* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Microbiology
Microorganism wikipedia , lookup
History of virology wikipedia , lookup
Germ theory of disease wikipedia , lookup
Trimeric autotransporter adhesin wikipedia , lookup
Phospholipid-derived fatty acids wikipedia , lookup
Globalization and disease wikipedia , lookup
Carbapenem-resistant enterobacteriaceae wikipedia , lookup
Transmission (medicine) wikipedia , lookup
Anaerobic infection wikipedia , lookup
Clostridium difficile infection wikipedia , lookup
Neonatal infection wikipedia , lookup
Schistosomiasis wikipedia , lookup
Gastroenteritis wikipedia , lookup
Urinary tract infection wikipedia , lookup
Human microbiota wikipedia , lookup
Infection control wikipedia , lookup
Marine microorganism wikipedia , lookup
Traveler's diarrhea wikipedia , lookup
Triclocarban wikipedia , lookup
Bacterial cell structure wikipedia , lookup
Hospital-acquired infection wikipedia , lookup
Prepare by S.V ****************************************************************************************** 09/21/07 Microbiology ******** -Introduction: Microbiology is a branch of Biology deals with study of micro organisms. -Micro organisms: are present everywhere in the earth includes air, soil, water, plants, animal, humans and dead materials -Micro organisms: are unicellular and Milticellular -Some of them are pathogenic (causing disease) and most of them are non-pathogenic. -Micro organisms: are very small to be seen only through microscope -Antory Van Leeuwenhork ( 1675 netherlands) who observed bacteria and protozoa( micro organisms) first with this sample microscope. so he is a father of microbiology. -The microorganisms or microbes are classified based on the presence of nucleus. These are Prokaryotic micro organisms, Eukaryotic micro organisms and virus. Prokaryotic -The nucleus and membrane bound organelles are not present -The side of the cell is 0.2-2µm -The genetic material is freely distributed in the cytoplasm. -The ribosome 70s. S=Svedberg unit: to measure the size of ribosome. Eg: Bacteria Eukaryotic -Nucleus and membrane bound organelles (mitochonchondri) endoplasmic reticulum and Golgi body are present. -The cell size is 2-20µm -The genetic material is present in the nucleus -The 80s ribosome is present Eg: fungi and protozoa - the virus is also considered as microorganism but it is call acellur and non cellular organism. Bacteria -It is a prokaryotic microorganism the size range between 0.2-0.5 µm -Most of them are nonpathogenic because it doesn’t contain virulent factor properties (toxic components) and some of them are pathogenic (contains virulent factors). -Most of the bacteria can live in extreme condition and can change the environment. Morphology of Bacteria - There shapes are many shapes of bacteria including Cocci, Bacilli and Spirochetes I. Cocci or Coccus: some of the bacteria are look like spherical shape or round shape, such type of bacteria are called Cocci they are different type of Cocci based on the number of cell and arrangement. a) Mono Coccus: single cell b) Diplococcus noncapsulated: two cell joined together to form this structure (pair) and it don’t have membrane which surrounded the cell. c) Diplococcus encapsulated: two cells joined together with membrane coated over the cell. d) Streptococcus some bacteria look like chain like structure is called Streptococcus e) Staphylococcus the bacteria look like clusters of grape. II. Bacilli or Bacillus : most of the bacteria are look like rod shape or cylinder shape. This is called bacilli, there are several type - Mono Bacillus: single rod shaped - Diplo Bacillus: two rods joined together to form this shape - Flagellated Bacillus: some bacteria have flagella (hair like structure) present in the cell wall which help the bacteria move from one place to another place. - Coccobacillus: it look like round as well as rod such type of bacteria are called coccusbacillus. - Comma shaped bacillus: some bacteria look like comma shape - Sporbearing bacillus: some bacteria can release the spore which is highly resistant to live in extreme condition and can live for more than too fears such type is called spore bearing bacillus. - Strepto bacillus: chain like arrangement III. Spirochetes: the bacteria look like spiral shape structure Page 1 Prepare by S.V ****************************************************************************************** 09/21/07 Classification of Bacteria The classification of bacteria is base on the cell wall. There are: I. Thick walled bacteria II. Thin cell walled III. Wall less bacteria I. Thick wall bacteria Some bacteria are having thick and rigid cell wall is made up of peptidoglycan layer (polysaccharide+peptid) it provides protection to the bacteria. There are two types of thick cell walled bacteria. Gram positive bacteria and Gram negative bacteria The gram positive bacteria and gram negative bacteria can be observed or identified by Gram staining technique.( Hans Christian Gram 1884) in the technique the Gram positive appears like violet color or blue color after added the reagent. The gram negative bacteria appear like pink color or red color after adding the reagent. Gram staining technique Take bacteria sample (blood or saliva) then put the blood sample into the slide and make a thin film (smear) then add crystal violet after that wait for 2 minutes followed by add water then add gram iodine and wash with water. Then add alcohol followed by with water. Finally add safranin wait for 60 seconds wash with water. Take the slide and keep it into violet color is gram positive. If it pink or red color is gram negative. - Gram positive bacteria It contains more than 40 layers of peptidoglycan in the cell wall give more rigid (strong) and provides protection of the bacteria. The cell wall also contain Fibrillar layer which acts as a toxic component (virulent factor). The cell wall contain Teichoic acid and Lipoteichoic acid which give support to the cell wall. - Gram negative bacteria The cell wall of the gram negative bacteria contain single layer of peptidglycan The cell wall also contain Lipopolysaccharide which acts as a virulent factor. - Gram positive bacteria are two shape normally: 1. Gram positive cocci Ex. Staphylococcus species, streptococcus species, entorococcus faecalis 2. Gram positive rods Ex. Bacillus species, clostridium species, corynebacterium diphtheriae Gram negative bacteria are two shape normally: a. Gram negative cocci: Ex. Neisseria species, b. Gram negative rods: Ex. Salmonella species, shigella species, Escherichia coli, Vibrio cholerae, Campylobacteria jejuni, Pseudomonas species, Helicobactor pylori, Klebsiella pneumoniae, Proteus species, Bacteroides pertusis, Brucella species, Yersinia species, Fronciesella tulerensis, Legionella pneumophila, Haemophilus influenzae. Acid Fast Bacteria Acid fast is the name of the staining technique to identify some bacteria. Acid Fast staining method Take bacteria sample→ make thin smear→ add carbal fuchsin+ phenol→ keep this slide in boiling water for few minute→ wash with water→ add acid(3%)- Alcohol(97%)→ wash with water→ add Methylene blue→ wash with the slide. Keep this slide and through microscope. If it look like Reddish color confirm that the bacteria is acid fast bacteria. -The acid fast bacterial cell wall contain single layer of peptidoglycan, Fatty acid and waxes. -The Fatty acid and waxes acts as virulent factor of bacteria wich cause diseases of the humans. Ex. Myobacterium tuberculosis, Myocobacterium leprae, Nocardia species. Page 2 Prepare by S.V ****************************************************************************************** 09/21/07 II. Thin cell wall bacteria: Some of bacterial is very thin and it is flexible in nature Ex. Spirochetes III. wall less bacteria The wall less bacteria which do not have the cell wall. Structure Properties of Bacteria Cell wall: the outer layer of the bacteria which is made up of peptidoglycan. It