????(enteric bacilli)

1
????
2
????(enteric bacilli)
????????????? ????????????????
??????
??????????
??????,?????????????
??????,???30???,120??????
3
????(enteric bacilli)
????? ????? ????
????? (?????)
???
????? ?????
????? (?????)
???
4
???????????????
?? ???
???? ???? ????
????? ????? ?????? ????
????? ????? ???????
????? ????? ???? ????
?????? ??????? ????
????? ????? ?????? ????
????? ??????? ????????
????? ????? ????
???????
5
????????
1????????
2????????
????/???????? ????????????????
6
3????????
??????
????????????????
?????
???????
??????
??????
7
????IMViC????
?? ??? V-P
???? ????
????
????
/
????? / /
/
????? / /
/
8
4???????? 
K???Vi (??)
H?? (??)
O?? (LPS??)
F?? (??)
9
O--Ag???????
O????
???????
LPS
????
??A
S R??
10
H--Ag????,???
H O ??
?????K--Ag ?Vi--Ag ,??? ????????,???
ECA ???????? ?LPS????,???????, ?????????
11
5??????? 
??60 ? 30min ?(?)?????? ???????
12
6????
S-R?? ??-?? (????) H-O??
????,O????(????) ???? ?????
13
???????????????
??????(????)
????(??????????????? )
??(???? ???????????)
???(???? ????????????????)
???(???? ?????????????????)
14
??? ?????
Escherichine
??????????????
???????(E.coli)????
???????????,?????
?????
15
?????
????,?????
????
???????????????
???????
????
????????????,??????
????????
16
??????????
?????? ?????? ????? ????
17
????
1????? 2??????
??????
18

• ??????
• ????? ?? H2S IMViC ?? ????? - -
  - -

????
()
()
??????
19
????
1?O?? ?170?(????????) 2? H?? ?60? 3? K??
?100?
20
???
1??? (????-??) 2??? (60 ? 15min) 3??????,??????? 4
???????????
21
??
1????????(?????)OKH ?O111K58H2 2??????
??(?????) ETEC ???? EIEC
???? EPEC ???? EHEC ????
O157 EAEC ????
22
?????????
?????? ?????? ?????
23
????
????(????)???? ??????? ?????????(LT)
?????(ST)
Vero???????(SLT)
24
????
?????????????????
?????? ????ETEC?????
EIEC????? EPEC?????
EHEC????????
EAEC????????
25
????????????
26
Enterohemorrhagic Escherichia coli
?????????(EHEC) ???O157H7,5???????
O157H7????
27
Enteroaggregative Escherichia coli
?????????(EaggEC)????
?????????????
????
????????????????,?????
28
???
???????? ??????????????????
29
?????????????
???????? ????
30
??????
?????
??????????????
?????? ???? ?????????????
?????? ?????????????????
???????????
31
?????
??????????,?????????????
??????
?1000ml???????
?1ml?1g???????
????
??????
3?????/1L?? 100?????/1ml??
32
??
1????????? 2???ETEC???? 3??????????????????
33
??? ???? shigella
????????????????,
??????dyseatery bacteria
?????
34
??????????
?????? ?????? ????? ????
35
????
1????????,??? 2??????????? 3??????S??? 4????????,?
????? 5????????????R??? ??????
36
????
????
????
????
()
(-)
()
(-)
??????
????
37
????
1?O??????????????? 2?K??????? 3??H??
38
???
1????????? (60 ? 10 min) 2?37 ? ????20 d?????96
d 3????????????? 4 ?????????????
39
?????????
? ? ? ?
? ? ?????
A110
8a?8b?8c ????? B16,x,y??
1a?1b?2a

2b?3a?3b

3c?4a?4b ????? C118 ?????
D1
40
????????
?????? ?????? ?????
41
????
????????????
????
???????????,?????
??????,???

