醫(yī)學微生物學課件：真菌學基礎(chǔ)和病原性真菌

1、真菌學基礎(chǔ)和病原性真菌 Basic mycology and pathogenic fungi真菌 fungus, fungi真菌 fungus, fungi真菌 fungus, fungiKingdom FungiZygomycota (接合菌門)Basidiomycota (擔子菌門)Ascomycota (子囊菌門)Chytridiomycota (壺菌門)The Fungi Kingdom1) fungi lack chlorophyll2) fungi are not photosyntheticcannot produce their own food3) they never r

2、eproduce by seeds4) most fungi have cell walls made of chitinReasons Fungi Are Different From PlantscellulosePlant cell walls are made of what?most are saprophytessome are parasitesSaprophyte-feeds on dead/decaying organisms1) Eukaryotic 2) Heterotrophs 3) Most of them are multicellular4) They canno

3、t move on their ownCommon Characteristics of FungiSizeA. MorphologySec. 1 Biological characteristicsA. MorphologyUnicellular: Yeast (酵母)Multicellular: Filamentous fungi (絲狀真菌) / Mold (霉菌) Dimorphic (雙相性) fungiSec. 1 Biological characteristicsThey are fungi which can exist as filamentous form or as y

4、east. At room temperature, it grows as a mold.At body temperature, it grows as a yeast.Several species are potential pathogens, such as Candida albicans.Dimorphic fungiYeastCryptococcus neoformans新生隱球菌Yeast Candida albicans 白假絲酵母菌 Moldhypha（菌絲）+ spore（孢子）Hypha and mycelium 菌絲和菌絲體Mycelium vegetative

5、aerial reproductive Spore Sexual Asexual Conidium (分生孢子) Thallospore (葉狀孢子) Sporangiospore (孢子囊孢子)Conidium (分生孢子)SporeConidium (分生孢子)Spore厚膜孢子關(guān)節(jié)孢子Thallospore (葉狀孢子)Spore芽生孢子Thallospore (葉狀孢子)SporeSporangiospore (孢子囊孢子)Spore MoldHypha Sporeunicellular fungiyeast multicellular fungi (mold)hyphasporemy

6、celiumvegetative aerial reproductive sexual asexual thallosporeconidiumsporangiosporeDimorphic fungiB. Structure and chemical component1.Mucus （capsule）2.Cell wallPolysaccharides 3.Cell membraneErgosterol（麥角固醇） target4.Septa （隔膜）5.Cell nucleus，organelles Asexual reproduction Yeast:BuddingFissionC. R

7、eproduction C. albicans Asexual reproduction Yeast:BuddingFission Mold:Sporulation SeptaHypha fragmentC. Reproduction Asexual Sexual C. Reproductionhypha(n)haploid(2n)diploidmating strainmating strainFUSION ofgametangiasporangiumsporesMEIOSISZygomycete (Bread Mold)Sabouraud medium (沙保培養(yǎng)基)Colonies Ye

8、ast type Yeast-like type Filamentous D. CultureYeast type colony of C. neoformansYeast-like type colony of C. albicansFilamentous colony of moldFilamentous colony of A. flavus (黃曲霉菌)ResistanceDry, UVChemical disinfectors, commonly antibioticsSensitivityWet heatLarkmycin (灰黃霉素)Nystain B (制霉菌素B)Amphot

9、ericin B(兩性霉素B)Miconazole (咪康唑) E. ResistanceImportance of fungi to humansFood productionbreadbeer, wineMedicine productionantibioticsSec. 2 Mycotic infection, pathogenesis and immunityA. Infectious source Endogenous ExogenousB. PathogenesisPathogenic mycosisSuperficialSubcutaneousEndemic (dimorphic

10、, systemic mycosis) Opportunistic mycosisMycotic hypersensitivity MycotoxicosisMycotoxins and cancers節(jié)菱孢菌3-硝基丙酸鐮刀霉菌雪腐鐮刀菌烯醇Anti mycotic immunityBarrier of skin and mucus membrane Normal floraMacrophages Sec. 4 Pathogenic mycotic infectionA. Superficial mycotic infection（淺部真菌感染）Cutaneous mycosis（皮膚感染真