protects the bacgteria. Cytoplasmic membrane: it is a layer which surround the cytoplasm. It acts as a permeable layer and it allowed the inside toxic components to go outside and cause diseases to the humans body. Ribosome: the synthesis of protein take place in ribosome. Chromosome: it contain DNA (Deoxy Ribose Nucleic Acid) as a genetic natural. Plasma: it is an extrachronosomal circular DNA which contains ß-lactamase enzyme provide to some antibiotic like penicillin. Inclusion: it is an energy stored material which give energy to live the bacterial cell. Virulent properties of bacteria The pathogenesis of bacteria refers to the presence of virulent factor (toxic component) in the bacteria. The virulent factor is the main causative thing for diseases. There is several type of virulent factor. i) Adherence factor: the bacteria contain hair like structure called Flagella and Pilus which help he bacteria to adhere the host cell surface. After adherence the bacteria can release the toxic material and make disease. ii) Capsule: it is presents in the cell wall of bacteria which is made up of popolysaccharide which fight against phagocytic cell (type of immune cell) like Microphage. Because whenever the bacteria is enter into the body the phagocytic cell immediately attack the bacteria and kill is so, if the capsule is present the bacteria can easily live in the human body. iii) Exotoxins: it is found in gram positive and gram negative bacteria it is made up of polypebtides and has got two subunit normally. A-subunit and B-subunit. The function of B-subunit is to bind the host cell after that the subunit release the toxin then the toxin can easily attack the various organs like Kidneys, heart, liver, lungs act. It also cause hemorrhage (bleeding) and swelling. iv) Endotoxin: it is found in the gram negative bacteria which is made up of Lypopolysaccharids. It cause fever, general ache and general weakness. v) Enzyme: the bacteria contain some enzymes which act as a toxic enzymes. The function of this enzymes is to attacks the cell membrane, tissue matrix and connective tissues lead to paralysis. vi) Enterotoxin: this toxin is present inside the cell of bacteria which attacks the mucus membrane in the intestinal tract and cause vomiting and diarrhea. vii) Cell surface carbohydrates and proteins: the bacteria also contain some toxic carbohydrate and proteins which attacks the immune cell in the human body so that the bacteria can easily attacks the cells. Culture of Bacteria The culture (grow) of bacteria is very important to find the name of the bacteria and with this culture we can choose the antibiotic to cure the diseases. Requirement for Bacteria Culture 1. petridish: it is a glass plate in this we can cure the culture bacteria. 2. Medium: it is nutrient material which feed the bacteria to grow 3. Incubation chambar: highly sterilized chambar to keep the culture plate here. 4. Water: to clean the glass wares 5. Patient sample: blood, sputum, stool, urine, mucus, wound tissue… Procedure: Medium pour Blood sample put different (antibiotic) Zone formation Incubation for 2 days → Petridish Or petriplate → → bacteria ceftriaxone penicillin Clavithromycin Erythromycin Keep it into Microscope and find out Page 3 Prepare by S.V ****************************************************************************************** 09/21/07 Gram positive cocci bacteria infection I. Staphy loccal infection The staphylococcus bacteria are clusters of gram like shape. There are three important staphyloccus species are causing disease. i) Staphylococcus aureus: it is a gram positive cocci bacteria 1. 2. 3. 4. 5. 6. 7. Phathogenesis Coagulose enzyme: this enzyme is present in the bacteria which stimulates the prothrombin to clot the blood in the injured region and make infections because the prothrombin is acting as a blood clotting factor involve in the blood clotting. One the blood is clotted in the injured region the bacteria can make colonies and cause wound infection. Catalase: it is an enzyme which breaks the H2O2 (hydrogen peroxide) in to H2O+O2 because the H2O2 act as a antibacterial agent in the body so that the enzyme can attack this H2O2 and cause infection. Protein-A: it is a protein toxic which fight against the immure protein like complement protein. Enterotoxin: it cause a diarrhea and vomiting while eating the contaminated or spoiled food and water. Toxic shock syndrome toxin: it is a toxin released from the bacteria. The function of this toxin is to make toxic shock in the wound regionally especially the vaginal wound. Exfoliatin: this is an toxin which attacks the epidermal layer of the skin to make scales in the skin. Leukocidin: it is an another toxin which attacks the leukocyte (WBC) Disease Abscess or wound infection: infection in the wound region with pus. Gastritis: inflammation in the digestive tract. The symptom like diarrhea, vomiting, abdominal pain, loss of appetite etc. Toxic shock syndrome toxin: sever shock pain in the vaginal wound region with the present of pus. Folliculitis: inflammation with pus in the follicles. Staphyloccal scalded skin syndrome: The inflammatory condition in epidermal layer of the skin. The damage or breakdown of the epidermis which make skin scales. This disease is very common in young children (below 5 year). 1. 2. 3. 4. 5. Transmission - Transmitted from contaminated or spoild food and water - It also transmitted from infected patient to normal person and environment Diagnosis Blood culture and blood smear to find out these bacteria. Coagulase test: take citrated plasma (plasma contain sodium citrate) and add the bacterial culture. Keep the tube for incubation at 31 0c for 4 hour. If any clot formation take place confirm that the patient is infected with staphylococcus aureas. Treatment: vacomycin is an antibiotic to kill this bacteria. Prevention: - avoid contact with infected patient - Make yourself proper hygieon - Avoid contaminated food and water ii) Staphylococcus epidermidis: It is a gram positive bacteria Virulent factor: Glycocalyx: it is made up of glycoprotein and polysaccharide which is found in the cell wall of S.epidermidis. the function of glycocalyx is to adhere in the prosthetic (arrificial) heart valves and prosthetic hip and make infections. Diseases 1. Endocaditis:it is an inflammation condition of prosthetic heart valve in the endocosodium of the heart. The S.epidermidis bacteria can release the glycocalyx and stick in to prosthetic heart valve and make infection as well as damage in the valve.This condition the patient have symptom like hemorrhage, circulatory problem, serve, chest pain, nausea and heart attack. 2. Prothetic hip infection: the inflammation in the prosthetic hip region especially artificial hip implanted patient. The patient have symptom like sever joint pain, swelling in the joint etc. 3. Neonated sepsis: it is an inflammatory and infection in the blood of neonate (just born baby or below 1 month baby) the S.epidermidis is normally found in the vaginal region, during child birth the bacteria enter through placenta and spread through out the blood and entire organs of the baby to cause this infection. The symptom like hemorrhage, diarrhea, skin rashes, jaundice etc. Page 4 Prepare by S.V ****************************************************************************************** 09/21/07 Transmission: During dental surgery, childbirth the bacteria can easily enter and cause disease. Diagnosis: Blood culture and blood smear to identify these bacteria. Treatment: Vacomycin + Hentamicin + Rifampin Prevention: During dental surgery, the patient should be treated with Cefazolin (antibiotic). During pregnancy the women should maintain hygiene. iii) Staphylococcus saprophyticus: it is gram-positive bacteria Virulent factor: pilus: it is a heir like structure which is present outside the cell wall. The function is to adhere the host cell surface especially the urinary tract. Disease: urinary