INTRODUCTION TO
sex pili – longer but few,
BACTERIOLOGY
BACTERIOLOGY
BACTERIA
• Are prokaryotic cells which
contains both DNA and RNA that
measures 1-5 um in dm (average)
• Microscopic, single-celled
organisms that exist in their
millions, in every environment,
both inside and outside other
organisms
• A large group of single-cell
microorganisms that causes
infections and disease in animals
and humans
CLASSIFICATION OF BACTERIA
A. According to Shape
CLASSIFICATION OF BACTERIA
B. ACCORDING TO MORPHOLOGY
STRUCTURE OF BACTERIA
TYPES OF PILI/ FIMBRIAE
• a. common / ordinary pili –
shorter but greater in number
• b.
responsible for bacterial asexual
conjugation or transfer of genetic
material
CLASSIFICATION OF FLAGELLA
- based on number and locomotion
Atrichous – no flagella
Monotrichous – single polar flagellum on
1 end
Amphitrichous – single polar on both ends
Lopotrichous – tuft or group of flagella on
one end or both ends
Peritrichous – surrounds the whole
microorganism
Physiological Characteristics of Bacteria
Based on physiologic requirement
 Nutrition = autotrophic/
lithotrophic; organotrophic
 Oxygen
o aerobes (obligate/
facultative);
o anaerobes (obligate/
facultative);
o Microaerophiles
 Carbon Dioxide
 capnophiles
 Temperature
a.Psychrophilic / Cryophilic
cold-loving bacteria = between 10-
20C temp
b. Mesophilic o Water is drawn inside the
requires moderate temp, 20-40C cell, when microbial
pathogens fall on mesophilic suspension is exposed to
solution of lower
c. Thermophilic
concentration
heat-loving bacteria, higher temp
50- 60C Bacterial Growth
d. Thermoduric
able to survive temporary at high
temp

 pH
- slightly alkaline or neutral: 7.2
– 7.6pH
a. Basophilic - alkaline
Types of Bacterial Replication
environment - Asexual Reproduction
- ex. V. Choloriae Binary fusion
A. Fecalis
b. Acidophilic - acidic
environment
- ex. L. Acidophilus /
Doderlein’s

 Salt
 Moisture
 Osmotic pressure

BACTERIAL OSMOTIC PRESSURE

(Cell Membrane) Conidia
 PLASMOLYSIS
PHENOMENON

o Bacteria subject to
HYPERTONIC SOLUTION
(shrinkage of cell)

o Water is drawn out of the

microbial cell, when
microbial suspension is
exposed to solution of BUDDING
higher concentration

 PLASMOPTYSIS
PHENOMENON

o Bacteria subjected to
HYPOTONIC SOLUTION Reproduction through cyst formation
(bacteria swells)
 3. Cell Volume determination after
centrifugation
4. Turbidimetric methods

II. BACTERIAL NUMBER

Usage of:
1. Coulter Counter
2. Staining Slides
3. Pipet Dilution Methods
Reproduction through Endospore 4. Counting Chamber (Petroff-
Formation Hausser CC)
5. Calibrated Wire loop Method (for
urine colony counting)
COLLECTION & HANDLING
SPECIMEN FOR MICROBIOLOGIC
EXAMINATION
• Precaution Guidelines:
• 1. Collect specimen before any
antimicrobial agent has been
administered
Types of Bacterial Replication • 2. Collect specimen at the right
stage of the disease
o Sexual Reproduction (Gene • Ex. Enteric infection
(intestinal) = during acute
Transfer)
diarrheal stages
• 3. Collect specimen at the right site
o Vertical
of infection
o Horizontal
• 4. Collect specimen with little
contamination as possible
• - aseptic technic

