ÃÑ·Ð ´ëÀå°æ Á¤¸®
1. gastric acidity loss: salmonella, enteric pathogen
Vibrio cholerae, Shigella flexneri
2. T cell deficiency
thymic aplasia, Hodgkin's disease, sarcoidosis: Listeria, Mycobacterium, Candida, HSV,
AIDS : Pneumocystis carini, CMV
3. B cell deficiency
1) Bruton's X-linked agammaglobulinemia: S. pneumoniae, other streptococci
2) Agammaglobulinemia, CLL, multiple myeloma
: H. influenza, N. meningitidis, K. pneumoniae, S. aureus
3) selective IgM deficiency: S. pneumoniae, H. influenza
cf. Multiple myeloma¶§ pneumonia¸¦ Àß ÀÏÀ¸Å°´Â ±Õ: S. pneumoniae, S. aureus,
K. pneumoniae
pyelonephritis : GNB(E. coli)
4. steroidÅõ¿©½Ã cell mediated immunityÀå¾Ö À¯¹ß
5. encapsulated bacteria: H. influenza, S. pneumoniae, N. meningitidis
encapsulated bacteriaÀÇ °¨¿° À§ÇèÀÌ ³ôÀº °æ¿ì´Â?
B cell deficiency(multiple myeloma, CLL), splenectomyÈÄ
6. neutropenia: GNB, pseudomonas
7. ¼÷ÁÖÀÇ ¹æ¾î±âÀü
1) physical & chemical factor: skin, mucous membrane, endogenous microbial flora,
gastric acidity
2) inflammatory response: phagocyte, complement
3) RES system
4) immune response
8. ±Þ¼º¿°Áõ¹ÝÀÀ½Ã Áõ°¡ÇÏ´Â °Í: CRP, serum amyloid A protein, ¥á1-glycoprotein,
ceruloplasmin, ¥á-macroglobulin, complement, ¥á1-AT, fibrinogen
°¨¼ÒÇÏ´Â °Í: albumin, transferrin, ¥á2-HS glycoprotein, AFP
9. °¨¼ö¼º °Ë»ç ÇØ¼®½Ã ÁÖÀÇÁ¡
1) °¨¼ö¼º °Ë»ç¿¡ »ç¿ëÇÑ ±Õ¼ö°¡ ÀûÀ¸¸é °¨¼ö¼ºÀ¸·Î º¸°íÇÒ ¼ö ÀÖ´Ù.
2) P. aeruginosaÀÇ °æ¿ì¿¡ ¥â-lactamase°¡ À¯¹ßµÉ¼ö ÀÖÀ¸¹Ç·Î ¹Ýµå½Ã 24½Ã°£ÈÄ¿¡ Àç¹è¾ç
ÇÑ´Ù.
3) in vitro¿¡¼´Â °¨¼ö¼ºÀÌÁö¸¸ in vivo¿¡¼´Â Ç×»ýÁ¦°¡ µµ´ÞÇÏÁö ¸øÇÒ¼ö ÀÖ´Ù.
: S. typhiÀÇ °æ¿ì cefazolin, GMÀÇ °æ¿ì intracellular organism¿¡´Â µèÁö ¾Ê´Â´Ù.
cf. mycoplasma, chlamydia, legionella µî°ú °°Àº intracellular organism¿¡´Â cell
penetrationÀÌ
ÁÁÀº Ç×»ýÁ¦(rifampin, macrolide, quinolone, chloramphenicolµî)¸¦ »ç¿ëÇØ¾ß ÇÑ´Ù.
10. °áÇÙ±ÕÀÇ rifampin ³»¼º°Ë»ç: rpoB gene mutation
11. °¨¿°ÀÌ ÀǽɵǴ ȯÀÚ¿¡¼ Ç÷¾×¹è¾çÀÌ À½¼ºÀÎ °æ¿ì
i) slow growing or fastidious(¹è¾çÁ¶°ÇÀÌ ±î´Ù·Î¿î) organism
ii) ±ÕÀÌ Ç÷·ù³»·Î ħ¹üµÇÁö ¾Ê´Â °æ¿ì
iii) prior antibiotic administration
12. DMȯÀÚ °¨¿°À» ¿¹¹æÇϱâ À§ÇÑ vaccine: pneumococcal vaccine, influenza vaccine, Td
vaccine
13. killed vaccine: Japanese encephalitis, rabies, influenza, hepatitis B, cholera
¹ÌÄ£ Àΰ£ÀÇ Á×Àº ³ú ÄÝ!
¹ÌÄ£: ±¤°ßº´, ÀÎ: ÀÎÇ÷翣ÀÚ, °£: °£¿°, ³ú: ³ú¿°, ÄÝ: ÄÝ·¹¶ó
14. live attenuated vaccine: typhoid fever, yellow fever, smallpox, polio, varicella, MMR,
BCG
ÀåÆ¼Çª½º¿¡ °É·Á Ȳõ±æ °¥»· Çß´ø ¼Ò¼ö°¡ »ì¾Ò´Ù. - MBC -
Ȳ: Ȳ¿, õ: õ¿¬µÎ, ¼Ò: ¼Ò¾Æ¸¶ºñ, ¼ö: ¼öµÎ, M