tract infection (UTI), the urinary tract infection consist of urethra, bladder, prostate(non), ureter and kidney. The bacteria can easily attack the urinary tract and make infection. - Urethritis: the inflammation occurs in the urethra - Cystitis: the inflammation condition in bladder - Prostatitis: the inflammation in the prostate region of the man - Pyclorephritis: inflammatory in the kidney. The UTI symptom like pyuria, Nocturia, dysuria, hematuria and foul smell urine Transmission: through ascending way to get inside the urinary tract. The unsterilized urinary catheter cause UTI Diagnosis: urine culture to find out these bacteria Treatment: Norfloxacin (antibiotic) alone or Norfloxacin + Trinethoprin sulfanethoxazole as a combination therapy for sever UTI. Prevention: the urinary catheter should be sterilized properly before insertion. The toilet should be cleaned always especially in hospital. II. Steptococcal infection The streptococcus bacteria are classified in to three group namely Group A Streptococcus pneumonia: it has α-Hemolytic enzyme that lye hemoglobin and make color change( from red to 50/gree color) during culture process. Group B Streptococcus pyogenes, streptococcus agalatias, streptococcus mutans and streptococcus sanguis: this bacteria have ß-hemolytic enzyme that make 100% green color during the culture process. Group C Enteroccus faecels: there will not be any colors change during culture. i. Streptococcus pneumonia: it is a gram positive bacteria look like chain structure. 1. 2. 3. Virulent factor: pilus: help the bacteria to attach into the host cell capsule: it is made up by of polysaccharides which fight against phagocytic cell like macrophage Pneumolysin: it is an enzyme that invade (attach) the cell membrane in the respiratory tract it also have hemolytic action and against immune cell. Disease -Pneumonia: the inflammation condition in the alveoli region (air sac) of the lung. The symptom like difficult to breath, cold, cough, yellow color sputum, fever and malaise. -Sinusitis: the inflammatory condition in the sinus region. The symptom like sneezing, runny, nose, swollen in the sinus, pain and fever. -Otitis media: the S. pneumonia also attack the middle ear (eardrum) and make infection there. The symptom like ear pain, difficult to hear the sound and fever. Transmission: Through respiratory droplet from infection patients. Diagnosis: Sputum culture, the culture plate will become 50% green color from red color Treatment: Cephalexin (antibiotic) to kill S. pneumonia + Cetrizene for runny nose Prevention: avoid contact with infection patient Page 5 Prepare by S.V ****************************************************************************************** 09/21/07 ii. Streptococcus pyogenes: it is a gram positive look like chain structure. 1. 2. 3. 4. 5. 6. Virulent factor capsule: have “antiphagocytic” streptolysin “s”and “o”: it has hemolytic action. And lyses the hemoglobin molecule an important for finding the bacteria during blood culture. Protein F: This protein specifically attach into the fibronectin (a protein is found in the pharynx region) and cause inflammation in the pharynx region. Dnases: it is an enzyme that attach DNA Exotoxin: it is also called erythrogenic toxin which make skin rashes (scars) after the scarlet fever Hyaluronidase: the enzyme which attach the hyaluronic acid which is found in the connective tissue like skin and make inflammation Diseases 1. pharyngitis: the inflammatory condition in the pharynx region. The symptom like red color swollen in the pharynx region, sore throat, difficult to swallow food, pain in the pharynx region, fever etc. 2. Cellulitis: the inflammation in the connective tissue like skin especially the lower arms and lower legs will have infection. The symptom like red colour rashes, pain, fever etc. 3. Rheumatic fever: the inflammatory condition in the heart, skin and joint. The patient will have symptom like murmur, obstruction in the heart resell, swelling in the joint, pain and fever and skin rashes. 4. Impetigo: the common skin disease in children. The symptom blister in the skin, red rashes, fever, malaise etc Transmission :Transmitted easily from infection person to normal person while touching the body and respiratory droplets. Diagnosis: blood culture and blood smear with gram staining technique. Physical examination and patient history Treatment: Cephalexin (antibiotic) is an effective drug for streptococcus pyogenes infection. Preventtion: - avoid contact with infection patient - Hygiene is important iii. streptococcus agalactiae: it is a gram positive bacteria look like chain structure Virulent factor: capsul: it has antiphagocytic action Disease 1. Neonatal meningitis: the sever inflammation in the meninges (membrane which surround brain and spinal cord) region in neonatal. The S. agalactiae is found in the vaginal region of the pregnant women and during the child birth the bacteria can easily trans into the baby’s blood to placenta and cause infection in the meningitis. The symptom like hemorrhage, felling exited, confusion, fever, poor breath feeding, jaundice, diarrhea and vomiting. 2. Omphalitis: the inflammation in the umbilical cord region in the neonates. It is uncommon in neonates the symptom like pain with sever red rashes around the umbilical cord, fever, pus formation in the umbilical region etc. 3. Endometritis: the inflammation condition in the endometrial region of the uterus due to S.agalactiae bacteria. The symptom like excessive vaginal bleeding, excessive vaginal fluid discharge, pain and fever. 4. Osteomyelitis: it is a bone or joint infection due to S.agalactiae bacteria. The symptom like server swelling in the joint, pain and fever. Transmission: this bacteria is mainly transmitted from mother to baby during childbirth it can also transmit from theusterilized surgical instruments. Treatment: Ceftriaxons: it is an antibiotic which kill this bacteria effectivety Prevention: -give ampicillin to mother during the childbirth -use sterilized surgical instruction before doing surgery -use batadine or bacitracin to wash the umbilical cord region after childbirth to prevent omphalitis. The childbirth center or hospital should be hygienic. Page 6 Prepare by S.V ****************************************************************************************** 09/21/07 iv. Streptococcus mutans and streptococcus sanguis: these are gram positive look like chain structure Virulent factor: Glucans: it is a cell surface carbohydrate present in the cell wall of these bacteria. The function of glucans is to adhere of attach into the dental region and prosthetic heart valve to cause infection Disease 1. Dental caries: the inflammatory condition in the dental region due to S.mutans and S.sanguis. the symptom like black or brown colour appearance in the dental region, swelling in the guns and tooth loss. 2. Endocarditis: the inflammation in the prosthetic heart valves due to these bacteria. The symptom like murmur, circulatory problem, ECG abnormalities and chest pain. Transmission: this bacteria normally present in oral cavity and when ever the oral hygiene is not there can easily make infection. During dental surgery the bacteria can enter into the blood steam to attach the prosthetic heart valves to cause endocarditis Diagnosis -physical appearance of the oral cavity -blood culture - Treatment Streptomycin or Gentamicin of dental caries Warm salt water gargle is important Vacomycin + Gentamicin for endocarditis - Prevention give Ceftriazolin during dental surgery oral hygiene is important V. Enterococcus faecalis: it is a gram positive with diplococcus appearance Disease 1. Urinary tract infection: the infection in the urinary tract including urethra, bladder, prostate (men) and kidney. The symptom like dysuria, pyuria, nocturia, hematouria, freguency urination, foul smell urine and back pain. 2. Biliary tract infection: the biliary tract comprise of gallbladder, bile duct and liver. The bile acid are secreted from the liver and stored in the gallbladder and bile duct. The function of the bile acids to make digest the fatty foods. The E.faecalis bacteria can easily enter to the biliary tract during gastresinstestinal surgery to cause infection in this region. 