42
????
1????
??-????????????
2?? ?
?????
?????
??
???
???????
??????????
??
?????
???(A?1?) ????
????????
?????????
43
????????
????
????
????????????
????,???????
??????????????
?????
??
????????(???)
44
????
???????
????????????? ??????????

???????????????
??????

???????????????
45
???????
46
???
????? ???????????,???,
?????
47
????????????
???????? ????
48
??????
?????/??
???/??30????????
????
????
SS??(???????)
?????(????)
??????
?????(????)
??????
????(Senery??)
49
????
??
??????? ???Sd???
??
???????? (?????????)
50
??? ???? Salmonella
??????????????
??????,???????
??????????
???????
51
??????
?????
52
????(Salmonella)
?????67?O???2200??????, ??????????, ?????
???? ????? (?????)
?
???
????? ???? ?????
????
????
?????
??????? ????????
??
53
??????????
?????? ?????? ????? ????
54
????
1? G-??, ????, ???, ????? 2?????/?? 3??????,
?????S??? 4????,?????,??????H2S ????????????????
55
????????????
56
?????????????????
?????
????
????
????
(-)
()
(-)
()
??????
?????
57
????
1?O?????58?, ?? 42?,
A-E?,??? 2?H??I ?(???)?II?(????)
??????? 3?Vi(??)???????
58
????

• ????O-Ag ???(LPS),??
• ?Ti-Ag,??????IgM???
• (???????)
• ????H-Ag ???, ?Td-Ag,??????IgG???
• (?????????)
• ??????(????)??,???
• Vi-Ag???????????,???????????,????????????
• M??????,????,????

59
Vi??
??
?????????
????,????????????? ????????
??
??
??VI??????????
60
???
1???????????????? 2?????2-3??????1-2? 3???????(
60 ? 30min ) 4??????? 5??????
61
?????????
? ?? O??
H??I H??II A ???????? 1?2?12
a B ?????
1?4?5?12 b 1?2
?????? 1?4?5?12 i
1?2 C1 ????? 6?7?Vi
c 1?5 ??????
6?7 c 1?5 D
????? 9?12?Vi d
?????
1?9?12 g?m E ????
3?10 e?h
1?6
62
????????
?????? ?????? ?????
63
????
???(inv??????) Vi?? ??? ???
64
????
????????? ??????? ???
65
??????, ??????? ????????
?????? ????
1????
??? ???
??? ???
?? ???
????? ???
???
???
?
??????
????????
????? ????? ????? ???? ?????????
????
66
2????(????)???
??108
?????? ?????? ?????
????(????????? ??????)
3????
???(???????????)
????? ?????? ?????? ?????
?
????????????????
67
4???????
?1-5????????,????1??,??????,??????????,????
68
???
????? ?????
?????????,???????
69
????????????
???????? ????
70
??????
????????????????
?????? ???????? ????
????
71
??????
???
?????? ???? ??? ?1????? ???? ? ?1-3????? ??? ?2?
????? ?
??
SS??
?????
?????
????
??????
72
??????????
73
??????
???
1?????
????????????, ?????????????????

???????????
2??????
?Vi??
74
Widal test

• ????
• ???(Widal)????
• ????????O?H?????????????H??????????????
• ??????????????, ?????????

75
Widal test??

• ??????
• Hgt1160 O gt180
• ????
• H?O ?????
• O??
• IgM ?,???,??????,
• ???????
• H ??
• IgG?,???,????,????
• ??????????????

76
Widal test??

• H?O????????
• ??(?)????
• H?O????????
• ??(?)????
• H??O??
• ???????????????
• H???O?
• ?????????????
• ?????????

77
??
????????(???) Ty-2la?????? ????,????
??????????,??????? ????????????
78
????
1????????????? 2?????????????????? 3??????????????
??? (??????) 4?????????????????
79
????
1??????????????????? 2??????????????El
Tor?? 3?????????????? 4????????????? 5????????????
???? 6?????????????? ????????????