MICROPARA LABORATORY

Session 1
Simple microscope – has only 1 lens
Compound microscope – has 2 sets of lenses. It can magnify things 100-200
times larger than they really are.
Electron microscope – can magnify objects up to 300 000 times. they do not
use lenses but use electrons to enlarge the image.
PARTS OF A MICROSCOPE
1. Ocular (lens) eyepiece – the lens of the microscope that you look
through.
2. Course adjustment – the large knob on the microscope that you turn to
bring the object into focus.
3. Fine adjustment – the small nob on the microscope that brings the image
into focus.
4. Arm – the part of the microscope supporting the body tube.
5. Body tube – the part of the microscope that holds the eyepiece and the
objective lenses.
6. Nosepiece – the part of the bottom of the body tube that holds the
objective lenses and allows them to be turned.
7. High power objective lens – the lens that magnifies the object the
greatest amount (usually 40x)
8. Low power (scanner) objective lens – the lens that magnifies the object
the least amount (usually used to find the object; magnifies only 3x or 4x)
9. Middle power objective lens - the lens that usually magnifies the object
more than the scanner lens but less than the high power lens (usually 10x
to 20x)
10.Stage – the fat part below the objective lens where the slide is placed.
11. Clip – the part that holds the slide in place so it doesn’t move.
12.Diaphragm – the part that controls the amount of light entering the field
of view
Session 2

Alcohol lamp – used for heating sterilization and combustion in laboratory.

Autoclave – used to decontaminate certain biological waste and sterilize media

instruments and lab aware.

Centrifuge – used for separation of fluids gas or liquid based on density.

Centrifuge tubes – used to contain liquids during centrifugation which separates the
sample into its component by rapidly rotating it around a fixed axis.

Erlenmeyer Flask – used for pH titrations and in microbiology for the preparation of
microbial cultures.

Fermentation tubes – used to verify gas production in fermentation exercises.

Glass slide – is a thin flat rectangular piece of glass

Hanging drop slide – used to observe motility of bacteria

Laboratory incubator – used to grow and maintain microbiological or cell cultures

Inoculation loop – used primarily by microbiologists to take and transfer a small

sample (inoculum) of a microorganisms culture for example for stripping on a culture
plate

Inoculation needle – used in the field of microbiology to transfer and inoculate living
microorganisms

Magnetic stirrer – used in laboratories and consist of a rotating magnet or a

stationary electromagnet that creates a rotating magnetic field.

Petri dish – used to culture different type of cells including bacteria and molds.

Refrigerators – used in the laboratory with the function of refrigerating preserving and
storing

Laboratory spatulas – utensils that help with mixing scrapping and other tasks related
to transferring materials and samples from one place to another

Staining jars – use to stain cells and tissues on glass microscope slides staining
process

Test tube with a screw – used for the collection storage and transportation of small
amounts of liquid or solid samples.

Test tube rack – used to hold multiple test tubes

Weigh boats - used to weigh substances that will be transferred to another vessel as
well as protect the scale tray.

Session 4

3 STAINING TECHNIQUES COMMONLY USED IN MICROBIOLOGY:

1. SIMPLE STAINING-a single basic dye is used to color and highlight the entire
organism.

2. DIFFERENTIAL STAINING-distinguish bacteria according to their reaction to

particular stains, E.g. Gram stain procedure that classifies bacteria either as
Gram-positive or Gram-negative.

3. SPECIAL OR STRUCTURAL STAINS-are used to color specific part or structure of

a microorganism, e.g. endospore, flagellum, or capsule.

SMEAR-a thin film of the organisms is prepared, dried, and fixed onto a clean slide.

STAIN (DYE) - an organic compound coating a BENZENE RING PLUS A CHROMOPHORE

AND AN AUXOCHROME GROUP.

TYPES OF STAINS:

1. ACIDIC STAINS -are ANIONIC, which means that, on ionization of the stain,
the chromogen portion exhibits a negative charge and therefore has a
strong affinity for the positive constituents of the cell.