MAJOR APPROACHES TO BYPASS

Replication Process
NORMAL FLORA CONTAMINATION
o Fork Formation
o Primer Binding o Clean area with disinfectant
o Elongation o Specimens:
o Termination  Urines –
suprapubic
aspiration technic
 Sputum – perform
transtracheal
procedure
o Sufficient quantity of
Ways to Determine Quantity of Bacteria specimen
i. BACTERIAL MASS  Ex. Blood = 20 to
30ml adult
1. Nitrogen determination  1 to 5ml
2. Dry weight determination child/
 underdevel • COLD TEMP APPLICATION
oped
immune • ULTRASONIC VIBRATIONS
system • UVR – Ultraviolet Radiation
o Prompt delivery to the (bactericidal)
lab
o MECHANICAL METHODS
 rapid
transport o FILTRATION
o ULTRCENTRIFUGATIO
Suprapubic Aspiration N
Sterilization and Disinfection o LYOPHILIZATION
PHYSICAL STERILIZATION CHEMICAL METHODS
HEAT APPLICATION A. Selective – antibiotics
a. Moist Heat
- Autoclave B. Non-Selective – disinfectants
- Tyndallization C. Ex. Alcohol
- Inspissation D. Muriatic acids: 2 salts of heavy
- Pasteurization metals (1% AgNO
b. Dry Heat a. → Gonococcal Opthalmia
- flaming Neonatorum
- use of oven b. → Crede’s Prophylaxis (1%
- incineration AgNOreatment)
- cremation
Suprapubic Aspiration E. Oxidizing Agents
F. ex. KMnO H →disinfectant
→ uses control organisms (S. typhi,
Staph Aureus)
BACTERIOLOGIC SPECIMENS
Specimen Handling
o Urine specimen
- refrigeration temp = 24hrs
Sterilization and Disinfection = allowable time
• Sterilization
• Total elimination of o Stool & Sputum
infection - refrigeration time allowable
• Disinfection = 2-3hrs (beyond, discard)
• Partial elimination of
infection
o CSF – no refrigeration
PHYSICAL STERILIZATION
HEAT APPLICATION - incubate at incubators for
a. Moist Heat 12hrs or at room temp at
- Autoclave 1hr
- Tyndallization
- Inspissation o Viral culture (blood)
- Pasteurization - freeze at -70C
b. Dry Heat - whole blood – DO NOT
- flaming FREEZE instead separate
- use of oven serum from
- incineration  Packed RBC then ref
- cremation serum
 • Collection:
TERMINOLOGIES WITH BLOOD • GS - (+) of bacteria in
SPECIMEN specimen but not routine
* BACTEREMIA • = use of calibrated
wire loop
•
= presence of bacteria Stool Specimen: Gram Staining:
temporarily
* SEPTICEMIA • Gm (+) clusters – staph. food
• = (+) of bacteria in blood poisoning (vomiting, diarrhea
causing harm/ injury to
the host. • Gm (+) bacilli – C. Difficile
• Gm (-) bacilli – Vibrio/
General Considerations in Blood Campylobacter
Collection • Normal flora of stool = gm (-)
• Ideal time: shortly before expected bacilli
rise of temp • Vibrio = “comma-shaped”
• A single negative blood culture Stool Examination
does not rule out bacteremia
• Should be presented at 2 different
sites
• Blood should be prevented from
clotting

