從 臨 床 分 離 的 K. pneumoniae 以 脈 衝 式 電 泳 實 驗 技 術 做 菌 株 基 因 的 分 型 ， 並 以 電 腦 軟 體 從 事 精 確 的 基 因 比 對 分 出 不 同 族 群 ， 從 菌 株 黏 液 特 性 差 異 、 宿 主 潛 在 疾 病 的 生 理 機 能 、 細 菌 的 侵 襲 性 感 染 等 因 素 ， 分 析 其 在 不 同 族 群 間 和 相 同 族 群 內 的 差 異 ， 我 們 發 現 K. pneumoniae 的 基 因 分 型 是 多 樣 性 的 而 其 和 臨 床 病 症 的 表 現 並 無 一 致 性 ； 電 腦 軟 體 精 確 比 對 後 可 將 所 有 菌 株 分 為 八 個 cluster A、 A’、 B、 C、 D、 D’、 E、 F，
所 分 離 出 的 菌 株 3/4 以 低 黏 液 性 特 性 表 現 ， 且 大 部 分 屬 於 non-cluster， 而 在 不 同 cluster 中 A’、 D、 D’以 高 黏 液 性 菌 株 佔 多 數 ， E、 F 則 以 低 黏 液 性 菌 株 佔 多 數 ， cluster 內 以 院 外 感 染 菌 多 但 和 黏 性 無 關 ； 分 析 cluster A 菌 株 黏 性 和 院 外 感 染 上 是 沒 有 相 關 的 ； 糖 尿 病 患 者 分 離 的 菌 株 在 黏 性 、cluster、
院 外 感 染 等 有 關 的 統 計 上 並 無 差 異 ， 但 院 內 感 染 病 患 無 DM 者 明 顯 多 於 DM 者 ； 血 液 及 體 液 分 離 出 的 K. pneumoniae 以 肝 硬 化 患 者 感 染 佔 多 數 ， 則 可 能 是 由 於 宿 主 全 身 系 統 性 的 免 疫 反 應 低 下 所 導 致 ， 肝 膿 瘍 的 院 外 、 院 內 感 染 分 析 具 有 統 計 上 之 顯 著 差 異 ， 卻 無 發 現 專 一 性 的 肝 膿 瘍 clusters， 但 由 於 菌 株 數 太 少 有 待 更 進 一 步 的 研 究 證 實 。
參 考 文 獻
1. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference Committee: American College of Chest Physicians/Society of Critical Care
Medicine Consensus Conference: Definitions for sepsis and organ failure and guidelines for the use of innovative
therapies in sepsis. Crit Care Med . 20:864, 1992.
2. Abbott., Klebsiella, enterobacter, citrobacter and Serratia.
In manual of clinical microbiology. 7
t h
ed. American Society for Microbiology Press, Washington D.C. 475-482. 1999.3. Anil Mishra., Fundamental signals that regulate eosinophil homing to the gastrointestinal tract. J Clin Invest,
103:1719-1727. 1999.
3. Appelbaum P.C., Four methods for identification of Gram-negative nonfermenting rods： Organisms more commonly encountered in clinical specimens.
J.Clin.Microbiol. 12;271-278, 1980.
4. Biron., Role of early cytokines, including α andβ interferons (IFN-α /β ), in innate and adaptive immune responses to viral infections. Semin, Immunol, 10:383.
1998.
5. Bober LA., The effect of GM-CSF and G-CSF on human neutrophil function. Immunopharmacology 29:111, 1995 6. Brandborg LL., Bacterial and miscellaneous infections of
the liver. In:Hepatology. Zakim D, Boyer TD, eds.
Philadelphia:Saunders. 1086-98, 1990.
7. Brook I, Frazier EH. Microbiology of liver and spleen abscesses. J Med Microbiol 47:1075–80. 1998.
8. Brooks K.A., A clinical evaluation of the API microtube systems for identification of enterobacteriaceae.
Am.J.Med.Techn.40:55-61, 1974.
9. Bryan C. S., Analysis of 1,186 episodes of gram-negative bacteremia in non-university hospitals: the effects of antimicrobial therapy. Rev. Infect. Dis. 5:629-638, 1983.
