Figure1.

SkinSmearCandidaalbicans
www.meddean.luc.edu

Candidaalbicans

Contents
1.
2.
3.
4.
5.
6.
7.

IntroductiontoMycology
BiologicalProfile
Diseasecapabilities
Pathogenesis
Detection
Drugtherapy
Research

TheSituation
Frequency
mostcommonfungalpathogenworldwide
4thleadingcausesofnosocomialinfections,40%mortality
significantmortalityandmorbidityinlowbirthweightinfants
affects75%women,45%experiencerecurrenceA
>10millionvisits/year
classifiedasaSTDbyCDC

Immunocompromised
cancerandHIVAIDspatientsC

mostcommonlymanifestedinpatientswithleukemia
orHIVAIDsinfections.Oralcandidiasisisoftena
cluetoacuteprimaryinfectionC

PublicConcerns
increasingresistancetodrugtherapiesduetoantibioticsand

antifungals

MycologyBasics
Kingdom:Fungi
Morethan10millionspecies,butonly~400humandisease(*)
SexualGroups
Ascomycota*
Basidiomycota*
Zygomycota*
Chytridia
FungiImperfecti*

www.ken.coar.org

www.arboretum.harvard.edu

Veryfewspeciesareinacommensalrelationshipwithhumans
includesCandidaalbicansandMalaseziafurfur
Diseasescausedbyfungiareusuallyaccidental
www.bio.umass.edu
EndogenousandExogenousSources
Increasingproblemduetoantibacterial&immunosuppressiveagents

Molecularmechanismsofpathogenesisnotwelldefined

The5maingroups

Figure1.ClassificationofFungi.Fungiareclassified
basedontheirabilitytoreproducesexually,asexually,bya
combinationofboth.Thedifferentreproductivestructures
placesthemintheappropriatecategory.(Baron,1996)

FungalCharacteristics
Plantlikelackingchlorophyll
Cellwallchitinousmatrix
Freelivingsaprobesandheterotrophs
needsCarbonsourceand
Nitrogensource
YeastsorMoldsorboth
Figure1.Penicilliumchrysogenumwww.doctorfungus.org
Successofaninfection
Accidental
Overcominghostbarriers
Presidinginhostwithimmunologicaldefects

YeastCharacteristics

MouldCharacteristics

solitary,unicellular

filamentoushyphae

reproductionviabudding

hyphalformation

roundedshape

tipsmayberounded
(conidia/spores)

moist&mucoidcolonies

Figure1.TypicalYeast

Figure2.Typicalmould

YeastBudFormation

Figure1.Stagesofbudgrowthand
yeastcellcycle(Baronet.Al.,1996)

HyphalFormation

Figure1.Polarizedhyphalformation(Baronet.Al.,1996)

BiologyofCandidaalbicans
Commensal

Pathogen

Athinwalleddimorphicfungus
Morphogenesis
Unicellularyeast(harmeless)
Filamentous(pathogenic)
PrincipalCellWallPolymers
Gluccan
Mannan

Figure1.YeastinOralScraping
Asampleofanoralscrapingcontainsyeastcellsand
pseudohyphae
(www.doctorfungus.org)

Strictaerobe,favorsmoistsurfaces
Commensallyfoundingut,genitals,andlungs
BodyTemp37C,neutralpH

RapidMultiplication&Spread

DiseasesbyC.albicans
Thrush
Esophagitis
CutaneousCandidiasis
GenitalYeastInfections
DeepCandidiasis

OropharyngealThrush
*Pseudomembranous
*Atrophic
*Angularchelitis
Figure1.Angularchelitis
(www.emed.com)

Symptoms
RiskFactors
HIV
Treatment:topical
antifungals

Figure3.OralThrush,pseudomembranous
(www.emed.com)

Figure2.OralThrush,atrophic
(www.mycolog.com)

GenitalYeastCandidiasis
Symptoms
RiskFactors
disruptionofnormal
microbiota

Figure1.VaginalYeastCulture
(www.euromeds.co.uk)

Treatment
directgenitaladministration
tablets,suppositories,creams

Figure2.Plasmacellbalanitis.A
bandlikeinfiltrateofplasmacellsisin
thedermisofthemalepenis.
(www.webpathology.com)

DeepCandidiasis

Figure1.Fourformsofinvasivecandidiasis
(www.doctorfungus.org)

Pathogenesis
HostRecognition
Adhesins
Enzymes
Hydrolases:Phosphoplipases,Lipases,Proteinases
Morphogenesis
YeastformtoFilamentoushyphae/pseudohyphae
PhenotypicSwitching

Virulence assay of different C. albicans strains using the skin equivalent (AST 2000)
Figure 1. skin equivalent before infection

Figure 2. Infection with pathogenic clinical isolate of C. albicans.

After 48 h the yeast penetrates the skin equivalent and destroys
the tissue

Figure 3. Infection with non-pathogenic C. albicans. This strain is not

able to penetrate into the tissue and thus behaves as avirulent as shown
in the mouse model of systemic infection.

(Fraunhofer,2002)

MORPHOGENESIS

Figure1.Morphogenesis.
Morphogenesisin
C.albicansisapivotal
virulencefactorthatallows
rapidmultiplicationand
subsequentdissemination
inhosttissue.
(www.kent.ac.uk)

Figure2.MorphogenicformsofCandidaalbicans

http://cbrrbc.nrccnrc.gc.ca/thomaslab/candida/caindex.html

ToolsforDetection&Diagnosis
OldMethods
RestrictionEnzymeAnalysis
Currentmethods
CultureandSerology
PCRBasedMolecularTechniques

QuickTime and a
TIFF (Uncompressed) decompressor
are needed to see this picture.

targetsSAPs
Advantages
Disadvantages
Fig.1.ThroatSwab(www.nlm.nih.gov)

Future
NonPCRBased
Fluorescentinsituhybridization

CurrentDrugTherapies
MajorDrugCategories
Polyenes
Problems: Catalaseactivity,ergosterolproduction
Azoles
Problems:Enhanceddrugefflux

FDAapprovedantifungaldrugs

QuickTime and a
TIFF
(Uncompressed)
de
are needed to see this

AmphotericinB(Fungizone)
Clotrimazole(Mycelex)
Fig.1.Fungizone
Fluconazole(Diflucan)
(www.bms.se)
Itraconazole(Sporanox)
Ketoconazole(Nizoral)
Nystatin(Mycostatin)

MedicalEconomics.DrugTopicsRedBook.Montvale,NJ:MedicalEconomics
Co.,Inc.,2000.

Research
Biotechnologicalmethodsforrapid
identificationanddetectionofCandida
strains
Newantifungalagents
Molecularpathogenesis
Emergingopportunisticstrains
PublicHealthMeasuresinlimiting
nosocomialrelatedinfections

References
D.www.webpathology.com
C.http://www.ncbi.nlm.nih.gov
B.http://www.emedicine.com/emerg/topic76.htm
A.http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/31092.html

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