Properties of Sodium Polyanethol

Sulfonate (SPS), liquid
• Antiphagocytic
• Anticomplementary
• Neutralizes bactericidal
effect of serum Sputum Specimen
• Partially inactivating Ideal sputum sx should contain less than
certain aminoglycoside 10 epith cells (↑= discard) & more than 25
antibiotic pus cells
Indications of (+) Blood Culture Collection:
• 1. Turbidity 1. Direct smearing – GS –
• 2. Hemolysis gen. bacteria flora; AFB –
• 3. Colony/ pellicle formation MTB
• 4. Production of gas bubbles 2. Culture in appropriate
• * Discarding time: media
• Blood: 7 days 3. Concentration technic with
• Except: aid of digesting substances
• a.
Brucellosis CEREBRO-SPINAL (CSF) SPECIMEN
• b. Fungemia - Obtained by lumbar tapping
• c. 1. Collection
Endocarditis 2. Direct smearing – GS
• = 2-4 weeks 3. BAP – gm (+) cocci
Urine Specimen 4. CAP – gm (-) cocci
• Ideal: mid-stream voided in 5. EMB – gm (-) bacilli
morning (clean catch) • Discarding time: 72 hrs or 3 days
Cultivation, Isolation and Identification d. K/A + gas + H 䔖
of Bacteria • IMViC Test
INDOLE
BIOCHEMICAL PROPERTIES OF
BACTERIA • *Principle:
- Demonstrate enzyme system within • Organism producing
microbial cell enzyme TRYPTONASE
- Consider metabolic end processes in (able to degrade AA,
which organic compound serves as tryptophan, pyruvic acid,
electron donors and electron ammonia and indole-
acceptors combination with aldehyde
Biochemical Properties of Bacteria reagent to produce colored
• Carbohydrate Fermentation Test products).
• IMViC Test • *Tests:
• Catalase Test • Kovac’s (red color)
• Urease Test • Erlich’s + ether/ xylene (to
• Oxidase Test extract the substance
• Phenylalanine Deaminase Test indole)
• Lysine Decarboxylase test • Spot Indole
• Coagulase Test • -rapid method for
Carbohydrate Fermentation Test detection of
Principle: Based on anaerobic substance indole
decomposition/ degradation of • - reagent 1% P-DAc
substances (Paradimethylamino
cinnamaldehyde)
TSI = butt and slant medium • - commercially
Indicators: available in filtrated
a) a. pH - phenol red paper strips (+) blue
-acid & alkaline reaction color
i. Acid- yellow (A) • METHYL RED
ii. Alkaline – red (K) • * Principle:
b.)Ferrous Ammonium Sulfate • Organism fermenting
-H production glucose produce large
- blackening of the medium amounts of acids in the
from butt to slanted area process. Results is
c.)Gas production based on final pH reached
- (+) bubble formation, by the culture.
cracks, open spaces • * Interpretation of Result:
or gaps • (+) if pH 4.4 & lower
TSI = butt and slant medium • (-) if pH 4.5 & higher
Reactions: • Acid = red
a) a. K/A = alkaline/ acid = • * used for demonstration of mixed
red/yellow acid fermentation pathway
= 1 sugar fermented
(glucose only) • VOGUES-PROSKAUER
b) b. A/A = acid/acid = y/y = 2-3 • *Principle:
sugars fermented • Organisms fermenting glucose
= always with glucose produce not only acid but
c) c. K/K = alkaline/alkaline = R/R compound known as
= no sugars fermented “ACETYLMETHYLCARBINOL /
 ACETOIN”, which in presence of • * Medium: CUA (Christensens
KOH will be oxidized into Urea Agar)
DIMETHYLCARBINOL and later • * Indicator: phenol red , (+) dark
will react with guanidine products pink color
to produce color. Oxidase Test (Spot Oxidase Test)
• Reagents: * Presumptive test for Neisseria
• 5% alpha napthol in ethyl alcohol * Reagents:
• 0.3% creatine in 40% KOH 1. PADAM =
• 48 hr culture → (+) bright cherry ParaAminoDimethylAmyline
red Monohydrochloride
• CITRATE 2. TMPDD =
• * Principle: TetraMethylParaphenyline Diamyl
• Some organisms utilize Dihydrochloride
citrate as their sole source -in filter paper, production of blue to
of carbon-producing acetate dark purple color (+)
and other alkaline carbonate Phenylalanine Deaminase Test
end products * Principle:
• * Indicator: • Based on the presence of
• Bromthymol Blue (+) PAD which deaminates
production of PRUSSIAN phenylalanine into phenyl
BLUE indicates alkaline pyruvic acid
condition *Reaction:
• (+) production of dark-
green color after addition of
ferric chloride reagent
Lysine Decarboxylase Test
* Medium:
LIA = Lysine Iron Agar