3. Acute cholocystitis: the inflammation in the gallbladder. 4. Cholangitis: the inflammatory in the bile duct. The symptom of biliary tract infection like jaundice, loss appetite, fell fullness, vomiting, hapatomegaly and liver necrosis. Transmission The E.faecalis mainly transmitted from the unsterilized surgical instruments during gastrointestinal surgery, urinary tract surgery and unsterilized urinary catheter. Diagnosis: urine culture and blood culture Treatment: -Norfloxacin + Trinethoprin sulfamethoxazole for UTI -Quinupristin + Dalfoprinstin (two different antibiotic) for the treatment of biliary tract infection. - Prevention the surgical instruments should be sterilized properly before doing the surgery give Cefazolin during the surgery the urine catheter should be sterilized properly and it should be properly inserted in to the urinary tract Page 7 Prepare by S.V ****************************************************************************************** 09/21/07 Gram positive rod shaped bacteria Pathogenic I. Bacillus anthracis: it is a gram positive spore forming rod shaped bacteria look like drum stick shape. The spore is look like the round shape structure which can live in the extreme climatic condition. Virulent factor: 1. Capsule: it has antiphagocytic action 2. Anthrax toxic: it comprises of three portion ulcer contain protective antigen, edema factor and lethal factor. * Protective antigen: it helps the toxin to binds with host cell surface. *Edema factor: the function is to make edema (swelling) in tissue *Lethal factor: it is responsible for causing cell death or necrosis Disease The B.anthrasis cause anthrax disease. There are three type of anthrax disease. 1. Inhalational anthrax: There is inflammation in the lung due to B.anthracis. the B.anthracis spore normally found in the soil and can directly enter in to the respiratory tract while inhalation. It can also transmitted from the B.anthracis infected animal. Symptom like chest pain, cough, fever, yellow coloured sputum and general weakness. 2. Gastrointestinal anthrax: The server inflammation in the gastro intestinal tract due to bacillus anthracis contaminated vegetables, fruits and animal meat. The symptom like abdominal cramps, bloody vomiting, bloody diarrhea, abdominal pain and loss of appetite. 3. Cutaneous anthrax: The bacillus anthracis spores can easily enter into the skin (cutaneous) region when there is an injury which cause server inflammation over there. The symptoms like ulcer in the skin, redness and blister ( pus is filled in small lesion) Transmission: The bacillus anthracis spores are easily transmitted from the soil, contaminated vegetable, fruits, infection meat, air (by inhalation) and fly bite. Diagnosis: - blood, sputum, stool and wound culture to find out this bacteria - chest x’ray to find out the lung infection - Treatment Ciprofloxacin or doxycycline or vacomycin or Erythromycin for the treatment of B.anthracis infection Erythromycin cream for contaneous anthrax - Prevention wash vegetables and fruits before eat cook properly and make more than 100 0c of meat to prevent from B.anthracis gastrointestinal anthrax the wound must be maintain properly keep away fly bite II. Clostridium tetani: it is a gram positive spore forming rod bacteria it look like drum stick shape and the inside spore look like spherical or round shape. Virulent factor: Tetanospasmin it is exotoxin and also calls neurotoxin because it attacks the nervous system and cause infection. This bacterial spores are present in the soil, if any injury or wound in the body can easily enter and penetrate in to the neral blood flow then the toxin is released from the spores and directly blocks the release of glycine and GABA (Gamma Amino Butyric Acid) neurotransmitter. This neuron transmitters are involving in the muscle relaxation (inhibitory neuron transmitters) when this toxin is blocking these neuron transmitter the patient will get server muscle contraction (spasm). Disease Tetanus: the server muscle contraction or muscle spasm due to tetanospasmin released from C.tetani bacteria which blocks the cilycin and GABA. The symptom like server muscle stiffness unconsciousness and felling exitation. Transmission The C.tetani spores normally found in soil, if any injury or wound in the body this bacteria can easily enter and cause disease. Diagnosis: blood culture, CSF culture and physical appearance Page 8 Prepare by S.V ****************************************************************************************** 09/21/07 Treatment: -Tetanus immunoglobulin injection (antibody) -vacomycin or ceftriaxone+ Metronidazole -Valium injection (antispasmodic drug) -most important the patient has to admit immediately and should be treat at least 1 week or 10 days. Prevention DPT vaccine: it contains three vaccines namely, Diphtheria pertusis and tetanus vaccine prevent from those three diseases. III. Clostridium botulinum It is gram positive spore forming rod bacteria look like drum stick structure. Virulent factor: Botulinum toxin: it is an neurotoxin and also called as exotoxin. This toxin specifically attacks acetyl choline neuron transmitter in the myoneural junction lead to flaccid paralysis. Because the acetyl choline is an important neurostransmitter for muscles contraction. Disease: Botulism: this is the rare condition that the stopped muscle contraction due to C.botulinum and the patient will not be able to contract the muscle. If the lung muscle is stopped to contract the patient will go to fatal condition. The botulism is also called as flaccid paralysis and there are three type of botulism. *Food borne botulism: the paralysis due to ingestion of contaminated foods especially improperly preserved food (Tin or Cans food) *wound botulism: this bacteria can also enter through wound and cause paralysis is called wound botulism. *Infant botulism: the infant is getting paralysis due to ingestion of contaminated honey. The symptom like muscle weakness dry mouth, slurred speech, difficult to swallow foods, difficult to move body, vomiting and diarrhea. Transmission: from the soil, can enter to the wound and cause disease. It is also transmitted from contaminated food including honey. Diagnosis: -Elisa technique (enzyme linked immuno sorbent assay) to check the botulinum toxin found in blood. -Physical appearance -collecting patient history from the relative Treatment: -Botulinum antitoxin: it is an antibody getting from the horse that attacks specifically the botulinum toxin -Vacomycin or ceftriaxone -Metronidazole -make respiratory facility to supply oxygen -Human botulinum immunoglobulin for infant botulism -most importantly the patient has to admit immediately Prevention: -Avoid contaminated foods and honey -use quality food products including tin or cans foods -the wound properly cleared and closed it with band-acid -the food must be cooked properly before eat IV. Clostridium perfringens: It is a gram positive spore forming rod shaped bacteria and the size range between 1-4µm. Virulent factor: 1. α-toxin: it is an exotoxin which contain lecithinase enzyme which damage mammalian cell membrance, erythrocytes, leukocytes and patelets. 2. Enterotoxin: it attacks the mucus membrance and to release the fluid and intracellular proteins. The patient will get diarrhea and vomiting due to enterotoxin. 