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MICROBIOLOGY Class 2 “To love what you do and feel that it matters – how could anything be more fun?” Katherine Graham Categories of Disease from Memmler’s Chapter 5 Infection Degenerative diseases Nutritional diseases Metabolic disorders Immune disorders Neoplasms Psychiatric disorders Complementary and Alternative Medicine (CAM) Naturopathy Chiropractic Acupuncture Biofeedback Exercise, massage, yoga, meditation, etc. NIH: National Center for Complementary and Alternative Medicine (NCCAM) Predisposing Causes of Disease Age Gender Heredity Living conditions Emotional disturbance Physical and chemical damage “Occupational” diseases Preexisting illness Types of Illnesses Acute illness: sudden onset and lasts for a short time Chronic illness: comes on slowly and lasts a long time Terminal illness: there is no potential for cure Survival of Microorganisms Spores Temporarily inactive microbial life form; can resist heat and destructive chemicals and survive without moisture; reactivate and reproduce when conditions are favorable Antibiotic-resistant bacterial strains No longer respond to drugs that once were effective against them Chain of Infection An infectious agent A reservoir for growth and reproduction An exit route from the reservoir A mode of transmission A port of entry A susceptible host Chain of Infection (cont’d) Medical Asepsis Confines or reduces the numbers of microorganisms Involves measures that interfere with the chain of infection in various ways Examples: Performing hand hygiene Wearing hospital garments Principles of Medical Asepsis Microorganisms exist everywhere except on sterilized equipment Frequent handwashing and maintaining intact skin reduces transmission of microorganisms Blood, body fluids, cells, and tissues are major reservoirs of microorganisms Personal protective equipments serve as barriers to microbial transmission Sterilization Consists of physical and chemical techniques that destroy all microorganisms including spores Physical sterilization: radiation, boiling water, free-flowing steam, dry heat, steam under pressure Chemical sterilization: peracetic acid, ethylene oxide gas Principles of Surgical Asepsis Once equipment and areas are free of microorganisms, they remain in that state if contamination is prevented Sterility preserved: touching one sterile item with another that is sterile Once a sterile item touches something that is not sterile, it is considered contaminated Any partially unwrapped sterile package is considered contaminated Principles of Surgical Asepsis (cont’d) Question the sterility of an item considered unsterile Longer the time since sterilization, the more likely that the item is no longer sterile Commercially packaged sterile item is not considered sterile past its recommended expiration date Opened sterile item or area, left unattended, is considered contaminated Principles of Surgical Asepsis (cont’d) Once a sterile item is opened or uncovered, it becomes contaminated The outer 1-inch margin of a sterile area is considered a zone of contamination A wet sterile wrapper wicks microorganisms from its supporting surface, causing contamination Principles of Surgical Asepsis (cont’d) Coughing, sneezing, or excessive talking over a sterile field causes contamination Reaching across an area that contains sterile equipment may cause contamination Sterile items located or lowered below waist level are considered contaminated General Gerontologic Considerations Older clients more susceptible to infections Maintain intact skin, proper aseptic techniques, perineal hygiene, thorough handwashing; indwelling catheters should be avoided Bladder training, annual immunizations Ill health care workers should take sick leave rather than expose susceptible clients to infectious organisms Modes of Transmission From infected human, insect, or animal host to another susceptible host Through direct or indirect contact Portals of Entry and Exit Skin that is open Respiratory tract Digestive system Urinary and reproductive systems Microbiology – The Study of Microorganisms Bacteria (bacteriology) Viruses (virology) Fungi (mycology) Protozoa (protozoology) Algae (algology) Naming Bacteria Genus name: Capitalized and italic species name: lowercase and italic EXAMPLE: Escherichia coli or E. coli Bacteria Single-celled organisms Lack a true nucleus Found everywhere Anaerobic Aerobic Facultative anaerobes Shape and Arrangement of Bacteria Cocci Bacilli Short rods with a slight curvature Spirilla Short, slender rods Vibrios Round Long wavelike cells resembling a corkscrew Spirochetes Long wavelike cells capable of waving and twisting motions Viruses Extremely small microorganisms Composed of a core of nucleic acid (DNA or RNA) surrounded by a coat of proteins Grow only within living cells Virus size comparison. Infectious Agents Smaller than Viruses Prions Composed solely of protein Viroids Composed solely of RNA, no protein coat Fungi Large group of simple plantlike organisms, few are pathogenic Yeasts Single-celled forms of fungi Molds Fuzzy, filamentous forms of fungi Protozoa Animal-like, single-celled microbes found all over the world Amebas Ciliates Flagellates Sporozoa Some parasitic protozoa. • Why are the parasites in E described as intracellular? • What is the role of the vectors shown in C and E? Parasitic Worms Parasites with human hosts, also called helminths Helminthology The study of parasitic worms. Roundworms Ascaris Pinworms Hookworms Trichina (trichinosis) Filaria worm (filariasis, elephantiasis) Microbes and Public Health Sewage and garbage disposal Water purification Prevention of food contamination Milk pasteurization Microbial Control Needs Increase in world population Disruption of animal habitats Increased travel (SARS) Opportunistic infections Changes in food handling Aseptic Methods Sterilization Bacteriocidal Disinfection Antisepsis Bacteriostasis - Inhibit growth of bacteria Does NOT KILL all bacteria but suppresses the growth so the body has an easier time fighting off those present - Kill or inhibit growth of pathogens Cause no harm to the host Cause no allergic reactions in a host Be stable when stored in a liquid or solid form Remain in specific tissues in the body long enough to be effective Kill the pathogens before they mutate and become resistant to it Must be able to travel to site of pathogen without harming host Target a metabolic process or structure that is not present as the host 5 common mechanisms of action Inhibition of cell wall synthesis Damage to cell membranes Inhibit either DNA or RNA synthesis or both Inhibit protein synthesis Inhibit enzyme activity Inhibit growth of bacteria Does not KILL all bacteria but suppresses the growth so the body has an easier time fighting off those present BACTERIOCIDAL Kills the bacteria Infection Control Techniques Universal precautions Handwashing OSHA Laboratory Identification of Pathogens Obtain and label specimens from patients Grow out bacterial cells Isolate individual organisms Multiply to form colonies Stain cells so they can be seen (Gram Stain) Perform tests to identify organisms Gram Staining 1. Obtain the sample to be assessed. 2. Plate it on a microscope slide. 3. Stain it with water soluble crystal violet dye. 4. Acetone or ethel alcohol rinse dehydrates the peptidoglycan layer of the cell membrane. Gram Positive sample retains the violet stain. Gram staining cont’d 5. A counter stain (saffranin) is applied to the rinsed cell. The color will be red. This is a gram negative. After a quick water rinse, the staining is finished. Gram positive cells retain the violet stain and gram negative are red. TB accepts neither water soluble stain; it must be checked with an acid-fast stain Other Methods of Identification Growth characteristics in liquid and solid media Oxygen requirements Ability of bacteria to utilize various carbohydrates Reaction to various chemicals Serologic (immunologic) tests Susceptibility Now that the culture has been identified, we need to know what antibiotic will kill it. The growth of the culture will have different antibiotics applied to determine which will kill the bacteria. If the antibiotic does not kill the bacteria, the bacteria is called resistant. Killed = susceptible to the antibiotic Questions?