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Chapter 11: Physical and Chemical Control of Microbes I. aseptic Lister started _________ Joseph ______ techniques with medical phenol applications. By using carbolic acid (_______) -soaked rags and instruments during and after surgery, gangrene and other infections following surgery greatly diminished. II. Terminology and Methods of Control Sterilization A. _____________means COMPLETE destruction of viruses and microbes (including endospores) so that even if they are placed in a new growth medium, they will not revive or reproduce. Disinfection B. __________means to reduce the number of pathogens (including viruses) until they are not a hazard, usually involving the use of antimicrobial chemicals. Decontamination refers to removing toxins. C. _______________ Sanitization refers to a substantially D. ____________ reduced microbial population that meets accepted health standards. A clean appearance is expected! E. Different situations warrant different levels of microbial control. 1. daily life handwashing with plain soap and water Simple ____________ is considered to be the single most important step in preventing the spread of many infectious diseases! 2. hospitals nosocomial (hospital acquired) infections because of: Danger of ___________ weakened condition of hospitalized patients a. _________ pathogenic b. higher concentration of sick people with ____________ microbes (*many resistant forms!!) invasive procedures (such as) c. _______ carriers d. many health care workers are ______ aseptic care (handwashing e. lack of _______ between patients, using gloves, etc.) 3. microbiology/research/hospital laboratories aseptic techniques must use ________ clean a. Work surfaces should be ______. sterile b. All media and instruments must be ______. cultures must be properly disposed of. c. Used ________ III. Selection of an antimicrobial procedure depends on many factors microbe the extent of ____________, contamination such as the type of _______, environmental conditions, and potential risk of _________. infection ____________ A. types of resistant microbes endospores 1. Bacillus and Clostridium can make ___________. waxy cell walls. 2. Mycobacterium has ______ Pseudomonas is capable of metabolizing unusual 3. ____________ substances for food. (Like disinfectants!) B. the extent of contamination (size of the microbial population) 90 1. ‘Industry standard’ requires that ____% of the population is 2 minutes of exposure to the treatment killed with every __ 4 minutes a. 100 microbes 10 microbes 1 microbe in __ 20 minutes b. 1010 microbes would take ___ washing scrubbing first helps reduce the population SO, ________/_________ before disinfection or sterilization. C. environmental conditions temperature 1. _____________ ( heat chemical action) pH 2. _____ saliva _______, dirt _______, blood ______ feces can all block chemical action 3. ____, D. Potential risk of infection Critical items come into direct contact with body tissues. 1. _______ Semicritical 2. ____________ items come into contact with mucous membranes, but do not penetrate body tissues. Noncritical items only touch keratinized skin surfaces. 3. ____________ IV. Methods of Physical Control denaturing cell proteins /enzymes. It is the Heat works by_________ A. ______ most common control method because it is fast, reliable, inexpensive & nontoxic. Moist heat 1. ______ Boiling 100°C/10 minutes (kills most microbes & a. _______ endospores inactivates most viruses, but does not destroy __________). Pasteurization a brief heat treatment followed by rapid cooling. b. ____________: (Kills pathogens and reduces the number of spoilage organisms in milk, juices, wine, beer: Does not sterilize!) (1). LTLT (Low Temperature Long Term) 63°C/30 minutes *(2). HTST (High Temperature Short Term) 72°C/15 seconds Autoclave (steam under pressure) c. __________ (1). 15-20 psi/15-20 minutes/121°C Sterilizes equipment, media, etc. (2). ________ (3). used in canning procedures to destroy endospores Clostridium botulinum __________! 