LESSON 1: MEDICAL MYCOLOGY  Bacteriophage – virus that and possibly destroys
bacterial cells
Overview of the Microbial World
 Anton van Leeuwenhoek
- Dutch biologist
- Beasties in a water droplet (with his homemade
microscope)
- Father of protozoology amd bacteriology
 Prokaryotes – NO true nucleus nor nuclear
membrane. NO mitochondria, no endoplasmic
reticulum (ER), nor Golgi Apparatus
 Eukaryotes – with complex cell structures in which
the genetic material is organized into a membrane
bound nucleus
1. Bacteria – unicellular; NO nuclear membrane and true
nucleus; classified. as prokaryotes (NO Mitochondria,
Endoplasmic Reticulum, nor Golgi Apparatus)
2. Parasites – eukaryotic as unicellular, ex. protozoa;
obtain their nutrition through ingestion, some capable of
locomotion (motile);
Locomotive structures such as flagella (whip-like,
pseudopodia (false feet); or cilia (eyelash)
- Others are nonmotile;
- Others are multicellular (ex. tapeworm)
3. Fungi – heterotrophic; eukaryotes, obtain nutrients
through absorption
1. Yeasts – unicellular fungi, reproduce asexually; true
yeast do NOT form hyphae or mycelia
Multicellular fungi have filaments (hyphae) which
interweave to form mats called mycelia
2. Moulds – filamentous forms, reproduce asexually and
sexually
3. Dimorphic – Some fungi assume both morphologies
(yeast and hyphae/mycelia forms), growing as yeast
at incubator or human temperature; and filamentous
form at room temperature; dimorphic fungi produce
systemic diseases in human hosts
4. Viruses – smallest infectious particles (virions); virion –
virus outside of the cell
 Cannot be seen in an ordinary light microscope;
 Neither prokaryotic nor eukaryotic;
 Affects cell lines (viral diseases) such as:
a) Inclusions – rounding up of cells
 Syncytium – cell fusion of host cells into
multinucleated infected forms
How to distinguish cells with viral disease?
 Viruses consist of DNA or RNA, but NOT both;
genome may be double-stranded DNA (dsDNA),
single-stranded DNA (ssDNA), double-stranded RNA
(dsRNA), or single-stranded RNA (ssRNA).
 Are acellular (NOT composed of cells), lack
cytoplasmic membranes, and are surrounded by a
protein coat.
 Are obligate intracellular parasites that require host
cells for replication (increase in number does NOT
involve mitosis, meiosis, or binary fission) and
metabolism; lack enzymes, ribosomes, and other
metabolites; “take over” host cell function to produce
virus; growth (increase in size) does NOT occur in
viruses.
 Viruses are mostly host and/or host cell specific:
Examples:
a) Human immunodeficiency virus (HIV) infects T
helper lymphocytes, NOT muscle cells, in
humans
b) Rabies – can infect dogs, skunks, bats, and
human (brain)
Taxonomy
According to Classification and Identification
1. Genotype - genetic makeup of an organism, or
combinations of forms of one or a few genes under
scrutiny in an organisms genome.
Example of genotypic characteristics:
Basic sequencing of DNA or RNA and DNA base
composition ratio to measure the relatedness of 2
organisms
2. Phenotype – readily observable physical and functional
features of an organism expressed of phenotypic
characteristics:
a) Macroscopic (colony morphology on media)
b) Microscopic (size, shape, arrangement into groups or
chains of organism morphology,
c) Staining characteristics (gram-positive or gram-
negative;
d) Nutritional requirements, physiologic and biochemical
characteristics
e) Susceptibility or resistance to antibiotics or chemicals
According to Levels of Classification or Subsets:
 Domain – ex. Bacteria/Archaea; Eukarya for plants
and protists
 Kingdom – animalia, protista, monera
 Phyla (division),
 Family
 Genus (genera)
 Species
 Strains
 Recent taxonomists - organisms are in 3 domains
(replaced some kingdom). Each of these domains are
divided into kingdom based on similarities of RNA,DNA
and protein sequences:
 Prokaryotes includes domains Archaea (archaeobacteria)
and bacteria (Eubacteria)
o Archaea – not encountered in clinical
microbiology; ex. are salt loving and heat loving
cells (extremes)
 Eukaryotes – includes fungi, parasites, algae, protozoa,
animals and plants; larger and contain membrane
encased organelles (with specific function) or
compartments
Cytoplasmic Structures
 Nucleus – has DNA with discrete chromosomes
(genes) covered with basic proteins called histones.
Nucleus has bilayered nuclear membrane
 Nucleolus – site of ribosomal RNA synthesis
 Endoplasmic Reticulum – membranes, as rough
ER, covered with ribosomes the site of protein
synthesis; ribosomes gives the rough appearance
- As smooth ER, NO ribosomes so does NOT
synthesize protein but synthesize phosholipids
(like rough ER)
 Golgi apparatus – modify and package protein sent
to it by rough ER
Other Membrane Enclosed Organelles
 Mitochondria – main site of energy production
- Contain their own DNA and the electron transport
system that produce energy for cell functions
 Lysosomes – contain hydrolytic enzymes for
degradation of macromolecules and microorganisms
within the cell
 Peroxisomes – contain protective enzymes that
break down H2O2 and other peroxides generated
within the cell
  Chloroplasts – for plant cells, site of photosynthesis
(energy production), produces glucose from CO 2 and
H2O. Fungi are NOT plants and therefore have NO
chloroplasts.