2. BASIC STAINS -are CATIONIC, because on ionization the chromogen

portion exhibits a positive

ACIDIC STAINS ------- Sodium, potassium, calcium, or ammonium salts of colored

acids
ionize to give a negatively charged chromogen

BASIC STAINs ------- The chloride or sulphate salts of colored bases ionize to
give a positively
charges chromogen
 BACTERIA MORPHOLOGY COLOR GRAM REACTION

Bacillus subtilis Rod-shaped Purple Gram positive

Enterococcus ovoin in chain/pairs Purple Gram positive

Escherichia Coli Rod-shaped Pink Gram negative

Staphylococcus Spherical Purple Gram positive

Streptococcus Spherical ovoid cocci Purple Gram positive

THE CHARACTERISTICS OF BACTERIAL COLONIES IN AGAR PLATES:

1. SIZE - only isolated or well-seperated colonies should be measured.

a. PINPOINT-extremely small colony, measuring only a fraction of mm in

diameter or less than 1 mm

b. LARGE-colonies measuring 5 to 10 mm in diameter

2. MARGIN OR EGDE AND FORMS-the periphery of bacterial colonies may have

different patterns depending on the species.

a. Entire or circular edge

b. Irregular projections such as undulate, filamentous, lobate, erose, or curled

c. Forms such as punctiform, circular, filamentous, irregular, chizoid, & spindle

3. ELEVATION-bacterial colonies may be thin or thick, and their surfaces may be

flat or raised and may have varying degrees of convexity.

4. SURFACE TEXTURE -a bacterial colony's texture may be described as:

a. SMOOTH-shiny and glistening

b. ROUGH-dull, granular, matte

c. MUCOID-slimy, gummy

d. WRINKLED - crumpling, folding

5. CONSISTENCY - this growth feature can be determined by touching the

colony using an INOCULATING NEEDLE
 a. BUTYROUS - the colony has a butter-like consistency

b. MSCOUS OR STRONGLY-a portion of the colony may come off of the agar
surface

c. RUBBERY -the whole colony comes off of the agar plat

d. DRY, BRITTLE OR POWDERY - the colony breaks when touched by a needle

6. OPTICAL FEATURES-degree of opacity may be expressed as:

a. OPAQUE-impenetrable to light

b. TRANSPARENT-a clear image is seen and as if there is no intervening

material

c. TRANSLUCENT permits the passage of light

7. CHROMOGENESIS OR PIGMENTATION-there are bacterial cultures that

produce and retain water-insoluble pigments intracellularly, hence causing the
colonies to become color (pigmented), Some bacterial strains with pigmentation
as follows: a.

a. STAPHYLOCOCCUS AUREUS-gold

b. SERATTIA MARCESCENS-red

c. MICROCOCCUS LUTEUS-yellow

d. CHROMOBACTERIUM VIOLACEUM-violet

8. ODOR-if the smell emitted is disting, (ie., sweet putrefactive, or fruity)

TYPES OF AGAR:

1. MACCONKEY AGAR-inhibits growth of Gram-positive bacteria and thus are

selective for Gram- negative bacteria.

2. PHENYLETHYL ALCOHOL (PEA) AGAR AND COLISTIN-NALIDIXIC ACID

(CNA)agar-inhibits growth of Gram-negative bacteria and thus are selective
for Gram-positive bacteria.

3. THAYER-MARTIN AGAR & MARTIN LEWIS AGAR (chocolate agars containing

extra nutrients plus several antimicrobial agents) are selective for
N.GONORRHEA

4. MANNITOL SALT AGAR (MSA)-grows only salt-tolerant (haloduric) bacteria.

Type of Agar Bacterial studies

1. Blood agar Support growth of most bacteria

2 Luria Bertani (LB) Used for routine cultivation of fastidious

microorganisms and serve

agar as a general medium for microbiological

studies

3. Chocolate agar Support growth of Haemophilus species and

Neisseria

4. MacConkey agar Supports the growth of gram-negative bacteria

5. Nutrient agar To grow different type of bacteria (not all)

and some fungi

6. Neomycin agar To culture microorganisms anaerobically

HANDWASHING is an effective way to protect the microbial cultures, the staff, and the
community.

A laboratory session should start with washing the hands with soap or detergent to
remove transient microbes that might contaminate cultures. Also, the last thing to do
before leaving the area is to wash thoroughly and disinfect the hands to remove
pathogens.

PROPER HANDWASHING by clinical personnel is the most effective method of controlling

infections, especially nosocomial ones.

