MICP211 - LECTURE

Koch’s four postulates are:

COVERAGE
1. Introduction to Microbiology
2. Normal Flora of the Human Body
3. Microscope
4. Bacteria and Disease
5. Disinfection and Sterilization
6. Human Host Defense
7. Bacteria Morphology
8. Bacterial Growth
9. Antimicrobial Agents
INTRODUCTION TO MICROBIOLOGY
Microbiology
- Greek word, “mikros” meaning small; and “bio”
meaning life
- study of all living organisms that are too small to be
visible with the naked eye
- study of microorganisms, those being unicellular (single
cell), multicellular (cell colony), or acellular (lacking
cells)
Microorganism and Pathogens
- micro means “very small” and, organism means “anything
having life”.
- Therefore, microorganism is a tiny living thing, too small
to be seen by the naked eye.
- Other terms are microbe or germ.
- Some of these microorganisms cause illness in human
which are called "pathogens"
Evolution of Microbiology
Before the actual discovery of microbiology in the 17th
century:
 Jainism postulated existence of unseen microbiological life
 First century book, on Agriculture, Roman scholar Marcus
Terentius Varro was the first known to suggest the
possibility of disease spreading by unseen organism
Robert Hookie (1635 – 1703)
- First to use a microscope to observe living things:
- Discovered cell, basic unit of a living organism
Antonie Van Leeuwenhoek (1632 -1723)
- Observe microorganism, using a microscope of his own
design, creating the single lens microscope
- The “Father of Microbiology.
Edward Jenner (1749-1823)
- English physician was the first to prevent small pox.
Louis Pasteur (1822-1895)
- Father of modern microbiology/ father of bacteriology;
introduced pasteurization.
Joseph Lister (1827-1912)
- Introduced aseptic techniques for control of microbes by the
use of physical and chemical agents.
- The “Father of Antiseptic Sugery”
Robert Koch (1843 – 1910)
- all, isolated anthrax bacillus (Bacillus anthracis, the cause
of anthrax) in 1876
- perfected the technique of isolating bacteria in pure culture
- 1882, discovered Mycobacterium tuberculosis
 The organism causing the disease can be found in sick
individuals but not in healthy ones.
 The organism can be isolated and grown in pure culture.
 The organism must cause the disease when it is introduced
into a healthy animal.
 The organism must be recovered from the infected animal
and shown to be the same as the organism that was
introduced.
 The combined efforts of many scientists and most
importantly Louis Pasteur and Robert Koch established the
Germ theory of disease. The idea that invisible
microorganisms are the cause of disease is called germ
theory.
Paul Ehrlich (1854 – 1915)
- In 1904, found that the dye Trypan Red was active against
trypanosome that causes African sleeping sickness and
could be used therapeutically, referred as “magic bullet”.
- In 1910, he collaborated with a Japanese doctor in the
discovery of Salvarsan (Arsenobenzol), treatment for
syphillis
- Marked the beginning of chemotherapy and use of
chemicals that selectively inhibit or kill pathogens without
causing damage to the patient
Alexander Fleming (1881 – 1955)
- In 1929 discovered the first antibiotic penicillin
Hans Christian Gram (1853 – 1938)
- Inventor of the Gram staining technique was a pioneering
biologist who devised the system of classification which led
to as many as 30,000 formally named species of bacteria.
Theodor Escherich (1857 – 1911)
- Discovered the bacterium which he called “bacterium coli
commune” and which was later to be called Escherichia coli
in 1919.
- Determined its properties and relationship of intestinal
bacteria to the physiology of digestion in the infant.
John Tyndall (1820 – 1893)
- Discovered highly resistant bacterial structure, later known
as endospore, in the infusion of hay
- Prolonged boiling or intermittent heating was necessary to
kill these spores, to make the infusion completely sterilized,
a process known as Tyndallisation.
Albert Ludwig Sigesmund Neisser (1855 – 1916)
- Discovered the causative agent (pathogen) of gonorrhea, a
strain of bacteria that was named in his honour (Neisseria
gonorrhoeae)
Ignaz Philipp Semmelweis
- Described as the “savior of mothers”
- Proposed the practice of washing hands with chlorinated
lime solutions in 1847.
Selman Abraham Waksman (1888 – 1973)
- Researched into decomposition of organisms that live in soil
enabled the discovery of streptomycin and several other
antibiotics.
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John Snow (1813 – 1858) Classification of Pathogens
- “Father of Field Epidemiology” conducted studies of Bacteria
cholera outbreaks both to discover the cause of disease and - Simple, single-celled organisms, no true nucleus.
to prevent its recurrence (unicellular)
- Developed geographic distribution of cases, is called a spot - Grow in many environments; Grouped into:
map. a) Anaerobic
Luc Antoine Montagnier (1932) - Can grow in the absence of oxygen.
- French virologist - Ex: Clostridium tetani – tetanus
- Discovered of the human immunodeficiency virus (HIV) – b) Aerobic
1983 - Requires oxygen for growth.
- the Pasteur Institute in Paris discovered HIV-1. - Ex: Mycobacterium tuberculosis – lungs
- Using the established techniques, they cultured T cells c) Facultative Anaerobes
from a lymph node biopsy from a 33-year-old - Can grow with or without oxygen.
homosexual French patient with symptoms that can - Ex: Escherichia coli – lower intestine
precede AIDS Bacteria is Classified by the shape and how they cluster together
- HIV – virus, AIDS – disease (arrangement):
Significance to the Nursing Profession A. Cocci – spherical, ovoid or round
- Line of defense against microorganism a) Streptococci
- Cut the chain of infection - Gram positive bacteria arranged in chains,
- Accurate nursing interventions and management like a string of beads.
- Ex: Streptococcus pyogenes (pharyngitis
and rheumatic fever)
MICROBIOLOGY b) Staphylococci
- Gram positive arranged in large clusters
- Ex: Staphylococcus aureus (pneumonia,
Applied endocarditis, sepsis)
c) Diplococci
- Can be gram positive or negative; round
disease‐ environmentally‐ bacterium that typically occurs in the form of
industrial two joined cells.
related related - Ex: Neisseria gonorrhea (responsible for
gonorrhea) STI
bacteriology B. Bacilli
physiology microbial Immunology - Gram positive, straight, slender rods, cigar-shaped
metabolism with tapering ends.
mycology epidemiology
- All endospore-forming bacteria are bacilli.
parasitology genetics etiology
protozoology
C. Endospores
- Bacteria which produce resistant forms that can
MICROBIOLOGY tolerate long periods of dryness or other adverse
conditions.
- Ex: Clostridium, Botulinum, Bacillus anthracis
Basic D. Curved rods
- Ever-present phenotype bacteria
Disease‐ 1) Vibrios
By Organism By Process - short rods with a slight curvature like a
related
comma; gram negative and highly motile.
- Ex: Vibrio Cholera (responsible for
bacteriology cholera)
physiology microbial Immunology 2) Spirilla
mycology metabolism epidemiology - Long and wavelike cells resembling a
parasitology genetics etiology corkscrew; gram negative bacteria
protozoology - Ex: Campylobacter jejuni (responsible for
campylobacteriosis)
3) Spirochetes
- Spiral-shaped capable of waving and
twisting motion

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 MICP211 - LECTURE
Other types of bacteria include:
D. Flagella
- Are of the many types of bacteria that are capable of
swimming rapidly by means of threadlike
appendages.
- Ex: Helicobacter pylori
E. Mycoplasma
- Genus of bacteria that lacks cell wall around their
cell membranes; smallest bacterial cells, can survive
without oxygen and comes in various shapes.
- Ex: Mycoplasma pneumonia (walking pneumoniae)
F. Chlamydia
- Smaller than rickettsia and can replicate only within
a host cell.
- These bacteria usually spread though sex or contact
with infected genital fluid.
- Ex: Chlamydia trachomatis (common sexually
transmitted disease)
Virus
- Smallest of all pathogens; replication within the host
- Composed of a core of nucleic acid, with single strand or
double strain RNA or DNA
- Ex: HIV, Varicella, Rubella, Rubeola, Mumps virus,
Influenza, Ebola, Polio, Hepatitis, MERS, SARS, COVID
19
Fungi
- Can be single celled or very complex multicellular
organisms
- Non-green, plantlike organisms
 Yeasts – single-cell forms
- which needs food, warmth, and moisture
to thrive.
- It converts its food sugar and starch
through fermentation, into carbon
dioxide and alcohol.
- It's the carbon dioxide that makes baked
goods rise.
 Molds – filamentous forms
- A thin flexible thread like object or very
long thin cylindrical single cells.
- A growth of minute fungi forming on
vegetables and animal matter.
 Mycotic
- diseases caused by fungi that invades the
tissues.
- superficial, subcutaneous, or
systemic disease.
- Ex: athlete's foot, ringworms (Tinea capitis,
Tinea corporis)
 Candida – yeast like fungus that may infect a
weakened host; it may be in the skin, oral/mouth,
digestive tract, vaginal tract and lungs.
Protozoa
- Single-cell, animal like organism
- Found in soil, body of water from moist grass to mud
puddles to sea
- Four (4) main division includes:
1) Amoeboid (Amebas/Amoeba)
- unicellular organisms consisting mainly of
cytoplasm and a flexible cell wall.
- Ex: Entamoeba histolytica (responsible for
Amebiasis)
2) Ciliates
- presence of numerous cilia (tiny hairs) that
produce a wave action to propel the organism.
- Ex: Balantidium coli (responsible for
balantidiasis- chronic diarrhea)
3) Flagellates
- free living, non-photosynthetic flagellates without
a cell wall;
- possesses flagella for locomotion and capturing
prey.
- Ex: Trypanosoma brucei (responsible for African
Trypanosomiasis or “sleeping sickness”)
4) Sporozoa
- Also known as apicomplexans
- Uninucleate and their body is covered by a
pellicle – very thin layer of protein that protects
cell membranes in many types of protozoa
- They do not possess cilia or flagella.
- Ex: Plasmodium malariae/ falciparum
(responsible for malaria); Cryptosporidium
parvum (leading causes of human
cryptosporidiosis; watery diarrhea)
Helminths
- large, multicellular organisms that are generally visible to
the naked eye in their adult stages
- Three main groups of helminths:
1) Flatworms
- group of soft-bodied, usually much flattened
invertebrates.
- Ex: trematodes (flukes) and cestodes
(tapeworms)
2) Acanthocephala
- known as spiny- or thorny-headed worms
- common parasites of wildlife and some
domestic animal species.
- Ex: Moniliformis moniliformis (responsible
for acanthocephaliasis)