Microbial Nutritional Requirements for Growth
1. Autotrophs – grow simply using CO2 as the sole source
of carbon with only water and inorganic salts required in
addition.
- Autotrophs obtain energy by:
a. Photosynthesis (phototrophs)
b. Oxidation of inorganic compounds
(chemolithotrophs)
2. Heterotrophs – require more complex substances for
growth; require an organic source of carbon such as
glucose, and obtain energy by oxidizing or fermenting
organic substances (glucose as both carbon and energy
source)
Environmental Factors Affecting Growth
1. Obligate aerobes – requires Oxygen for growth(bacteria)
2. Aerotolerant anaerobes – facultative aerobes, can
survive in the presence of Oxygen but not use Oxygen in
metabolism
3. Obligate anaerobes – cannot grow in the presence of
oxygen
4. Facultative anaerobe – can grow w/ or w/o Oxygen
5. Capnophilic – organisms grow best when the atmosphere
is enrich with extra CO2 (5% to 10%)
Host-microbe Relationship
 Symbiosis – living together ; both benefit from one
another (host and organism) - mutualism
 Commensalism – organism benefits but NO
beneficial or harmful effect to the host
 Parasitism – one specie (organism/microbe) benefits
at the expense of the other (host)
Fungi are Eukaryotic, spore-bearing, heterotrophic
organisms that produce extracellular enzymes and absorb
their nutrients.
Fungi – Kingdom Mycota
Divisions - Phyla – Chytridiomycotina, Glomeromycota,
Zygomycota, Basidiomycota, Ascomycota, Microsporidia,
Neocallimastigomycota
Fungi are dependent upon enzyme systems to derive energy
from organic substrates.
 Saprophytes – live on dead organic matter, enriched
by nitrogenous matter, but are capable of maintaining
a separate existence as an opportunistic pathogen in
humans or animals. Fungal infections are generally
NOT communicable in a usual sense from person-to-
person
 Parasites – live on living organisms
 Dermatophytes – fungi that infect the skin and grow
in the keratin layer
Primary Route of Infection
Fungi
 Humans become accidental host for fungi by inhaling
spores or by the introduction of fungal elements into tissue
by trauma. Humans are relatively resistant to fungal
infections, EXCEPT for disease caused by dimorphic
fungi.
 Alteration in the host particularly in the immune system
causes fungal infection;
 Or caused by immunosuppressive agents or serious
underlying disease - - lead to infection by organisms that
are normally nonpathogenic (ex. progressive infections as
HIV, Diabetes mellitus, or in patients with impaired
immunologic function resulting from corticosteroid or
antimetabolite chemotherapy (immunocompromised)
 No fungus species can be considered completely
innocuous (not harmful). Mushrooms look innocuous but
are deadly.
Fungi are essential in recycling of elements, especially carbon.
Life would be impossible without fungi - decomposers
Role of fungi in the economy:
1. Industrial uses of fungi
 Mushrooms. (Class Basidiomycetes); 200 edible
 Truffles. (Class Ascomycetes)
 Natural food supply for wild animals.
 Yeast as food supplement, supplies vitamins.
 Penicillium roquefort - ripens cheese, adds
flavor (roquefort cheese – French cheese from
goat’s and ewe’s (female sheep) milk, contain
blue mold); P. camemberti
 Fungi used to alter texture, improve flavor of
natural and processed foods.
2. Fermentation
 Fruit juices (ethyl alcohol).
 Saccharomyces cerevisiae - brewer's and
baker's yeast.
 Fermentation of industrial alcohol, fats, proteins,
acids, etc.
3. Antibiotics
 First observed by Fleming; noted suppression of
bacteria by a contaminating fungi of a culture
plate.
 Penicillium notatum – antibiotic produced by
deuteromycete
4. Plant Pathology
 Most plant diseases are caused by fungi -
Chestnut blight, Dutch Elm disease, Apple scab,
Brown rot
 Many smuts (produce black powdery masses of
spores) and rusts attack cereals
 Agaricus campestris – mushroom found in the
grocery
  Shitake mushroom
5. Medical importance
 100-150 species are recognized human
pathogens.
 Most prefer to be free-living saprophytes; and
only accidentally become pathogens.
 To be pathogenic, they must tolerate the
temperature of the host site and possess an
enzymatic system that allows them to utilize
animal tissues
 Increased incidence of fungal infections in recent
times
 Some fungi cause human diseases:
o ringworm, athlete’s foot, Histoplasmosis
(systemic disease)
 Cyclosporine – drug used to suppress immune
responses in patient’s receiving organ transplant was
produced from fungi
 Some fungi are poisonous (cyclopeptides are toxic
substance found in mushrooms)
 Ergot – type of fungus (Claviceps purpurea); causes
nervous spasm, convulsion, psychotic declusion,
gangrene
 In 1722, Ergot was called St. Anthony’s fires and its
outbreak caused many to be burned at the stake as
witches
Importance of Medical Mycology
 During the time period between 1941 and 1973, the
number of reported deaths in the U.S. due to scarlet
fever, typhoid, whooping cough, diphtheria, dysentery
and malaria decreased from 10,165 cases to 107; but
reported deaths due to mycoses during the same time
period, increased from 324 to 530.
 Increased mobility - We can travel to a geographical
area where a fungus exists as part of the commensal
flora of the local population, or is endemic to the area.
 We have an aging population.