10. Butter TJ., Pyogenic liver abscess. Gut. 10:389-99. 1969.
11. Callery MP., Organ interactions in Sepsis. Host defense and the hepatic -pulmonary macrophage axis. Arch. Surg.
126:28-32, 1991
12. Castillo C.B., Comparative evaluation of the Eiken and API 20E systems and conventional methods for identification of members of the family enterobacteriaceae.
J.Clin.Microbiol. 20:754-757, 1984.
13. Chang FY., A clinical study of Klebsiella liver abscess. J Formos Med Assoc. 87:282-7, 1988.
14. Chang FY., Comparison of pyogenic liver abscess caused by Klebsiella pneumoniae and non -Klebsiella pneumoniae pathogens. J Formos Med Assoc 94:232-7, 1995
15. Chang, SC. Klebsiella pneumoniae isolates causing liver abscess in Taiwan. Diagn. Microbiol. Infect. Dis.
37:279–284.2000.
16. Chang CW. Nosocomial Methicillin-Resistant
Staphylococcus Aureus Infections in a Medical Center. The Journal of Nursing Research, 4:345-354. 1996.
17. Chen YS., pyogenic liver abscess:report of 72 cases. Chang Gung Med J. 13:31-8, 1990.
18. Cheng DL., pyogenic liver abscess:clinical manifestations and value of percutaneous catheter drainage treatment. J Formos Med Assoc 89:571-6, 1990.
19. Cheng, D.L., Y.C. Liu, M.Y. Yen, C.Y. Liu, and R.S. Wang.
Septic metastatic lesions of pyogenic liver abscess:
association with Klebsiella pneumoniae bacteremia in diabetic patients. Arch. Intern. Med. 151:1557–1559. 1991.
20. Cheng LD., Klebsiella pneumoniae liver abscess in Taiwan.
J Infect Dis Soc ROC 8:2-5, 1997.
21. Chew SK., pyogenic hepatic abscess and diabetes
mellitus:a probable association. Ann Acad Med. 14:261-5, 1985.
22. Chien MN., Klebsiella pneumoniae liver abscess in patients with Diabetes mellitus:An Analysis of 95 cases. J Intern
Med Taiwan. 12:142-148, 2001.
23. Chiou CS., Comparison of Pulsed -Field Gel
Electrophoresis and coagulase gene restriction profile analysis techniques in the molecular typing of
Staphylococcus aureus. J. Clin. Microbiol. 38:2186-90,
2000.
24. Chiu CT., A clinical study on pyogenic liver abscess. J Formos Med Assoc. 86:405-12, 1987.
25. Chiu, C.T., D.Y. Lin, and Y.F. Liaw. Metastatic septic endophthalmitis in pyogenic liver abscess. J. Clin.
Gastroenterol. 10:524–527. 1988.
26. Christine D. Steward., Characterization of Clinical Isolates of Klebsiella pneumoniae from 19 Laboratories Using the National Committee for Clinical Laboratory Standards
Extended -Spectrum -Lactamase Detection Methods. J. Clin.
Microbiol. 39:2864-2872, 2001.
27. Cortes Guadalupe., Molecular analysis of the contribution of the capsular polysaccharide O side chain to the virulence of klebsiella pneumoniae in a murine model of pneumonia.
infection and immunity 70:2583-2590. 2002.
28. Cross A. S., Recruitment of Murine Neutrophils in Vivo through Endogenous Sialidase Activity, J. Biol. Chem.
278:4112 - 4120. 2003
29. Cryz, S. J., E. Fürer, and R. Germanier. Experimental
Klebsiella pneumoniae burn wound sepsis: role of capsular polysaccharide. Infect. Immun, 43:440-441. 1984.
30. Dalton DK., Multiple defects of immune cell function in mice with disrupted interferon-γ genes. Science. 259:1739, 1993.
31. Dorman T., Altered immune function after trauma and
hemorrhage: What does it all mean? Crit Care Med 22:1069, 1994.
32. Duggan J. M., Septicaemia as a hospital hazard. J. Hosp.
Infect. 6:406-412, 1985.
33. Eliashiv A., Depression of cell-mediated immunity in diabetes. Arch Surg. 113:1180-3, 1978.
34. Evgeny Vinogradov., The str ucture of the core region of the lipopolysaccharide from Klebsiella pneumoniae O3. Eur. J.
