ADAMAWA STATE COLLEGE OF NURSING AND MIDWIFERY, YOLA

COURSE CODE: GNS 124

COURSE TITLE: MICROBIOLOGY

TOPIC: INTRODUCTION TO MICROBIOLOGY, UNIT I

TO COVER:

1. Definition of Some Microbiological Terms

2. History Band Development of Microbiology
3. Relevance of Microbiology to Nursing/Midwifery
4. Classification/Groups of Microorganisms
5. Identification of Microscope

INTRODUCTION TO MICROBIOLOGY

Microbiology can be defined as the study of microorganisms (bacteria,

fungi, protozoa, yeasts, rickettsias, mycoplasmas, chlamydiae, and some
helminthes) and other agents, like the viruses that can be seen well only
with the aid of a microscope (Eugene, Evans, Nancy, Denise & Martha,
1998).
Viruses are entities that are totally dependent on the presence of a living
cell for replication, while microorganisms are for the most part single celled,
but they also include certain multi-cellular types. Viruses do not exhibit
cellular characteristics.
Microorganisms are very diverse in nature; the only feature they have
in common is their small size. The study of microbiology may seem only as
an academic affair to a student nurse or midwife and limited only in the
care of their patients. No, because of the diverse nature of these organisms,
the patterns of their behaviors and the environment they like most bring
about their differences ranging from those beneficial to man, through those
harmless, to those which are harmful (disease causing) to man and even
death.
The knowledge of the way in which these organisms work is
important to a nurse or a midwife to apply the principles of aseptic
techniques in the control of infections caused by these organisms. The
knowledge of microbiology by a nurse or a midwife is unquantifiable when
the skills are needed in the care of a patient, to prevent and control cases
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arising as a result of these organisms.
The techniques of personal, hospital and community hygiene are
microbiologically based techniques. An understanding of microbiology is
very essential in the promotion of these principles or techniques.
The promotion of personal hygiene, which includes, routine bathing, tooth
brushing (oral hygiene), ventilation, and proper hand washing before and
after every exercise, the use of protective coverings as gloves, masks,
rubber boots and eye glasses; clean nails (manicure and pedicure), clean
environment, immunization, hair care, uniforms and eating habits should be
maintained.
The hospital hygiene to include proper disposal of infected materials and
specimens, and utensils by disinfection, sterilization, burial and incineration;
isolation/segregation/separation of patients with similar cases, that is,
patient/client placement.
The community/public hygiene should include supply of potable drinking
water, open drainages and buildings, routine environmental sanitation,
construction of public lavatories (toilets).
The ignorance of personal, hospital and public hygiene can pose serious
health problems ranging from filthy (dirty) and unpleasant environment to
infection by microorganisms, which do not exclude any body, either patient,
hospital staff and the entire community.
Infection is very dangerous, not for only causing pains or discomfort, but
for prolonged treatment, increase loss of working time, wastes of
resources, and result in anxiety and restlessness to patient’s relatives. The
hospital and the community are never left out in terms of economic and
social effects of infection, which may include obstruction of admission
arrangements, high drugs and dressing bills, pressure on hospital staff as a
result of emergence of drug-resistant strains of organisms, etc.

BENEFICIAL EFFECT OF MICROORGANISMS

Compost Formation, Nitrogen Fixation, Maintenance of Soil Fertility,

Digestion of Cellulose (gram positive Ruminococcus), Decomposition,
Silage Making, Sewage Treatment in Medicine, Manufacturing of
Drugs/Vaccines, Antibiotics, Source of Vitamin B, Source of Enzymes in
Industries, For Baking, Preparation of Alcoholic Drinks, Making of
Cheese/Yoghurt, Retting of Jute, Curing of Tobacco, Tanning of Hides and
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Skins

HARMFUL EFFECT OF MICROORGANISMS

Cause of Disease, Spoilage of Food, Deterioration of Material

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SOME OF THE DIFFERENCES BETWEEN BACTERIA AND VIRUSES ARE AS
FOLLOWS:

S.N. Characteristics Bacteria Viruses

1 Size Larger (1000 nm) Smaller (20-400 nm)

No cell wall. Protein

Peptidoglycan or
2 Cell Wall coat
Lipopolysaccharide
present instead.

3 Ribosomes Present Absent

One cell
4 Number of cells No cells
(Unicellular)

Between living and non

5 Living/Non-Living Living organisms
-living things.

DNA AND RNA DNA OR RNA enclosed

Nucleic Acid (DNA
6 floating freely in inside a coat
and RNA)
cytoplasm. of protein.

7 Infection Localized Systemic

Able to reproduce Need a living cell to

8 Reproduce
by itself reproduce

Invades a host cell and

takes over the cell
causing it to make
Fission- a form of
copies of the viral
9 Reproduction asexual
DNA/RNA. Destroys
reproduction
the host cell releasing
new viruses. Fusion or
Assemblage

A bacterial illness
commonly will last Most viral illnesses last
10 Duration of illness
longer than 10 2 to 10 days.
days.

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 A bacterial illness A viral infection may or
11 Fever notoriously causes may not cause
a fever. a fever.

Possesses a Lack cellular

12 Cellular Machinery
cellular machinery machinery

Visible under Light Visible only under

13 Under Microscope
Microscope. Electron Microscope.

Viruses are not

beneficial. However, a
Some bacteria are particular virus may be
14 Benefits beneficial (Normal able to destroy
Flora) brain tumors. Viruses
can be useful in
genetic engineering.