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 MICP211 - LECTURE
3) Roundworms  Skin normal flora are also present but at fewer amounts.
- elongated, with bilaterally symmetric bodies that  E.g Diphtheroid (Corynebacterium xerosis) Moraxella
contain an intestinal system and a large body cavity. species, non-hemolytic streptococci, staphylococci
- Ex: ascariasis, trichiniasis, hookworm, enterobiasis Normal Flora of Skin
Algae - Consist primarily bacteria and fungi.
- Group of oxygenic, phototrophic microbes which has a - Resident bacteria of the skin can be in any layer of the
nucleus; can generate oxygen through photosynthesis skin
- Harmful algae produce toxins that may cause poisoning to - Skin can acquire any transient bacteria from the
humans when consumed environment - washed off or die because the skin has
- Ex: Pseudo-nitzschia (Amnesic shellfish poisoning); Red acidic pH and produce sweat.
Tide (harmful algal bloom – toxic to marine life and Two types of flora in the Skin:
dangerous when consumed by human) 1. Resident Flora
 Staphylococcus- epidermis
NORMAL FLORA OF THE HUMAN BODY  Staphylococcus aureus
- The human microbiome (or human micro biota)  Staphylococcus
microorganisms that reside on the skin, saliva and oral  Diphtheroid
mucosa, conjunctiva, and gastrointestinal tracts.  Propionibacterium acnes
- They include bacteria, fungi  Yeast- candida
Types of Normal Flora 2. Transient Flora
1. Resident flora  Micro coccus
- Fixed types of microorganisms regularly found in a
 Bacteroid
given area at a given age.
- If disturbed, it reestablishes itself.
Normal flora of Digestive System
2. Transient flora
1. Microflora of Oral Cavity
- consists of non-pathogenic or potentially pathogenic
- Aerobic and anaerobic bacteria
microorganisms
- common: C. diphtheroid, S. aureus, and S. epidermis,
- It is derived from the environment, does not produce
yeast, molds, protozoa and viruses
disease, and does not establish itself permanently.
Mouth/ Oral cavity
- If disturbed, transient microorganisms may colonize,
- Lactobacilli, staphylococcus, streptococcus, Bacteroid,
proliferate, and produce disease
Corynebacterium, Nocardia
The Importance of Normal Flora
- Teeth: Streptococcus mutants, hemolytic streptococci,
1. Synthesized B-complex and Vit K
fusobacterium.
2. Protect our body by preventing the colonization of
pathogenic microorganism.
Normal flora of Gastro Intestinal Tract
3. Elevates the immune system.
Stomach
4. Produces the antibiotic like substance: e.g., Bacteriocin -
- A lot of microorganism are washed from the mouth into
inhibits the growth of pathogenic microorganisms.
the stomach but most of them are killed because the
5. Produce endotoxins - complement pathway, the defense
stomach fluid are gastric fluid that highly acidic (pH 2-3)
mechanism of the body
- Stomach fluids act as chemical barrier
Harmful effects of Normal Flora
- Eg. acid tolerant streptococci, staphylococci lactobacilli,
 Become opportunistic pathogens and cause the disease. candida albicans, Helicobacter.
 Cause diagnose confusion
 Penicillinase producing microorganisms - antibiotic Small Intestine:
resistance (Drug resistant 1. Duodenum: gram-positive cocci and rod
Distribution & Occurrence of the Normal Flora 2. Jejunum: gram-positive, gram negative bacterium can
 Normal Flora of skin be seen, Lactobacilli Diphtheroid, Enterococcus
 Normal Flora of eye (or) conjunctiva faecalis, Yeast- Candida albicans
 Normal Flora of digestive tract 3. Ileum – PH – alkaline, anaerobic gram-negative
 Normal Flora of respiratory tract bacteria are more mainly entero bacterial.
 Normal Flora of urinary tract Large Intestine:
 Normal Flora of genital tract - Larges microorganism in the body. Anaerobic gram-
Normal Flora of Eye (OR) Conjunctiva positive, non-sporing bacteria
Low number present due to: - Bacteroides, bifidobacterial, lactobacillus, E. coli,
 High moisture protease, yeast, Candida and protozoans, Entamoeba
 Blinking mechanically removes the bacteria hystolitica
 Lachrymal secretions include lysozyme
 The conjunctiva of the eye has primarily S. epidermidi,
S. aureus, C diptheroid and S. pneumonia

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 MICP211 - LECTURE
Normal flora Respiratory Tract Principles of Medical and Surgical Asepsis
Upper respiratory tract Medical asepsis Surgical asepsis
- Nasal passage, pharynx, esophagus  Practice which  Total elimination of all
- staphylococcus, streptococcus, diphtheroid, reduces the number, microorganisms, spores
Bacteroides, Micrococci, Haemophiles etc. growth and spread of  Total elimination of all
Lower respiratory tract microorganisms microorganisms, spores
- Trachea, Bronchi, Lungs  Referred to as ‘clean’  Methods:
- It is mostly sterile technique - Steam, radiation,
- Because the mucous membranes of the lungs remove  Hand washing 20 – chemicals, or gas
any microbes. 60seconds
Normal flora of the Genitourinary Tract Medical Asepsis
Normal flora of the urinary Tract  They include: hand washing, bathing, cleaning
- Urethra and urinary bladder are sterile. environment, gloving, gowning, wearing mask, hair
- Non-pathogenic Gram-positive cocci & Gram negative and shoe covers, disinfecting articles and use of
Enterobacteriaceae member may be extremely found as antiseptics
normal flora. The Five Moments of Hand hygiene
Normal Flora of Genital tract: 3. Before touching a patient
- Mycobacterium smegmatis is commonly present in 4. Before clean/ aseptic procedure
both male and female genital tract. 5. After body fluid exposure risk
1. Male genital tract: 6. After touching patient
- Lactobacillus, Bacteroides, staphylococci & 7. After touching patient surroundings
Corynebacterium Personal protective equipment (PPE)
2. Female genital tract - Specialized equipment and attire used in healthcare facilities
- The vagina of new born is colonized by lacto-bacilli to protect not only the healthcare workers but also the
- The adult female genital tract has complex normal flora patients and visitors against infections.
from puberty to menopause. - These include masks, gowns, and goggles.
- The pH is acidic 4.2 – 4.6 Acidophilic colonizing Universal precautions
bacteria - specific measures geared towards handling of patients with
- E.g.: lactobacilli known as the Doderline bacilli, an infection from an unknown pathogen to decrease the
staphylococcus epidermis, streptococci, Pepto risk of transmission.
streptococci, clostridium species, diphtheroid, candida. - These precautions apply to all body fluids including blood,
skin and mucous membranes.
MEDICAL & SURGICAL ASEPSIS Standard Precautions
(microbial control) 1. Hand hygiene
Asepsis 2. Use of personal protective equipment (gloves, mask,
- Absence of germs or microorganism eyewear)
- Clinical condition where infectious agent is spread 3. Respiratory hygiene/ cough etiquette
throughout the body of the individual from localize side 4. Sharp safety
infection and manifest symptoms of organ damage. 5. Safe injection practices (aseptic technique for parenteral
Medical Asepsis medications)
- is any practice that reduces the number and spread of
microorganisms.
6. Sterile instruments and devices
Surgical Asepsis 7. Clean and disinfected environmental surface
- is the process that eliminates completely all
microorganisms and their spores from the surface of an Transmission – based Precautions for Use with Specific
object. Types of Patients
- Protection against infection before, during and after a Airborne Precaution (Droplet nuclei Smaller than 5 microns)
surgical procedure  Infection/Condition
- Measles,
Goal of surgical asepsis - chicken pox (varicella)
- The goal of asepsis is to prevent the contamination of the - pulmonary or laryngeal TB
open surgical wound by isolating the operative site from  Barrier Protection
the surrounding non-sterile environment. - Private room with negative-pressure
- Mask or N-95
Droplet precautions (droplets larger than 5 microns)
 Infection/Condition
- Diphtheia (pharyngeal),
- rubella, pneumonia or scarlet fever,
- pertussis, mumps, M. pneumonia,
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 MICP211 - LECTURE
 Barrier Protection person are short distance to the
- Private room projected a short host's nasal mucosa,
- mask or N95 distance to the mouth or conjunctiva
Contact precautions (direct patient or Environmental contact) host's nasal
 Infection/Condition mucosa, mouth or
- Colonization or infection conjunctiva
- Major wound infections; herpes simplex Occurs by
- Scabies; varicella zoster(disseminated) dissemination of
 Barrier Protection either small
- Private particle nuclei of
- gloves, gowns evaporated
The Spread of Infection: Six Links droplets or dust
Airborne particles
containing the
infectious agent.
These agents can
be blown from the
soil by the wind
currents
May include food,
Vehicle water, blood and
fomites
Includes
Vector-borne mosquitoes, fleas,
Chain of Infection ticks, rats
1st Link: Presence of Pathogens
 Infectious Agents 5th Link: Portal of Entry
 Normal flora that become pathogenic  Eye, nares, mouth, vagina, cuts, scrapes
2nd Link: Reservoir  Wounds, surgical sites, IV or drainage tube sites
- refers to the source of pathogens  Bite from a vector
 Where pathogens live and multiply 6th Link: Susceptible Host
 May be living  Person with inadequate defense
- Humans, animals, insects  Three determining factors:
 May be non-living  Virulence
- Foods, floors, equipment, contaminated  Number of organisms
water  Host’s defenses
3rd Link: Portal of Exit
 Via Nurse’s role in
- Bodily fluids  Containing nosocomial infections
- Coughing, sneezing, diarrhea - Clean, disinfect, sterile
- Seeping wounds  Controlling/ eliminating reservoirs
- Tubes, IV lines - Bathing, dressing changes, patent drainage systems
 Controlling the portal of exit
4th Link: Mode of Transmission - Cover mouth/nose, wear mask, client teaching
 Contact  Controlling transmission
- Direct – touching, kissing, sexual contact - Do not share equipment, proper handling of linens,
- Indirect – contact with a fomite handwashing, PPE
 Droplet: Cough, sneeze  Controlling portal of entry
 Airborne: Via air conditioning, sweeping - Maintain skin integrity, position changes, proper
Mode of Transmission wiping techniques
Contact Direct contact Sexual contact,
Transmission kissing, touching
Contact with a
Indirect contact contaminated
intermediate object
Occurs when Occurs when droplets
Droplet droplets from from infected source
infected source person are projected a