Simple handwashing using soap helps remove oil while scrubbing with brush for 7-8
minutes eliminates both transient and resident microbes.

Handwashing is under the umbrella of HAND HYGINE. HAND HYGIENE is defined by the
World Health Organization as a general term that applies to handwashing, antiseptic
handwash, antiseptic hand rub or surgical hand antisepsis.
ACCORDING TO THE WORLD HEALTH ORGANIZATION (WHO), THERE ARE FIVE
MOMENTS FOR HAND HYGIENE:

1. Before patient contact

2. Before and antiseptic task

3. After body fluid exposure risk

4. After patient contact

5. After contact with patient surroundings

GRAM STAIN REAGENTS

1. Crystal violet (CV) – primary basic stain

2. Grams iodine – not a stain; it forms a crystal violet -iodine complex (CV-i)
inside the cell wall.

3. Decolorizer – ethyl alcohol.usedd to remove the primary stain. It removes the CV

-I complex from cells without teichoic acid.

4. Safranin – secondary (counter) basis stain.

Session 7
MODES OF TRANSMISSION OF NOSOCOMIAL INFECTION

 Presence of microorganisms in hospital environment

 Immunocompromised patients

 Transmission of pathogens between staff and patients and among patients

Session 8
DIFFERENT MODES OF DISEASE TRANSMISSION

 Source (or reservoir) of the infectious agents

- An infectious agent – refers to the microorganisms responsible for causing

the infection such as bacteria. Viruses. Fungi or parasites. This agent can
can be transmitted from one person to another through various means.
 A susceptible host with a portal of entry receptive to the agent

- A susceptible host – refers to an individual who is vulnerable to being

infected by the infectious agents.

 Mode of transmission for the agent

- A mode of transmission – can be spread through different mode of

transmission including direct contact airborne transmission droplet spread
fecal-oral route vector-borne transmission or through contaminated food
or water.
MICROPARA LECTURE

Session 1

IMPORTANCE OF MICROBIOLOGY

Microbiology – is essentially an advance biology course; can be defined as the study

of microbes; from bios referring to living organisms and logy meaning “the study of”);
micro means very small

Microbes – are said to be ubiquitous means they are virtually everywhere; study of
certain non living entities.¬¬ – the two major categories of microbes are: Acellular
microbes (called infectious particles) Cellular microbes ((called microorganisms)

Disease-causing microorganisms are technically known as pathogens: the vast majority

of known are nonpathogens.

The microbes that help us (microbial allies): and those that harm us (microbial enemies)

Session 2

PIONEERS OF MICROBIOLOGY

1. Anton Van Leeuwenhoek (1632-1723)

 The first person to see live bacteria and protozoa: father of

microbiology: father of bacteriology: father of protozoology

 As a hobby he ground tiny glass lenses which he mounted in small

metal frames thus creating today are known as single-lens
microscope or simple microscopes.

 He wrote “my method for seeing the very smallest animacules I do

not impart to others; nor how to see very many animacules at one
time. This I keep for myself alone.”

2. Louis Pasteur

 A French chemist; his contribution are considered by many people to

be the foundation of the science off microbiology and a cornerstone
of modern people

 He discovered what occurs during alcoholic fermentation: he also

discovered forms of life that could exist in the absence of
oxygen.(aerobes – organisms that requires oxygen. Anaerobes –
organisms that do not require oxygen)

 Develop pasteurization a way to kill microbes that were causing

wine to spoil.

3. Robert Koch
  He discovered that B. anthracis produces spores capable of
resisting adverse conditions

 He developed methods of fixing staining and photographing

bacteria

 R.J Petri invented a flat glass dish now known as a petri dish.


Session 3

Cell - defined as the fundamental unit of living organisms.

Session 5

Taxonomy - according to Bergey’s Manual of systematic bacteriology. Taxonomy (the

science of classification of living organisms.)

Consist of 3 separate but interrelated areas: classification – arrangement of organisms;

nomenclature -assignment of names; identification – process of determining.

Session 6

Staining procedure

As they exist in nature, most bacteria are colorless, transparent, and difficult to see.
Therefore, various staining methods have been devised to enable scientists to examine
bacteria. In preparation for staining, the bacteria are smeared onto a glass
microscope slide (resulting in what is known as a smear"), air-dried, and then "fixed"

The two most common methods of fixation are heat fixation and methanol fixation.