Virus does not respond

15 Treatment Antibiotics
to antibiotics.

Staphylococcus
HIV, Hepatitis A virus,
16 Examples aureus, Vibrio
Rhino Virus, etc.
cholerae, etc.
Food poisoning,
AIDS, common cold,
gastritis and
17 Diseases/Infections influenza,
ulcers, meningitis,
chickenpox, etc.
pneumonia, etc.

DEFINITION OF MICROBIOLOGICAL TERMS

Agar - is a compound that is derived from algae, containing many nutrients,
and solidifies into gel and used as a medium for bacterial growth.
Antisepsis - This term is applied to a process of disinfection on tissue. Only
disinfecting agents that are not toxic to the tissue may be used as
antiseptic agents.
Avirulence - not likely to cause disease in another organism, or lack of
competence of an organism to cause or produce disease
Bacilli – cylindrical or rod shape bacteria
Bacteremia – bacteria in blood
Cocci bacteria – spherical shape bacteria
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Cocco-bacilli bacteria – oblong or oval shape bacteria
Colonization – domination of an article/material/surface, or establishment
of microbial growth on a body surface
Culture – microorganisms grown
Culture media or growth media - are specific mixtures of nutrients and
other substances that support the growth of microorganism
Decontamination - is a combination of processes that removes or destroys
contamination so that infectious agents or other contaminants cannot
reach a susceptible site in sufficient quantities to initiate infection, or other
harmful response. The various levels of decontamination are: physical
cleaning, disinfection, antisepsis, sterilization, incineration, etc
Disease - is the result of a microorganisms penetrating the body surfaces,
entering the body tissue, multiplying, and causing the host to react by
making an immune response, or is the result of a severe infection that
leads to symptoms and signs of illness.
Disinfection – is the reduction in the number of infective
agents/microorganisms on surfaces using chemical
Endemic – the constant presence of a disease or agent of disease in a
community
Epidemic – an acute outbreak of disease in a community, or region in
excess of normal expectancy, and derived from a common or propagated
source
Epidemiology – the study of the spread, distribution, prevalence, and
control of disease in a community
Germs – causative agents, infective agents, microorganisms, microbes
Incubation – growing microorganisms in a controlled environment
Infection – is the invasion of the host tissue by an infective agent, or a
disruption in normal functions of the host which may not result in disease
Infectious disease – an illness caused by a pathogen through transmission
from an infected human, animal, or contaminated environment. Any
condition in which there is a noticeable impairment of the body function by
an infecting agent, or any disease as a result of microbe.
Inoculate – add microorganisms to media
Media – food for microorganisms
Micro – small, one millionth part, very small
Microbes - microorganisms, infective agents, causative agents, germs,
pathogens
Microbiology – the study of microorganisms and viruses, visible only with a
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microscope
Micrococci - cocci in tetrads, (in fours), tetra cocci
Microscope – An optical instrument used for viewing/observing very small
objects,
Non-infectious or non-communicable disease – is a disease that is not
caused by microorganism, and is not communicable, e.g., diabetes, Hbp,
Cancer, sickle cell anemia, hemorrhoids, epilepsy, fibroid
Nosocomial infection – hospital acquired infection
Opportunist – a microorganism which causes disease only when the
immune system is impaired, weak, prone, susceptible, debilitated,
immunodeficient (organisms of the normal flora)
Pandemic – a disease which spreads to several communities (countries)
and affect a large number of people (all over disease), AIDS, Corona
disease etc
Pathogen – any disease-producing microorganism
Petri dish –round glass container used for culturing microorganisms
Septicemia – blood poisoning (pyemia) caused by the spread in the blood
of pus-forming bacteria released from an abscess
Slide – rectangular glass for staining samples/organisms
Smear – spread specimen on a slide
Specimen – sample used for testing and diagnosis, e.g., urine
Spirilla - spirally twisted, cork screw shaped, rigid bacteria
Spirochetes – cork screw shaped, flexible bacteria
Sporadic disease – breaks out only occasionally
Staining – application of dye(s) on specimens to reveal microorganisms on
the specimens
Staphylococci – cluster or group of cocci bacteria; cocci in clusters
Sterilization – destruction of all microorganisms, usually by heat
Streptococci - chain cocci or cocci in chain
Toxemia – toxins in blood
Vibrios - curved rod shaped, or comma shaped bacteria
Viremia – viruses in blood
Virulence – enhance disease-producing capabilities of microorganism, or
the ability to cause damage in a host, or the relative ability of a
microorganism to overcome host defenses
Wire-loop –wire for inoculation
Zoonotic disease – disease of animals in humans
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8
HISTORY BAND DEVELOPMENT OF MICROBIOLOGY
Introduction
For many years, nothing concrete was known about the subject
microbiology. Modern ideas were said to have started in 1546 when
Girolamo Fracastoro first suggested that infection is composed of minute
insensible particles and the infection is spread by the means of those
minute insensible particles; that is, the microorganisms cause disease or
infection and spread disease or infection. He noted that infection was the
same for ‘he who received as for he who had given’ the infection. It was a
great achievement, noting that it aided the transmission of disease, and
contagion was recognized in some diseases like syphilis and plague. That
instigated other scientists to search for the minute insensible particles or
microorganisms, which was not possible and seriously taken by people,
until the invention of a microscope by Antony van Leeuwenhoek in 1674
through which and when the subject microbiology had the real meaning.

