پایان نامه فراوانی نسبی آنزیم متالوبتالاکتاماز در سویه‌های سودوموناس ائروژینوزای جدا شده از نمونه‌ های بالینی در شهر یزد به روش E Test

فهرست:

فصل اول: مقدمه و مروری بر مطالعات مشابه. 1

1-1- خانواده پسود و موناداسه آ 2

1-2- تاریخچه P. aeruginosa.. 3

1-2-1- خصوصیات مورفولوژیک P. aeruginosa. 5

1-2-2- خصوصیات رشد. 5

1-2-3- هوازی‌های اجباریObligate aerobes 5

1-2-4- مشخصات کشت... 6

1-2-5- مواد آلی مورد نیاز 7

1-2-6- محیط‌های کشت... 8

1-2-7- پیگمان.. 9

1-2-8- شاخص‌های بیماریزایی در P. aeruginosa. 11

1-2-8-1- پیلی(Pili) 11

1-2-8-2- آلژینات (Alginate) 12

1-2-8-3- اندوتوکسین.. 12

1-2-8-4- پروتئاز‌های خارج سلولی.. 13

1-2-8-5- همولیزین‌ها 15

1-2-8-6- فسفولیپاز ‍C. 15

1-2-8-7- رامنولیپیدها 15

1-2-9- توکسین‌های خارج سلولی.. 16

1-2-9-1- اگزوتوکسینA. 16

1-2-9-2- اگزوآنزیم S. 16

1-2-10- لوکوسیدین با وزن ملکولی بالا. 17

1-2-11- سیدروفورها 17

1-2-12- لیپاز 17

1-2-13- سیتوتوکسین 18

1-2-14- پایوسیانین       18

1-2-15- سیستم ترشحی نوع III 18

1-2-16- اپیدمیولوژی.. 19

1-2-17- بیماریهای ناشی از P. aeruginosa. 20

1-2-17-1- باکتریمی.. 20

1-2-17-2- عفونت‌های گوش.... 20

1-2-17-3- عفونت‌های چشم.. 21

1-2-17-4- عفونت‌های مجرای تنفسی.. 21

1-2-17-5- عفونت‌های استخوان و مفصل.. 22

1-2-17-6- عفونت‌های سیستم عصبی مرکزی.. 22

1-2-17-7- عفونت‌های دستگاه گوارش.... 22

1-2-17-8- عفونت‌های پوست و بافت نرم. 23

1-2-17-9- عفونت‌های دستگاه ادارای.. 24

1-2-17-10- باکتریمی.. 24

1-2-17-11- عفونتهای استخوان و مفصل.. 24

1-2-17-12- عفونت‌های سیستم عصبی مرکزی.. 24

1-2-17-13- اندوکاردیت عفونی.. 25

1-2-17-14- عفونت‌های مجرای تنفسی.. 25

1-2-17-15- عفونت پوست و بافت‌های نرم. 26

1-2-17-16- عفونت‌های ادراری.. 26

1-2-18- متالوبتالاکتاماز 27

1-2-19- شیوع مقاومت متالوبتالاکتامازها 27

1-2-20- انواع  تیپ‌های متالوبتالاکتاماز 28

1-2-21- The Imipenemase(IMP) Type 28

1-2-22- The Veronese Imipenemase (VIM) Type 28

1-2-23- New Delhi Metalo β-lactamase-1 (NDM-1) Type 28

1-2-24-  دیگر تیپ‌های متالوبتالاکتاماز 29

1-2-24-1- روش‌های تشخیص متالوبتالاکتاماز 29

1-2-24-2- سنجس حساسیت) آنتی بیوگرام) 29

1-2-24-3- روش E.Test به وسیله نوار    MBL. 30

مروری بر مطالعات گذشته. 31

فصل دوم: مواد و روش‌ها 34

2-1 بیان مسئله و اهمیت موضوع. 35

2-2- اهداف... 36

2-2-1- اهداف اصلی طرح.. 36

2-2-2- اهداف ویژه طرح.. 36

2-3- سؤالات و فرضیات... 36

2-4- نوع و روش مطالعه. 37

2-5- روش کار 37

2-5-1- انواع محیط کشت... 37

2-5-2- مکانکی آگار(Mac Conkey agar) 37

2-5-3- محیط کشت  SIM.. 38

2-5-4- روش آماده سازی معرف کواکس جهت تست اندول.. 39

2-5-5- محیط کشت OF. 39

2-5-6- محیط کشت TSI 39

2-5-7- محیط سیمون سیترات... 40

2-5-8- محیط مایع( ( MR-VP. 40

2-5-9- طرز تهیه معرف VP. 41

2-5-10- طرز تهیه معرف MR. 41

2-5-11- تست اکسیداز 41

2-6- روش اجرای کار 42

2-6-1- جمع آوری نمونه‌ها 42

2-6-2- تعیین آنزیم متالوبتالاکتاماز 43

2-6-3- آنالیز آماری.. 44

2-6-4- محدودیت و مشکلات اجرایی طرح.. 44

2-7- جدول متغیرها 45

فصل سوم: یافته‌ها 46

3-1- نتایج.. 47

فصل چهارم: بحث، نتیجه گیری و پیشنهادات... 69

4-1- بحث... 70

4-2- نتیجه گیری.. 75

4-3- پیشنهادات... 75

Abstract. 76

فهرست مراجع.. 77

ضمیمه: پرسشنامه  84

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