3. Degradative enzyme: the C-parfringens contain Dnase which attaks DNA, proteases which damage proteins, hyaluronidase enzyme that brak the collagen. The most important degradative enzyme is to make gas formation in the tissue. Page 9 Prepare by S.V ****************************************************************************************** 09/21/07 Disease: 1. gas gangrene: the formation of gas in the necrotic tissue or dead tissue due to C.perfringens. the gas gangrene tissue will not have blood circulation, vasoconstriction and increased vascular permeability. The gas includes Hydrogens 5,9%, CO2 7,4 %, N2 74% and O2 16% found in the gas gangrened tissue. The gas gangrene happens due to burn injury, accidental and surgical wound whenever the C.perfringens enter in this regions will produce gas formation and make the cell to die the symptom like swelling or edema, pain, pus formation (rare), loss of sensation and fever. If it is not treated immediately the patient will die. 2. food poisoning: the ingestion C.perfringens contaminated food will lead to server gastro intestinal problem including diarrhea, vomiting, abdominal pain, fell fullness and loss of appetite . 3. clostridial endometitis: the neurotic tissue formation in the uterus region due to improper treatment or surgery with abortion the improperly cleaned fetus will leads to necrotic tissue with gas formation ( gas gangrene) will lead to fatal. If the doctor using unsterilized surgical instruments will cause this disease. Symptom: Excessive vaginal bleeding, excessive vaginal fluid discharge with pus, server pain and fever. Transmission: the bacteria is normally found in the soil, air hospital environment and contaminated food will cause disease Diagnosis: blood, wound, stool culture, x-ray and CT-scan to see the gas gangrene in the GI-tract and uterus. - Treatment: wound debridement (surgical removal of necrotic tissue) Clindamycin is also administer while doing the surgery - Prevention wound maintain ( use antiseptics like Betadine) give Cefdiniv (antibiotic) to accidental case avoid contaminated food look properly before eat V. Clostridium difficle: It’s a gram positive rod shaped spore forming bacteria Virulent factor: 1. Toxin-A: it is also called enterotoxin that make inflammation in the GI tract 2. Toxin-B: it is also called exotoxin or cytotoxin which attacks the protein synthesis in human body. Disease Pseudomembraneuse colitis: the false membrane formation in the colon region, due to C.difficile this bacteria is normally found in the hospital environment mainly toilet whenever the chronic patient is talking regular antibiotics will have ulcer formation in the GI region. When the patients is having the ulcer in the GI tract if the bacteria enter to the ulcer region will make server inflammation over there with the formation of Pseudomembrance (accumulation of bacteria in the GI region). Symptom: diarrhea, abdominal pain and abdominal tenderness (fell pain when pressure cones). Transmission: This bacterium is found in the hospital environment and can easily transmitted through fecal and oral contaminated. Diagnosis: stool culture and endoscopy ( it is an instrument fixed with camera to easily find out ulcer, tumor or cancer in the UI tract. - Treatment: stop Ampicilin or Clindamycin immediately Laproscopic surgery to remove Pseudomembracne Administer with Vacomycin + Metronidazole Give portoprozole or Rebeprozole (antiulcer drug) before food (15mn). Prevention -chronic patient give Partoprozole or Omeprozole or Rabeprozole with antibiotic -the hospital environment should be more hygienic always -avoid contaminated food Page 10 Prepare by S.V ****************************************************************************************** 09/21/07 VI. Corynebacterium Diphtheriae It is a gram positive rod shape look like L shape or V shaped appearance Virulent factor: Diphtheria toxin: it is an exotoxin which is highly protein paten toxin, have to subunits namely A and B subunit. The B-subunit bind to mucus membrane in the throat region as well as skin and then the A-subunit invade the tissue especially the throat region and skin. Disease: 1. pharyngell and tonsillar diphtheria: the inflammation condition in the pharynx and tonsils region due to the diphtheria toxin release from C.diphtheriae. these toxin also invade the nasal region and cause inflammation over there. The symptom like sore throat, swollen in the throat region, dry cough, pain and fever. This disease is common in children. 2. Cutaneous diphtheria: it is inflammation condition in the skin due to C.diphtheriae. whenever the bacteria enter into the skin through injury or wound can attacks the cutaneous layer of the skin and cause infection. The symptom like skin ulcer, redness around the infected region, pain and fever. Transmission: this bacteria is easily transmitted from infected patient to normal patient through respiratory droplets. It can also transmitted from soil to the wound can cause disease. Diagnosis: Mucus or nasopharyngel swab culture to find out this bacteria Treatment: Erythromycin Prevention: DPT vaccine Page 11 Prepare by S.V ****************************************************************************************** 09/21/07 Summaries Gram positive bateria Gram positive bacteria contain 40 layer of peptidoglycan, cell wall contain Fibrillar layer act as virulent factor and Teichoic and Lipoteichoic acid. Gram positive bacteria are two shape * Gram positive cocci v. Enterococcus faecalis -Disease: Urinary tract infection, biliary tract infection, acute cholocystitis, cholangitis -Treatment: Norfloxacin+ trimethoprim sulfamethoxazole for UTI, Quinupristin+Dalfoprinstin * Gram positive I. staphy loccal infection i. staphylococcus aureus -Phathogenesis: coagulose enzyme, catalase, protein-A, Enterotoxin, toxic shock syndrome toxin, Exfoliatin,Leukocidin. -Disease: Abscess or wound infection, Gastritis, toxic shock syndrome toxin, Folliculitis,staphyloccal scalded skin syndrome. -Treatment: Vacomycin ii. staphylococcus epidermidis -virulent factor: Glycocalyx -Disease: Endocarditis, Prothetic hip infection, neonated sipsi. -Treatment: Vacomycin+Hentamicin+Refampicin iii. staphylococcus saprophyticus -virulent factor: pilus -Disease: (UTI) urethritis, cystitis, prostatitis, pyclorephritis -Treatment: Norfloxacin or Norfloxacin+Trimethprin sulfamethoxazole i. streptococcus pneumonia -virulent factor: Pilus, capsule pneumolism -Disease: pneumonia, sinusitis, otitis media -Treatment: Cephalexin to kill s.pneumonia+cetrizene for runny nose II. clostridium tetani -virulent factor: tetanospasmin -Disease: Tetanus -Treatment:Tetanus immunoglobulin injection, Vacomycin or cefriaxon+Metronidazole, Valium IV. clostridium perfringens -virulent factor: α-toxin,Enterotoxin,Degradative enzyme -Disease:gas gangrene,food poisoning,clostridial endometitis -Treatmen: wound debridemen,Clindamycin ii. streptococcus pyogenes -virulent factor: capsul, streptolysin “s” and “O”, protein-F, Dnase, Exotoxin, Hyaluronidase -Disease: Pharyngitis, cellulitis, Rheumatic fever impetigo. -Treatment: Cephalexin iv. Streptococcus mutans and streptococcus sanguis -Virulent factor: Glucans -Disease:Dental caries,Endocarditis -Treatment - Streptomycin or Gentamicin of dental caries - Warm salt water gargle is important - Vacomycin + Gentamicin for endocarditis I. Bacillus anthracis -virulent factor: capsule, anthrax toxic( protective antigen, Edema factor, Lethal factor) -Disease: Inhalational anthrax, Gastrointestinal anthrax, Cutaneous anthrax -Treatment: Ciproxacin or doxycycline or vacomycin or Erythromycin, Erythromycin cream for contaneous anthrax III. clostridium botulinum -virulent factor: Botulinum -Disease: botulism (food, wound, infant botulism) -Treatment: Botulinum antitoxin, vacomycin or ceftriaxone, metronidazole, make respiratory facility, human botulinum immunoglobulin for infant botulism II. streptococcal infection iii. Steptococcus agalactiae -virulent factor: capsul -Disease: Neonated meningitis,omphalitis, Endometritis, osteomyelitis rod shaped bacteria V. Clostridium difficle -Virulent factor: Toxin-A,Toxin-B -Disease: Pseudomembraneuse colitis -Treatment - stop Ampicilin or Clindamycin immediately - Laproscopic surgery to remove Pseudomembracne - Administer with Vacomycin + Metronidazole - Give portoprozole or Rebeprozole (antiulcer drug) before food (15mn). VI. Corynebacterium Diphtheriae -Virulent factor: Diphtheria toxin -Disease: pharyngell and tonsillar diphtheria, Cutaneous diphtheria Treatment: Erythromycin ******************* Sorry for any mistakes that happen and happy for tell me about my mistakes. You can download it from www.sovann.co.nr Page 12 Prepare by S.V ****************************************************************************************** 09/21/07 Gram-negative bateria Pathogenic gram-negative cocci bacteria I. Neisseria gonorrhoeae: it is a gram-negative cocci bacteria look like kidney or been shaped structured. 