Biochem. 268:1722-1729, 2001.
35. Fang, C.T., Y.C. Chen, S.C. Chang, W.Y. Shau, and K.T.
Luh. Klebsiella pneumoniae meningitis: timing of
antimicrobial therapy and prognosis. Q. J. Med. 93:45–53.
2000.
36. Fang CT., A novel virulence gene in Klebsiella pneumoniae strains causing primary liver abscess and septic metastatic complications. J.Exp.Med. 199:697-705. 2004.
37. Fearon., The instructive role of innate immunity in the acquired immune response. Science. 272:50. 1996.
38. Fraga J R., Liver abscess and sepsis due to Klebsiella pneumoniae in a newborn. Clin Pediatr. 13:1081-2. 1974.
39. Fritig., Antimicrobial proteins in induced plant defense.
Curr. Opin. Immunol. 10:12. 1998.
40. Fung, C P., F.Y. Chang, A global emerging disease of Klebsiella pneumoniae liver abscess: is serotype K1 an important factor for complicated endophthalmitis? Gut.
50:420-424. 2002.
41. Gail Hecht., Innate mechanisms of epithelial host defense:
spotlight on intestine. Am J Physiol Cell Physiol, 277:
C351-C358, 1999.
42. Gautom R. K. , Rapid pulsed -field gel electrophoresis protocol for typing of Escherichia coli O157:H7 and other gram-negative organisms in 1 day. J. Clin. Microbiol.
35:2977-2980, 1997.
43. Gori A., Comparison of pulsed -field gel electrophoresis and randomly amplified DNA polymorphism analysis for typing extended-spectrum-beta-lactamase- producing Klebsiella pneumoniae. J. Clin. Microbiol.
34:2448-2453, 1996.
44. Govantes F., Mechanism of translational coupling in the nifLA operon of Klebsiella pneumoniae. EMBO J.
17:2368–2377, 1998.
45. Govantes F., Mechanism of coordinated synthesis of the
antagonistic regulatory proteins NifL and NifA of Klebsiella pneumoniae. J. Bacteriol. 178:6817-6823, 1996.
46. Green DR., Trauma and the immune response. Immunol Today 9:253, 1988
47. Greenstein AJ., Continuing changing patterns of disease in pyogenic liver abscess:a study of 38 patients. Am J
gastroenterol. 79:217-26. 1984
48. Hany., Surfactant Protein D Binds Selectively to Klebsiella pneumonia e Lipopolysaccharides Containing Mannose-Rich O-Antigens. The Journal of Immunology, 169:3267-3274.
2002.
49. Held T. K., Binding to and Opsonophagocytic Activity of O-Antigen-Specific Monoclonal Antibodies against
Encapsulated and Nonencapsulated Klebsiella pneumoniae Serotype O1 Strains . Infect. Immun. 68:2402-2409. 2000.
50. Helen Karlsson., Innate Immune Responses of Human Neonatal Cells to Bacteria from the Normal Gastrointestinal Flora. Infection and Immunity, 70:6688-6696, 2002.
51. Ho., Antibiotic Usage in Community-Acquired Infections in Hospitals in Taiwan. Journal of the Formosan Medical
Association, 101:34-42. 2002
52. Ho., Taiwan Seeks to Solve Its Resistance Problems . Science, 291:2550-2551.2001.
53. Horwitz MA., Phagocytosis of microorganisms.Rev Infect Dis. 14:104-23, 1982.
54. Howard BJ., Clinical and Pathogenic Microbiology. St.
Lous: The C.V. Mosby Co. 1987.
55. Isenberg HD. Essential Procedures for Clinical Microbiology, American Society for Microbiology, Washington, D.C. 1998
56. Jacoby, G. A. Extended -spectrum ß-lactamases and other enzymes providing resistance to oxyimino -ß-lactams. Infect.
Dis. Clin. N. Am. 11:875-887, 1997.
57. Kandel G., pyogenic liver abscess:new concepts of an old disease. Am J Gastroenterol. 79:65-71, 1984.
58. Kaper B. K., Escherichia coli O157:H7 and Other Shiga Toxin-Producing E. coli Strains. Washington, DC. American Society for Microbiology Press, 1998.
