Microbiology

Examination

Guo qinglian （ 郭清莲）

Zhongnan Hospital of Wuhan

University
 The purpose of microbiology is to
study the characteristics of
microorganisms and how to
examine them.
 In previous lessons, the knowledge
of bacteria was introduced.
 This lesson, we will discuss the
contents about fungi and viruses,
as well as that of hospital-acquired
infections.
Fungi
 Fungi are a diverse group of
organisms ranging in size from
some unicellular microscopic types
called yeasts to some large
multicellular branching forms such
as mushrooms.

Yeast mushroom mushroo

 Morphological and physiological
characteristics are the major
means of classification.
 Environmental factors play a major
role in determining fungal form
and physiology ， so the
classification has been difficult and
frustrating.
 Fungi were originally classified as
plants, but because of their
variability,diversity,and asorptive
nutrition ,they have been placed in
a separate kingdom:the Fungi, or
Myceteae.
 The thallus （菌体） is the basic
vegetative （繁殖） unit of the
fungi.

thallus
 If the thallus is filamentous （丝状的） ,
it is called a mold.
 If the thallus is spherical ， it is called
a yeast.

yeast
mould
yeast
 Individual filaments in the mold are
called hyphae （菌丝） , which
when organized into a dense mat
are called a mycelium （菌丝体） .

hyphae hyphae mycelium

 Hypae show variation in structure
and function depending on the
species involved.
 Fungi are found primarily in the
soil.
 They produce extracellular
enzymes that digest organic
debris,and therefore important in
the recycling of elements and in
maintaining the fertility of the soil.
 Only a few species are infectious
to animals or humans.
 Some of these infectious species
are dimorphic and can exist in
either a mold or yeastlike state,
depending on environmental
conditions.
  Fungal reproduction may be sexual
or asexual.
 Budding or binary fission occurs in
some yeasts, but the spore is the
major reproductive unit.

Budding binary fission

Budding
Spores can be produced sexually
or asexually. Asexual spores may
arise directly from hyphae, or
they may be produced on or in
specialized structures arising from
the hyphae.
Fungi diseases
 Fungi diseases are called mycoses
and are divided into the following
types ： systemic, superficial,
subcutaneous （皮下的） ,
cutaneous and opportunistic.
 Fungal diseases in the healthy
person are rare.
 Nearly all fungal diseases are
acquired by contact with spores in
the soil or by inhalation of spores
dispersed in the air.
The ability of the spores to cause
disease is related to the number of
spores to which the host is
exposed and the state of health of
the individual.
Treatment of fungal
diseases
 Treatment of fungal diseases is divided
between two types of agents:topical
（表面的） and systemic.
 Topical agents include
nystatin,tolnaftate and miconazole.
 Systemic agents include amphotericin B
and flucytosine （氟胞嘧啶） .
Viruses
 Viruses are submicroscope,
obligate, intracellular parasites
that rely on their host for energy
and nutrients.
 Viruses have plagued humans
since their existence, but an
understanding of their nature is
only of recent origin.
 In 1886, the particles of smallpox
was first seen, though it was
thought to be spores of the
bacterial .
 Viruses are given independent
status because they are the
smallest of microbial agents and
because they are obligate
intercellular parasites.
 The virus is totally dependent on a
living host for its survival.
 Viruses are infectious agents that
can parasize all forms of life.

HBV Tobacco virus bacteriophage

 The absolute necessity of a virus
for its host is emphasized by the
fact that viruses cannot make their
own ATP.
 They lack the enzymatic capacity
to totally replicate themselves.
 Viruses range in size from 18nm to
over 250nm.
 The largest virus is smallpox( 天花病
毒 ), and it is the only one which can
be seen with compound microscope.
 The smallest virus is
bacteriophage （噬菌体） .

bacteriophage
smallp
Structure of viruses
 Chemically, viruses consist of a
core of nucleic acid, either RNA
and DNA, surrounded by a protein
coat.
 Some viruses also contain a lipid
envelope called envelope.
 Viruses are classified according to
certain parameters:type of nucleic
acid,
capsid symmetry ,capsomere
mumber, size of virus, and
molecular weight of nucleic acid.
 Viruses can be grown in tissue culture
or embryonated egg.
 Growth often results in cellular
degeneration, which can be detected
as a cytopathic effect (CPE).
 The CPE are visible with the naked
eye or with a compound microscope.
 Viral infection is usually associated
with some cytopathic
effect （ CPE ） .
 The number of viruses in a
suspension can be determined by
applying certain tehniques:
electron microscope, agglutination
of red blood cells, or measurement
of CPE
Nosocomial infection
 Diseases acquired in the hospital
are refered to as nosocomial.
 Bacteria are the most frequent
etiological agents of hospital-
associated diseases.
 Other microorganisms may also be
involved.
 The gram-negative aerobic bacilli,
such as members of the
Enterobacteriaceae, are the most
common cause of bacterial
deseases.
 The organisms causing disease in
the hospital may be derived from
the host (endogenous) or from
sources, outside the host
(exogenous).
 So nosocomial infection can be
divided as endogenous infecton
and exogenous one.
 The infectious agents can be
transmitted in the hospital in the
same way as in the community.
 Many factors contribute to the
acquisition of hospital-associated
diseases and may be associated
with the patient or with the
hospital.
 The host’s susceptibillity to
infection is influenced by the type
of microorganism invoved, the
dose of the microorganism, the
site of infection, and the efficiency
of the specific and nonspecific
immune mechanism.
 Most diseases develop in patients
who have some underlying disease
or condition that impairs the
normal immunological response.
 Hospital procedures, both
diagnostic and therapeutic, have
increased in recent years, and with
their increase has been an
increase in hospotal-associated
diseases.
 Catheterization （导管插入） and
the use of intravenous infusion
devices have contributed to the
majority of diseases, but other
sourses such as respiratory
therapy and anesthetic （麻
醉） devices also play an important
role.
 The improper use of drugs,
primarily antimicrobials, has led to
the development of resistant
species of microorganisms, toxic
reactions, and allergic responses in
the hospitalized patient.
 Some antimicrobials destroy
members of the indigenous
microflora and create sites for
infection by resistant species.
 Other drugs, particularly those
used during leukemia, cancer
therapy, or transplantation,
susppress the immunological
response and also make the
patient susceptible to infection by
his own microorganisms.
 The hospitalized patient is also
subject to cross-infection from
other patients and from hospital
staff who may be carriers of
infectious microorganisms.
 Nurses and physicians are the
most frequent carriers of infectious
agents.
The principal sites of infection
and the microorganisms
involved
 The urinary tract – E.coli and other G- bacilli
 The respiratory tract - G- bacilli and staphylococci
 Surgical wounds – staphylococci
 Skin and eyes – staphylococci and G- bacilli
 Burn wounds – pseudomonas aerugiosa and
Staphylococcus aureus
 Bacteremia –E.coli and other G- bacilli
Preventing methods
 The most important method for
preventing hospital-associated
diseases is handwashing by
hospital staff.
 Disinfection of the site of injection
is also an important means of
preventing infection, since many
hospitalized patients are subjected
to hypodermic injections.
 In most hospitals an infection-
control committee is in charge of
surveying the number, types and
sites of infection in the hospitalized
patients and promulgating this
information to hospital personnel.
 It is also the purpose of the committee
to suggest methods for reducing
hospital-associated disease.
 Such proposals may include reducing
the use of certain antimicrobials for
treatment or suggesting the use of new
disinfectants.