Alexander Fleming, in 1921 Discovers lysozyme

in 1929, discovered and described the properties of the first antibiotic,
penicillin from Penicillium chrysogenum. He is regarded as father of
antibiotics

Antony van Leeuwenhoek, in 1676, observed bacteria and protozoa

(animal cules) using his homemade microscope. He is called father of
microscopy and indeed the father of microbiology. He also gave first
complete account of RBCs.
He demonstrated the capillary connections between arteries and veins. •
He described for the first time the spermatozoa from insects, dogs and
man. • He studied structure of the optic lens, striations in muscles, mouth
parts of insects.

Armauer Hansen, in 1868, discovered Mycobacterium leprae, the cause of

leprosy

Edward Jenner, in 1796, introduces cow pox vaccination for small pox

Girolamo Fracastoro, in 1546, first suggested that infection is composed

of minute insensible particles and the infection is spread by the means of
those minute insensible particles (the microorganisms).

Hans Christian Joachim Gram (1853—1938), identified Gram status of

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bacteria as, Gram-positive and Gram-negative bacteria

Ignaz Semmelweis (1818—1865). In (1846), he first demonstrated that

hand washing is very important tool in prevention of infection. • Regarded
as “saviour of mothers” Demonstrated that childhood fever is a contagious
disease transmitted by physicians to their patients during childbirth

John Snow, 1853 - 1854, demonstrated the epidemic spread of cholera

through a water supply contaminated with human sewage

Joseph Lister, in 1867, published the first work on aseptic surgery

(disinfection, sterilization), beginning the trend toward modern aseptic
techniques in medicine. He is the father of antibiotic surgery

Richard Julius Petri, in 1887, adopted two plates to form a container for
holding media and culturing microbes – the petri dish

Louis Pasteur (1822- 95), coined the terms microbiology and vaccine, and
introduced the terms aerobic and anaerobic in describing the growth of
yeast at the expense of sugar in absence of O2. He is the father of modern
microbiology. In 1860-61, he disproved the theory of spontaneous
generation. In 1860-64, he gave experimental evidence that fermentation
and putrefaction are effects of microbial growth. That yeasts degrade
sugar to ethanol and carbon dioxide and multiply in the process, called
fermentation. In 1863-65, he invented process of Pasteurization. In 1885,
he develops rabies vaccine

Paul Ehrlich (1854-1915). In 1879, he applied stains to cells and tissues for
the purpose of revealing their function.
In 1882, he reported the acid fastness of tubercle bacillus. In 1898, he
proposed side chain theory of antibody production. In 1909, he introduced
salvarsan, an arsenical compound, sometimes called the “magic bullet”. •
Magic bullet was capable of destroying the spirochaete of syphilis with only
moderate toxic effects. • He founded new branch of medicine known as
CHEMOTHERAPY.

Robert Gallo and Luc Montagnier, in 1983, isolated and characterized HIV,
the causative agent for AIDS

Robert Koch, in 1876, reported the isolation of Bacillus anthracis, the cause
of Anthrax, a serious and fatal disease of human, sheep and other animals,
in pure culture.

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In 1877, introduced the method of making smears of bacteria on glass
slide, and of staining them with aniline dyes

In 1881, He introduced the use of pure culture techniques for handling

bacteria in the laboratory;

In 1882, He identified the causative organism for tuberculosis, called

Mycobacterium tuberculosis, also known as Koch’s bacillus

In 1883, He discovered Vibrio cholerae

In 1884, He formulated group of criteria known as Koch’s postulates, that:

1. The microorganisms must be present in every case of the disease,

except for non-communicable disease;
2. The microorganisms must be grown in pure culture from the
diseased host;
3. The same disease must be produced when a pure culture of the
microorganism is inoculated into a healthy, susceptible host;
4. The microorganisms must be recovered from the experimentally
infected host.
5. Specific antibodies to the organism should be demonstrable in the
serum of the patient.

RELEVANCE OF MICROBIOLOGY TO NURSING

The understanding and the importance of microbiology to a Nurse or a

Midwife are unquantifiable to their field of study, and these provide the
basis for safe care delivery. The relevance of microbiology to a Nurse or a
Midwife is to help them in:

1. The provision of knowledge on the different microorganisms and the

diseases they cause;

2. Understanding on the characteristic features, environmental

preference and conditions favorable for the growth, multiplication
and transmission of microorganisms to individuals;

3. Giving necessary steps in the prevention, control, occurrence and

spread of the infection, both in hospital and in the community;

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 4. Explaining the concept of immunity and immune response as applied
to epidemiology;

5. Performing simple specific laboratory investigations;

6. Interpreting results of laboratory findings;

7. Giving health education on the cause, mode of spread,

prevention/control and the treatment of diseases caused by
microorganisms to the members of the community/society.

NOMENCLATURE AND CLASSIFICATION / GROUPS OF

MICROORGANISMS AND VIRUSES

Nomenclature of Organisms

Nomenclature can be defined as: 1. The assignment of names to a

taxonomic group that has been defined by similarities in certain
characteristics; 2. The system of assigning names to organisms. The
scientific naming is based on taxonomic group, which incorporates two
names (binomial nomenclature). Almost all organisms are named
according to binomial system or binomial nomenclature, that is,
assignment of two names called genus and species, as devised by
Swedish botanist, Carl van Linne or Carolus Linnaeus (1707—1778).