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 MICP211 - LECTURE
MICROSCOPE Darkfield Microscope
- Used to examine objects that are too small to be seen by - 1,000x
naked eye. - Uses reflected light instead of transmitted light
- An optical instrument used to magnify micro-organisms a - opaque disc condenser that blocks light
hundredfold or even a thousand-fold. - specimen: appears bright
- Hundredfold: defined as 100 times as much - background: dark
- Thousand-fold: 1,000x - only the object is illuminated in darkfield microscope
Microscopy – science of investigating small objects and - purposes:
structures using a microscope  for spirochetes
Simple Microscope  for external details of specimen ex. Outline
- Uses only one lens or group of lenses in one unit to magnify  for unstained, transparent, absorbs little/ no light
objects
- Ex: jewelry eyepieces, pocket magnifiers, reading glasses
Compound microscope
- Uses two types of lens to magnify object
- Two types of lenses
a) Eyepiece lens
b) Objective lens – create resolved image then magnified
by eyepiece lens for viewing; with different zoom levels
of magnification
Phase-contrast Microscope
- 1,000x
- Introduced by Frits Zernike, dutch physicist 1934
- Produces high-contrast images of specimen (with contrast –
enhancing optical technique
- Differences in refractive indices and light waves passing
through transparent objects assume different phases.
- Purpose:
1. For transparent specimen: thin tissue slices, living cells
in culture, and subcellular particles (eg. Nuclei and
organelles)
2. Detailed exam of internal structures (e.g. Endospores)
3. Study of binary fission and motility

3 types of Microscope
 Light microscope – 1,000x
 Electron microscope – 100,000x
 Atomic force microscope
1. Light microscope
- Compound light microscope
- Uses visible light and a system of lenses to magnify images
2. Electron Microscope
of small objects
- Uses a beam of accelerated electrons as a source of
- There are two basic types of magnifying lens system:
illumination, and magnets to focus the beam.
a) Eyepiece (ocular) – contains ocular lens
- Higher resolving power than light microscopes and can
b) Object lenses – positioned above microorganisms.
reveal the structure of smaller objects.
Bright-field Microscope - Magnifies up to 2 million times
- Illuminates field evenly - Used to visualize viruses and the sub cellular structures of a
- Magnifies 1000 to 1500x cell.
- Specimen appears dark with low contrast, so object needs - Ernst Ruska, German Engr (1933) – built first prototype,
staining resolution power up to 50nm
- Use for bacteria and fungi - Ex: Virus, subcellular structure of cell
- For stained and naturally pigmented microorganism
- Source of illumination: visible light
- Cannot view – if object is 0.2um or less.

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 MICP211 - LECTURE
- 2 types: Fluorescent Microscope
1. Transmission electron microscope - Uses 1 ultraviolet light and 2 fluorescent dyes called
(TEM) fluorochromes.
- Original electron microscope - Micro-organisms fluoresces or appears to shine against
- 2-dimensional; black and white dark background
image - To detect antigen and antibodies
- Magnifies 200,000x - Ex: immunofluorescence or the Fluorescent – antibody
technique

2. Scanning electron
microscope
- 3D structure; black and
white
- Magnifies it 10,000x
3. Atomic force Microscope
- A type of high-resolution scanning probe microscope that
has a resolution that you can measure in fractions of a
nanometer.
- Allows topographical imaging of DNA molecules samples,
protein adsorption or crystal growth, and living cells
adsorbed on biomaterials.
Scanned Probe Microscope
- Scanned through surfaces of microorganism
- For molecular and atomic share of
microorganism
- Temperature, chem. Properties
- Developed by Dr. Gerd Binnig and Dr.
Heinrich Rohrer, Swiss Scientists 1980
- Produces a map showing bumps and valleys of the ATOM
on the surface
- For:
 Molecular and atomic shape of organisms
- Variations of temperature of cell
- Chemical properties
- Physical probe – goes back and forth organism
- Computer – gathers data; generate image
Differential Interference Contrast Microscope
Nomarski Interference contrast (NIC)
- Developed by Georges Nomarski 1952
- 2 beams of light instead of one
- Appears 3 dimensional
- Higher resolution
- Colors due to prisms
Confocal Microscope
- Other names:
 Confocal Laser Scanning Microscope (CLSM)
 Laser Confocal Scanning Microscope (LCSM)
- Micro-organisms is stained with
fluorescent dye to emit light.
- Scanned by laser in planes and region.
- Use computer
- Produce 3-dimensional image
- Use: study physiology of cell
BACTERIA AND DISEASE
Pollution
- Undesirable substance in water, air or soil;
surroundings
Contamination
- Presence or organisms outside body, water, food and
other biological substances
Infection
- Invasion by pathogenic microorganisms
- Bot synonymous to disease
Disease
- Undesirable relationship bet host and pathogen
- Interruption in normal functioning
Pathogen
- Organism that invades and causes damage, injury
Pathogenicity
- Pathogenic – ability of organism to cause disease
 Non virulent form – no surrounding outer capsule of
polysaccharide
 Virulent form – surrounding outer capsule

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 MICP211 - LECTURE
Koch’s Postulates (Germ Theory)  Enterotoxin – affects cell lining of GIT
- Formulated by Robert Koch & Friedrich Loeffler in 1884,  Cytotoxin – kills host cells/ affect their
based earlier concepts described by Jakob Henle function
- Koch's postulates are four criteria to establish causative b) Endotoxin
relationship between microbe & disease. - Outer membrane of gram negative
1. The organism must always be present in every case of - In outer membrane of cell wall
the disease - Fever, weakness, aches, shock (specific
2. The organism must be isolated from a host containing symptoms)
the disease and grown in pure culture - Ex: meningococcal, meningitis, UTI
3. Samples of the organism taken from pure culture must
cause the same disease when inoculated into a healthy
animal in the laboratory
4. The organism must be isolated from the inoculated
animal must be identified as the same original organism
that was first isolated from the originally diseased host
The Factors that influence occurrence of Infection
1. Portal of Entry
- organization may fail to produce disease when
introduced into some other route/ pathway.
- Streptococci
 Pneumonia – lungs
 Cellulitis – skin (itis – inflammation)
 No effect – swallowed
2. Virulence of Microorganism
- Ability to produce disease
- Overcoming defensive powers of host
 Capsule, chemical substances in cell wall –
evades phagocytosis
 When freshly discharged 4. Immunologic
 Rabies – near CNS - Consequences of the immune response of the host to
3. Number of Microbes microorganism
- Abundant; Small number of microorganisms - Ex: damage to liver – Hepatitis
- Index person – unang una nagkasakit - Complement
4. Defensive Powers of the Host Classification of Infection
- Old – weak immune system; young – immature Based on the manner causative agent reaches the host:
immune system 1. Communicable
How organism produce disease - Directly or indirectly transmitted from host to host
1. Mechanical - Ex: Diphtheria/ tuberculosis/ rabies
- organism directly damage tissues or surface a) Contagious – disease is rapidly/ easily transferred
- Ex: Leprosy – nerve (nawawala ung pakiramdam) / b) Fulminating infection – infection that results to
warts – skin death over a short period of time
2. Chemical 2. Non- communicable
a) Leucocidins - Disease is not spread from one person to another
- Destroys white blood cells (escapes phagocytosis) - Agent normally inhabits the body
b) Coagulase - Produces the disease only when introduced into the
- Coagulates fibrinogen of blood body
3. Toxin – poison - Ex: tetanus – not communicable but infectious
a) Exotoxin Based on the source of microorganism:
- inside gram positive bacteria as metabolic product 1. Exogenous infection
of growing cell - From the outside the body
- toxic substances secreted by bacteria and released - Those that originate outside the body
outside the cell 2. Endogenous infection
- affects cell functions, nerves, GIT (specific area) - From inside the body
- no fever - Already present/ dormant – inactive
- Ex: Diphtheria, Botulism – food poisoning, Other terms:
Tetanus Specific infection – disease is caused by microorganism that is
- 3types: known…
 Neurotoxin – interferes in nerve impulse Non-specific infection – disease is caused by several
transmission microorganism. Ex: UTI, flu-like, infection