(a) Heat fixation is usually accomplished by passing the smear through a Bunsen
burner flame. If not performed properly, excess heat can distort the morphology of the
cells. Methanol fixation, which is accomplished by flooding the smear with absolute
methanol for 30 seconds, is a more

(b) satisfactory fixation technique.

In general, fixation serves three purposes:

1. It kills the organisms,

2. It preserves their morphology (shape)

3. It anchors the smear to the slide.

Session 7

Protozoa

 Are eukaryotic organisms that together with algae are classified in the second
kingdom (Protista) of the fie-kingdom system of classification
  Most protozoa are single-celled free-living microorganisms

 Do not have call wall

 Parasitic protozoa - breaks down and absorb nutrients from the body

Fungi

 The study of fungi s called mycology: and a person who studies fungi is called
a mycologist

 Are found almost everywhere on earth

 Saprophytic fungi – living in organic matter in water and soil; parasitic fungi –
living on and within animals and plants

 Saprophytes - their main source of food is dead and decaying organic

matter.

Algae

 Are photosynthetic eukaryotic organisms that together with protozoa are

classified in the second kingdom of five kingdom of system of classification.

 Referred to as protists .

 Consist of cytoplasm.a cell wall.cell membrane.nucleus

plastids.ribosomes.mitochondria. and golgi bodies.

 Produce their energy by photosynthesis using energy from the sun

 Algae are classified as green golden (or golden brown) brown and red.

Session 8

Mutations

A change in the characteristics of a cell caused by a change in the DNA molecule

(genetic alteration) that is transmissible to the offspring is called a mutation. There are
three categories of mutations: beneficial mutations, harmful (and sometimes lethal)
mutations, and silent mutation

1. Beneficial mutations, as the name implies, are of benefit to the organism.

2. Harmful mutations result in the production of nonfunctional enzymes. Some

harmful mutations are lethal to the organism.

Lethal mutation happens when an enzyme that catalyzes a metabolic

reaction essential to the life of the cannot catalyze the reaction, the
cell will die.

3. Silent mutations (or neutral mutations), meaning that they have no effect on the
cell. For example, if the mutation causes an incorrect amino acid to be placed
 near the center of a large, highly convoluted enzyme, composed of hundreds
of amino acids, it is doubtful that the mutation would cause any change in the
structure or function of that enzyme. If the mutation causes no change in
function, it is considered silent. Most likely, spontaneous mutations (random
mutations that occur naturally) occur more or less constantly throughout a
bacterial genome. However, some genes are more prone to spontaneous
mutations than others.

Mutagens-physical or chemical agents that cause an increased mutation rate

Mutant-the organism containing the mutation

Session 9

Factors that affect microbial growth

1. Availability of nutrients

many nutrients are energy resources; organisms will obtain energy from
these chemicals by breaking chemical bonds. Nutrients also serve as
sources of carbon, oxygen, hydrogen ,nitrogen phosphorus, and sulfur
as well as other elements.

2. Moisture

Water is essential for life: cells are composed of between 70% and 95%
water.

3. Temperature

Thermophiles - organisms that “love” high temperature: can found at

hot springs

Mesophiles – grow best at moderate temperature: 37’C – 37.4’C

Psychrophiles – organisms that “love” cold temperature.

Psychroduric – microorganisms that prefer warmer temperature but can

tolerate or endure very cold temperature and can be preserved in the
frozen state.

4. pH

acidophiles – prefer a pH of 2 to 5.

Alkaliphiles – prefer an alkaline environment (pH 8.5): inside the intestine

(pH 9): Vibrio cholerae - the bacterium that causes cholera – is the
only human pathogen that grows well above pH 8.

5. Osmotic pressure - is the pressure that exerted on a cell membrane by

 solutions both inside and outside the cell.

Session 10

Antibiotic – is a substance produced by a microorganisms that is effective in killing or

inhibiting the growth of other microorganisms.

Session 11-12

Epidemiology - is the study of factors that determine the frequency distribution and
determinants of diseases in human populations and ways to prevent control or
eradicate diseases in populations.