11、菌） Subcutaneous mycosis（皮下組織感染真菌） Cutaneous mycosis -皮膚癬菌 -角層癬菌Tinea（癬）Tinea (癬-表皮癬菌屬)運動員足Athletes foot(皮膚癬菌)黃癬（毛癬菌屬）Yellow tinea白癬（小孢子菌屬）White tinea花斑癬（糠秕孢馬拉色菌）Tinea versicolorSubcutaneous mycosis -孢子絲菌 -著色真菌Wound infectionSubcutaneous mycosis申克孢子絲菌Dimorphic fungi申克孢子絲菌病Sporotrichum schenckii infec

12、tion著色霉菌病Chromomycosis Assays for tineaSkin /hair/nailsMicroscopy: hypha, spore10%KOH/NaOH,heatCulture of superficial mycosisSpecimens+70% ethanol/2%carbolic acid dipped in about 2-3min washing with steriled NS Sabourauds agar2-3W Colonies : morphology and color Microscopy: hypha and spore B. System

13、ic mycosis （深部真菌感染）Dimorphic fungiOpportunistic fungiCandida albicans (白假絲酵母菌)Cryptococcus neoformans (新生隱球菌)Asperillas (曲霉)Mucor (毛霉)Pneumocystits carinii (卡氏肺孢菌)1. Candida albicans (白假絲酵母菌,白色念珠菌)Pseudomycelium1. Candida albicans (白假絲酵母菌,白色念珠菌)Unicellular yeast type fungusNormal floraskin/month/upp

14、er respiratory tract /intestine/vaginaResistance PathogenesisPathogenic factorsGlucoprotein on cell wallBudding tube (芽管)Pseudohyphae (假菌絲)Toxin, hydrolyzase (水解酶)Diseases Cutaneous and mucosal candidiasis -thrush (鵝口瘡)/皮膚糜爛/陰道炎Systemic candidiasis -pneumonia/bronchitis(支氣管炎) /enteritis/septicemiaCN

15、S infection-meningitis(腦膜炎)/brain abscess(腦膿腫)Pathogenesis鵝口瘡Candidiasis皮膚念珠菌病念珠菌性龜頭炎皮膚念珠菌病（皮膚皺褶處）CandidiasisPseudomyceliumSpecimens Gram stainPseudomyceliumAssays for candidiasisAssays for candidiasisAssays for candidiasis2. Cryptococcus neoformans(新生隱球菌)Unicellular fungusIn nature- feces of peace

16、bird, soil2. Cryptococcus neoformans(新生隱球菌)Unicellular fungusIn nature- feces of peace bird, soilNormal flora-superficial, month, intestineOpportunistic fungusCNS infection , systemic infection, lesions in skin, lungs or other organs Pathogenic factorCapsule EnzymesSuperficial cryptococcosis皮膚新生隱球菌病

17、 Assay for C. neoformansCSFSputum Ink negative stain3. Asperillas (曲霉菌)Ubiquitous3. Asperillas (曲霉菌)Ubiquitous3. Asperillas (曲霉菌)UbiquitousAspergillosis (曲霉病)LungSystemic Toxicosis and cancersAflatoxin AF-liver cancerAflatoxin AF(黃曲霉素)4. Mucor (毛霉菌)UbiquitousMucormycosis (毛霉病)NoseEarBrain Intestine

18、Mucormycosis (毛霉病)2009年02月12日,香港瑪麗醫(yī)院證實出現(xiàn)數(shù)宗血癌及淋巴癌患者腸道受毛霉菌感染的罕有個案。其中一名患急性血癌的六歲男童在化療后腹部腫脹，做手術(shù)時發(fā)現(xiàn)其腸臟發(fā)黑潰爛，最后因嚴重感染死亡。5. Pneumocystits carinii (卡氏肺孢菌)Ubiquitous Latent infection in healthy peoplePCP in immunodeficiency patientsYeast Unicellular, spherical to ellipsoid (315m) fungal cells that are usually r

19、eproduced by budding.Mold Hyphal or mycelial colony or form of growth.Summary Two particular componentsPolysaccharides ErgosterolForms Unicelluar or multicelluar fungi-hypha or sporePathogenic fungi causeTinea, Cutaneous and Subcutaneous mycosisMycotoxicosisOpportunistic fungi causeSuperficial and systemic infection, mycotic hypersensitivity Diagnosis Smear and microscopy, Sabourauds agarKey wordsMycology fungus (fungi)yeastmoldhypha (hyphae)sporedimorphic fungiSabour