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Incidence of a Disease  Nutritional status
- Refers to the number of person in a population who acquired  Age
the disease at a particular point of time  Lifestyle
 Incidence Rate – number or new cases  Habits
 Prevalence rate – number of new and old cases  Occupation
 Presence of pre-existing disease
Occurrence of a Disease  Intake of meds that affect immune system
Epidemic  Emotional disturbances
- Rapid spread of infectious disease to large number of people Opportunistic infection
in a given population within a short period of time - An infection caused by pathogens (bacteria, viruses, fungi
Endemic or protozoa) that take advantage of an opportunity not
- Constantly present in a particular place normally available, such as a host with a weakened immune
- Ex: Malaria in palawan; schistosomiasis – leyte system, an altered microbiota (such as a disrupted gut
Sporadic microbiota) or breached integumentary.
- Occurs occasionally
Pandemic Stages of Infectious Disease
- Present worldwide 1. Incubation period
Other terms: - Time interval between entry of microorganism and the
 Bacteremia – bacteria in blood appearance of 1st signs and symptoms
 Septicemia – actively multiplying bacteria in the blood 2. Prodromal period
 Pyemia – pus-producing bacteria in the bloodstream - Mild symptoms of disease which are nonspecific (fever,
 Toxemia – toxin in blood cough, colds, malaise)
 Viremia – virus in the blood 3. Period of Illness
Duration of Disease - Period of maximal invasion/Disease Is most acute
 Acute during this period
- Shows rapidly for short period of time  Fulminant infection
 Chronic - If disease is not successfully overcome, patient
- Occurs slowly; occurs long period of time may die in short period of time
 Latent  Carrier state
- Inactive for long time but can become active again - Does not show s/s but still continues to shed
According to extent of host involvement infecting microorganism
Local Infection 4. Period of Decline/ defervescence
- Invading microorganism are limited to a relatively - sign and symptoms start to subside.
small area of the body (isang lugar lng) - patient may become vulnerable to secondary infections
- Ex: boils (not fully recovered)
Focal infection 5. Period of Convalescence
- Localized in specific part of body that may spread to - patient regains strength, body returns to its pre-diseased
another part of body via blood or lymphatic vessel (isa normal condition. (complete recovery)
lng pinuntahan)
- Ex: teeth, tonsils or sinuses Reservoir of Infection
Systemic or Generalized Infection - Continual source of disease-producing microorganism
- Invading microorganism or their products are spread - Living – Animal, Humans
throughout the body by blood or lymphatic (madaming - Non-living – soil
parts)
- Ex: influenza Routes of Transmission
Primary infection Transmission – pathway of causative agents from source to
- Acute infection that causes initial illness infection of susceptible host
Secondary infection 1. Contact
- Due to opportunistic pathogens after primary infection  Direct – person to person
weakened body’s defense  Indirect – from reservoir to susceptible host
Subclinical infection/ Inapparent Infection  Droplet – spread in droplet nuclei Travels <1 meter
- Does not cause noticeable illness 2. Vehicle Transmission
- Ex: Hepatitis - Transmission of organism through media such
Predisposing Factors as food, water, air
- Makes body more susceptible to development of particular
disease
- Ex: gender – UTI; genetics
- Other factors:
 Geographical location
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 Foodborne
- Pathogens are transmitted through ingestion of
food that improperly cooked, prepared, poorly
red, unsanitary condition
- Ex: food poisoning, AGE
 Airborne
- Refers to spread of pathogens by droplet
nuclei in dust that travels > 1 meter from
reservoir to the host
- Ex: Measles, tuberculosis
 Waterborne
- Pathogen is spread through contaminated
water. Ex: cholera
3. Vectors
- Animals that carry microorganism from one host to
another
 Insects (arthropods) – most important group of
vectors
a) Mechanical transmission – passive transport
of organism on insects’ feet or other parts
b) Biological transmission – active transport of
organism. Microorganism enters insect vector
after insect bites an infected person
DISINFECTION AND STERILIZATION
Disinfection
- Process of killing of harmful microorganism
Disinfectants
- an agent, such as heat, irradiation or chemical that
disinfects by destroying, neutralizing or inhibiting the
growth of disease-carrying microorganisms.
- Not sporicidal but maybe sporostatic. (sporicidal – hindi
sila nakakapatay ng spores, they stop the duplication of
m.o.)
Sterilization
- refers to the process by which all pathogens are destroyed,
including the spores.
- Methods include physical and chemical sterilization.
Antiseptic
- Products that destroy or inhibit the growth of
microorganisms in or on living tissue
Aseptic/ Asepsis
- Characterized by the absence of pathogenic microbes
- The measures to prevent an infection from entering
wound referred to as asepsis. While those to cause the
exclusion destruction of harmful microbes are called
antisepsis.
Spores
- Microscopic reproductive cells that are capable of
developing into a new bacterium or any organism without
fusion with another reproductive cell.
- Active reproductive structure
- Forming bacteria
 Bacillus (aerobic species) gram+
 Clostridium (anaerobic species) gram+
a) Endospores (some bacteria)
- Dormant, non-reproductive structure
- has thick protein coat and this helps them survive when
moisture or nutrient supply is low
-Resistant to ultraviolet radiation, desiccation, high
temperature, extreme freezing, chemical disinfectant
- Sense and adapt to changes in their environment.
- Can survive environmental assaults that would
normally kill the bacterium
 Bacillus cereus – emetic syndrome (vomiting) &
diarrhea
 Bacillus anthracis – skin, lungs or bowel disease that
can be deadly
 Bacillus thuringiensis - a species of bacteria that
lives in soil. It makes proteins that are toxic to
some insects when eaten, but not others; used as an
insecticide.
 Clostridium botulinum - are often found on the
surfaces of fruits and vegetables and in seafood;
The organism grows best under low-oxygen
conditions and produces spores and toxins. The
toxin is most commonly formed when food is
improperly processed (canned) at home.
 Clostridium tetani – tetanus
b) Sporulation
- Formation of spores from vegetative cells during
unfavorable environmental conditions.
- It describes as an adaptive response that allows the
organism to survive even at worse conditions.
- Process to form endospores
- Copy of chromosome (most valuable) and cytoplasm
enclosed
c) Germination
- Dried spore lands on moist nutrient- rich surface
- New bacterial cell emerges (a seed)
Methods of Sterilization
1. Physical methods
- Heat: dry/moist,
- Radiation: ionizing radiation, non-ionizing radiation,
U.V. light
- Filtration
a) Radiation
- U.V. light – has limited sterilizing power because
of poor penetration into most materials
- Generally used in irradiation of air in certain areas
e.g., operating rooms and T.B. laboratories
- Non ionizing radiation – it uses a longer wave
length and low energy. It loses the energy to
penetrate substances. (UV light)
- Ionizing radiation - travel as a particle or electron
magnetic wave. Can come in the form of Gamma
and Xray that react with DNA resulting in a
damaged cell.
b) Filtration
- May be done under either negative or positive
pressure
- The membrane filter made from cellulose acetate
- Removes most bacteria but viruses and some
small bacteria e.g., Chlamydia’s and
Mycoplasmas may pass through
- Only sterilization method that eliminates bacteria
by spreading m.o. from sterilize medium.
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- The recommended size filter that will exclude the
smallest bacterial cell is 0.22-micron filter.
- Effective method for heat sensitive liquids.
2. Chemical methods