1. 2. Virulent factor: Ig-A protease: it is a toxic enzyme that specifically attacks the IGA (immunoglobulin-A or antibody-A) which facilitate the infection Pilus: it is made up of pilin protein which bind with the cell surface to cause infection. Disease: this bacteria cause Gonorrea disease or (STD) to the human. Gonorrhea in the men: the infection in the genital region like pinis as well as the pelvis region also the symptom like preseminal fluid discharge, pain, burning sensation, itching, felling uncomfortable, fever and irritation while pass the urine. Gonorrhea in the woman: the N-gonorrhoeae invade the vaginal, vulva and also make infection in the urethra to cause server inflammation. The symptom like excessive vaginal fluid (yellow coloured fluid) discharge, burning sensation, itching, dysuria, pain and feeling uncomfortable. Gonococcal pharyngitis: the inflammation in the larynx due to N-gonorrhoeae. This disease is common in the people who have habit of oral sex with infection partner. Neonatal Conjunctivitis: the bacteria can also cause inflammation in the conjunctival region of the eye to cause server infection in the neonate. This bacteria is transmitted from mother to baby and the symptom like closured eyes, pain, fever and sometime the loss of eyes will happens when it is not treat immediately. Transmission: Multi sexual contact including oral sex, mother to child Diagnosis: physical appearance of the genital region, patient history, vaginal fluid culture and seminal fluid culture. Treatment: Ceftriaxone is an effective Prevention: avoid multi sexual activity and use condoms II. Neisseria meningitis: it is a gram negative cocci bacteria look like kidney or been shaped structure. It is also called mingococcus bacteria. 1. 2. 3. Virulent factor: capsul: it has antiphagocyte action Ig-A (immunoglobulin-A) and facilitate the infection. Endotoxin: it cause inflammation, fever and shock. Disease: Meningococcal meningitis: it is an inflammation condition in the meninges due to N-meningitidis. the symptom like stiff neck, headache, confusion, hyperactivity, fever and fatigue. Transmission: this bacteria is transmitted through respiratory droplets only. Diagnosis: CSF culture, blood culture, brain MRI Treatment: Ceftriaxone Prevention: - Meningococcal vaccine - avoid contact with infection person Page 13 Prepare by S.V ****************************************************************************************** 09/21/07 Pathogenic gram negative rod bacteria I. Escherichia coli (E-coli): it is gram negative flagellated rod shaped bacteria. 1. 2. 3. 4. Virulent factor: pilus: it is an extra hair like structure to attack the host cell capsul: it can protect to the bacteria from phagocyte Endotoxin: it cause server and shock Enterotoxin: it cause watery and sometime bloody diarrhea. 2. 3. Disease: Traveller’s diarrhea: the diarrhea disorder happens with frequent travelers the E-coli bacteria can easily contaminate food and water can make diarrhea. UTI: the infection in the urinary tract including urethra, bladder, ureter and kidney Neonatal meningitis: this E-coli bacteria can easily transmit from mother to neonate and cause infection in the meningitis - Transmission: through contaminated food mother to child unsterilized urine catherter ascending way to enter from the contaminated place to urinary tract while passing the urine. 1. Diagnosis: CSF culture, urine culture, stool culture Treatment: -Norfloxacin+ trimethoprin sulfametho xazole for UTI -ceftriaxone for neonate meningitis -Ciprofloxacin + Ornidazole for travels diarrhea -used electrolytes as a rehydration treatment Prevention: -avoid contaminated food and water -give ampicillin or penicilling to pregnant woman -used sterilized urine catherter II. Salmonella typhi: it is a gram positive flagelled rod shaped bacteria. The size of the cell bacteria 0,1-0,3 µm Virulent factor: 1. flagella: it is an extra hair like structure help the bacteria to attack the host cell surface it is also celled ‘H’ antigent 2. Endotoxin: it cause fever and also called ‘o’ antigent 3. capsul: it is made up of polysaccharide that fight agent phagocytes. It is also called ‘vi’ antigent Disease: typhoid fever it is a high body temperature due to S-typhi. The body temperature between 100 0F – 105 0F with diarrhea rarely. The fever will be there for 7-14 days. The symptom like fatigue, malaise, bodyache, vomiting sensation, loss of appetite and abdominal pain (rarely). Transmission: through contaminated food and water Diagnosis: blood culture, WIDL test ( it is a blood test to find out the S.typhi found in the patient bloody. Treatment: - ciprofloxacin for 10-12 days -Ornidazole for diarrhea -Electrolytes as a rehydration treatment Prevention: -Capsular polysaccharide vaccine for typhoid fever -Avoid contaminated food and water Page 14 Prepare by S.V ****************************************************************************************** 09/21/07 III. Vibrio cholerae: it is a gram-neagative camma shaped Virulent factor: choleragen: it is an enterotoxin also called cholera toxin it invade the mucus membrane in the GI tract lead to massive of fluid (water) and ions in the form of diarrhea. Disease: Cholera: it is an acute diarrhea condition due to v.cholerae. the symptom like watery diarrhea, abdominal cramps, weigh loss. Weakness, anoexia etc. Transmission: transmission maninly throght fecal and oral contamination that mean contaminated food and water as well as from the feces and this bacteria can spread. Diagnosis: stool culture Treatment: - ofloxacin + Ornidazole - Electrolytes Prevention: - avoid contaminated food and water - keep the patient toilet more clear IV. Shigella dysenteriae: it is a gram negative rod shaped bacteria Virulent factor: shigatoxin: it is an entero toxin attacks the mucus membrane to cause bloody diarrhea Disease: dysentery it is an acute diarrhea disorder which excessive release of the fluid and ions in the form of bloody diarrhea. Transmission: transmission maninly throght fecal and oral contamination that mean contaminated food and water as well as from the feces and this bacteria can spread. Diagnosis: stool culture Treatment: - ofloxacin + Ornidazole - Electrolytes Prevention: - avoid contaminated food and water - keep the patient toilet more clear V. Campylobacter jejuni: it is a gram- negative microaerophilic rod and bacilli bateria Virulent factor: enterotoxin: it invade the mucus membrane in the stomach and small intestine lead to water and blood diarrhea. Disease: Campylobacterosis: it is an inflammation condition in the gastro intestinal region due to c.jejuni. it is also called as gastroenteritis. The symptom like hamatochezia, abdominal distension, abdominal cramps, anoerexia and watery diarrhea. Transmission: This bacteria normally present in the animal feces. If the person who ingest the animal feces contaminated food and water will get infection. Diagnosis: stool culture Treatment: - -ofloxacin or ciprofloxacin + Ornidazole or metronidazole - Electrolytes Prevention: avoid contamination food and water Page 15 Prepare by S.V ****************************************************************************************** 09/21/07 VI. Helicobacter pylori: it is a flagellated mono bacillus gram negative bacteria 1. 