A.Y. 2019/2020
Overall hours
Learning objectives
The course aims to provide students with:
i) the cellular and molecular bases of microbial pathogenicity and microorganism-host interactions;
ii) the main mechanisms of defense and prevention of infections, including the targets of antimicrobial drugs and the preparation of vaccines;
iii) the knowledge of the main laboratory investigations for the etiological diagnosis of infections.
Expected learning outcomes
a) know the fundamental molecular and cellular mechanisms involved in the interaction between microorganisms and host;
b) understand the importance of the defense mechanisms and the prevention measures of infectious diseases;
c) analyze and interpret the results of diagnostic investigations in order to identify the most suitable antimicrobial therapeutic approach.
Course syllabus and organization

Single session

Course syllabus
The course includes the presentation and discussion of the following topics, subdivided into a general part (General microbiology) and a clinical part (Clinical microbiology, i.e. the etiological infection agents grouped by microbiological sub-discipline: Bacteriology, Virology, Mycology and Parasitology).

General microbiology:
· Microbiota (resident microbial population of the human body and composition in the various districts)
· Interaction of infectious agents and human hosts
· Main transmission routes (horizontal and vertical) of infectious agents
· Basic concepts of colonization, symbiosis, commensalism, infection and disease
· Classification of infectious agents
· Morphology and structure of the bacterial cell with a focus on microbial structures external to the plasma membrane
· Virulence factor of bacteria: biofilm, capsule, enzymes, flagella, pili, plasmids, toxins
· Exchange of genetic information in bacteria: conjugation, transduction, transformation
· Bacteria culture and common staining procedures
· Sporulation and germination
· Approved antibacterial vaccines
· Mechanism of action of antibacterial drugs inhibiting cell wall synthesis, cytoplasmic membrane functions, protein synthesis and nucleic acids
· Mechanisms of bacterial resistance to antibiotics
· Molecular structure and classification of animal viruses
· Intracellular parasitism and phases of the replication cycle of animal viruses
· Mode of transmission and types of viral infection (acute, persistent, and latent)
· Antiviral drugs and their mechanism of action
· Approved antiviral vaccines
· Morphology, ultrastructure and function of the fungal cell, and mode of reproduction
· Mode of transmission of fungal infectious agents
· Pathogenicity of fungi
· Classification of fungal infections
· Drugs with antifungal activity: mechanisms of action, drug resistance development
· Morphology, structure-function relationship, and mode of reproduction of protozoa
· Mode of transmission and importance of the vectors
· Morphology and structure of parasites (worms and arthropods)
· Antiparasitic drugs and mechanisms of action
· Strategies for fighting parasites
· Role of prions in human and animal diseases
· Principles of infection diagnosis

Clinical microbiology:
Species features involved in human disease: pathogenetic potential, type of infection, drug-resistance of the main human pathogenic bacteria:
· Staphylococci, with particular reference to Staphylococcus aureus;
· Streptococci, with particular reference to: Streptococcus pneumoniae, S. pyogenes, S. agalactiae;
· Neisseriae with particular reference to: Neisseria gonorrhoeae and N. meningitidis;
· Enterobacteriaceae with particular reference to those exogenously acquired (Salmonella, Shigella, Escherichia and Yersinia spp.) and to the opportunistic endogenous species (E. coli, Klebsiella spp., Proteus spp., Enterobacter spp., etc.);
· Mycobacteria with particular reference to: Mycobacterium tuberculosis complex, M. ulcerans, M. leprae, M. avium intracellulare;
· Aerobic and anaerobic actinomycetes with particular reference to: Nocardia spp. and Actinomyces spp.;
· Gram-positive bacilli with particular reference to: Corynebacterium diphtheriae and Listeria monocytogenes;
· Spore-forming Gram-positive bacilli with particular reference to: Bacillus anthracis, B. cereus, Clostridioides difficile, Clostridium botulinum, C. perfringens and C. tetani;
· Pseudomonadaceae with particular reference to: Pseudomonas aeruginosa, Burkholderia spp., and Stenotrophomonas maltophilia;
· Gram negative bacilli with particular reference to: Acinetobacter spp., Campylobacter spp., Helicobacter pylori, Legionella pneumophila and Vibrio cholerae;
· Spiral bacteria with particular reference to: Treponema pallidum, Borrelia burgdorferi and Leptospira spp.;
· Mycoplasmas with particular reference to: Mycoplasma pneumoniae, M. genitalium, M. hominis, Ureaplasma urealyticum;
· Obligate intracellullar bacteria with particular reference to: Chlamydia trachomatis, Clamydiophila pneumoniae, C. psittaci, Coxiella spp., Ehrlichia spp., Rickettsia spp.