Sterilization by Heat
- Most common method: dry heat
- Dry heat: Simplest method is exposing the item to be
sterilized to the naked flame
- Ex: Bunsen burner – for sterilizing bacteriological loops,
knives, blades
 Hot air oven
- exposes items to 160°C for 1 hour.
- It has electric element in the chamber as source of heat Sterilization: Mechanism of Action
plus a fan to circulate air for even distribution of heat in  Protein Coagulation – they form into a thicker liquid
chamber  Disruption of cell membrane resulting in exposure, damage/
- Used for metals, glassware, ointment, oils, waxes loss of contents
powders etc.
 Removal of sulfhydryl group essential for normal
Sterilization by Moist Heat
functioning of enzyme (carbon, hydrogen, sulfur, nitrogen)
- Uses hot water; 100º C for about 15-20 mins a day.
 Substate competition – ability to inhibit the enzyme activity
- Ex: boiling, Tyndallization: also known as fractional
Substrate competition
sterilization and discontinuous heating
 Pasteurization
- It uses heat at temperatures sufficient to inactivate
harmful organisms in milk
- Does not achieve sterilization
- Hindi nya napapatay ung spores
- Temperature may be 138º C for a fraction of a second
(flash method), 71.7ºC for 15-20 secs or 62º C for 30
mins.
 Autoclaving
- Standard sterilization method in hospitals
- Tough double walled chamber in which air is replaced
by pure saturated steam under pressure.
- Temperature is > 100º C therefore spores are killed
- How to monitor autoclave
 Thermocouple
 Autoclave tape
 Browne’s tube Types of Disinfectants
Sterilization by Chemical Methods 1. Phenol
- Useful for heat sensitive materials e.g., plastics, lensed - Seldom used today; toxic to humans
instruments, endoscopes - Derivatives of the phenol molecule, however, are
- Activated alkaline glutaraldehyde 2%: immerse item in widely used
solution for about 20 mins if organism is TB. In case of - Phenolics injure plasma membrane, inactivate enzymes
spores, the immersion period is extended to 2-3 hours or denature proteins
- Ex: cidex – activated alkaline glutaraldehyde 2% - Stable, persistent and are not sensitive to organic matter.
Types of Chemicals 2. O-Phenylphenol
Aldehydes - The main ingredient in most formulations of Lysol
 Formaldehyde – an effective liquid decontaminant. 3. Hexachlorophene
 Paraformaldehyde- a solid polymer of formaldehyde. - pHisoHex used in nurseries and for surgical and
 Glutaraldehyde – a colorless liquid and has the sharp, hospital microbial control procedures to control gram
pungent odor typical of all aldehydes. It is capable of positive skin bacteria such as staphylococci and
sterilizing equipment, tough to effect sterilization of ten streptococci and streptococci
requires many hours of exposure. - excessive use can cause neurological damage.
Hydrogen peroxide – active against a wide range of 4. Triclosan
microorganism including bacteria, yeasts, fungi, viruses and - It has broad spectrum of activity, especially against
spores gram positive bacteria.
- It is also effective against gram negative bacteria and
fungi.
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5. Biguanides
- are active against bacteria, and show a degree of
activity against viruses and fungi which can be
enhanced by combination with other agents.
- Example: Chlorhexidine
6. Halogens iodine
- effective against all kinds of bacteria, many
endospores, fungi, and some viruses.
- Combination with amino acids and thyroxine enzyme
- An iodophores a combination of iodine and an organic
molecule. Iodophores not stain and are less irritating
than iodine.
- Examples are Isodine and Betadine.
7. Chlorine
- used as a gas or in combination with other chemicals.
- Example: Chlorine gas - Sodium hypochlorite,
Chloramines, Chlorine dioxide
8. Alcohol
- Both ethanol and isopropanol (rubbing alcohol) are
widely used, normally at a concentration of about 70%.
- Concentrations of 60% to 95% are effective.
- They are bactericidal and fungicidal but are not
effective against endospores or non-enveloped viruses.
- Alcohols enhance the effectiveness of other chemical
agents.
9. Heavy metals and their compounds
- Tiny amount of heavy metals (e.g. silver and copper)
are effective antimicrobials.
- 1% silver nitrate solution: gonorrheal ophthalmia
- Silver-sulfadiazine: wound dressings.
- Mercuric chloride: topical antiseptic and disinfectant
- Organic mercury compounds such as Mercurochrome
are less irritating and less toxic than inorganic mercury.
- Copper sulfate: destroy green algae in reservoirs or
other water.
- Zinc chloride is used in mouthwashes, and zinc oxide is
used in paints as antifungal.
Factors affect the efficiency of chemical agents
1. Concentration and potency
- In general, a higher concentration is bactericidal
whereas a lower concentration may only be
bacteriostatic.
- This is not true for alcohol. For Alcohol, the effective
bactericidal concentration is at 50% to 80%.
2. Duration of exposure
- The longer the time of exposure to the chemical agent,
the better the killing action.
3. Temperature
- A higher temperature speeds up the rate of a chemical
reaction and thus accelerates killing action.
- However, there are also certain chemical agents that
exert optimal effects at lower temperatures.
4. Nature of the surrounding medium
- Th pH of the medium and the presence of extraneous
materials like pus or blood decreases the efficiency of
the chemical agent.
- These materials may inactivate or lower the
concentration of the chemical agent or may bind the
chemical agent to its surface.
5. Nature of the organism
- This refers to the innate resistance of the
microorganism to disinfectants. Microorganisms
vary in their resistance to disinfectants.
- Mycobacterial cell wall is lipid-rich that makes it
difficult for the chemicals to penetrate it.
- Gram-negative bacteria have an outer membrane that
confers resistance to disinfectants.
6. Number of organism/ sizes of the inoculum
- The larger the number of microorganisms’ present,
the more time needed for a disinfectant to destroy all
of them.
Characteristics of Good Chemical agents
 Broad spectrum
 Fast acting
 Active in the presence of organic matter
 Active in any pH
 Stable
 Non-toxic, non-allergenic, non-irritative and non-corrosive.
 soluble in water and easy to apply.
 Leaves a residual antimicrobial film on treated surface.
 High penetrating power.
 Should not be expensive and must be easily available.
 Safe under storage and shipping for reasonable periods of
time.
 Should not have a bad odor
Disinfection: Mechanism of Action
Damage to the Cell Membrane
1. Surface active agents
- These agents are active against vegetative microbial
forms including Mycobacteria as well as enveloped
viruses.
- They are widely used as disinfectants in homes and
hospitals but their activity is reduced in the presence of
hard water and inorganic matter.
a) Cationic agents
- These are detergents where the fat-soluble portion is
positively charged due to combination with a
Quaternary nitrogen atom.
- These are called quaternary ammonium compounds
and are effective at alkaline pH.
- Examples are cetrimide and benzalkonium chloride.
b) Anionic agents
- These are negatively charged agents that contain
long chain hydrocarbons.
- Examples are soaps and bile salts.
- The remove dirt through the process of
emulsification and are most effective at acidic pH.
2. Phenolic compounds
- These act by disrupting cell membranes as well as
causing precipitation of proteins and inactivation of
enzymes.
- These are coal-tar derivatives that act as disinfectants at
high concentration and as antiseptic at low
concentration.
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- Phenols are bactericidal and fungicidal with good
activity against Mycobacteria but have poor activity
against spores and most viruses.
a) Phenol is no longer used as a disinfectant because it is
toxic to human cells. It is used as a gold standard in
the chemical evaluation of new chemical agents using
the phenol coefficient test.
b) Cresol are phenol derivatives more potent and safer
than phenol. An example is Lysol®.
c) Chlorhexidine is used as a skin disinfectant if in
isopropanol solution. The aqueous preparation is used
for wound irrigation. Its main use is as an antiseptic
hand wash.
d) Hexachlorophene is a chlorinated diphenyl which has
greater activity against gram-positive bacteria similar
to chloroxylenols.
e) Triclosan, an organic phenyl ether, has good activity
against gram-positive bacteria and a number of gram-
negative bacteria including Pseudomonas. It has some
activity on fungi and viruses.
3. Alcohol
- This acts by disorganizing the lipid structure of the cell
membrane, dehydrate cells, and cause denaturation and
coagulation of cellular proteins.
- The microbial killing property of alcohol is seen better
in a 70% aqueous solution compared to absolute
alcohol.
- The disadvantage of using alcohols is that they are skin
irritants and are also flammable.
a) Ethyl alcohol -used as skin antiseptic, it is
bactericidal and removes lipids from skin surfaces.
b) Isopropyl alcohol – has a greater bactericidal
activity than ethyl alcohol and is less volatile. It can
be used to disinfect surfaces. Inhalation of its
fumes can cause narcosis.
c) Benzyl alcohol – it is used mainly as a preservative.
d) Methyl alcohol – it is fungicidal and sporicidal
used in disinfecting inoculation hoods
Denaturation of Cellular Proteins
- Substances that cause the denaturation or loss of the normal
structure of proteins pave the way for the eventual
destruction of the bacterial cell.
- Denaturing agents include: acids and alkalis, alcohol and
acetone and phenol and cresol.
1. Heavy metals
- These can cause damage to the enzyme activity of the
bacteria.
- They also cause precipitation of proteins and oxidation
of sulfhydryl groups.
- mostly bacteriostatic than bactericidal.
1. Mercurials
- (e.g. mercurochrome and Merthiolate) are
biocidal and are used as antiseptics.
- These are active against viruses at dilution of
1:500 to 1:1000.
2. Silver compounds
- (e.g. silver nitrate) are bactericidal. 1% silver
nitrate solution is used Clinically as treatment
of ophthalmia neonatorum (Crede’s
prophylaxis).
- Silver sulfadiazine is used topically in the
treatment of burn wounds.
2. Halogens
- These bactericidal oxidizing agents that cause oxidation
of essential sulfhydryl groups of enzymes causing
inactivation of the enzymes.
a) Iodine (tincture of iodine, iodophores)
- considered the best antiseptic because it is
sporicidal, bactericidal, fungicidal, viricidal and
amoebicidal.
- It can be combined with neutral carrier polymers to
produce iodophores (e.g., povidone-iodine).
- A 10% solution of povidone-iodine is used for pre-
operative skin disinfection.
b) Chlorine
- is mainly used in the treatment of water (chlorine
gas).
- Hypochlorites are used for sanitizing dairy and
food processing equipment.
- It is also a common household disinfectant. At
higher concentrations, it is used to disinfect
swimming pools.
c) Hydrogen peroxide
- is a weak antiseptic and used only for cleaning
wounds and in the disinfection of surgical devices
and soft plastic contact lenses.
3. Alkylating agents
a) Aldehydes
- damage nucleic acids by alkylation of amino-,
carboxyl-, hydroxyl groups.
- It kills all microorganisms including spores.
 Formaldehyde (formalin)
- used for surface disinfection. It can be used to
sterilize Bedding and furniture.
- It is also used to kill Mycobacterium tuberculosis
in sputum and Fungi in athlete’s foot.
 Glutaraldehyde
- sporicidal and used as a cold sterilant in sterilizing
medical equipment. Such as respiratory therapy
machines and other equipment that can be damaged
by Heat.
- It is more potent than aldehyde.
- It requires alkaline pH for its action and exposure
time of at least 3 hours to be effective.
b) Ethylene oxide
- also, sporicidal and is used in the gaseous
sterilization of heat-sensitive materials or
equipment like heart-lung machine, respiratory and
dental equipment, and polyethylene tubes in
anesthesia machines.
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- It is more potent than glutaraldehyde but slower-
acting. It is highly flammable and is usually
combined with 10% CO2.
- It causes eye irritation and is mutagenic and
carcinogenic.
HUMAN HOST DEFENSES
Body defense mechanisms:
 Physical barriers
 Defensive cells and proteins, inflammation and fever
 The immune system
First Line of Defense
- Combination of physical and chemical barriers that prevent
all types of foreign agents from penetrating the outer layer
of the body
Physical barriers
1. Skin – cells filled with keratin, making skin impenetrable
and resistant to toxins
2. Mucous membranes – line the respiratory, digestive,
urinary and reproductive systems and protect the internal
lining; susceptible to physical attack, so they need a special
care/ protection
3. Hair – the nose act as a coarse filter
Chemical barriers
1. Sweat – wash away microbes and their acidity slows
bacterial growth
2. Mucous membranes – sticky, traps many microbes
3. Saliva and tears – enzyme called lysozyme that kills
bacteria by rupturing their cell walls
4. Cerumen (ear wax) – protects the canal by trapping dirt and
dust particles
Second Line of Defense
- Defensive cells
- Cells play a role in inhibiting or destroying the pathogen
before it harms the body. They are non-specific and react to
the presence of any foreign organism or substance.
Phagocytes
- Engulf pathogens, damaged tissue or dead cells
- Neutrophils, Macrophages
Eosinophils
- Discharge destructive enzyme to destroy pathogens too
big for phagocytes (e.g., parasitic worms)
Natural Killer Cells
- Seek out abnormal cells (e.g., cancer cells)
Defensive proteins interferon
- A virus enters a cell
- The infected cell produces interferon
- The interferon binds with other cells that become infected
with a virus, and protects it by stimulating the cell to
produce antiviral proteins that prevent the virus from
making copies of itself
- The interferon attracts and stimulates natural killer cells
and macrophages to kill cells infected with the virus
Defensive proteins complement system
(complement cascade)
- enhances the ability of antibodies and phagocytic cells to
clear microbes and damaged cells from an organism,
promote inflammation, and attack the pathogen's cell.
a. Destruction of pathogen (cell lysis – break down of
the cell membrane)
b. Enhancement of phagocytosis (opsonization)
c. Stimulation of inflammation
d. Chemotaxis
e. Attracting macrophages and neutrophils
Inflammation
- body's process of fighting against things that harm it.
When something damages your cells, your body releases
chemicals – histamine, bradykinin and prostaglandin
1. Redness – caused by increased blood flow to the
damaged area
2. Heat – increased blood flow elevates the temperature in
the area of injury, increasing metabolic rate of the body
cells
3. Swelling – histamine makes capillaries more permeable
than usual
4. Pain – causes person to protect the area
Fever
- abnormally high body temperature caused by pyrogens
(chemicals that set the “thermostat in the brain to a higher
set point)
- a mild or moderate fever helps the body fight bacterial
infections
Third Line of Defense
The Immune system
- Immunity means protection from infections
- The cells and molecules responsible for immunity
constitute the immune system and their collective and
coordinated response to the foreign substance
- i.e., infectious agents – immune response
- B-lymphocytes – produce antibodies; T-lymphocytes -
attack antigen directly and help control immune response
- when the first two line of defense of the body can not
prevent the infection, the immune system acts to eliminate
the infectious agent and prevent the body from infection
- immune response – immunity generally consists of two
steps:
1) recognition of the pathogen or foreign molecule
2) mounting reaction against the pathogen
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Classification of Immunity
Natural immunity
- it is resistance to a disease possessed by an individual, the
immunity that is naturally existing.
- For example, some individuals are more resistant to
certain infections than others
Acquired Immunity
- Immunity is induced in individuals by certain ways.
- Developed during a person’s lifetime; it is not inherited.
Acquired Active Immunity:
a) Naturally acquired active immunity
- Acquired when a person is exposed to natural
infectious or to some antigens in the day-to-day life.
b) Artificially acquired active immunity
- Acquired by administering specially prepared
antigens which produce specific antibodies
- This is also known as vaccination.
Acquired Passive Immunity:
a) Naturally acquired passive immunity
- Involves natural transfer of antibodies from a
mother to a fetus via placenta or breast milk and
thus providing immunity to the new born for a few
days to a few months
- The fetus is immune to those diseases for which the
mother is immune but for a short period of time
b) Artificially Acquired Passive Immunity
- Here antibodies are directly administered to body
for stimulation of immune response. These
antibodies are either produced in animals or in
human and they are
Two categories of Immunity
a) Innate immunity
- The first and second line of defense against infections
- Exist before encountering an infectious agent
- It is the defense mechanism which are present as
inherent
- Its mechanism is non-specific
- Components of Innate immunity:
 Physical and chemical barriers – skin, GIT and
acidic environment to stomach, respiratory tract,
tears, saliva, sweat
 Effector cells, phagocytes e.g., macrophage,
neutrophil, NK cells
 Blood protein, complements system, antibody
 Cytokines
b) Adaptive immunity
- Consists of defense mechanism which are stimulated by
exposure to infectious agents
- Its mechanism is specific because of its ability to
distinguish among different, even closely related
infectious agents
- It is of 2 types: Humoral and Cell
 Humoral immunity
- Mediated by antibodies, produced by B
lymphocytes (matured in bone marrow)
- It is the principal defense mechanism against
extracellular microbes and their toxins and assist
in their elimination
 Cell mediated immunity
- Mediated by cytokines, produced by T
lymphocytes (matured in Thymus Glands)
- It is the defense mechanism against intracellular
microbes
- Two types of T cell: Helper T Cells (TH) – activate
B cells to produce antibodies and macrophages to
destroy ingested microbes but they also help
activate cytotoxic T-cells to kill infected
target cells; Cytotoxic/ Cytolytic T Cells (CTL) –
it directly kill the pathogens
Antigens
- Substance which when introduced parenterally into the body
stimulates the production of an antibody which reacts
specifically and in an observable manner.
Types of Antigens
1. Autoantigens
- Usually, a normal protein or complex protein
- Ex: are a person own self antigen
2. Alloantigen’s
- Are antigen found in different members of the same
species (the red blood cell antigen A and B are
examples)
3. Heterophile antigen
- identical antigens found in the cells of different
species
Immunoglobulins
- also referred to as antibodies or Ig; Y shaped molecules that
connect on one end to invading microbes (antigens) and on
the other end they bind with various white cells that
effectively block and destroy the antigen
- Two identical strands of heavy chains and two identical
strands of light chains
- The end with the two heavy chains forms a stable non-
variable receptor point called an effector, which is the part
of the Ig molecule that binds with our own immune system
cells
- On the opposite end of the antibody are two antigen binding
sites, each with as light chain and heavy chain combination.
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Types of Immunoglobulin (GAMED) Vaccine
IgG - An immunobiological substance designed to produce
- 75% of total immunoglobulin specific protection against a given disease
- Appears in serum and tissues - It stimulates the production of protective antibody and other
- Assumes a major role in bloodborne and tissue infections immune mechanism
- Activates the complement system - Vaccination – administration of antigenic material to
- Enhances phagocytosis stimulate an individual immune system to develop adaptive
- Crosses the placenta immunity to a pathogen
IgA - Can prevent or ameliorate morbidity from infection
- 15% of total immunoglobulin Types of Vaccine
- Appears in body fluids 1. Live attenuated vaccines
- Protection against respiratory, gastrointestinal, and - Prepared from live generally attenuated organisms
genitourinary infections - Ex: BCG – Typhoid oral – bacterial
- Prevents absorption of antigen from food - oral polio, yellow fever, Measles, Rubella, mumps,
- Passes to neonate in breast milk in protection Chicken pox, Influenza – viral
IgM 2. Inactivated or killed vaccines
- 10% of total immunoglobulin - Organisms killed by heat or chemicals
- Appears mostly in intravascular serum - Safe but generally less efficacious than live vaccines
- Appears as the first immunoglobulin produced in response - Ex: typhoid, Cholera, Pertussis, Plague – bacteria
to bacterial and viral infections - Rabies, Salk (polio), Hepatitis A & B, etc. – viral
- Activates the complement system. 3. Toxoids
IgE - Certain organisms produce exotoxins, these toxins are
- 0.004% of immunoglobulins detoxicated and used in the preparation of vaccines
- Appears in serum - Highly efficacious and safe
- Takes part in allergic and hypersensitivity of reactions - Ex: Diphtheria, tetanus – bacterial
- Combats parasitic infections. 4. Cellular fractions
IgD - Vaccines which are prepared from extracted cellular
- 0.2% of immunoglobulins fractions
- Appears in small amount in serum - Duration of experience is limited and their efficacy and
- Possibly influences B-lymphocytes differentiation but role safety are high
is unclear. - Ex: Meningococcal vaccine, Pneumococcal vaccine,
Hepatitis B polypeptide vaccine
Cellular immune response 5. Combinations
- Develop gradually - If more than one kind of immunizing agent is included
- T lymphocytes in the vaccine it is called mixed or combined vaccine.
- Stem cells continuously migrate from the bone marrow to the - Ex: DPT – diphtheria -pertussis- tetanus
thymus gland, where they develop into T cells - DT - Diphtheria – tetanus
- By spending time in the thymus, theses cells are programmed - Hepatitis A & B
to become T cells rather than antibody producing B - Hepatitis A & typhoid
lymphocytes. 6. Polysaccharide Vaccines
Cellular immune response cont... - A unique type of inactivated subunit vaccine composed
 T cells attack foreign invaders directly of long chains of sugar molecules that make up the
 The T cells then carry the antigenic message or blue surface capsule of certain bacteria
print to the lymph nodes, where the production of other - Pneumococcal disease, meningococcal disease and
T cells is stimulated Salmonella Typhi
 Some T cells remain in the lymph nodes and retain a 7. Recombinant Vaccines
memory for the antigen - Vaccine antigens may also be produced by genetic
Types of T Cells engineering technology
1. Helper T cells - Hepatitis B, human papillomavirus (HPV) and
- Secrete cytokines that attract and activate B cells influenza
- Produce different types of cytokines The Genetic Approach (nucleic acid vaccine)
2. Cytotoxic T cells  DNA and RNA are the instructions our cells use to make
- Direct attack microorganism proteins. In our cells, DNA is first turned into messenger
- Called killer cells RNA, which is then used as the blueprint to make specific
- Releasing cytolytic enzymes and cytokines proteins
3. Suppressor T cells  A nucleic acid vaccine delivers a specific set of instructions
- Suppressing cytotoxic and helper T cells to our cells either as DNA or RNA, for them to make the
- Preventing the cytotoxic cells specific protein that we want our immune system to
recognize and respond to.