59. King H., Global burden of diabetes, 1995-2025:prevalence, numerical estimate, and projections. Diabetes Care .
21:1414-31,1998.
60. Ko, W.C., Community acquired Klebsiella pneumoniae bacteremia: global differences in clinical patterns. Emerg.
Infect. Dis. 8:160–166. 2002.
61. Koneman EW., Color Atlas Textbook of Diagnostic Microbiology, 5
t h
eds. Lippincott-Raven Publisher, Philadelphia, PA. 1997.62. Lamm., Interaction of antigens and antibodies at mucosal surfaces. Annu. Rev.Microbio,. 51:311. 1997.
63. Land MA., Pyogenic liver abscess: changing epidemiology and prognosis. South Med J. 78:1426-30. 1985.
64. Lau Yeu-Jun., Identification of a Major Cluster of
Klebsiella pneumoniae Isolates from Patients with Liver Abscess in Taiwan. J. Clin. Microbiol. 38: 412-414, 2000.
65. Lin T., Direct costs -of illness of patients with diabetes mellitus in Taiwan. Diabetes Res Clin Pract. 39(suppl 1):S43-6, 2001.
66. Lindroos PM., Interleukin-1ß (IL-1ß) and the IL-1ß-alpha 2-macroglobulin complex upregulate the platelet-derived growth factor alpha-receptor on rat pulmonary fibroblasts.
Am J Respir Cell Mol Biol. 13:455-465, 1995.
67. Lister PD., Granulocyte colony-stimulating factor protects control rats but not ethanol-fed rats from fatal pneumococcal pneumonia. JInfect Dis 168:922, 1993.
68. Lee Ping Yu., Clinical features and in Vitro antimicrobial susceptibilities of community-acquired Klebsiella
pneumoniae meningitis in Taiwan. J. antimicrob.chemother.
51:957-62, 2003
69. Liu, Y.C., D.L. Cheng, and C.L. Lin. Klebsiella pneumoniae liver abscess associated with septic
endophthalmitis. Arch. Intern. Med. 146:1913–1916. 1986.
70. Lo., T Cell Responses to Gram-Negative Intracellular Bacterial Pathogens: A Role for CD8+ T Cells in Immunity to Salmonella Infection and the Involvement of MHC Class Ib Molecules. J. Immunol. 162:5398-5406. 1999.
71. Lorraine B., The Acute Respiratory Distress Syndrome. N.
Engl. J. Med. 342:1334-1349, 2000.
72. Mancilla J., The interleukin-1 receptor antagonist can either reduce or enhance the lethality of Klebsiella pneumoniae sepsis in newborn rats. Infect. Immun.
61:926-932,1993.
73. Martinet Y., Cytokines in human lung fibrosis. Arch Toxicol Suppl. 18:127-139, 1996.
74. Medzhitov., An ancient system of host defense. Curr. Opin.
Immunol. 10:12 1998.
75. Metchnikoff., Immunity in the Infectious diseases.
MacMillan, New york. 1905
76. Moore-Gillon JC, Eykyn SJ, Phillips I. Microbiology of
pyogenic liver abscess. BMJ (Clin Res Ed) 283:819–21.
1981.
77. Mowat AG., Chemotaxis of polymorphonuclear leukocytes from patients with diabetes mellitus. N Engl J Med.
284:621-7, 1971.
78. Murray PR., Baron EJ, Pfaller MA., Tenover FC, Yolken RH..Manual of Clinical Microbiology, 7
t h
eds. American Society for Microbiology, Washington, D.C. 1999.79. Nelson S., Granulocytecolony-stimulating factor enhances pulmonary host defences in normal and ethanol-treated rats.
J Infect Dis 164:901, 1991.
80. Ochsner A., Pyogenic abscess of liver. Am J Surg . 40:292-318. 1938
81. Orskov, I., and F. Ors kov. Sero typing of Klebsiella . Methods Microbiol, 14:143-164. 1984.
82. Pascal K., Cardiac Inflammation and Innate Immunity in Septic Shock. Chest, 121:1329-1336. 2002.
83. Peter M Houck., Timing of Antibiotic Administration and Outcomes for Medicare Patients Hospitalized With
Community-Acquired Pneumonia Archives of Internal Medicine, 164:637-644, 2004.