Interaction among Pathogens, Hosts and Environments

1. Factors pertaining to the pathogen:

- The virulence of the pathogen; some pathogens are more virulent than
others (Virulence is a measure or degree of pathogenicity

- A way for the pathogen to enter the body (ie., Is there a portal of
entry?)

- The number of organisms that enter the body (Le., Will there be a
sufficient number to cause infection?)

2. Factors pertaining to the host (i.e., the person who may become infected):

- The person's health status (e.g., Is the person hospitalized? Does he or

she have any underlying illnesses? Has the person undergone invasive
medical or surgical procedures or catheterization? Does he or she have
any prosthetic devices?)

- The person's nutritional status

- Other factors pertaining to the susceptibility of the host (e.g., age,

lifestyle [behavior], socioeconomic level, occupation, travel, hygiene,
substance abuse, immune status [immunizations or previous experience
with the pathogen])

3. Factors pertaining to the environment:

- Physical factors such as geographic location, climate, heat, cold,

humidity and season of the year.

- Availability of appropriate reservoirs, intermediate hosts and vectors

Sanitary and housing conditions, adequate waste disposal adequate
healthcare

- Availability of potable (drinkable) water

Mode of transmission
 - Contact (direct or indirect)

- Droplet

- Airborne

- Vehicular

- Vector transmission

Session 13

Water Treatment

Water must be properly treated to make it safe for human consumption. It is interesting
to trace the many steps involved in such treatment.

1. The water first is filtered to remove large pieces of debris such as twigs and
leaves.

2. Next, the water remains in a holding tank, where additional debris settles to the
bottom of the tank; this phase of the process is known as sedimentation or settling

3. Alum (aluminum potassium sulfate) is then added to coagulate smaller pieces of

debris, which then settle to the bottom; this phase is known as coagulation or
flocculation.

4. The water is then filtered through sand or diatomaceous earth filters to remove
the remaining bacteria, protozoan cysts and oocysts, and other small particles. In
some water treatment facilities, charcoal filters or membrane filtration systems are
also used.

5. Finally, chlorine gas or sodium hypochlorite is added to a final concentration of

0.2 to 1.0 ppm, this kills most remaining bacteria. In some water treatment facilities,
ozone (03) treatment or ultraviolet (UV) light may be used in place of chlorination.

Session 14

Health care associated infections - or HAI are infections that are acquired within
hospitals or other healthcare facilities.

Infection control – are designed to break various links in the chain of infection.

Medical asepsis – is a clean technique. Its goal is to exclude pathogens.

Aseptic technique – are actions taken to prevent infection or break the chain
infection.

Session 16

Pathogenesis of Infectious Diseases

 1. Entry of the pathogen into the body. Portals of entry include penetration of
skin or mucous membranes by the pathogen, inoculation of the pathogen into
bodily tissues by an arthropod, inhalation (into the respiratory tract). ingestion
(into the gastrointestinal tract), introduction of the pathogen into the
genitourinary tract, or introduction of the pathogen directly into the blood
(e.g., through blood transfusion or the use of shared needles by intravenous
drug abusers).

2. Attachment of the pathogen to some tissue(s) within the body.

3. Multiplication of the pathogen. The pathogen may multiply in one location of

the body, resulting in a localized infection (e.g. abscess), or it may multiply
throughout the body (a systemic infection).

4. Invasion or spread of the pathogen.

5. Evasion of host defenses.

6. Damage to host tissue(s). The damage may be so extensive as to cause the

death of the patient.

Session 17

FIRST LINE OF DEFENSE

1. Skin and mucous membranes as Physical Barriers

2. Cellular and Chemical factors

a. Skin - the dryness acidity and temperature of the Skin inhibit

colonization and growth of pathogens

= oily sebum – produce by the sebaceous glands in the Skin contains

fatty acid that are toxic to other pathogens

= perspiration – flushed organisms from pores and the surface of the

Skin

= sloughing off the dead Skin - removes potential pathogens from the
Skin (ex. Lufa or dried patola)

b. Sticky mucous membranes – kill, inhibit, or trapped pathogens

c. Respiratory tract – the mucociliary covering on epithelial cells move

trapped dust and microbes upward toward the throat where they are
swallowed and expelled.

d. GIT – the pathogens entering the GIT are often killed by ‘digestive
enzymes or the ‘acidity or alkalinity of different anatomical regions.

e. URINARY TRACT - peristalses and urination serve to remove pathogens.