In the binomial system, the first word in the name is the genus (plural
genera), with the first letter always capitalized. The second word is the
species name which is not capitalized. Both words are always italicized. In
hand writing, they are always underlined separately, example, Escherichia
coli, Staphylococcus aureus.
Like many bacteria, Escherichia coli, was named after the person that
discovered, isolated and described it (the German Physician, Theodore
Escherichia, (1857—1911)). In this case, the species name comes from the
location (colon) where the organism is commonly found. Based on
morphology, e.g., Bacillus cereus, Spirillum minus; Based on description,
e.g., Staphylococcus aureus, Lactobacillus acidophilus; Based on event, e.g.,
Legionella pneumophila
In abbreviation, the genus name is commonly abbreviated with the first
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letter always capitalized, dotted, and both, with the species name, italicized
or underlined separately. Example, E. coli, S. aureus.

In contraction, the first word, that is, the genus name is the only contracted
and dotted, and both, with the species name, underlined or italicized
separately. Example, Esch. coli, Staph. aureus, Strep. fecalis.

The italicizing or underlining is not applicable to algae and viruses, because

algae have only one name, and viral agents end with virus as suffix

CLASSIFICATION/GROUPS OF MICROORGANISMS AND VIRUSES

Microorganisms are classified into the following:

1. Algae, e.g., Spirogyra, Diatoms, Chlorella, Palmella, Synedra, Anabaena

2. Protozoa, e.g., Plasmodium species, Trypanosoma species,

Trichomonas vaginalis, Giardia lamblia, Entamoeba histolytica, Toxoplasma
gondii
3. Fungi, e.g., Candida albicans, Pneumocystis jirovecii, Microsporum
species, Epidermophyton floccosum Trichophyton species, Aspergilus
species, Cryptococcus neoformans, Coccidioides immitis, Malassezia
furfur, Histoplasma capsulatum
4. Bacteria, e.g., Escherichia coli, Staphylococcus aureus, Streptococcus
pneumoniae, Bacillus anthracis, Corynebacterium diphtheriae, Clostridium
tetani, Mycobacterium tuberculosis, Neisseria meningitides, Neisseria
gonorrhoeae, Shigella dysenteriae, Salmonella species, Vibrio species,
Pseudomonas aeruginosa
5. Chlamydias/iales (other bacteria), e.g., Chlamydia trachomatis,
Chlamydiophila pneumoniae, Chlamydiophila psittaci
6. Rickettsias/iales (other bacteria), e.g., Rickettsia rickettsii, Rickettsia
prowazekii, R. akari, R. tsutsugamutshi, R. typhi
7. Mycoplasmas (other bacteria), e.g., Mycoplasma pneumoniae,
Mycoplasma genitlium, Mycoplasma hominis, Ureaplasma urealyticum
8. Viruses, e.g., Mumpsvirus, Rubeolavirus, Coronavirus, Rubellavirus, HIV,
Lassa virus, Poliovirus, Ebolavirus, Hepatitisvirus, Zikavirus, Varicella
zostervirus, Rhinovirus, Herpes simplexvirus, Rabiesvirus, Human
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papillomavirus etc.

9. Helminthes (worms, some), e.g., Necator americanus, Strongyloides

stercoralis, Wuchereria bancrofti, Ascaris lumbricoides, Enterobius
vermicularis, Trichuris trichiura, Dracunculus medinensis, Schistosoma
haematobium, Ochocerca volvulus, Paragonimus westermani, Taenia
species, Diphyllobothrium latum

Brief Description of the Groups of Organisms

Algae (Eukaryotes)

They are very simple important group of plants without true leaves, stems
and roots that grow in or near water. They are either multicellular or
unicellular.

Their scientific study is called Phycology or Algology.

Importance of algae or uses:

They serve as:

1. Food for marine animals; 2. Diatomaceous earths used in preparing

detergents;

3. Fine abrasive polishes; 4. Paints removers; 5. Decolorizing and

deodorizing oils;

6. Fertilizers; 7. Vitamins; 8. Antibiotics and agar; 9. Filtering agents;

10. Additives to paints, and increase night visibility of signs and license
plates;

11. INSECTO to dehydrate insects and causes them to die;

12. INSECTO as feeds for poultry, livestock and pets with no ill effects.

Protozoa (singular, protozoan) (Eukaryotes)

Protozoa can be defined as usually motile eukaryotic unicellular protists.

Protozoa mean first animals. They are non-photosynthetic unicellular

organisms. They are generally regarded as the form of animal life. Their
scientific study is called Protozoology.

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Fungi (singular, fungus) (Eukaryotes)

They are eukaryotic, spore-bearing organisms with absorptive nutrition, no

chlorophyll (non-photosynthetic). Their scientific study is called Mycology.

Forms of Fungi:

Yeast: Is a unicellular fungus that has a single nucleus and reproduces

sexually or asexually by budding and transverse division. Yeast cells are
commonly spherical to egg or Irish potato shape. -

Mold: is a type of fungus that forms slimy or cottony growth on food stuffs
and leather, and are filamentous. -

Mushroom: is a filamentous fungus with large fruiting bodies that are

edible-

Bacteria (Prokaryotes)

Are a group of microorganisms all of which lack a distinct nuclear

membrane and most of which have a cell wall of unique composition. They
are also minute unicellular organisms ranging in size from 0.3 μm to 14 μm
in length (1 μm =0.001 mm). Their scientific study is called Bacteriology.