84. Pittet, D., Association of secondary and polymicrobial nosocomial bloodstream infections with higher mortality.
Eur. J. Clin. Microbiol. Infect. Dis. 12:813-819, 1993.
85. Podschun R., Klebsiella . Spp. as nosocomial
pathogens:epidemiology, taxonomy, typing methods and pathogenicity factors. Clin.Microb. Rev. 11:589-603. 1998.
86. Prescott SM., Two of the usual suspects, platelet-activating factor and its receptor, implicated in acute lung injury. J Clin Invest. 104:1019-1020, 1999.
87. Ribot EM., Rapid Pulsed -Field Gel Electrophoresis Protocol for Subtyping of Campylobacter jejuni. J Clin Microbiol 2001; 39:1889-94.
88. Richards., H., and N. Datta. Plasmids and transposons
acquired by Salmonella typhi in man. Plasmid , 8:9-14. 1982.
89. Rubin RH, Swartz MN, Malt R. Hepatic abscess. Changes in clinical, bacteriologic and therapeutic aspects. Am J Med 57:601–10. 1974.
90. Ruslan., Innate Immunity. The new England journal of
medicine, 343:338-344. 2000.
91. Rustgi AK., Pyogenic and amebic liver abscess. Med clin North Am. 847-58. 1989.
92. Ryan KJ, ed. Sherris Medical Microbiology:An introduction to infectious disease. 3
rd
ed. London Prentice-Hall International Inc. 1994.93. Sanjeevi C. B. , MHC Class I Chain-Related Gene A Alleles Distinguish Malnutrition-Modulated Diabetes,
Insulin-Dependent Diabetes, and Non-Insulin- Dependent Diabetes Mellitus Patients from Eastern India. Annals of the New York Academy of Sciences 958:341-344, 2002
94. Schjetne Karoline W., Cutting Edge: Link Between Innate and Adaptive Immunity: Toll-Like Receptor 2 Internalizes Antigen for Presentation to CD4
+
T Cells and Could Be an Efficient Vaccine Target. The Journal of Immunology, 171:32-36. 2003,
95. Seeto RK., pyogenic liver abscess:c hangesin etiology, management, and outcome. Medicine 75:99-113, 1996.
96. Sher., Immunity to infection. Curr. Opin. Immunol. 7:471.
1995.
97. Sunita Shankar-Sinha., The klebsiella pneumoniae O antigen contributes to bacteremia and lethality during
murine pneumonia. Infection and Immunity. 72:1423-1430, 2004.
98. Susana Merino., Cloning and sequencing of the Klebsiella pneumoniae O5 wb gene cluster and its role in pathogenesis.
Infection and Immunity. 68:2435-2440, 2000.
99. Tan JS., Neutrophil dysfunction in diabetes mellitus. J Lab Clin Med. 85:26-33,1975.
100. Thomas K. Granulocyte Colony-Stimulating Factor Worsens the Outcome of Experimental Klebsiella
pneumonia e Pneumonia Through Direct Interaction With the Bacteria. Blood , 91: 2525-2535, 1998.
101. Thulstrup AM., Population-based study of the risk and short-term prognosis for bacteremia in patients with liver cirrhosis. Clin Infect Dis. 31:1357-1361, 2000.
102. Tsay Ren-Wen., Characteristics of bacteremia between community-acquired and nosocomial klebsiella pneumoniae infection. Arch Intern Med . 162:1021-1027, 2002.
103. Vasselon Thierry ., Toll Receptors: a Central Element in Innate Immune Responses . Infection and
Immunity,70:1033-1041, 2002.
104. Vesy C. J., Lipopolysaccharide-Binding Protein and Phospholipid Transfer Protein Release Lipopolysaccharides from Gram-Negative Bacterial Membranes. Infection and Immunity, 68:2410-2417, 2000.
105. Wang, J.H., Primary liver abscess due to Klebsiella pneumoniae in Taiwan. Clin. Infect. Dis, 26:1434–1438.
1998.
106. M. Weiss., Granulocyte Colony-Stimulating Factor to Prevent the Progression of Systemic Nonresponsiveness in Systemic Inflammatory Response Syndrome and Sepsis Blood. 93:425–439, 1999.