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 MICP211 - LECTURE
BACTERIA MORPHOLOGY Other variety shapes:
3 basic shapes of bacteria  Pleomorphic
1. Coccus (plural: cocci) - Pleo- = many; -morphic = shape
- Shapes: Oval, Round and Spherical - Ability of some bacteria to alter their shape or size
- Ex: staphylococcus and streptococcus in response to environmental conditions
Arrangement of Bacterial Cocci:  Corynebacterium diphtheria
a) Diplococci - Club-shaped
- In pairs Cell Structures (Prokaryote)
- Ex: Neisseria gonorrhoeae (gonorrhea) and I. Extracellular
Neisseria meningitides (meningococcal) A. Envelope structures
b) Streptococci Cell wall
- In chains - other name: Murein Sacculus
- Ex: streptococci pyogenes (strep throat) and - principal component is peptidoglycan
Streptococci mutans (tooth decay) - Functions:
c) Staphylococcus  provides rigid support
- Irregular, grape-like cluster  provides shape to bacteria
- Ex: staphylococcus aureus (skin infection, food  provides protection from osmotic damage
poisoning)  important role in cell division
d) Sarcina/ Octad - Purpose:
- Cube-like packet of 8 cocci  provides rigid support and shape to bacteria
- Ex: Sarcina aurantiaca (normal flora of skin/ GIT –
 provides protection from osmotic damage
body odor)
 site of action of beta-lactam antibiotics
e) Tetrad
- Cubelike packet of 4 cocci Gram- negative Gram-positive
- Ex: Aerococcus (found in urine – cause UTI, - Thin layer/ - Thick layer/ multilayered
septicemia bacteremia, endocarditis) monolayered - Components:
2. Bacillus (plural: bacilli) - Surrounded by an outer  Lipoteichoic acid – for
- Shapes: rod shape and cylindrical membrane attachment
- Ex: Escherichia coli and Salmonella  Teichoic acid – for
Arrangement of bacteria bacilli: attachment and surface
a) Diplobacilli antigen, illicit antibody
- two bacilli linked end to end response, tensile
- Ex: Klebsiella rhinoscleromatis (cause URTI, strength
pneumonia)
b) Streptobacilli
- Ex: streptobacillus moniliformis (cause of Rat bite
fever)
c) Palisades
- Fence like
- Ex: chlamydia trachomatis
d) Coccobacillus
- Short rod-shaped often mistaken as coccus
- Ex: haemophilus influenza
3. Spirillum (plural: Spirilla)
- Spiral shape and curved bacteria
- Can be gently curved shape to a corkscrew like
- Many are rigid and capable of movement Outer membrane
- Ex: treponema pallidum - Gram negative bacteria’s outer membrane
Varieties of spirillum: - Made of LPS (Lipopolysaccharide)
a) Vibrio cholerae - LPS has Lipid A – responsible for endotoxin production
- Short curved rod - O polysaccharide – the polysaccharide component of outer
- Plural – vibrios membrane; antigenic
- Comma shaped Cell membrane
- Less than one complete turn or twist in the cell - Other name: cytoplasmic membrane; plasma membrane;
b) Spirochetes cell sack
- Helical shape and flexible bodies - Located beneath the cell wall
- Move by means of axial filamaents - It encloses the cytoplasm of cell
- Ex: Leptospira a species (Leptospira interrogans) - Like a skin around the cell, separates content of cell from
the outside