The Structure, Function and Shapes of Bacteria:

Some of the basic structures that can be observed microscopically in a

typical bacterial cell structure are illustrated bellow:

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Title: An Anatomy of a bacterium

Bacterial structure and function

1. Cell wall -- preserves the shape of an organism

2. Plasma (cytoplasmic) membrane -- allows diffusion of liquid to take

place between the cell cytoplasm and the environment.

3. Nucleo (plasma) area -– contains nuclear materials, or deoxyribonucleic

acid (DNA), not bounded by nuclear membrane as with animal and plant
cells.

4. Mesosomes -- are vacuoles which sometimes may be formed by

invagination of the cytoplasmic membrane. They play a role in cellular
respiration, synthesis of cell wall, DNA replication, distribution of daughter
cells, and secretion of waste.

5. Division points (transverse septum)—are partial septa consisting of cell

wall and cell membrane which grow completely across the cell at the time
of cell division, thus dividing it into two new cells.
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6. Ribosomes -- are very tiny numerous granules of ribonucleic acid (RNA)
or protein.

7. Inclusion granules -- are stored substances of phosphate, glycogen and

starch, and CO2.

8. Fat globules -- are stored substances of lipid

9. Flagella -- are hair like processes which propel species that possess
them by a lashing movement, or are flexible whip like processes used for
locomotion, e.g., E. coli, Salmonella species

10. Capsule -- is a protective gelatinous layer covering the cell wall,

possibly connected with virulence, e.g., with Streptococcus pneumoniae
and Klebsiella pneumoniae.

11. Fimbriae and pili -- are short stout hair like processes; fimbriae which
are shorter than pili are used for attachment to surfaces, while pili longer
than fimbriae and in number are used for transferring DNA from one cell to
another as sex pili, e.g., in Neisseria gonorrhoeae, and E. coli.

12. Basal body – it is the germinating point or origin part of a flagellum

which holds the flagellum firmly into the bacterium.

Shapes and arrangements of Bacteria

Most bacteria assume one of the following shapes:

1. Oval or Spherical shape or cocci

Associations/arrangements or groups of Cocci

(a) Single cells as in monococci, e.g., Micrococcus flavus

(b) Cocci in clusters as in staphylococci, e.g., Staphylococcus

aureus, Staphylococcus epidermidis, Staphylococcus capitis,
Staphylococcus haemolyticus
(c) Cocci in chain as in streptococci, e.g., Streptococcus pyogenes,
Streptococcus pneumoniae, Streptococcus mutans, Streptococcus bovis
(d) Cocci in pairs as in diplococci, e.g., Diplococcus pneumoniae
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(Pneumococci) Neisseria gonorrhoeae, N. meningitidis, Moraxella
catarrhalis, Enterococcus species,
(e) Cocci in tetrads as in tetracocci, e.g., Tetracoccus, Aerococcus
urinae, Tetragenococcus, Pediococcus, Micrococcus tetragenus,
Micrococcus luteus
(f) Cocci in octet as in sarcinae, e.g., Sarcina ventriculi, Sarcina
ureae, Sarcina lutea, Sarcina aurantiaca, Sarcina maxima
2. Cylindrical (rod shape or bacilli)

Associations/arrangements or groups of Bacilli

(a) Single bacillus is called Monobacillus, e.g., Escherichia coli, Salmonella
enterica, Salmonella choleraesuis, Mycobacterium tuberculosis,
Mycobacterium leprae, Lactobacillus acidophilus, Lactobacillus plantarum,
Lactobacillus brevis, Lactobacillus bulgaricus, Clostridium species
(b) Coccobacilli – the length of the bacterium is approximately the same as
its width. They are shorter in length and appear stumpy. They are oblong in
shape, e.g., Bordetella pertussis, Bordetella parapertussis, Haemophillus
influenzae, Haemophilus ducreyi, Gardnerella vaginalis, Chlamydia
trichomatis, Brucella spp.
(c) Bacillus in pairs as in Diplobacilli, e.g., Coxiella burnetii,
Klebsiella rhinoscleromatis (Diplobacillus pneumoniae) Klebsiella
pneumoniae, Moraxella bovis, Bacillus Lichenniformis

(d) Bacilli arranged in elongated chains as in Streptobacilli

e.g., Streptobacillus moniliformis, Streptobacillus Levaditi,
Streptobacillus felis, Streptobacillus hongkongensis, Bacillus subtilis,
Bacillus cereus.

(e) Septate bacilli arranged in chain in a sheath as in

Trichome, e.g., Thiothrix nivea, Saprospira grandis

(f) Bacilli bend at the point of division and resemble a picket fence, or bacilli
arranged side by side like a match stick as in Palisade, e.g.,
Corynebacterium diphtheriae

3. Spiral bacteria
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(a) Comma shaped bacilli – They exhibit comma shape with less than one
complete turn or twist in the cell,,,, e.g. Vibrio cholerae, Vibrio
parahaemolyticus, Vibrio mimicus, Vibrio hollisae, Vibrio vulnificus, Vibrio
damsella
(b) Spirilla - They are spirally twisted, cork screw shaped rigid bacteria, e. g.,
Spirillum vulutans, Aquaspirillum, Campylobacter jejuni, Helicobacter pylori,
Spirillum winogradskyi, Oceanospirillum, Spirillum minus.
(c) Spirochetes - They are cork screw shaped, flexible bacteria
e.g,.Treponema pallidum, Leptospira interogans, Borrelia burgdorferi,
Borrelia recurrentis
4. Actinomycetes – are branching filamentous bacteria resembling fungi.
They possess a rigid cell wall, e. g. Nocardia brasiliensis. Nocardia
asteroides. Streptomyces coelicolor. Streptomyces scabies, Candidatus
Savagella