* Principle:
Based on the presence of LD
Catalase Test which attacks amino acid lysine
- to differentiate two types of organism: to form cadaverine
staphylococcus (+) & streptococcus (-) * Indicator:
Principle: Bromcresol purple
Based on the presence of enzyme (+) purple/ violet color, Indicates
CATALASE, which catalyzes the alkaline condition
liberation of O H from H Coagulase Test
Result: O+) bubble formation= • - considered the best single
effervescence criterion to identify the
In testing for organism that grow on BAP, pathogenicity of Staphylococcus
avoid carry over of RBCs (normally Aureus
contain PEROXIDASES & CATALASES, * Principle:
leads to (+) reaction) • Based on the presence of
Urease Test Coagulase which results the
• * Principle: plasma to
• Based on presence of • agglutinate/clot
enzyme UREASE, which • Result: (+)
hydrolyses urea into agglutination/clot formation
ammonia, CO₂ + H₂O Coagulase Test
A. SLIDE test
* demonstrates bound, clumping
factor STAINING
* rubbing plasma with EDTA, • GRAM STAINING – a test used
* Reaction: to check for the presence of
(+) agglutination/ clumping bacteria at the site of the source of
If (-) proceed to tube coagulase test infection
B. TUBE test • ACID-FAST STAINING – a
- Demonstrates free coagulase or laboratory test that detects for the
unbound coagulase presence of bacteria that cause
- Confirmatory test tuberculosis (acid-fast bacilli)
* PROCEDURE: GRAM STAINING
0.5ml plasma + organism, incubate • GENERAL RULE:
35C for 4 hrs = positive clot / • 1. All cocci are gm (+) except
coagulum formation Neisseria, Branhamella, Veilonella
If (-) on tube: (gm -)
Final confirmation = reincubate • 2. All bacilli are gm (-) except:
tube for additional 8hrs at room • Mycobacteria
temperature, then report CONS (coagulase Arcanobacterium
negative staph) Actonomycedes
• Corynebacteria
4 hrs = staphylokinase → causes lysis of Brevibacillus
clot Nocardia
= to prevent false (-) reaction • Bacillus
STAINING Paenibacillus
-the process of artificially coloring Listeria
of microorganisms with dyes or reagents Monocytogenes
- purposes/ objectives: • Lactobacillus
1. to observe and appreciate Gordoniae
appearance of microbes E. Rhusiopathia
• Clostridia
2. to differentiate one microorganism from • 3. In spiral forms, do not normally
the other do routine gram staining but once
3. helps in the identification of some gram stain,
special structures • Spirochetes tend to be gram
STAINING (-)
2 GENERAL KINDS OF STAIN GRAM STAINING
Gram Stain: VIAS
1. SIMPLE - one dye addition of the color V = Crystal violet,
of the reagent itself primary stain, gm (+) purple
2. DIFFERENTIAL - addition of more I = Iodine, mordant
than 1 dye added in several steps. A = Acetone, decolorizer
STAINING S = Safranin,
PRIMARY SOLUTION includes 4 secondary stain/counter stain,
stains: gm (-) red
1. primary stain ACID FAST STAINING
2. mordant -enhances affinity of stain General Rule:
with the material All bacteria are non-acid fast except for
3. decolorizer MYCOBACTERIA – ACID FAST
4. counter stain/ secondary stain/ NOCARDIA - SLIGHTLY ACID
contrast stain FAST
 (CORYNEBACTERIA - non-acid 1. AXENIC / PURE -one type of
fast) specie
ACID FAST STAINING 2. MIXED - different species
WAYS TO FACILITATE ACID FAST 3. STOCK - use for research
STAINING pure culture for research purposes
1.Steaming process CLASSIFICATIONS OF CULTURE
2. By increasing concentration of basic I. CONSISTENCY / PHYSICAL
Carbol fuchsin + phenol STATE
3. By prolonging the contact of stain with 1. Liquid media - broth
the material 2. Semi-solid media
4. Addition of wetting reagents such as - 0.5 to 1% agar
Tergetol 3. Solid - 2 – 3% agar
ACID FAST STAINING II. According to COMPOSITION
1. Synthetic method
- composition is known
- ex. All
commercially prepared media
2. non-synthetic
- composition is unknown
- ex. Meat Extract Broth
(approximate)
III. According to USE
ACID FAST STAINING 1. Simple / Supportive - for non-fastidious
organism to grow up to
their natural range/ rates
Fastidious = requires complex
media, for routine
cultivation and culture
Ex. Nutrient Agar
BHIA (Brain Heart Infusion Agar)