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 MICP211 - LECTURE
- Functions:
 Carries enzymes
 Involve in selective permeability
 Active transport of molecules in and out of the
bacteria cell
Glycocalyx
- Thick layer of material located outside cell wall
- Produced by cell membrane and secreted outside cell wall
- Made of polysaccharide or polypeptide
- Outermost covering of some bacteria
- Slimy, gelatinous material
Types of Glycocalyx
a) Capsule – strong attached
- contains polysaccharides
- highly organized and firmly attached to the cell
wall
- indicative of virulence or degree of pathogenicity
- gelatinous; firmly attached to cell wall
- thwart innate defense system thus cause disease.
- Function: serves as antiphagocytic; survives longer
in human body
- Examples:
 Haemophilus influenza – cause of meningitis
and ear infection in children
 Klebsiella pneumoniae
 Neisseria meningitides
 Streptococcus pneumoniae
b) Slime layer – loosely attached
- Not highly organized, not firmly attached to the
cell wall
- Enables bacteria to glide or slide along solid
surfaces
- Ex: Pseudomonas species
- Aids in adherence
- Protects from dehydration and loss of nutrients
- Enable adherence; diffuse & irregular; detached
from cell but still surrounds cell
- Ex: teeth, plastic catheter, prosthetic device, dental
plaque
Biofilm
- Aggregate of bacteria held together by a mucus like
matrix of carbohydrate that adheres to a surface.
Periplasmic space
- Note: in gram negative only
- Fluid filed space between outer membrane and cytoplasmic
membrane
- Has enzyme for breakdown of large molecules
- And transports protein for regulation of osmolality of cells
- Detoxify, inactivate antibiotics
B. Appendage/ Projecting structure
Pili or Fimbriae
- Pilus – Latin for hair; plural – pili
- Rigid surface appendages; fine, short
- Made of protein sub unit “pilins” commonly in gram
negative organism
- Purpose of pili:
1) Common Pili – enables bacteria to adhere or attach in
surfaces (common pili)
2) Sex pillus – enables transfer of genetic material from
one bacterial cell to another conjugation
Flagella (singular: flagellum)
- Whip-like structures
- Thread like structures
- Made of protein sub unit flagellin
- Project from the capsule
- Organs of motility; like propeller
- Organelles of locomotion (cell movement)
- Types of flagella:
 Monotrichus – single polar (Vibrio cholerae)
 Lophotrichous– tuft at one end (Bartonella bacilliforms)
 Amphitrichous – at both ends of the bacteria (Spirillum
serpens)
 Peritrichous – all around the bacillus (Escherichia coli)
 Atrichous – without flagellum
Axial Filaments
- Other name: Endoflagella
- Usually in spirochetes
- Composed of bundles of fibrils
- Arise from end of bacteria cell and spiral around
- Moves the spirochetes in spiral, helical or inchworm
manner
- It wraps around the organism between layers of cell wall
- Ex: Treponema Pallidum (syphilis)
C. Internal Structures
Ribosomes
- site of protein synthesis
- target site of some antibiotic
Nucleoid
- no true nucleus
- does not contain nuclear membrane
- consist of gene material (DNA), which is single, circular or
double stranded DNA
Mesosome
- for secretion of substance (chromosomes) by bacterium
- function is for cell division; binary fission
Granules or Inclusion bodies
- found in certain bacteria
- for storage of food and energy
- Ex: Metachromatic granules of Corynebacterium
diphtheriae
Endospores/ Spores
- Composed of dipicolinic acid
- Resistant to cold, heat, drying, chemical and radiation
- Means of survival when moisture or nutrient supply is low
- Survives for many years in soil or dust resistant to
disinfectant and boiling
- With thick wall
- difficult to destroy/ tough dormant structure
- species which include clostridium and Sporolactobacillus
- causes diseases like botulism, anthrax, tetanus and acute
food poisoning
Cytoplasm
- semifluid gelatinous nutrient matrix
- insoluble H2O
- storage of granules, includes ribosomes and ER
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 MICP211 - LECTURE
BACTERIAL GROWTH REQUIREMENT Bacterial Growth Rate
Environment/ Physical Requirement 1. Lag Phase
 water/ moisture  Absorbs nutrient
 oxygen  Prepare for cell division
 osmotic condition  No increase in number
 pH 2. Log Phase/ Logarithmic / Exponential Phase
 Temperature  Multiplies rapidly & double in each generation time
Oxygen Requirement  Cells are metabolically active
Obligate Aerobes 3. Stationary Phase
- Have absolute or obligate need for oxygen  Equilibrium / Growth slows down
- Ex: Micrococcus species  The culture is at its greatest population density
Obligate Anaerobes  The number of bacteria that are dividing equal the
- Cannot multiply if any oxygen is present, often killed number of dying
even if with traces of oxygen 4. Death (or Decline) Phase
- Ex: Bacteroides (large instestine); Clostridium botulinum  Concentration of waste product increase while the
Facultative Anaerobes nutrient decreases
- Grows with oxygen but can also grow without it  Sporulation may occur in some bacteria
- Ex: Escherichia coli and yeast; Saccharomyces Nutritional Requirement
Microaerophiles 1. Carbon
- Require small oxygem (2%-10%) for aerobic resp  Autotroph/ Lithotroph
- Ex: Helicobacter pylori (cause of gastric and duodenal - Source of carbon are salt and water
ulcer); Spirillum volutans (an aquatic habitant)  Heterotroph
Environment Reqt:
- Organotroph
Aerotolerant Anaerobes
 Phototroph
- Can grow with oxygen presence but do not use it to
- Energy derives from light
transform energy
 Chemotroph
- Ex: Streptococcus pyogenes
- Energy derives from chemical substances
Temperature Requirement
2. Nitrogen, Sulfur and phosphorus
(Optimum Growth Temperature)
Psychrophile  Nitrogen & phosphorus – for synthesis of ATP & nucleic
- Between -5 C to 15 C acid
- Artic/ Antartic/ glacier  Nitrogen & sulfur - for synthesis of protein
Psychrotroph 3. Magnesium, Potassium, Calcium, iron and trace
- Between 20 C to 30 C elements
- But grows well in low temperature - For synthesis of cell material
Mesophiles 4. Growth factor
- Between 25 C to 45 C
- Grow in human body Bacterial Reproduction
Thermophile - Bacteria are prokaryotic cells…
- Between 45 C to 70 C Binary Fission
Hyperthermophile - The division of one cell into two cells, after DNA replication
- 70 C or greater & the formation of a separating membrane & cell wall
pH (hydrogen ion concentration of a solution) DNA Replication
1. Acidophile – grows at pH below 5 - before it divides in half, its chromosome must be duplicated
2. Neutrophile – multiples between pH 5 to 8 first.
3. Alkalophile – grows at pH above 8.5 Binary Fission
Water/ Moisture - parent cell splits in half to become 2 daughter cells.
- Bacteria cell is composed mainly of water Generation Time
- Except: Bacterial endospores, protozoan cyst - the time it takes for binary fission to occur.
- If placed in moist, nutrient rich environment They will grow - varies from one bacterial species to another & also depends
& reproduce normally on the growth condition
- Survive complete drying (desiccation) - ex. E. coli – generation time is every 20 mins.
Osmotic Condition Steps in the Pathogenesis of Infectious Disease
1. Osmotolerant – Requires high osmotic pressure; can 1. Portal of Entry
2. Attachment
tolerate hypertonic environment
3. Multiplication
2. Halophile – Requires high levels of NaCl / salt 4. Invasion or spread
5. Evasion of host defenses
6. Damage to hot tissues