2. ___ Dry heat sterilizes. moisture is a. Hot air ovens (160-170°C/2-3 hours) used when ________ undesirable. Incineration (burning) b. ____________ furnaces incinerators (1). _________/___________used to destroy disposable items, soiled dressings, tissue specimens etc. @ 800°C to 6500°C c. The hottest part of a Bunsen burner flame reaches 1,870°C for flaming ______ during lab. Microbiology is Fun! B. Radiation (waves having energy but no mass) causes lethal changes in DNA, denatures proteins, but doesn’t reliably destroy endospores)! ultraviolet 1. Nonionizing rays = ________ radiation a. can be used to reduce the number of organisms in air and on clean surfaces b. of limited use, cannot penetrate materials like cloth, glass, paper X-rays or _____________ Gamma rays 2. Ionizing rays = ________ a. can be used to __________ items that are sterilize heat or chemical sensitive, such as plastics b. more effective, penetrates liquids and most solids (used to treat Washington DC mail) c. In the US, radiation is approved to treat trichinosis pork to prevent ___________, to treat beef E. coli contamination and used to for ________ Salmonella contamination. treat chicken for _________ 3. microwaves heat they a. do not affect microbes directly, but may kill by _____ generate uneven b. drawback is that microwave heating is ________ C. Filtration (may be used for air, some heat sensitive materials such as serum, vaccines, drugs, IV fluidsbeer/wine) High-Efficiency 1. _____ ________Particulate ________ Air ____ (HEPA) filters remove airborne contaminants; used in operating rooma, for people with allergies, etc. liquids solids are separated from ________ 2. In fluid filtration, _______ by filters with extremely fine pores passing through _______ a. Mechanical force or vacuum suction helps fluid through the filter b. does not sterilize unless pore size is small enough to trap everything (smaller pores, cost) Chemical Control (* for heat sensitive items, large V. Methods of ________ surfaces) Destructive actions include injury to the cell _________, membrane DNA proteins inhibiting replication of _____. denaturation of cell ________, A. Disinfectants Vs Antiseptics Disinfectants are chemicals used on inanimate objects. 1. _____________ Germicides are chemicals that KILL/DESTROY germs. a. ___________ (examples: fungicides, bactericides, viricides) Germistatic refers to chemicals that do not kill, but b. __________ prevent the growth of microbes . (examples: bacteriostatic, fungistatic) Antiseptics are disinfectants nontoxic enough to be used on 2. __________ skin. potency (strength) B. Germicides are grouped according to their _______ Sterilants destroy everything, including endospores 1. __________ (for sterilizing scalpels, respiratory therapy equipment, proctoscopes, plastic Petri dishes, endoscopes) (ethylene oxide gas, hydrogen peroxide) High level disinfectants (do not reliably destroy endospores) 2. ____ (used for GI endoscopes) (iodine, phenol, chlorhexidine, heavy metals such as silver nitrate) Intermediate level disinfectants (will kill Mycobacterium, but do 3. ___________ not destroy all viruses or endospores, even with prolonged exposure) (used for stethoscopes, electrodes, thermometers) (alcohols: ethyl alcohol, isopropyl) Low level disinfectants (will not kill Mycobacterium) 4. _____ (soaps, detergents) Phenol coefficient C. ______ _________ (5% Phenol is the standard against which chemical agents are tested and compared) time 1. Each chemical is compared for the same length of _____ identical conditions organism under ________ on the same _________ concentration 2. IF the chemical being tested requires a greater ____________ less than time than phenol, its efficiency is _____ or a longer ______ phenol. IF the chemical being tested requires a lower concentration or a shorter time than phenol, its efficiency is _______ greater than phenol. 3. Ratio of: tested chemical activity phenol activity less efficient than phenol < 1 means _____ more efficient than phenol > 1 means _____ D. Selecting the Appropriate germicidal chemical Toxicity (the benefit of disinfecting or sterilizing an item or 1. ________ surface must be weighed against the risks associated with the use of that chemical) (hospital Vs home/office) material being treated (metal, rubber, 2. compatibility with the ________ glass, plastic) Residue may necessitate rinsing 3. ________ Cost and availability (bleach) 4. ______ Storage 5. _________ and stability (concentrates require less space and store for long periods, but when diluted/mixed, often have limited shelf life) Environmental 6. _____________risk (disposal procedures needed) VI. Methods used for Preservation (delaying spoilage) of Perishable Products Chemical preservatives (both nonfood and food) A. ________ acids lower pH (inactivates enzymes, inhibits 1. organic ______ growth, but does not always destroy microbes) nitrates and _______ 2. ________ nitrites inhibit germination of Clostridium botulinum endospores! B. Low Temperatures refrigerator 1. _____________ a. 0-10° C (___° C average) 4 b. retards but does not prevent growth freezer 2. ________ a. -20 ___° C b. prevents growth but does not kill all organisms osmotic pressure by adding _____ sugar salt or ______; C. Increased _______ causes water to leave the cell, killing it. Desiccation (dehydration) of the material (natural [sun] or D. ___________ artificial) E. ____________ Lyophilization (freeze-drying) rapidly frozen at temperatures well below 0°C 1. materials _______ moisture (lightweight) 2. vacuum while frozen to remove ________ 3. biological cultures, medications, foods (expensive) Chap 12: Elements of Chemotherapy I. Terminology Chemotherapy = use of chemical agents to treat disease A. ____________ Chemotherapeutic B. _________________ agent (CTA) = chemical agent used for treatment of disease (even cancer) Antimicrobial C. _____________ agent (AMA) = chemical agent used to treat diseases caused by microbes II. Antimicrobial Agents A. Types of antimicrobial agents Natural agents = metabolic products produced by 1. ________ certain groups of fungi and fungal-like bacteria that are antibacterial in action Synthetic 2. __________ agents = produced in the laboratory 3. _______________ agents = derivatives of natural agents Semi-synthetic altered in the laboratory by adding chemical groups to improve effectiveness B. Modes of action enzymes 1. interfere with microbe’s chemosynthesis by inhibiting ________ 2. Disruption/interference with competitive inhibition a. of an essential metabolite by _________ (Sulfa drugs mimic PABA, blocking folic acid synthesis) (p. 77) b. by weakening/disrupting the bacterial cell ______ (Penicillin inhibits the enzyme that builds the amino acid crosslinkages of peptidoglycan) (p. 78) c. by damaging the cell ___________ (Polymixin cleaves the layers of the membrane like a knife) (p. 78) d. by inhibiting ________________ at 70s ribosomes (p. 79) (Erythromycin inhibits translocase, freezing the ribosome on the mRNA.) (Tetracycline blocks tRNA attachment to mRNA) (Chloramphenicol inhibits transferase, preventing peptide bond formation between amino acids.) (Streptomycin causes a misreading of mRNA.) e. by inhibiting nucleic acid (______ and/or ____) synthesis (Antiviral: AZT inhibits reverse transcriptase.) (Antibacterial: rifampin inhibits RNA polymerase.) (Antifungal: griseofulvin inhibits RNA polymerase.) Folic acid PABA B. Modes of action enzymes 1. interfere with microbe’s chemosynthesis by inhibiting ________ 2. Disruption/interference with a. of an essential metabolite by competitive _________ inhibition (Sulfa drugs mimic PABA, blocking folic acid synthesis) (p. 77) wall b. by weakening/disrupting the bacterial cell ______ (Penicillin inhibits the enzyme that builds the amino acid crosslinkages of peptidoglycan) (p. 78) c. by damaging the cell ___________ (Polymixin cleaves the layers of the membrane like a knife) (p. 78) d. by inhibiting ________________ at 70s ribosomes (p. 79) (Erythromycin inhibits translocase, freezing the ribosome on the mRNA.) (Tetracycline blocks tRNA attachment to mRNA) (Chloramphenicol inhibits transferase, preventing peptide bond formation between amino acids.) (Streptomycin causes a misreading of mRNA.) e. by inhibiting nucleic acid (______ and/or ____) synthesis (Antiviral: AZT inhibits reverse transcriptase.) (Antibacterial: rifampin inhibits RNA polymerase.) (Antifungal: griseofulvin inhibits RNA polymerase.) Glycan “backbone” B. Modes of action enzymes 1. interfere with microbe’s chemosynthesis by inhibiting ________ 2. Disruption/interference with a. of an essential metabolite by competitive _________ inhibition (Sulfa drugs mimic PABA, blocking folic acid synthesis) (p. 77) wall b. by weakening/disrupting the bacterial cell ______ (Penicillin inhibits the enzyme that builds the amino acid crosslinkages of peptidoglycan) (p. 78) membrane c. by damaging the cell ___________ (Polymixin cleaves the layers of the membrane like a knife) (p. 78) d. by inhibiting ________________ at 70s ribosomes (p. 79) (Erythromycin inhibits translocase, freezing the ribosome on the mRNA.) (Tetracycline blocks tRNA attachment to mRNA) (Chloramphenicol inhibits transferase, preventing peptide bond formation between amino acids.) (Streptomycin causes a misreading of mRNA.) e. by inhibiting nucleic acid (______ and/or ____) synthesis (Antiviral: AZT inhibits reverse transcriptase.) (Antibacterial: rifampin inhibits RNA polymerase.) (Antifungal: griseofulvin inhibits RNA polymerase.) hydrophilic amphipathic hydrophobic B. Modes of action enzymes 1. interfere with microbe’s chemosynthesis by inhibiting ________ 2. Disruption/interference with a. of an essential metabolite by competitive _________ inhibition (Sulfa drugs mimic PABA, blocking folic acid synthesis) (p. 77) wall b. by weakening/disrupting the bacterial cell ______ (Penicillin inhibits the enzyme that builds the amino acid crosslinkages of peptidoglycan) (p. 78) membrane c. by damaging the cell ___________ (Polymixin cleaves the layers of the membrane like a knife) (p. 78) protein synthesis at 70s ribosomes (p. 79) d. by inhibiting ________________ (Erythromycin inhibits translocase, freezing the ribosome on the mRNA.) (Tetracycline blocks tRNA attachment to mRNA) (Chloramphenicol inhibits transferase, preventing peptide bond formation between amino acids.) (Streptomycin causes a misreading of mRNA.) e. by inhibiting nucleic acid (______ and/or ____) synthesis (Antiviral: AZT inhibits reverse transcriptase.) (Antibacterial: rifampin inhibits RNA polymerase.) (Antifungal: griseofulvin inhibits RNA polymerase.) B. Modes of action enzymes 1. interfere with microbe’s chemosynthesis by inhibiting ________ 2. Disruption/interference with a. of an essential metabolite by competitive _________ inhibition (Sulfa drugs mimic PABA, blocking folic acid synthesis) (p. 77) wall b. by weakening/disrupting the bacterial cell ______ (Penicillin inhibits the enzyme that builds the amino acid crosslinkages of peptidoglycan) (p. 78) membrane c. by damaging the cell ___________ (Polymixin cleaves the layers of the membrane like a knife) (p. 78) protein synthesis at 70s ribosomes (p. 79) d. by inhibiting ________________ (Erythromycin inhibits translocase, freezing the ribosome on the mRNA.) (Tetracycline blocks tRNA attachment to mRNA) (Chloramphenicol inhibits transferase, preventing peptide bond formation between amino acids.) (Streptomycin causes a misreading of mRNA.) RNA synthesis DNA and/or ____) e. by inhibiting nucleic acid (______ (Antiviral: AZT inhibits reverse transcriptase.) (Antibacterial: rifampin inhibits RNA polymerase.) (Antifungal: griseofulvin inhibits RNA polymerase.) C. Criteria that determine the effectiveness of antimicrobial agents 1. Selective ________ toxicity = destroys or inhibits microbe without affecting host cells Spectrum 2. __________ of activity = range of microbes inhibited or killed a. ______spectrum usually effective against Gram+ and GramBroad bacteria (1). useful when no time to figure out exactly which microbe is causing disease (2). disadvantage is that it disrupts normal flora too (resulting in secondary infections caused by opportunists). __________ Narrow b. _______spectrum requires identification of the pathogen 3. Tissue distribution, metabolism & excretion Soluble in body fluids (to be distributed in the blood) a. ______ Stable in body fluids (so it is not broken down easily) b. _______ assuring constant and effective levels in the body (pH of oral administration unless coated) stomach may limit ______ c. must be _________ absorbed by body tissues affected Half-life refers to the elimination rate of a drug d. _________ frequency (this dictates the ___________ of dosage needed) allergenic and not cause adverse reactions 4. should be non __________ mutagenic to reduce development of resistant 5. should be non __________ strains D. Disadvantages of antimicrobial therapy toxic effects on normal tissues (especially liver &/or kidneys) 1. ______ normal flora 2. disturb ____________ Allergic reactions 3. ________ resistant strains of bacteria, usually by 4. development of __________ enzymes that destroy AMA (such as penicillinase) producing _________ mutations occur naturally a. _________ plasmids that can be spread from b. resistance genes on _________ Conjugation bacterial cells to other bacterial cells by ____________, Transduction ______________, or Transformation ____________. E. Avoid disadvantages by Discriminate (careful) use of AMA 1. __________ a. Dr: proper ____________ identification of disease prescription of AMA microbe & proper __________ b. patient: maintain proper levels by (1). taking medication at prescribed intervals _________ (2). taking medication for prescribed time length of _____ Synergistic effect of combination of 2-more AMA when 2. _________ resistance is likely to develop disk-plate diffusion F. AMA testing = _________________ method (p. 66) 1. procedure lawn of a. Inoculate a solid ______ bacteria on agar b. Place paper disks saturated with antibiotics on the surface various _________ Incubate 24 hours and then observe c. ________ 2. The principle behind this is that during incubation, the antibiotic inhibits growth of the diffuses into the agar and, if effective, ________ bacteria in its presence. 3. observations a. _________________ (no growth around the disk means the Zone of inhibition AMA is effective) Satellite colonies are isolated colonies in the zone of b. _________ inhibition resistant cells from the original population! They represent ________ Overlapping antibiotics (with synergistic effects) may be needed if satellite colonies appear. Location of satellite colonies if present