ACID FAST STAINING 2. Enrichment - consistency usually liquid

• STAINING METHODS - ex. Selenite F – for isolation of
• 3. Pappenheim’s methods shigella and salmonella
• - differentiates M. Lacticola Tetrathionate broth- enhancing
(M. Smegmatis) from M. isolation of Shigella and Salmonella
tuberculosis Hajna gm(-) Broth
• 4. Baumgartens CLASSIFICATIONS OF CULTURE
• - differentiates M. Leprae III. According to use
from M. Tuberculosis 3. Enriched - consistency is solid
CHEMICAL METHODS 4. Differential - primary basis: differential
• CULTURE MEDIUM in cultural
- anything that possesses characteristics
nutritional or environmental requirement - ex. BAP – differential of
necessary for growth. hemolysis
• Culture MacConkey Agar – inhibit
- growth of microorganism obtain the growth of gm (+)
in culture medium. bacteria, lactose or Non-lactose
CULTURE MEDIUM fermenters
TYPES OF CULTURE
 Eosin Methylene Blue – Edge to disc = 10-15 mm
isolates gm (-) bacteria. 8. Incubate 35C for 24hrs
ANTIMICROBIAL SENSITIVITY 9. Interpret S, I, R (zone growth inhibition)
TESTING 2 PROCESSES FOR ZONE OF
- Highly standardized procedure that GROWTH INHIBITION
determines the sensitivity of certain 1. growth of inoculums
microorganism to a drug whose 2. diffusion of drug
concentrations is within achievable serum FACTORS AFFECTING ZGI
levels. • 1. pH of the media = 7.2 – 7.4
ANTIBIOTICS – chemicals produced by • 2. Thickness of the agar = 4-6mm
one organism by inhibiting the growth of • 3. Suitability of the medium used
other organisms. • Other media: BAP –
(Ex. Penicillin – from one fungus by Haemophilus
Alexander Fleming) • 4. Discrepancy in the technics of
PROPERTIES OF ANTIBIOTICS incubation
1. Most activity against pathogens • = ↓ in incubation time = ↓
2. Least toxicity to the host effect
3. With appropriate pharmacologic
effects
4. Most economical
METHODS FOR SENSITIVITY
TESTING
I. DILUTION METHOD
1. Test Tube
2. Agar
3. Microbroth
II.DISK-AGAR DIFFUSION METHOD
1. Kirby-Bauer VIROLOGY
2. ICS – International FORMS OF SKIN LESION
Collaborative Studies Method
METHODS FOR SENSITIVITY
TESTING
KIRBY-BAUER TECHNIC
Steps:
1. Pick 2-4 pure isolated colonies
2. Transfer / subculture to TSB
3. Incubate 35C for 2-5 hrs until becomes
turbid = (+) growth Morphology of the Virus
4. Compare turbidity to 0.5 McFarland Std • Properties:
McFarland std = 0.5 BaSO 䔬 0.5 ml of • Extracellular infectious
1.175% w/v (0.48M of BaCl 䔖 particle – Virion
• They cannot be seen under
䔖) + 99.5 ml of 1% or 0.36N of H 䔖 O 䔬
light microscope
5. Inoculate TSB content to MHA using
(ultramicroscopic)
overlap streaking with cotton swab
• Virus particle seen as
6. Stand at room temp for 10-15 mins (std)
ultramicroscopic are known
to allow uniform distribution of
as “elementary bodies”
inoculums
• Smaller than bacteria
7. Incorporate antibiotic disc
• Size range: 20-
Proper spacing of each disc = 18 to
300nm
24mm
 • Pass through
collodion membrane
• Seen in EM
• Sedimentation in the
ultracentrifuge
• Comparative
measurements

VIRAL STRUCTURE

Classification of Virus based on

Symptomatology
Generalized Diseases
Viral diseases wherein there is spread
throughout the body via the bloodstream
with multiple organ involvement and skin
rashes may occur.