5. Rectangular (box-shaped) bacteria- They appear rectangular in shape

e.g., Haloarcula marismortui, Haloarcula quadrata, Haloarcula salaria,
and Haloarcula tradensis.
6. Star-shaped bacteria- are bacteria that resemble a flat, six-pronged star
(star-shaped) with prosthecae called Ancalomicrobium e.g., Stella humosa,
Stella vacuolata
7. Pleomorphic bacteria- Bacteria with the ability to change their shape and
size in different environments, e.g., Arthrobacter species, Mycoplasma
pneumoniae, Mycoplasma genitalium
8. Stalked bacteria- These include such bacteria as Caulobacter crescentus,
Brevundimonas subvibrioides, Asticcaulis, Hyphomonas that possess a
stalk on one end of the cell

Chlamydiae (Bedsonia) (Other Bacteria) (Prokaryotes)

Chlamydiae are Gram-negative, non-motile, coccoid, obligate intracellular

parasites of prokaryotic cells that lack peptidoglycan (murein) layer with
size ranging from 0.2 μm to 1.5 μm.

Three species cause human disease: 1. Chlamydophilia pneumoniae,

causes Chlamydia pneumonia (TWAR) which is a respiratory tract infection,
characterized by fever, cough, sore throat, hoarseness of voice and pains
during swallowing; 2. Chlamydia trachomatis causes human disease as (a)
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a sexually transmitted disease of the name lymphogranuloma venereum
(LGV) phase 1, 2, and 3. It is also known as tropical or climatic bubo
because it is mostly found in tropical countries, (b) Non-gonococcal
urethritis (NGU) also known as non-specific urethritis that result in
urethritis in men and pelvic inflammatory disease in women, (c) neonatal
eye infection or inclusion conjunctivitis in new born and (d) severe form of
eye infection, trachoma. 3. Chlamydophila psittaci causes psittacosis
(ornithosis, or parrot fever), a bird to human disease.

Rickettsias (Other Bacteria) (Prokaryotes)

They are fastidious, obligate intracellular parasites. They are small, rod
shaped spherical - coccobacilli (pleomorphic) organisms maintained in the
environment through a cycle of mammals and insect vectors; that is, they
infect arthropods like, ticks, spiders, mites; lice, fleas, flies, through which
they can be transmitted to animals including human and cause disease.
They are similar to, but smaller than bacteria. They occupy a group
between bacteria and viruses.

Mode of living: Majority are strict parasites that grow only on living tissue
of suitable animal host (intracellular) where they resemble viruses, but
differ by possessing both RNA and DNA. Cell structure: they lack a cell wall;
cell size is variable, 0.15—1 mm in diameter.

Mycoplasmas (Other Bacteria) (Prokaryotes)

They are species of very minute, non-motile microbes that lack cell wall and
hence display a variety of forms-–pleomorphic and are independent. Under
broad classification, mycoplasmas are bacteria; but under narrow
classification, by possession of sterols in their cytoplasmic membrane,
which other bacteria do not have, and passing through bacterial filter,
carved them from bacteria as mycoplasmas. They are ubiquitous
(everywhere). Four species are pathogenic to humans: Ureaplasma
urealyticum, Mycoplasma genitalium, Mycoplasma hominis, and
Mycoplasma pneumoniae.
Viruses (Infectious Agents)

Viruses are non-living entities and therefore are not organisms, but
infectious agents. Indeed, they are merely bits of nucleic acid surrounded

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by a protein coat. They contain no ribosomes or any structures required for
the harvesting of energy. Therefore, they can only replicate inside living
cells whose capabilities they use for their replication. Furthermore, they do
not undergo cell division but replicate by assembling their structural
component. These agents can infect all forms of life, including all members
of the Bacteria, Archaea, and Eucarya.

They commonly are referred to by the organisms they infect. Those that
infect bacteria are bacteriophage, or phage (phage means ‘’to eat’’), e.g., T4
phage, Lambda (λ), ФX174, M13, fd, T1—T7, MS2, QB, parasite E. coli; Beta
(β) parasites Corynebacterium diphtheriae; Ф6 parasites Pseudomonas
phaseolicola.
Animal viruses infect animals and plant viruses infect plants. These
organisms are the host for the viruses.

Types of viruses

There are two basic types of virions: The naked or non-enveloped viruses
and the enveloped viruses. The attachment spikes project from the
envelope. Size ranges from 0.1 mm—0.3 mm in diameter. Most viruses are
ultramicroscopic; that is, too small than can be resolved by the light
microscope. They can pass through bacteria stopping filters. Their
scientific study is called Virology.

Two Different Types of Virions: (a) Naked virus, and (b) Enveloped virus

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Helmithes

Helminthes are organisms which, some are visible to the naked eyes
(macro), while some are not (micro), and implore the use of microscopes
to be visible.

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In humans, the helminthes that cause disease generally belong to one of
three classes: the nematodes (roundworms), e.g., Necator americanus;
trematodes (flukes), e.g., Onchocerca volvulus and the cestodes
(tapeworms), e.g., Taenia saginata, Taenia solium.

Helminthes enter the body in a number of ways. They may be eaten in

contaminated food, be passed through insects’ bite, or directly penetrate
the skin. They cause disease by invading the host tissue or robbing the
host of nutrients. Some helminthes have complex life cycles, involving one
or more intermediate hosts where early stages of development occur, and
a definitive host, where the sexually mature forms occur.

