cnadida albicans and aspergillus species
TRANSCRIPT
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Candida albicans and
Aspergilus species
Aguilar, Princess AlenBumagat, Giane Carla
Fernandez, JarlathSidocon, Erisia Shorouk
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Candida albicansMorphology
Methods of IdentificationPathogenicity
ViabilityMode of transmissionPrevention & Control
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Candida albicans Gen. Characteristics
Agent of yeast infectionsPremier cause of yeast infection in the
worldOval yeast with a single budThin walled, reproduce by budding or fissionNormal flora
◦Upper respiratory, gastrointestinal, female genital tracts, mucosa, skin, and digestive tract
In tissues, appear as budding yeasts or as elongated budding “pseudohyphae”
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Candida albicans. Notice the spherical chlamydoconidla (resting bodies formed from hyphal cells) and the smaller blastoconidia (asexual spores produced by budding).
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Microscopic features-almost complete sexual budding
C. albicans in mycelial or tissue phase with blastoconidia budding from the pseudohyphae.
Microscopic morphology of C. albicans showing budding spherical to ovoid blastoconidia.
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Methods of IdentificationGerm Tube Test (+) w/ capsule
◦ A rapid screening test for Candida albicans and Candida dubliniensis.
◦ 0.5 mL of serum, containing 0.5% glucose, is lightly inoculated with the test organism and incubated at 37°C for 2-3 hours.
On microscopy, the production of germ tubes by the cells is diagnostic for Candida albicans.
sugar assimilation profile distinctive green colour on
CHROMagar. production of chlamydospores
(corn meal agar @ 20°C)
Production of germ tubes by C. albicans
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Methods of Identification
CHROMagar Candida plate showing chromogenic colour change for C. albicans (green), C. tropicalis (blue), C. parapsilosis (white) and C. glabrata (pink).
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Pathogenicity:Candidiasis is an acute-to-chronic
fungal infection that can involve the mouth, vagina, skin, nails, bronchi, lungs, alimentary tract, bloodstream, or urinary tract.
Most widely recognized manifestation of C. albicans is THRUSH, an infection of oral mucosa which is also an indication of immunosuppression.
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Candidiasis Oral thrush
- is a yeast infection that forms white curd-like patches on the oral mucocutaneous membranes.
Vulvovaginitis/ vagina thrush
- as a thick yellow-white discharge.
- Diabetes, antibiotic therapy, oral contraceptives, and pregnancy predispose the patient to this condition.
- Due to loss of lactobacilli the C. albicans flourishes
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Cutaneous candidiasis
- Occurs in chronically moist areas of skin and in burn patients.- Onychomycosis and paronychia-Chronic mucocutaneous candidiasis
Cadidemias- occur in patients who have indwelling catheters.
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Viability: DRUG SUSCEPTIBILITY
- Sensitive to nystatin, miconazole, clotrimazole, ketoconazole, fluconazole, amphotericin B for invasive candidiasis
DRUG RESISTANCE- Resistant strains have been described for all the above antifungal drugs
SUSCEPTIBILITY TO DISINFECTANTS- Sensitive to 1% sodium hypochlorite, 2% glutaraldehyde, formaldehyde; only moderately sensitive to 70% ethanol (phenolic may be substituted)
PHYSICAL INACTIVATION- Inactivated by moist heat (121°C for at least 15 min)
SURVIVAL OUTSIDE HOST- Survives outside of host, especially in moist, dark areas
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Mode of transmission: Normal flora of oral cavity, genitalia,
large intestine or skin of 20% of humans
80% of nosocomial fungal infectionsEndogenous spread (part of normal
human flora); by contact with excretions of mouth, skin, and feces from patients or carriers; from mother to infant during childbirth; disseminated candidiasis may originate from mucosal lesions, unsterile narcotic injections, catheters.
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Prevention & Control: Keeping your skin clean and dry, by
using antibiotics only as your doctor directs, and by following a healthy lifestyle, including proper nutrition.
People with diabetes should try to keep their blood sugar under tight control.
HIV or another cause of recurrent episodes of thrush, then antifungal drugs such as clotrimazole (Lotrimin, Mycelex) can help to minimize flare-ups.
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For local infection, removal of the cause (eg. Moisture) & administration of antimicrobial agents are effective.
Tropical cream (eg. Nystatin & miconazole)
For systemic infection- oral ketoconazole can control mucocutaneous candidiasis.
For disseminated candidiasis- intravenous amphotericin B, oral flucytosine or oral ketoconazole can be effective if cellular immunity.
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Aspergillus speciesexist only as molds
MorphologyMethods of Identification
Pathogenicity:Viability:
Mode of transmission: Prevention & Control:
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GENERAL CHARACTERISTICS2nd most common isolated fungus after
CandidaA. fumigatus is the specie most commonly
isolatedPathogenic species are A. flavus, .A. terreus,
& A. nigerFast growing fungusNot dimorphic and producing septate hyphaeSpores are constantly present in the airDoes not cause disease, except for
immunocompromised person w/ 90% mortality
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MorphologyMay be either uniseriate or
biseriateArise from a “foot cell”, a
vegetative hyphaeUniseriate
◦Phialides attached to the vesicle at the end of conidiophore
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MorphologyBiseriate
◦Posses a supporting structure called metula
◦Metulae attached directly to the vesicle, & attached to each metula are phialides then eventually conidia are produced.