Classification of Virus based on

genomes

General Rules for Virus Classification

1. DNA VIRAL GENOMES
- All DNA viruses are dsDNA except
Parvoviridae
- All are linear except Papilloma,
Peplos Polyoma and Hepadnaviruses
(circular)
2. RNA VIRAL GENOMES
 - All RNA viruses are ssRNA except  Are double stranded (except
Reoviridae and Rotaviruses Parvovirus)
- Positive-stranded RNA viruses:  Are linear (except Papilloma &
Retrovirus, Togavirus, Flavivirus, Polyoma and Hepadna = PPH)
Coronavirus, Calicivirus,  Are icosahedral and replicate in the
Picornavirus nucleus except Poxvirus
3. Virus Ploidy Viral Replication: Lytic Cycle
 All viruses are haploid except
Retroviruses which have 2
identical ssRNA molecules
4. All DNA viruses replicate in the nucleus
except Poxvirus
5. All RNA viruses replicate in the
cytoplasm except Influenza and
Retroviruses
6. Naked viruses: Calicivirus,
Picornavirus, Reovirus, Parvovirus,
Adenovirus, Papilloma, Polyoma
7. Negative stranded viruses transcribe
negative strand to positive, and must
therefore bring its own RNA-dependent
RNA polymerase (arenavirus, bunyavirus,
paramyxovirus, orthomyxovirus, filovirus,
rhabdovirus)
8. Segmented viruses: all are RNA viruses,
which include Bunyaviruses,
Orthomyxoviruses, Adenoviruses,
Viral Cultivation
Reoviruses (BOAR)
Purpose of Viral Cultivation
9. DNA ENVELOPED VIRUSES:
1. To isolate and identify viruses in
Herpesviruses (HSV type 1 & 2,
clinical samples.
VZV, CMV, EBV), HBV, Smallpox
2. To do research on viral structure,
virus = HHS
replication, genetics, and effects on host
10. DNA NUCLEOCAPSID VIRUSES:
cell.
Papilloma virus, Adenovirus, Parvovirus =
3. To prepare viruses for vaccine
PAP
production
11. RNA ENVELOPED VIRUSES:
Specimen Collection, Transport &
Influenza, Parainfluenza, RSV,
Storage
Measles, Mumps, Rubella, Rabies,
• Throat swabs or washings
HTLV, HIV
• Rectal swabs
12. RNA NUCLEOCAPSID VIRUSES:
• Skin scrapings or lesion swabs
Enteroviruses (Poliovirus,
• Urine
Coxsackievirus, Echovirus, HAV),
• Body fluid or vesicle
Rhinovirus, Reovirus (rotavirus)
• Tissue biopsies
1. Specimens should be collected early in
REMEMBER:
the acute phase of infection that is within
• ALL DNA VIRUSES:
the first 72 hours of an illness
 Are HHAPPPPy viruses (Hepadna,
Herpes, Adeno, Pox, Parvo, 2. Inoculation of specimens into tissue
Papilloma, Polyoma) culture within 2-4 hours is best for virus
isolation.
3. Virus Transport Media • 3. Virus susceptibility to host
defenses. Natural selection favors
4. In transporting, specimens should be the dominance of low-virulence
kept at 4⁰C or on crushed iced until virus strains.
inoculated, however, if there is a delay of
more than 4 days, freezing the specimens
at -70⁰C is required.

RUBEOLA VS RUBELLA

Viral Pathogenesis

Factors that affect pathogenic Human Immunodeficiency Virus

mechanisms are:
• 1. Accessibility of virus to tissue,
• 2. Cell susceptibility to virus
multiplication, and
AIDS vs HIV

Stages of HIV

HIV: Mode of Transmission

HIV: Signs & Symptoms

HIV Pathogenesis
 Hepatitis Viruses
Stages & Symptoms of HIV
• Hepatitis refers to an inflammation
of the liver and commonly the
result of a viral infection, Other
possible causes of hepatitis include
autoimmune hepatitis and hepatitis
that occurs as a secondary result of
medications, drugs, toxins, and
alcohol. Autoimmune hepatitis is a
disease that occurs when your body
makes antibodies against your liver
tissue.
• The five main viral classifications
of hepatitis are Hepatitis A, B, C,
D, and E. A different virus is
responsible for each type of viral
Laboratory Diagnosis hepatitis.
• Screening Test Hepatitis A
• ELISA • Hepatitis A is an inflammation of
• Rapid Test the liver that can cause mild to
• Simple Test severe illness.
• Confirmatory Test • The hepatitis A virus (HAV) is
• Western Blot transmitted through ingestion of
• Culture contaminated food and water or
• Polymerase Chain Reaction (PCR) through direct contact with an
method infectious person.
• For early detection of viral nucleic • The risk of hepatitis A infection is
acid in infected peripheral blood associated with a lack of safe water
lymphocytes particularly in and poor sanitation and hygiene
neonates (such as contaminated and dirty
HIV Treatment & Prevention hands).
• A safe and effective vaccine is
available to prevent hepatitis A.
Causes & Symptoms of Hepatitis A
 Hepatitis B
• Hepatitis B is a vaccine-
preventable liver infection caused
by the hepatitis B virus (HBV).
Hepatitis B is spread when blood,
semen, or other body fluids from a
person infected with the virus
enters the body of someone who is
not infected.
Causes & Symptoms of Hepatitis B