 = the acidity of the vaginal fluid inhibits colonization of the vagina by
pathogens.

3. Microbial Antagonism – indigenous microflora prevents the establishment of

arriving pathogens

=Superinfection – decrease in the number of indigenous microflora at a

particular anatomical site can lead to a overgrowth of pathogens or
opportunistic pathogens present at the site.

SECOND LINE OF DEFENSE

1. Transferrin – a glycoprotein synthesized In the liver; its normal function ins to

store and deliver iron to hot cells; deprived pathogens of iron.

2. Fever – substances that stimulate the production of fever are called

pyrogens or pyrogenic substances; can slow down the rate of growth of
certain pathogens and can even kill some especially the fastidious ones.

=pyrogens – may originate either outside or inside the body.

3. Interferons – are small, antiviral proteins produced by virus infected cells;

“interfere” with viral replication.

4. Inflammation – the body normally responds to any local injury, microbial

invasion, or bacterial toxin.

=The primary purposes of the inflammatory response are to:

a. Localized an infection

b. Prevent the spread of microbial invaders

c. Neutralize any toxins being produced at the site

d. Aid in the repair of damaged tissues

=The four cardinal or S/S of inflammation

1. Redness

2. Heat

3. Swelling (edema)

4. Pain

Session 18

Helper T cells – are also known, as T-helper cells, TH cells, and CD4 cells; primary
function of helper T cells is secretion of cytokines.
Cytotoxic T cells – are also known as T cytotoxic cells, TC cells, and CD8 cells; primary
function of cytotoxic T cells is too destroy virally infected host cells, foreign cells, and
tumor cells.

Session 19

Infectious Diseases of the Skin

a. Epidermis – superficial portion of the skin

b. Dermis – inner layer of skin

c. Dermatitis – inflammation of the skin

d. Sebaceous glands – known as sebum

e. Folliculitis -inflammation of a hair follicle

f. Sty (or syte) – inflammation of the sebaceous gland that opens into a follicle of
an eyelashes. (timus-timus)

g. Furuncle – a localized pyogenic (pus-producing); also known as boil (uyapos)

h. Carbuncle – deep-seated pyogenic infection of the skin

i. Macule – surface lesion that is neither raised or depressed; such as the lesions
of measles.

j. Papule – surfaced lesion that is firmed and raised, such as the lesions of
chickenpox.

k. Vesicle – a blister or small fluid-filled sac, seen in chickenpox and shingles.

l. Pustule – a plus-filled surface lesions.

Infectious Disease of the Ears

= 3 pathways for pathogens to enter the ear

a) Through the eustachian (auditory) tube from the throat and nasopharynx

b) From the external ear

c) Via the blood or lymph

= Otitis Media – infection in the middle ear: Otitis externa – infection of the outer ear
canal .

Infectious Disease of the Eyes

a) Conjunctiva – the thin, tough lining that covers the inner wall of the eyelid and
the sclera ( the white of the eye)

b) Conjunctivitis – infection or inflammation of the conjunctiva

 c) Keratitis – infection or inflammation of the cornea-the domed covering the iris
and lens.

d) Keratoconjunctivitis – infection that involves both the cornea and conjunctiva.

(red eye)

Infectious Disease of the Respiratory System

Bronchitis – inflammation of the mucous membrane lining of the bronchial tubes

Bronchopneumonia – combination of bronchitis and pneumonia.
Epiglottitis – inflammation of the epiglottitis.
Laryngitis - inflammation of the mucous membrane of the larynx (voice box)
Pharyngitis – inflammation of the mucous membrane and underlying tissue of the
pharynx; commonly referred to as sore throat.
Pneumonia – inflammation of one or both lungs.

Infectious Disease of the Central Nervous System

Encephalitis – inflammation of the brain.
Encephalomyelitis – inflammation of the brain and spinal cord.
Meningitis - Inflammation of the membranes (meninges) that surround the brain and
spinal cord. Meningoencephalitis - Inflammation of the brain and meninges.
Myelitis - Inflammation of the spinal cord.