Main families, replication modalities, pathogenesis of infections related to:
· DNA viruses: Herpesviridae, Adenoviridae, Parvovirus B19, Papillomaviridae; Polyomaviridae, Poxviridae,
· RNA viruses: Orthomyxoviridae, Paramyxoviridae, Rhabdoviridae, Flaviviridae, Picornaviridae, Togaviridae, Coronaviridae, Reoviridae;
· Primary hepatitis viruses: HAV, HBV, HCV, HDV, HEV;
· Retroviridae: HIV, HTLV.

Morphological, cultural and pathogenic characteristics of:
· yeast-like fungi with particular reference to Candida spp., Cryptococcus spp.;
· filamentous fungi with particular reference to Aspergillus spp., Fusarium spp., Mucorales and dermatophytes;
· dimorphic fungi.

Morphological characteristics, mode of reproduction and pathogenesis of infections sustained by:
· Pathogenic amoebae,
· Giardia lamblia, Trichomonas vaginalis, Trypanosoma spp., Leishmania spp.,
· Sporozoa: Plasmodium spp., Toxoplasma gondii.

Life cycle, pathogenesis and control of the main helminths involved in human diseases with particular reference to: Cestodes, Nematodes and Trematodes.

Practical activities
· Cultures and isolation of bacteria
· Biochemical tests for bacterial identification
· Dilution and plating of biological samples to determine the bacterial load
· Performing the antibiogram
· Reading of identification tests
· Colony count for the determination of bacterial load
· Reading and interpretation of the antibiogram
Prerequisites for admission
Based on the knowledge acquired in the "Biology and Genetics" and "Chemistry and Biochemistry" courses, the student will gain understanding of the structural and molecular differences of the cell organization with particular reference to the differences between prokaryotes and eukaryotes.
Teaching methods
The program will be carried out through lectures (5 CFU) with the help of teaching material (slides and / or videos), and practical laboratory activities by performing conventional microbiological diagnosis methods, applied to a simulated urine sample (two afternoons).
Teaching Resources
Antonelli G., M. Clementi, G. Pozzi, G.M. Rossolini - Principi di Microbiologia Medica - Casa Editrice Ambrosiana, Rozzano (MI)
Murray P.R., K.S. Rosenthal, M.A. Pfaller - Microbiologia Medica, EDRA, Milano
Assessment methods and Criteria
The exam consists:
· in a preliminary written test consisting of 20 multiple-choice questions (only one correct answer) including a very brief justification of the made choice (time available 30 minutes). Each correct and justified answer will give a score of 1.5; unjustified, not given or incorrect answers will give a score of 0. Passing the written test with a minimum of 18/30 allows admission to the oral exam the following day.
· of an oral test in which the student will be evaluated for her/his ability to express with clarity and language appropriateness the most relevant morphological, metabolic and antigenic characteristics of microorganism; the pathogenetic mechanisms and the transmission pathways of infectious agents; and the relationship between microorganisms and human host, as well as the related defense mechanisms (immunological and pharmacological).
Informal teaching: 16 hours
Lessons: 60 hours
Professor: Morace Giulia
Gruppo 1
Professor: Morace Giulia
Gruppo 2
Professor: Morace Giulia
Gruppo 3
Professor: Borghi Elisa
by appointment
San Paolo Hospital, blocco C, 8° floor
Monday-Thursday by appointment
San Paolo, Bloc C, 8th floor