107. Woehlke G., Sequence of the sodium ion pump
oxaloacetate decarboxylase from Salmonella typhimurium. J.
Biol. Chem. 267:22798–22803, 1992.
108. Yinnon, A. M., Klebsiella bacteremia: community
versus nosocomial infection. Monthly J. Assoc. Physicians 89:933-941. 1996.
109. Yoshda K., Protection against pulmonary infection with Klebsiella pneumoniae in mice by interferon-{gamma}
through activation of phagocytic cells and stimulation of production of other cytokines . J. Med. Microbiol.,
50:959-964. 2001.
110. Yoshda K., Induction of interleukin-10 and
down-regulation of cytokine production by Klebsiella pneumonia e capsule in mice with pulmonary infection J.
Med. Microbiol. 50:456–461, 2001.
111. 行 政 院 衛 生 署 統 計 資 料 . 91 年 台 灣 地 區 主 要 死 因 分 析 , 2002
112. 蔡 世 澤 ., 台 灣 糖 尿 病 照 護 現 況 與 省 思 . Clinical Medicine 45:316-320, 2000.
113. Davise Laro. Medically Important Fungi, Third edition.
114. Diagnostic Microbiology 5
t h
1997 第 2-3 章 P69-170115. Diagnostic Microbiology 5
t h
1997， 第 3 章 ： p121-162 116. Fundamentals of Diagnositic Mycology Fisher Cook 117. Manual of Clinical Microbiology 7t h
1999， 第 3 章 ：p23-32
118. Manual of Clinical Microbiology 7
t h
1999 第 5 章 P33-106119. NCCLS. M100-S12 Vol.22 No.1
120. Principles and Practice of Clinical Mycology Kibbler, Mackenzie Odds(Editors ).
121.
Bionumerics software (Bionumerics version 2.5;
Applied Maths, Kortrijk, Belgium),
122. genomic fingerprintanalysis program Bionumerics version 2.0 (Applied Maths, Kortrijk, Belgium)
專有名詞中英文對照與縮寫表
克 雷 伯 氏 肺 炎 桿 菌 ： Klebsiella pneumoniae； K. pneumoniae 大 腸 桿 菌 ： Escherichia coli； E.coli
脈 衝 式 電 泳 ： Pulsed field gel electrophoresis ； PFGE 糖 尿 病 ： Diabetes mellitus
；
DM第 一 型 糖 尿 病 ： Type I DM, IDDM 第 二 型 糖 尿 病 ： Type II DM, NIDDM
糖 化 血 色 素 ： Glykosylert hemoglobin AI； HbAIc 社 區 性 肺 炎 ： Community acquired pneumonia； CAP
急 性 呼 吸 窘 迫 症 候 群 ： Acute respiratory distress syndromes ； ARDS
腫 瘤 壞 死 因 子 ： Tumor necrosis factor； TNF 介 白 素 -1： Interlukin-1； IL-1
血 小 板 活 化 因 子 ： Platelet activating factor； PAF 一 氧 化 氮 ： Nitric oxide； NO
散 佈 性 血 管 內 凝 血 ： Disseminated intravascular coagulation；
DIC
泌 尿 道 感 染 ： Urinary tract infection； UTI
聚 合 ? 連 鎖 反 應 ： Polymerase Chain Reaction； PCR
隨 機 增 幅 多 型 性 DNA 分 析 法 ： Randomly Am p lified Polymorphic DNAs； RAPD
群 組 ： Cluster
黏 液 性 試 驗 ： String test
金 黃 色 葡 萄 球 菌 ： Staphylococcus aureus 綠 膿 桿 菌 ： Pseudomonas spp.
黴 菌 ： Fungi 莢膜：Capsule
革 蘭 氏 陰 性 ： Gram negative 肝 膿 瘍 ： Liver abscess
鏈 球 菌 ： Streptococcus spp.