Session 20
Hepatitis

Type A hepatitis (also known as HAV infection, infectious hepatitis, and epidemic
hepatitis) — HAV, a nonenveloped, linear ssRNA virus in the genus Hepatovirus, family
Picornaviridae

Type B hepatitis (also known as HBV infection and serum hepatitis) — HBV, an
enveloped, circular dsDNA virus in the genus Orthohepadnavirus, family
Hepadnaviridae, the only DNA virus that causes hepatitis

Type C hepatitis (also known as HCV infection and non-A, non-B hepatitis) — HCV, an
enveloped, linear ssRNA virus in the genus Hepacivirus, family Flavivirida

Type D hepatitis (also known as delta hepatitis) — HDV or delta virus, an enveloped,
circular ssRNA viral satellite (a defective RNA virus) in the genus Deltavirus

Type E hepatitis — HEV, a spherical nonenveloped, ssRNA virus in the genus Calcivirus,
family Calciviridae
Type G hepatitis — HGV, a linear ssRNA virus in the genus Hepacivirus, family
Flaviviridae.

Session 21

Bacterial Infections of the Skin

Acne

- Acne is a common condition in which pores become clogged with dried sebum,
flaked skin, and bacteria, which leads to the formation of blackheads and
whiteheads (collectively known as acne pimples) and inflamed, infected
abscesses.

- Acne is most common among teenagers.

Pathogens: The etiologic agents of acne are Propionibacterium acnes and other
Propionibacterium spp., all of which are anaerobic, Gram-positive bacilli
Reservoirs and Mode of Transmission: Infected humans serve as reservoirs, although
acne is probably not transmissible.

Leprosy
- Leprosy is today more commonly known as Hansen disease.
- There are two forms of leprosy: (a) lepromatous leprosy, characterized by
numerous nodules in skin and possible involvement of the nasal mucosa and
eyes and (b) tuberculoid leprosy, in which relatively few skin lesions occur.
Peripheral nerve involvement tends to be severe, with loss of sensation.
Pathogen: The etiologic agent of leprosy is Mycobacterium leprae, an acid-fast
bacillus,
Reservoirs and Mode of Transmission: Infected humans serve as reservoirs, M. leprae is
present in nasal discharges and is shed from cutaneous lesions. The exact mode of
transmission has not been clearly established. The organisms may gain entrance
through the respiratory system or broken skin. Leprosy does not appear to be easily
transmitted from person to person.

Viral and Bacterial Ear infections

Otitis Externa (External Otitis, Ear Canal Infection, Swimmer's Ear)

- Otitis externa is an infection of the outer ear canal with itching, pain, a
malodorous discharge, tenderness, redness, swelling, and impaired hearing.
- Otitis externa is most common during the summer swimming season; trapped
water in the external ear canal can lead to wet, softened skin, which is more
easily infected by bacteria or fungi.
- Otitis externa is referred to as "swimmer's ear" because it often results from
swimming in water contaminated with Pseudomonas aeruginosa.
Pathogens: The usual causes of otitis externa are the bacteria Escherichia coli, P.
aeruginosa, Proteus vulgaris, and Staphylococcus aureus. Fungi, such as Aspergillus
spp. are less common causes of otitis externa
Reservoirs and Mode of Transmission: Reservoirs include contaminated swimming pool
water, sometimes indigenous microflora, or articles inserted into the ear canal for
cleaning out debris and wax

Otitis Media (Middle Ear Infection)

- Otitis media often develops as a complication of the common cold
- Manifestations can include persistent and severe earache, temporary hearing
loss, pressure in the middle ear, and bulging of the eardrum (tympanic
membrane).
- Otitis media may lead to rupture of the eardrum, bloody discharge, and pus.
Severe complications, including bone infection, permanent hearing loss, and
meningitis, may occur
Pathogens: Otitis media may be caused by bacteria or viruses. The three most common
bacterial causes are Streptococcus pneumoniae (a Gram-positive diplococcus).
Hemophilus influenzae (a Gram-negative bacillus), and Moraxella catarrhalis (a Gram-
negative diplococcus). Viral causes include measles virus, parainfluenza virus, and RSV.
Reservoirs and Mode of Transmission: Otitis medias is probably not communicable.