THE MICROSCOPE

A Microscope is defined as a simple instrument that produces a greatly

magnified image of an object, which may be so small to be seen with the
naked eyes, or an optical instrument used for viewing very small objects,
such as mineral samples, plant or animal cells and microorganisms,
typically magnified several hundred times.
Based on the number of magnifying lenses, microscopes are divided into
two: (i) A single (one) magnifying lens microscope, where the lens serves
as both the objective lens as well as the ocular (eye) lens, is called a Simple
Microscope. (ii) A two set of magnifying lenses: that are, the objective lens
and the ocular (eye) lens microscope, serve separately, is called a
Compound Microscope. The one used by Antony Van Leeuwenhoek
consists of a single magnifying lens and is called a Simple Microscope.
Nowadays microscopes have two sets of magnifying lenses: the objective
lens and the ocular (eye) lens and is called a Compound Microscope

Based on the source of illumination (or beam), there are two different sets
of microscopes also: (i) A microscope that uses a beam of light (being it
sunlight, electricity, moonlight, candle light, any source of brightness the
microscope can use) is called, a Light microscope. So named because
visible light illuminates the objects being studied. (ii) A microscope that
uses a beam of electrons from elements, say, mercury, lead, silver,
molybdenum, gold etc., is called an Electron microscope.

Based on the number of eye lens/eye piece, microscope is further divided

into two: (i) A microscope that uses one eye lens/eye piece, is called a
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Monocular microscope; (ii) A microscope that uses two eye lenses/eye
pieces, is called a Binocular microscope

Types of microscopes

Basically, there are two types of microscopes:

1. The Compound microscope, and

2. The Electron microscope.

The compound microscope is further divided into

(i) Bright field microscope; the bright field makes use of unstained
samples, called wet film or hanging drop, which reveal the
structural details, measuring appearance and size of bacteria,
protozoa, heminthes

(ii) (ii) Dark field microscope; it is used on very thin bacteria as

Treponems, flagellated bacteria and protozoans

(iii) Phase contrast microscope; it is used for living organisms. It

examines the internal structures of a living cell by improving the
contrast and differentiating structures within the cell that differ in
their thickness

(iv) Nomarski interference microscope. It demonstrates cell

organelles, quantitative measurement of the chemical
constituents of the cells, e.g., protein, lipid and nucleic acids, and

(v) Fluorescent microscope; it is used in the demonstration of antigen

of a pathogen by a direct fluorescence antibody (DFA), e.g.,
Neisseria gonorrhoeae, Corrynebacterium diphtheriae; estimation
of antibody in serum by IFA in Leptospirosis, Syphilis, Brucellosis.
Normally these dyes are used as fluorescence dyes: Auramine O
dye, Acridine orange dye, Rhodamine dye

While the electron microscope is also further divided into

(i) Transmission electron microscope; an electron source at the top

of the microscope emits electrons that travel through a vacuum in
the column of the microscope. Electromagnetic lenses are used to
focus the electrons into a very thin beam and this is then directed
24
 through the specimen of the interest

(ii) Scanning electron microscope. Scanning electron microscope

works by scanning a sample with electron beams. An electron gun
fires these beams, which then accelerate down the column of the
scanning electron microscope. During this action, the electron
beams pass through a series of lenses and apertures which act to
focus it.

A monocular (one eyepiece) Microscope

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Parts of Microscope and their Functions

Arm: it supports the body tube, and adjustment knobs. It is where a

microscope is held

Base (Foot): it supports the microscope, and is another side for holding a
microscope.

Body tube (Barrel): it holds the eye piece and the objective lenses.

Coarse adjustment knob: it brings objects into focus

Diaphragm: it regulates the amount of light that passes through the

specimens.

Eye piece/lens: It is where specimens are viewed; it increases the

magnification of objective lenses. It is replaceable, higher or lower
magnification, say, 10X or 15X.

Fine adjustment knob: it permits exact focus on objects or specimens.

Hole: packs and channels light to the objective lens.

Mirror: reflects and regulates light through diaphragm to hole on stage

Objective lenses: they are lenses of different magnifications, say, 1X, 4X,
10X, 40X, 44X, 45X, and 100X.

Revolving nose piece: holds the objective lenses to rotate the low and high-
power objective lenses.

Stage: is the platform where specimens for observation are laid.

Stage clips: they hold the slide firmly in place on the stage

SOURCE, TRANSMISSION AND COURSE OF INFECTION

Source of infection is a location from which a pathogen is immediately
transmitted to the host, either directly through the environment or indirectly
through an intermediate agent—immediate party to host. Therefore, source
of infection can be animate, e. g., human, animal or inanimate, e. g., soil, air,
water or food.
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Transmission of infection means transfer of pathogenic organism from
one source to another.
Types of transmission:
 Horizontal transmission, is the transfer of pathogen through air,
physical contact, ingestion of food or water, and vector,
 Vertical transmission, is the transfer of pathogen from a pregnant
mother to her fetus, during childbirth or breast feeding.
Modes of transmission of infection:
 Airborne; organisms, e.g., Mycobacterium tuberculosis,
Streptococcus pneumoniae, Bordetella pertussis, Neisseria
meningitidis, Rubeola virus, Varicella zoster virus
 Contact; organisms, e.g., Neisseria gonorrhoeae, Treponema
pallidum, HIV, HBV, HCV, Rhinovirus, Trichomonas vaginalis, Vibrio
cholerae
 Vehicle and Food or water; organisms, e.g., Salmonella typhi,
Salmonella. paratyphi, Staph. aureus, Clostridium botulinum
 Vector-borne; organisms, e.g., Rickettsia prowazekii-typhus, louse
Rickettsia rickettsii, Plasmodium spp, Trypanosoma brucei
rhodesiense, Trypanosoma brucei gambiense, Borrelia burgdorferi,
yellow fever virus, Yersinia pestis-plague, flea
Course of Infection
 Incubation period: the interval between introduction of an organism
to a susceptible host and the onset of an illness.
 Illness: is when a person experiences signs and symptoms of a
disease. Sometimes the onset of illness starts with prodromal phase
(first symptoms) of disease such as headache and malaise.
 Convalescence: is the stage of recuperation and recovery from a
disease.