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 MICP211 - LECTURE
Nomenclature – name Characteristic of Viruses
- Developed in 18th century by Carolus Linnareus  Lacks enzymes for energy production
- Binomial system = 2 names  Unable to replicate (multiply) on their own, replication is
directed by genome once in a host cell
Viruses are classified accdg to:
 type of genetic material - DNA or RNA
 shape of capsid
 size of capsid
 number of capsomeres
 presence/absence of envelop
Binomial Nomenclature  type of host that it infects
- A two-name system for writing scientific names  type of disease it produces
1) Genus name – written first and always capitalized  target cell
2) Species name  immunologic / antigenic properties
- written second and never capitalized
- relates to some characteristics of the species or to ANTIMICROBIAL AGENTS
the person who found the original - collectively referred as Chemotherapeutic agent used to
- for example: the scientific name for humans is treat infectious diseases
Home sapiens (Genus Homo = man, sapiens = - any chemical drug used to treat an infectious disease
thinking. In Latin = thinking man) Chemotherapy
 Both words are to be italized if typed, or underlined if - coined by Paul Ehrlich, German medical researcher.
hand written - Term to describe those chemical agents that kill
 Example: Felis concolor / F. concolor pathogens without injuring the host.
 Named after discover Antibacterial Agents
- eg. Yersinia pestis by Alexander Emile Jean - For bacteria
Yersin (1894) Antifungal Agents
- eg. Escherichia – Theodore Escherich - Fungal infections
- eg. Neisseria - Albert Ludwig Neisser - Ex: Butoconazole, Clotrimazole, Econazole,
- eg. Salmonella – Daniel Elmer Salmon Fenticonazole, Isoconazole, Ketoconazole
- eg. Bordetella – Jules Bordet Antiprotozoal Agents
Viruses Structure - Protozal diseases
Virions - Ex: Eflornithine, Furazolidone, Hydroxychloroquine,
- acellular Melarsoprol, Metronidazole
- the complete virus particles / components Antiviral Agents
- 3 major components: - For viral diseases
a) Viral genome - Ex: Abacavir Use for HIV, Acyclovir (Aciclovir) use
b) Protein capsid for herpes, Adefovir, Use for chronic Hepatitis B,
c) Viral Envelop - for some virus Amantadine Use for influenza, Ampligen, Tamiflu for
Viral Genome Influenza type A
- nucleic acid Anthelminthic Agent
- the genomes of viruses can be comprised of single or - used to treat infections of animals with parasitic worms.
double stranded DNA or RNA. - Ex: Albendazole, Mebendazole, Thiabendazole,
 DNA: Double Stranded / Single Stranded Fenbendazole etc.
 RNA: Double Stranded / Single Stranded Antimicrobial Chemotherapy
Protein Capsid - Used to treat any infectious disease
- covers the genomes Antibiotic
- made up of repeating structural subunits called as - a substance produces by microorganisms that is
capsomeres effective in killing or inhibiting the growth of other
a) Polyhedral – many sided ; 20 or more microorganisms-bacteria
b) Helical –coiled tubes - produced by certain moulds
c) Bullet shaped –
d) Spherical - ex: The mold Penicillium notatum,
e) Complex - combination the source of penicillin.
Viral Envelop
- Outer envelope composed of lipids & polysaccharides  The first and most important requirement. It should contain
- viral proteins serve as binding to receptors on the host the capability to kill or inhibit the growth of microorganisms.
cell, play a role in membrane fusion and cell entry, etc.

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 MICP211 - LECTURE
Types of Antibiotics based on type of action Disruption of cell membrane function
Bactericidal - Function: Lipopolysaccharide,
- antibiotics kill bacteria directly inner and outer membranes
- Ex: penicillin, daptomycin, fluoroquinolones, - ex. Polymyxin B, colistin,
metronidazole, nitrofurantoin, co-trimoxazole, daptomycin
telithromycin, etc. - ex. Fungi - Polyene antibiotics
Bacteriostatic (amphotericin B) act by
- antibiotics stop/inhibit bacteria from growing. binding with sterols of fungal cell membrane.
- Ex: Chloramphenicol, Clindamycin, Ethambutol, Inhibition of protein synthesis
Lincosamides, Macrolides, Nitrofurantoin, Novobiocin,  Protein - important component of a cell which is required
etc. for DNA, RNA, and ribosome
Types of Antibiotics based on the spectrum of activity  30S ribosomal subunit - ex.Aminoglycosides,
Narrow-spectrum tetracyclines
- antibiotics are only effective against a narrow range of  50S ribosomal subunit - ex. Macrolides, lincosamides,
bacteria chloramphenicol, oxazolidinones
- ex. penicillin G - effective at killing gram(+)tive
bacteria, but not very effective against gram(-)tive
bacteria.
Broad- spectrum
- antibiotics are effective against a broad range of
bacteria
- act against both gram (+) & gram(-) bacteria
- Ex. Ampicillin, Tetracyclines, Amoxicillin/clavulanic
acid, etc. Action as antimetabolites
According to absorbability from site of administration  Folic acid synthesis enzyme - ex.Sulfonamides, trimethoprim
1. Locally acting  Mycolic acid synthesis enzyme - ex. Isonicotinic acid
- ex: topical agents (topical ointments & eyedrops) hydrazide
- ex. Local Antifungal agents: administered topically
2. Systemically Acting
- affects several body system (ex:antibiotics
administered intravenously)
- ex. Systemic Antifungal agents: administered orally
or intravenously.
Mode of Action or Mechanism of Antimicrobial Drugs
Inhibition of nucleic acid synthesis

Classification based on source of antibacterial agents

1. Semi-synthetic antibiotics
- produced by microbe that are subsequently modified by
organic chemist to increase antimicrobial properties
- Ex. Ampicillin and amikacin
Inhibition of cell wall synthesis
2. Synthetic Antibiotic
- Many bacterial and fungal cells
- man made in lab.
have rigid external cell walls –
- Purely made of chemicals
antimicrobial agents destroy
- 1st synthetic antibiotic was organoarsenic compound
- Ex. penicillin and cephalosporin –
salvarsan, now called arsphenamine (by Paul Ehrlich)
with B-lactam ring which cross-
Ex. sulphonamides, cotrimoxazole, quinolones,etc
linking/ interferes peptidoglycans
3. Natural Antibiotic
in cell wall.
- not made of synthetic material
- Not for Fungi
- produced naturally. (environment)
- Ex. Garlic etc.

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 MICP211 - LECTURE
Antimicrobial Resistance (AMR)  Klebsiella pneumoniae: intestinal bacteria. Resistance in K.
- occurs when bacteria, viruses, fungi and parasites change pneumoniae to last resort treatment (carbapenem
over time and no longer respond to medicines antibiotics)
- making infections harder to treat; increases risk of disease Bacteria
spread, severe illness and death.  Rifampicin-resistant TB (RR-TB)
Acquired resistance  Multi-drug resistant TB (MDR-TB)
- when a particular microorganism obtains the ability to resist Virus: Drug-resistant HIV (HIVDR).
a particular antimicrobial agent to which it was previously Parasite: Plasmodium falciparum resistance to sulfadoxine-
susceptible pyrimethamine
Multidrug-resistant (MDR) Fungal: Drug-resistant Candida auris
- resistant to at least one antibiotic in three or more drug
classes.
Superbugs
- Bacteria with resistance to several commonly used
antibiotics.
Combination therapy PowerPoints:
- Treatment involving more than one drug. Science of Microbiology – Mam Carulla & Handouts sa canvas
- Rationale: lesser likelihood that pathogen develops Normal Flora of the Human Body – Mam Carulla
resistance to multiple drugs. Microscope – Mam Aida
Empirical diagnosis and/or treatment Bacteria and Disease – Mam Aida
- Diagnosis or treatment base on clinical educated guess in the
Disinfection and Sterilization – Mam Ilarde & Handouts sa
absence of complete or perfect information.
Causes canvas
1. Natural occurrence Human Host Defense – Mam Carulla
- able to adapt to their environment survive and continue Bacteria Morphology – Mam Aida
to produce offspring Bacterial growth – Mam Aida
2. Self-medication Antimicrobial agents – Mam Aida
- taking medicines on one's own initiative or on another Kung may book kayo, mas maganda gamitin nyo rin sya
person's suggestion, who is not a certified medical habang ginagamit nyo tong reviewer hihi Masyadong marami
professional" to perooo kaya yannn. Gooodd luck :))) – Aki
3. Clinical misuse
- prescribed antibiotics were unnecessary duration of
therapy was incorrect
4. Environmental pollution
- inappropriate disposal of unused/ expired medication
exposes microbes in environment to antibiotics; trigger
evolution of resistance
5. Livestock
- Antibiotics are fed to livestock to act as growth
supplements & preventative measure to decrease
infections.
- Results in transfer of resistant bacterial strains into the
food that humans eat, causing potentially fatal transfer
of disease
6. Pesticides
- overuse results in many of these microbes evolving a
tolerance against these antimicrobial agents

Bacteria
 Rifampicin: resistant TB (RR-TB)
 Multi-drug resistant TB (MDR-TB)
 Ciprofloxacin: varied from 8.4% to 92.9% for Escherichia
coli (UTI)
 Staphylococcus aureus: Methicillin-resistant
 Staphylococcus aureus (MRSA) infections
 Neisseria gonorrhoeae: injectable extended spectrum
cephalosporin (ESC) ceftriaxone is the only remaining
empiric monotherapy for gonorrhea

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