Diagnosis & Treatment of Hepatitis A

Diagnosis & Treatment of Hepatitis B

 Diagnosis & Treatment of Hepatitis C

Hepatitis C
• It is among the most common
bloodborne viral infections in the
United States and typically
presents as a long-term condition.
Related to the togaviruses and
flaviviruses which causes the
parenterally transmitted Non-A,
Non-B hepatitis. Hepatitis D
Causes & Symptoms of Hepatitis C • Unclassified virus which possesses
an envelope composed of HBsAg
and a very small viroid-like RNA
molecule. It is a defective mutant
virus that replicates only in HBV
infected cells; thus, the delta agent
requires co-infection with hepatitis
B for damage to occur.
Causes & Symptoms of Hepatitis D
 Hepatitis E
• Hepatitis E is a waterborne disease
that results from exposure to the
hepatitis E virus (HEV). Hepatitis
Diagnosis & Treatment of Hepatitis D E is mainly found in areas with
poor sanitation and typically results
from ingesting fecal matter that
contaminates the water supply.
Symptoms & Treatment of Hepatitis E
 COVID-19

Diagnosis & Treatment of Hepatitis E • Etiologic Agent: SARS-CoV-2

• Severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2)
stands for severe acute respiratory
syndrome coronavirus 2. It is a
virus that causes respiratory illness
in humans. It passed from animals
to humans in a mutated form and
was first reported in December
2019 in an outbreak occurring in
Wuhan, China.

• SARS-CoV-2 is a member of a
large family of viruses called
coronaviruses. These viruses can
infect people and some animals.
SARS-CoV-2 was first known to
infect people in 2019. The virus is
thought to spread from person to
person through droplets released
when an infected person coughs,
sneezes, or talks.

• The virus propagates and migrates

down the respiratory tract along the
conducting airways, and a more
Stages of Liver Damage robust innate immune response is
triggered.
Corona Virus (Covid-19) Symptoms

MYCOLOGY
• A plant-like organism that do not
possess chlorophyll and
- are larger and more complex than
the bacteria
• Classified as Thallophytes –
primary division of the plant
- kingdom which are commonly
called algae. They possess
- true nuclei and are heterophilic
members of the plant family
- that lack stems, leaves, roots and
other parts of a vascular
- plants.
• Has defined nuclear membrane,
presence of mitochondria,
- cell wall, no teichoic / muramic
acids, cell membrane, no
- respiratory enzymes
• Resistant to penicillin, tetracyclines
& chloramphenicol
• Sensitive to griseofulvin &
amphotericin B
• Has more than 1 chromosome and
protein associated
• Has 80 sedimentation coefficients
and cultivates less than
- pH 6.0
Structure of Fungi
Basic Morphologic Forms of Fungi
YEASTS
• Unicellular organisms, spherical
to ellipsoidal
• Moist colonies, creamy, opaque and
pasty
MOLDS
• Multicellular filamentous
 Divides by binary fission but most
reproduce asexually by budding
Structure of Molds
• 1. Hyphae – branching, cylindrical
tubules which are the basic structural
units of molds
• Types of Hyphae:
• aseptate hyphae (coenocytic)
– multinucleate structure
without divisions
• septate hyphae – hyphae
divided into cells by
crosswalls
• 2. Mycelium – mass or group of
countless intertwined hyphae that
accumulates during active growth in
the mold form.
Mold Structure
• Dimorphic Fungi
• pathogenic fungi exhibit
thermal dimorphism. They
grow as yeasts at 37⁰C and as
molds at 25⁰C or 30 ⁰C. other
dimorphic fungi develop
under different growth
conditions.
 B. Asexual Reproduction: Conidia
• a. microconidia – borne directly on the
side of the hyphal strand or at the end
Types of Reproduction:
of a long or short conidiophore; small,
unicellular, round, elliptical or
A. Sexual Reproduction of Fungi
pyriform in shape
• b. macroconidia (fuseaux) – usually
borne on a short to long
conidiophores; large usually
multiseptate, and a club or spindle-
shaped that maybe smooth or rough
walled
Classification of Fungi