厭 氧 菌 ： Anaerobic Bacteria 多 因 子 疾 病 ： Multi-factorial
細 菌 性 肺 炎 ： Bacteremic pneumonia 社 區 獲 得 性 ： Community-acquired 院 內 感 染 性 ： Hospital-acquired 敗 血 症 ： Sepsis
細 胞 間 質 素 ： Cytokine 內 毒 素 ： Endotoxin
前 列 腺 素 ： Prostaglandins
皮 下 基 質 ： Subendothelial matrix 腦 膜 炎 ： Meningitis
眼 內 炎 ： Endophthalmitis 變 形 桿 菌 ： Proteus mirabilis 腸 內 菌 ： Enterobacteriaceae 細 胞 壁 ： Cell wall
細 胞 質 膜 ： Cytoplasmic membrane 細 胞 質 ： Cytoplasm
? 聚 醣 ： Peptidoglycan; mucopeptide 磷 酸 壁 ： Teichoic acid
脂 蛋 白 ： Lipoprotein 外 膜 ： Outer membrane
脂 多 醣 類 ： Lipopolysaccharide O 抗 原 ： O Antigen
脂 質 ： Phospholipid 染 色 體 ： Chromosome 核 質 ： Nuclear material 類 核 ： Nucleoid
黏 液 層 ： Slime layer 線 毛 ： Pili
多 糖 類 ： Polysaccharide 多 胜 ? ： Polypeptide 醣 盞 ： Glycocalyx 外 源 性 ： Exogenous 內 源 性 ： Endogenous
脂 磷 壁 酸 ： Lipoteichoic acid
外 膜 蛋 白 ： Outer membrane protein 凝 血 素 ： Hemagglutinins
鞭 毛 ： Flagella
先天性免疫：Innate immunity
表 皮 及 黏 膜 防 禦 機 轉 ： Epidermis and mucosa barriers
發 炎 反 應 ： Inflammatory response
吞 噬 作 用 ： Phagocytosis
吞 噬 性 空 泡 ： Phagosome
受 器 媒 介 之 吞 噬 作 用 ： Receptor-mediated endocytosis
後 天 性 免 疫 ： Adaptive immunity
識 別 分 子 ： Recognition molecules
血 清 分 型 ： Serotyping
高 黏 液 性 ： Hypermucoviscosity 低 黏 液 性 ： Hypomucoviscosity 引 子 ： Primer
電 場 ： Electric field 瓊 膠 ： Agarose
安 全 操 作 台 ： Laminar flow 劃 線 法 ： Streak method
四 區 劃 線 法 ： Four-phase streaking method
標 準 圈 環 直 接 劃 線 法 ： Calibrated loop-direct streak method 溫 箱 ： Incubator
需 氧 細 菌 類 培 養 ： Aerobic bacteria culture 拋 棄 式 接 種 環 ： Inoculation loop
細 菌 藥 物 敏 感 性 試 驗 ： Sensitivity test for bacteria 瓊 脂 紙 錠 擴 散 試 驗 ： Disc agar diffusion test
消 化 ： Digestion
恆 溫 定 量 清 洗 裝 置 ： Plug washing machine 外 部 參 考 值 ： External reference
內 部 參 考 值 ： Internal reference
附 錄 壹、 儀器設備與分析軟體
脈衝式電場電泳系統：CHEF Mapper® XA System, Bio-Rad, USA 影像處理系統：AlphaEase
TM
, Alpha Innotech Corporation, San Leandro,CA, USA
濁度計：DADE BEHRING, MicroScan, Dada Behring Inc. West Sacramento, CA, USA
恆溫培養箱：Orbital Shaking incubator OS 1500R
震盪恆溫水浴槽：Shaking Bath, Model: B602D, Lead-Biotech Instrument co. Taiwan
乾浴器：Universal Cold block bath, LB-DB2, Lead-Biotech Instrument co. Taiwan
高速離心機：Centrifuge, KM-15200 KUBOTA Corporation, Tokyo, Japan
震盪機：Vortex-Mixer, Model: VM-2000, Digisystem Labatory Instrument INC.Taiwan
無菌操作台：Laminar Flow, San-Hsing heater Industrial Co., Ltd.Taiwan 高壓滅菌釜：Autocleave, SAKURA, neoclave ASV-3022, KUBOTA
Corporation, Tokyo, Japan
UV 平 台 ： Hoefer® MacroVue UV-25 USA
UV 平 台 ： Hoefer® MacroVue UV-25 USA