Whooping Cough (Pertussis)

- Whooping cough is a highly contagious, acute bacterial childhood (usually)
infection.
- The first stage (the prodromal or catarrhal stage) of the disease involves mild,
cold like symptoms
- The second stage (the paroxysmal stage) produces severe, uncontrollable
coughing fits.
- The coughing often ends in a prolonged, high-pitched, deeply indrawn breath
(the "whoop," from which whooping cough gets its name). The coughing fits
produce a clear, tenacious mucus and vomiting. They may be so severe as to
cause lung rupture, bleeding in the eyes and brain, broken ribs, rectal prolapse,
or hernia.
- The third stage (the recovery or convalescent stage) usually begins within 4
weeks of onset.
Pathogen: Pertussis is caused by Bordetella pertussis, a small, encapsulated, nonmotile,
Gram-negative coccobacillus that produces endotoxin and exotoxins.
Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. Transmission
occurs via droplets produced by coughing. Patient Care: Use Droplet Precautions for
hospitalized patients until 5 days after initiation of effective therapy

Session 22
Rocky Mountain Spotted Fever (Tickborne Typhus Fever)
 - Rocky Mountain spotted fever (RMSF) is a tickborne rickettsia disease
characterized by sudden onset of moderate- to-high fever, extreme exhaustion
(prostration) muscle pain, severe headache, chills, conjunctival infection, and
maculopapular rash on extremities on about the third day, which spreads to
the palms, soles, and much of the body

- In about 4 days, small purplish areas (petechiae) develop as a result of

bleeding in the skin.

Pathogen: The etiologic agent of RMSF is Rickettsia rickettsia, a Gram-negative

bacterium. Like all rickettsia, R. rickettsi is an obligate intracellular pathogen; it
invades endothelial cells (cells that line blood vessels).

Reservoirs and Mode of Transmission: Reservoirs include infected ticks on dogs, rodents,
and other animals. Transmission occurs via the bite of an infected tick. Person-to-
person transmission rarely occurs-through blood transfusion. Patient Care: Use
Standard Precautions for hospitalized patients

Epidemic Typhus Fever

- Epidemic typhus or louseborne pidemic Typhus Fever. Epidemic typhus or

lousebome is typhus is an acute rickettsial disease, often with sudden onset of
headache, chills, prostration, fever, and general pains.

- A rash appears on the fifth or sixth day, initially on the upper trunk, followed
by spread to the entire body, but usually not to the face, palms, or soles.

- Epidemic typhus fever may be fatal if untreated.

Pathogen: The etiologic agent of epidemic typhus is Rickettsia prowazeki, a Gram-

negative bacterium and obligate intracellular pathogen.

Reservoirs and Mode of Transmission: Reservoirs include infected humans and body lice.
Transmission occurs from human to louse to human. Patient Care: Use Standard
Precautions for hospitalized patients.

Tetanus (Lockjaw)

- Tetanus is an acute neuromuscular disease induced by a bacterial exotoxin

called tetanospasmin, with painful muscular contractions, primarily of the
masseter (the muscle that closes the jaw) and neck muscles, spasms, and rigid
paralysis.

- Respiratory failure and death may result

Pathogen: Tetanus is caused by Clostridium tetani, a motile, Gram-positive, anaerobic,

spore-forming bacillus that produces a potent neurotoxin-called tetanospasmin.

Reservoirs and Mode of Transmission: Reservoirs include soil contaminated with human,
horse, or other animal feces. Person-to-person transmission does not occur Patient
Care: Use Standard Precautions for hospitalized patients.
Lyme Disease

- Lyme disease or Lyme borreliosis is a tick-borne disease characterized by three

stages:

- an early, distinctive, target like, red skin lesion, usually at the site of the tick
bite, expanding to a diameter of 15 cm, often with a central clearing early
systemic manifestations that may include fatigue, chills, fever, headache, stiff
neck, muscle pain, joint aches, with or without lymphadenopathy, and

neurologic abnormalities (e.g., aseptic meningitis, facial paralysis, myelitis, and

encephalitis) and cardiac abnormalities several weeks or months after the
initial symptoms appear

Pathogen: The etiologic agent of Lyme disease is Borrelia burgdorferi, a loosely

coiled Gram-negative, spirochete

Reservoirs and Mode of Transmission: Ticks, rodents (especially deer mice), and
mammals (especially deer) serve as reservoirs. Transmission occurs via tick bite. Person-
to-person transmission does not occur Patient Care: Use Standard Precautions
hospitalized patients.