• Ascomycotina (the ascomyces) -

Sexual fusion results in a sac or ascus
containing the meiotic products as
four or eight spores. Asexual spores
are borne externally at the tips of
hyphae. (Ex: trichophyton,
microsporum, Blastomyces)
• Basidiomycotina (the basidiomyces)
- Sexual fusion results in formation of
a club-shaped organ called a
BASIDIUM, on the surface of which
are borne at four meiotic products.
Asexual spores are borne externally at
the tips of the hyphae. (Ex:
Cryptococcus Neoformans)
• Deuteromycotina (the imperfect
fungi) - This is not a true phylogenetic
group but rather an artificial class into
B. Asexual Reproduction: Thallospores which are temporarily placed all forms
in which the sexual process has not yet
• Arthrospores been observed. Most of the members
• Blastospores resemble ascomyces morphologically.
(Ex: Epidermophyton, Sporothrix,
• Chlamydospores Candida species)
 • Zygomycotina (the phycomyces) - Tinea Versicolor Tinea Nigra
Mycelium usually non-septate; Cause Malassezia furfur Phaeoannellomyces wernekii
asexual spores produced in indefinite
Clinical Description Brown scaly areas on Brown patches on hands
numbers within a structure called a
SPORANGIUM. Sexual fusion results Trunk, arms, face
in formation of a resting, thick-walled Description hyphae & yeast-like Black-yeast like colonies
cell termed a ZYGOSPORE. Ex: Spore on direct prep Mold like with age 1-2
Rhizopus Nigrans “spaghetti & meatballs clavate cells
MYCOSES – Fungal Infections Black Piedra Vs White Piedra
BLACK PIEDRA
Cause: Piedraia Hortae
Description: presence of brown-black nodules outside hairshaft

WHITE PIEDRA
Cause: Trichosporon Beigelii
Description: light brown nodules on beard

Microsporum
• Microsporum Audouiinii
• Microsporum Canis

Fungal Infections • Microsporum Gypseum

1. Superficial Mycoses – no cellular Trichyphyton

response by host; Tinea Versicolor/ • Trichophyton Mentagrophytes
Ptyriasis (uneven skin pigmentation)
• Trichophyton Rubrum
a. Black Piedra
• Trichophyton Tonsurans
b. White Piedra
• Trichophyton Schoeleinii
2. Cutaneous Mycoses –
Dermatomycoses (keratinized tissues) • Trichophyton Violaceum
a. Microsporum
b. Trychophyton
c. Epidermophyton
3. Subcutaneous Mycoses – Epidermophyton
subcutaneous tissues & muscles
E. Floccosum
a. Sporotrichosis - affects skin and nails (especial y feet, hands and groin)
1. Systemic Mycoses – involves deep - macroconidia: large, smooth, club-shaped, found in singles or clusters at end of
tissues & organs Hyphae, 2-4 septa
a. Yeasts
-no microconidia
- olive green or khaki color
b. Dimorphic Fungi
Sporotrichosis
Superficial Mycoses
• Sporothrix Schenckii
• Chromoblastomycosis
 • Mycetoma • Microscopic – Staining (PAS);
Fluorescent-AB Staining
• Eumycotic (true fungi)
• Wet mounts – Slide & tube
• Actinomycotic (fungus-like
KOH (10% to 20%); India Ink
bacteria)
• Fungal Culture
• Phaeohyphomycosis
• Tests
Yeasts
• Serological Tests
• Cryptococcus Neoformans
• Agglutination: Whole cell,
• Candida Albicans
Latex Particle, Passive
Dimorphic Fungi Haemagglutination

• Histoplasma Capsulatum / Darling’s • Immunodiffusion

Disease
• Counter
• Blastomycosis Dermatitidis / Immunoelectrophoresis
Gilchrist’s Disease / North American
• Indirect Fluorescent Antibody
Blastomycosis
Detection
• Paracoccidioides Brasillensis / South
• ELISA, RIA
American Blastomycosis
• PCR & Other Molecular
• Coccidioides Immitis / San Joaquin
Methods
Valley Fever/ Dessert Fever
Common Tinea Infections
1. Tinea Barbae: ringworm of the beard
2. Tinea Capitis: ringworm of the scalp
3. Tinea Corporis: ringworm of the body
4. Tinea Cruris: ringworm of the groin
5. Tinea Pedis: ringworm of the foot or
“athlete’s foot”
6. Tinea Unguium: ringworm of the nails
Common Tinea Infections

Laboratory Diagnosis
• Direct Examination