LESIONS PRODUCED BY INFECTIOUS AGENTS IN THE BODY

The result of invasiveness of an organism is the lesion/injury produced, and
it depends on the genus and species of the organism. This can also simply
mean disease caused by the organism. Some lesions produced by bacteria
27
include:
 Granuloma; Yersinia pestis, Chlamydia trachomatis, HIV
 Boils; Staphylococcus aureus
 Gastric and duodenal ulcers; Helicobacter pylori
 Excessive secretion of fluid; Vibrio cholerae
 Spasm; Rabies virus
 Muscular paralysis Clostridium botulinum
 Death of epithelial cells (necrosis), Gas gangrene; Clostridium
perfringense
 Gummas; Treponema pallidum
 Pyemia; Staphylococcus aureus, E. coli, Pseud. aeruginosa
 Arthritis; Streptococcus pyogenes, Neisseria gonorrhoeae

UNIT II INFECTION PROCESS AND INFECTIOUS DISEASE CONTROL

CHAIN OF INFECTION

Infectious Disease Model

Controlling and preventing the spread of infectious disease relies on

understanding the foundations of disease transmission. The process of
infectious disease transmission involves a series of interaction between an
agent (pathogen), host, and environment. This classic triad of interactions
is presented as the communicable disease model. Infectious agents may
be bacteria, viruses, parasites, or fungi. When agent and host interact in an
optimal environment, it initiates a cascade of events that lead to infection,
disease, and death or recovery.1 It is important to note that infection does
not necessarily equal disease. Infection is a disruption in normal functions
of the host but may not result in disease. Disease is the result of a severe
28
infection that leads to symptoms and signs of illness.

Figure: interaction between an agent (pathogen), host, and environment.

An infectious disease (communicable disease) is defined as an illness

caused by a pathogen through transmission from an infected human,
animal, or contaminated environment.1 The concept of infectious diseases
naturally involves a social phenomenon, whereby the interactions between
individuals is a driving force enabling transmission.
The series of events that allow infectious diseases to spread between
individuals in our population is known as the “Chain of Infection”.
Transmission occurs when the agent leaves its reservoir or infected host
through a portal of exit and invades a susceptible host through a mode of
transmission and portal of entry.

The Chain of Infection Model:

As noted, the causation and spread of infectious disease involves the

interplay between agent, host, and environmental factors. The model
includes the following six links:

1. Infectious agent (The cause of the infectious disease): Pathogenic

bacteria, virus, fungi, parasite etc.

2. Reservoir (place where agent lives, grows, and multiply): Examples of

these include humans, animals, pets (dogs, cats, reptiles), food, soil, water,
29
air etc.

3. Portal of exit (how infectious agents leave reservoir): Examples include

through the respiratory tract, mouth and nose (vomit, saliva,
phlegm/mucus), urethra (urine), anus, feces (diapering and toileting),
vagina (vaginal fluids), penis (seminal fluids) or skin lesions (pus, blood,
serum).

4. Mode of transmission (the way infectious agents travel to infect another

host): This can include direct/indirect contact through sex (direct); droplets
(sneezing, coughing, yawning, talking, singing etc.), vehicle, or fomite
(moneys, door handles, pens, etc.) indirect; airborne, for a far distance;
vector borne (mosquitoes, tsetse flies, flies, cockroach, ticks etc.); food
and water means of transmission.

5. Portal of entry (how infectious agents make their way inside a host):
Entry portals typically include exposed environments like the eyes, mouth,
nose, vagina, penis, open wounds etc.

6. Susceptible host: Exposure to an infectious agent does not always

cause disease. Factors like age, underlying health conditions, health habits,
and immunization history can affect your risk to infection. Babies 
Children  Adolescent, Elderly  People with a weakened immune system 
Unimmunized people  Anyone

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BREAKING THE CHAIN OF TRANSMISSION

1. Infectious Agent, through

Diagnosis and treatment
Antimicrobial stewardship
2. Reservoir, through
Cleaning, disinfection, sterilization 4. Mode of Transmission,
Infection prevention policies through
Pest control Hand hygiene
3. Portal of Exit, through Personal protective equipment
Hand hygiene (PPE)
Personal protective equipment Food safety
(PPE) Cleaning, disinfection and
Control of aerosols and splatter sterilization
(Respiratory etiquette) Isolation
Proper waste disposal 5. Portal of Entry, through
31
Hand hygiene 6. Susceptible Host, through
Personal protective equipment ( Immunizations
PPE) Treatment of underlying disease
Personal hygiene Health insurance, Patient
First aid education
Removal of catheter and tubes

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