2. Virulent factor: Flagellar: for attachment to the GI tract (especially stomach and duodenum) Urease enzyme: it convert the urea in to ammonia from the GI region. One amononia is formed it will damage the mucus membrane and also neutralizes the HCL in the stomach which facilitate the bacteria can live long time in the stomach to cause infection. Disease: Gastric ulcer and duodenum ulcer: the inflammation in the stomach and duodenum due to H.pylori. the symptom like bleeding, server addominal pain, loss of appetite, vomiting while brush, diarrhea (sometime) constipation (rarely) and burning sensation. Transmission: through contaminated food and water Diagnosis: Endoscopy and tissue scopy, serological to find out urease enzyme found in the blood Treatment: - Clarithromycin + Metronidazole + Rabeprazole (or) Ofloxacin + Ornidazole + pantoprazole (10-12 days) Prevention: - avoid contaminated food and water. VII. klebsiella pneumoniae: it is a gram negative rod shaped encapsulated bacteria Virulent factor: 1. capsule: it has antiphagocytic action 2. Endotoxin: it cause fever and shock 1. 2. Disease: Pneumonia: the inflammation in the alveoli region of the lungs UTI: the inflammation in the urinary tract Transmission: this bacteria normally found in the hospital environment and it is transmitted easily through respiratory droplet and unsterliezed urinary catheter. Diagnosis: sputum and urine culture with gram staining procedure to find out this bacteria Treatment: -Norfloxacin + trimethoprin sulfamethoxazole -Cephalexin or Erythromycin → Pneumonia Prevention: -used sterilized urine catheter and proper insertion is important -make hospital environment more hygienic VIII. Proteus vulgaris and P.mirabilis It is maltiflagellated gram negative rod shaped bacteria 1. 2. Virulent factor: flagella: it help the bacteria to move and adhere in to the host cell surface. urease: it is an enzyme that convert the urea into ammonia in the urine then the ammonia will damage the epithelial layer in the UT and increase the alkalin PH in the urine lead to stone or calculi formation in the bladder or kidney. Damage epithelial layer→ UTI urease→ ammonia increase urine PH → stone formation Page 16 Prepare by S.V 1. 2. ****************************************************************************************** 09/21/07 Disease: calculi: the formation of stone in bladder or kidney due to change in the Ph cause by ammonia the calculi is composed of Megnesium ammonia hydroxide, it is also called as stuvite UTI: the inflammation in the urinary tract Transmission: Through ascending way to enter in to the urinary tract and cause infection Diagnosis: urine culture, scan to identify stone Treatmetn: -Norfloxacin with trimethoprin sulfamethoxazole or cefotaxine -avoid calcium contain foods -drink plenty of water -laser surgery if the stone size is more then 10 mm Note( banana stem juice) drink in the morning Prevention: avoid urination at contaminated place IX. Pseudononas aeruginosa: it is a gram negative rod shaped bacteria 1. 2. 3. Virulent factor: pili and flagella: help the bacteria to moved and attach Exotoxin: it attach the skin tissue and mucus membrane in the respiratory tract and cause infection Endotoxin: cause fever and shock Disease: 1. wound infection: Abscess or infection in the injured region due to P.aeruginosa. the symptom are pus shock , pain. 2. Pneumonia, 3sepsi( bacteriaemia): infection in the blood as well as inflammation in the internal organs. The symptom like jaundice, hemorrhage, weakness fever and bodyache. Transmission: through respiratory droplets and wound entry Diagnosis: wound, blood, sputum culture Treatment: - cepholexin → pneumonia - ceftriaxone → sepsis and wound infection Prevention: use cefdiniv for wound infection X. Haemophilus influenzae: it is a coccobacillus bacteria Virulent factor: 1. Ig-A prolease: it is an enzyme that attack Ig A 2. capsule: it act against phagocytes Disease: 1. pneumonia, 2.otitis media, 3. sinusitis, 4.mengitis Transmission: sputum and CSF culture Treatment: - cephalexin for pneumonia, otitis media, sinusitis -ceftriaxon for meningitis Prevention: capsular polysaccharide vaccine give along with DPT vaccine. Page 17 Prepare by S.V ****************************************************************************************** 09/21/07 XI. Bordetella pertusis: it is a gram negative rod shaped bacteria Virulent factor: 1. pili: for attachment 2. pertussis toxin: it is a portent toxin that attack the lymphocytes which make infection in the respiratory tract 3. Adnylate cyclase: it is an enzyme that active against phagocytes 4. tracheal cytotoxin: it damage the traches Disease: pertussis or whooping cough: it very common disease in children that there is an inflammation in the respiratory tract when the patient have pertussis. This symptom like high pitch sound or bark sound will come while coughing, cough ends with vomiting, thick yellow color sputum, fever and the cough will be there for 1-4 weeks Transmission: through respiratory droplet Diagnosis: sputum calture Traeatment: Erythromycin Prevention: DPT vaccine XII. Brucella abortus, B suis, B melitensis There are gram negative coccobacillus bacteria also called as zoomotic bacteria. These attacks primarily animals and from the animals. The human will get this bacteria lead to infection. Virulent factor: Endotoxin: it invades reticuloendothelial cell like liver, lymph node, spleen and bone marrow and cause fever. Disease: UNDULANT fever or Brucellosis: it is a fever with inflammation condition in the reticuloendothelial system. It is an irregular fever that means sudden increase and decrease of body temperature. The other symptom like lymphadenopathy, hepatospleenomegaly ect. - Transmission: B.abortus transmitted from cattle B.suis transmitted from pig B.melitensis transmitted from goat and sheap When the person who touches the contaminated animal that mean infected animal meat, ingestion of infected meat and milk. Diagnosis: blood culture, Agglutination test is a blood test ( serological test) to check this bacteria Treatment: Tetracyclin + Gentamycin Prevention: avoid infection animal meat and milk products XIII. Francisella tulareasis: it is a small coccusbacillus gram negative bacteria. This bacteria primarily attack the fox and rodent (mice, rod, squirrel, etc). from those animal it will be transmitted through tick (vector) by bite to the human then the human will get infection it is also called as zoonotic bacteria. Virulent factor: the exact toxin is not clearly understood specially the endotoxin but this organism attack the recticuloendothelial system. Disease: Tularema: it is ulcer formation in the tick bite region of the body in this condition the patient will have symptom like fever, hemorrhage in the bite region, swelling lymphadenopathy, hepathospleenomegaly and weakness. Transmission: this bacteria is transmitted through tick from infection animal to humans. Diagnosis: it is difficult to culture and can indentified by Agglutination test. Treatment: Streptomycin Prevention: - keep away from tick bite - use insecticides to kill the insects Page 18 Prepare by S.V ****************************************************************************************** 09/21/07 Acid Fast Bacteria Infection 1. Mycobacterium tuberculosis: it is acid fast rod shaped bacteria having rich amount of lipid in the cell wall. Virulent factor: the virulent factor are not clear understood but this bacteria have rich of fatty acid and wax in the cell wall of the bacteria which help the bacteria from the phagocytes this bacteria can easily live inside the phagocytes (macrophages) and multiply over there and damaged the cell to cause sever granulona or tubercle formation in the lungs. Disease: Tuberculosis or TB: is the granulona or tubercle formation in the lungs, tissue, and other organs of the body primarily the M.tuberculosis attack the lungs and cause sever infection ( tubercle or granulona or nodule or lesion formation) there. This bacteria attack many organs and tissue of the body except pancreas, skeletal muscle, thyroid and heart. Whenever this bacteria goes will make infection there and make tubercle formation. The symptom like initially cough with bloody sputum, chest pain, difficult to breath, weight loss, weakness, fever, lekaemia (increase WBC count). Transmission: through respiratory droplet from the infected person to normal person while coughing and sneezing. When the person who have weak immune system (immunocompromised patient) will get very easily the TB. It can also attacks old age people, poor nutrition, regular smoker and children. Diagnosis: - Tuberculin skin test: inject the tuberculin injection contain purified protein derivative (PPD) into the skin and wait for 48-72 hours. After this duration if any swelling arise in the injected region, you can confirm the patient is TB positive if no swelling the patient is negative. - Chest x’ray or CT scan - PCR- test (polymerase chain reaction test) to identify this bacteria found the serum or sputum Treatment: -Rifanpin+ Isoniazial + Pyrazinanide + Ethambutol for 6-12 month Prevention: BCG vaccine (bacilli calmette gurein) Spirochetes 1. Treponeme pallidum: it is spiral shaped bacteria. It doesn’t have any virulent factor but this bacteria invade the genital region, pelvis and conjuctive to cause infection. This can also make sever inflammation in the many internal organ of the body and to cause sever infection. Disease: syphilis: it is a sexually transmitted disease (STD) cause by T.pallidum. these are three stage of syphilis 1. Primary syphilis: when the bacteria is enter into the body the symptom like ulcer in genital and mouth (oral sex) during this stage this bacteria will happen between 3-6 weeks. 2. secondary syphilis: the sever skin rash around the body with swelling in the lymph node. It happen after 6 weeks. 3. Tertiary syphilis: this fatal stage, the patient will get sever inflammation in the heart, liver, kidney, bone, brain and eyes. The patient will get heart attack, liver and kidney failure, paralysis, stroke and blinese. Transmission: multi sex with multi partners including vaginal sex, penile sex and oral sex Diagnosis: VDRL test: (venecal disease research laboratory test ) to find out the bacteria found in the serum culture in not useful. Treatment: Penicillin-G injection is effective for all stage of syphilis. Prevention: avoid multi sex activity with multi partner use condoms 2. Chlamydia trachomatis: it is a intracellular bacteria. It is not coming under gram positive and negative or acid fast or spirochetes. There is no virulent factor has been identify. This attack the genital region, pharynx, pelvis, cervix, lymph node, conjuntive and rectum to cause infection. Disease: chlemydia: it is a sexually transmitted disease (STD) this bacteria attacks the urethra region of both men and women to cause urethritis. It attacks the vaginal region to cause vaginitits. if the infection in the penis region is called balanitis. If the infection in the lymph node near to the genital region is called lymphogrnuloma venereum. If the infection is in the anus is called proctitis. The neonate will get this bacteria from the positive mother during child birth will lead to neonatal conjunctivitis. The symptom like itching, burning pain, dysuria, excessive penile and vaginal fluid discharge, pyuria, irregular menstrual bleeding, swelling around the genital region and fever ect. Transmission: multi sex with multi partner Diagnosis: Agglutination test or Elisa test or PCR test Treatment: Azithromycin or Doxycyclin or levofloxacin Prevention: avoid multi sex activity, use condome Page 19 Prepare by S.V ****************************************************************************************** 09/21/07 Pathogenic gram negative rod bacteria I. Escherichia coli (E-coli): -Virulent factor: pilus, capsul, Endotoxin, Enterotoxin: -Disease: Traveller’s diarrhea, UTI, Neonatal meningitis -Treatment: -Norfloxacin+ trimethoprin sulfametho xazole for UTI -ceftriaxone for neonate meningitis -Ciprofloxacin + Ornidazole for travels diarrhea -used electrolytes as a rehydration treatment II. Salmonella typhi: -Virulent factor: flagella, Endotoxin, capsul -Disease: typhoid fever -Treatment: -Ciprofloxacin for 10-12 days -Ornidazole for diarrhea -Electrolytes as a rehydration treatment III. Vibrio cholerae: it is a gram-neagative camma shaped -Virulent factor: choleragen: -Disease: Cholera: -Treatment: - Ofloxacin + Ornidazole - Electrolytes IV. Shigella dysenteriae: it is a gram negative rod shaped bacteria -Virulent factor: shigatoxin: -Disease: dysentery -Treatment: - ofloxacin + Ornidazole - Electrolytes V. Campylobacter jejuni: it is a gram- negative microaerophilic rod and bacilli bateria -Virulent factor: enterotoxin -Disease: Campylobacterosis -Treatment: -ofloxacin or ciprofloxacin + Ornidazole or metronidazole - Electrolytes VI. Helicobacter pylori: it is a flagellated mono bacillus gram negative bacteria -Virulent factor: Flagellar, Urease enzyme -Disease: Gastric ulcer and duodenum ulcer -Treatment:Clarithromycin + Metronidazole + Rabeprazole(or)Ofloxacin + Ornidazole + pantoprazole (10-12 days) VII. klebsiella pneumoniae: it is a gram negative rod shaped encapsulated bacteria -Virulent factor: 1. capsule, Endotoxin: -Disease: Pneumonia, UTI -Treatment:-Norfloxacin+trimethoprin sulfamethoxazole -Cephalexin or Erythromycin → Pneumonia VIII. Proteus vulgaris and P.mirabilis: It is maltiflagellated gram negative rod shaped bacteria -Virulent factor: flagella, urease: Damage epithelial layer→ UTI urease→ ammonia increase urine PH→stone formation -Disease: calculi, UTI -Transmission: -Treatmetn: -Norfloxacin with trimethoprin sulfamethoxazole or cefotaxine, -avoid calcium contain foods -drink plenty of water, -laser surgery if the stone size is more then 10 mm Note( banana stem juice) drink in the morning IX. Pseudononas aeruginosa: it is a gram negative rod shaped bacteria -Virulent factor:pili and flagella, Exotoxin, Endotoxin -Disease: wound infection, Pneumonia, 3sepsi ( bacteriaemia) -Treatment: - cepholexin → pneumonia - ceftriaxone → sepsis and wound infection X. Haemophilus influenzae: it is a coccobacillus bacteria -Virulent factor: Ig-A prolease, capsule: it act against phagocytes -Disease:pneumonia, otitis media, sinusitis, mengitis -Treatment:- cephalexin for pneumonia, otitis media, sinusitis -ceftriaxon for meningitis XI. Bordetella pertusis: it is a gram negative rod shaped bacteria -Virulent factor: pili, pertussis toxin, Adnylate cyclase, tracheal cytotoxin -Disease: pertussis or whooping cough: -Traeatment: Erythromycin XII. Brucella abortus, B suis, B melitensis -Virulent factor: Endotoxin -Disease: UNDULANT -Treatment: Tetracyclin + Gentamycin XIII. Francisella tulareasis: -Virulent factor: the exact toxin is not clearly understood specially the endotoxin but this organism attack the recticuloendothelial system. -Disease: Tularema: it is ulcer formation in the tick bite region of the body in this condition the patient will have symptom like fever, hemorrhage in the bite region, swelling lymphadenopathy, hepathospleenomegaly and weakness. -Treatment: Streptomycin Acid Fast Bacteria Infection 1. Mycobacterium tuberculosis: -Disease: Tuberculosis or TB -Treatment: -Rifanpin+ Isoniazial + Pyrazinanide + Ethambutol for 6-12 month Spirochetes 1. Treponeme pallidum: -Disease: syphilis: it is a sexually transmitted disease (STD) cause by T.pallidum. these are three stage of syphilis -Primary syphilis, secondary syphilis, Tertiary syphilis: -Treatment: Penicillin-G injection is effective for all stage of syphilis. 2. Chlamydia trachomatis: -Disease: chlemydia: -Treatment: Azithromycin or Doxycyclin or levofloxacin ********** Sorry for any mistakes that happen and happy for tell me about my mistakes. You can download it from www.sovann.co.nr Page 20 Thank you