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MorphologyColor of the fungus comes from the conidia,
asexual spore.Colors are black, white, yellow, brown, tan,
green, gray, beige, pink, but most pathogens are green to tan colored.
“Fungus balls” in the lungs of agricultural workers who routinely are in contact w/ fungal conidia from environmental sources. This can be seen through X-ray and can be removed through surgery.
Erect conidiophore arising from a foot cellConidia can be aligned in very straight,
parallel columns or in radiant pattern around the vesicle and it can be rough or smooth.
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Aspergillus fumigatusMost important pathogenCan colonize and later invade
abraded skin, wounds, burns, the cornea, the external ear, or paranasal sinuses.
may grow at temp. range of 20-50°C, best grow at 40-45°C◦Produces conidial heads w/
numerous conidia◦Hyphae are septate
w/ dichotomous branching
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Aspergillus flavusGrowing on cereals or nuts
produces aflatoxins that may be carcinogenic or acutely toxic especially in the liver
• Uniserate or biserate or both w/ phialides covering the entire spherical vesicle
• Conidia are globose to subglobose (3-6 um in diameter), pale green and conspicuously echinulate. Some strains produce brownish sclerotia.
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Aspergillus nigerBeano™ is an enzyme
preparation from A. niger that breaks down CHO typically found in beans, Cabbage, broccoli and other high fiber foods which are tending to produce flatulence as a result of microbial action in the intestines.
Biserate w/ phialides covering the entire surface of the spherical vesicle; conidia are black
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Microscopic featuresSPECIES CONIDIOPHORE PHIALIDES VESICLE
A. clavatus Long, smooth Uniseriate Huge, clavate-shaped
A. flavus Colorless, rough Uni-/biseriate Round, radiate head
A. fumigatus
Short (<300 µm), smooth, colorless or greenish Uniseriate Round, columnar
head
A. glaucus group
Variable length, smooth, colorless Uniseriate
Round, radiate to very loosely columnar head
A. nidulans Short (<250 µm), smooth, brown
Biseriate, short
Round, columnar head
A. niger Long, smooth, colorless or brown Biseriate Round, radiate
head
A. terreus Short (<250 µm), smooth, colorless Biseriate Round, compactly
columnar head
A. versicolor Long, smooth, colorless Biseriate Round, loosely
radiate head
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Colony IdentificationSPECIES SURFACE REVERSE
A. clavatus Blue-green White, brownish with age
A. flavus Yellow-green Goldish to red brown
A. fumigatus Blue-green to gray White to tan
A. glaucus group Green with yellow areas
Yellowish to brown
A. nidulans Green, buff to yellow Purplish red to olive
A. niger Black White to yellow
A. terreus Cinnamon to brown White to brown
A. versicolor
White at the beginning, turns to yellow, tan, pale green or pink
White to yellow or purplish red
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IdentificationGrowth is rapid to moderately
rapid (colonies may be seen in 4 days)
Powdery in textureA. nidulans and A. glaucus slowly
grows, in 7 days reaching 0.5 -1cm at 25°C
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A. clavatus
A. flavus
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A. glaucus
A. fumigatus
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A. nidulans
A. niger
A. terreus
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Pathogenecity=Aspergillosis
Invasive aspergilloma◦ Neutropenia is the single most predictive factor for
developing this Dse.◦ The Px has sinusitis, & dissemination throughout the
body◦ There may be high titers of galactomannan Ag in
serumAspergillus spp. Are the frequent cause of disease
in the bone marrow transplant recipient in addition to other cancer transplant Px.
Allergic aspergillosis◦ High titer or IgE Ab against Aspergillus is detected◦ Infection is initiated as the fungal conidia were inhaled,
thus airborne In the lung air spaces, conidia begin to germinate and
invade tissue
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PathogenecityConidia in the earwax can lead to
a painful ear Dse known as Otomycosis
Common to people with Asthma or cystic fibrosis
Invasive type only affects immunocompromised patients
Can cause multiple organ involvement- brain, liver, heart, and bone producing hemoptysis and granulomas
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Symptomsw/in the few days, Px
develops a severe fever that fails to response to anti-fungal therapy
Pneumonia like symptoms are possible
Wheezing (as in asthma)CoughingChest painShortness of breathAspergilloma/ “Fungus
balls”
Fungus balls
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TreatmentVoriconazole -first-line treatment for
invasive aspergillosis. Amphotericin B for invasive aspergillosisItraconazoleLipid Amphotericin FormulationsCaspofunginMicafunginPosaconazole**immunosuppressive medications should be discontinued or decreased.
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PreventionWear an N95 mask when near or in a dusty
environment such as construction sitesAvoid activities that involve close contact to
soil or dust, such as yard work or gardeningUse air quality improvement measures such
as HEPA filtersTake prophylactic antifungal medication if
deemed necessary by your healthcare provider
Clean skin injuries well with soap and water, especially if the injury has been exposed to soil or dust
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Thank you for listening!