerobic/facultatively anaerobic
----blood/serum agar medieum
----blood/serum tellurite (K2TeO3) media
--- -colonies appear dark gray to black: gravis; intermedius; mitis
 Sensitivity
----moist heat (100℃, 1 min; 58℃,10 min)
---- disinfectants;
---- penicillin
 Resistance
----drying
---- cold
 Variation
Ⅱ. Pathogenesis – virulence factor
 Diphtheria toxin
 Cord factor
 K antigen
Ⅲ. Immunity
 Persistent immunity
----Antitoxin; IgG/IgA
----A correlation between the immunity and the age
* 6 months----not sensitive
* 1 year or so---- sensitive death
* adult-----have immunity
Ⅳ. Laboratory diagnosis
 Specimen : swab, suspected lesions
4
 Smear: alkoline methylene blue, Gram stain, and Albert stain
 Culture
– Blood plate, Loeffler slant, and Tellurite plate
 Virulence test
– In vivo – “Virulence” test, protective test
– In vitro – Elek plate test, serological precipitation test of soluble antigen and antibody
Ⅴ.Prevention and Treatment
 Prevention
----Active immunization – Triple vaccine DPT
----Passive immunization – Antitoxin
 Treatment
----Diphtheria antitoxin, antibiotics (such as penicillin) Biological properties
question
思考题
Pathogenicity and immunity of M.tuberculosis？
5