BACHELOR OF SCIENCE IN NURSING:

MICP 211 MICROBIOLOGY AND PARASITOLOGY

COURSE MODULE COURSE UNIT WEEK

No. 6 2 - MIDTERM PERIOD 7

BACTERIAL INFECTIONS. s1

 Read course and unit objectives

 Read study guide prior to class attendance
 Read required learning resources; refer to unit terminologies for jargons
 Proactively participate in classroom discussions
 Participate in weekly discussion board (Canvas) Answer and submit course unit tasks

At the end of this unit, the students are expected to:

Cognitive:
1. Recognize pathological capacity of microorganisms.
2. Correlate bacterial, viral and fungal infections as per signs and symptoms, pathogen, reservoir,
transmission and diagnostic laboratory.
3. Name several diseases associated with bacteria, viruses and fungal infections per body system.
Affective
1. Listen attentively during class discussions
2. Demonstrate tact and respect of other students’ opinions and ideas
3. Accept comments and reactions of classmates openly.
Psychomotor:
1. Participate actively during class discussions
2. Follow Class rule and Apply Netiquettes
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 3. Use correct procedural technique in demonstrating laboratory procedures preparation, collecting
associated with bacteria, viruses and fungi
4. Integrate knowledge about the bacteria, viruses and fungi during case analysis.

The material in this module was drawn from the book Microbiology and
Parasitology. Dr. Bartolome and Dr. Quiles' A Textbook and Laboratory Manual
for the Health Science (2nd edition).

Learn and comprehend the entire description of Infections by Body System:

Chapters 16 through 23 (pages 269 - 397).

P athogenic bacteria possess characteristics that enable them to circumvent the body's
defenses and exploit its resources, resulting in infection. It spreads by a variety of
mechanisms. A significant number of organisms must survive in the environment and
reach a vulnerable host in order for it to spread.

Immediately below is a description of SKIN BACTERIAL INFECTIONS. So, shall we start Future RNs?

BACTERIAL SKIN INFECTIONS

STAPHYLOCOCCI:

Staphylococcus aureus

 S. aureus is a Gram-positive coccus usually arranged in grapelike clusters.

 Produce enzymes &d toxins for its pathogenicity and through direct invasion and destruction of tissues
 Found in the skin and nasopharynx
 Mode Of Transmission
 Skin infections are transmitted through:
 direct contact with person having purulent lesions,
from hands of healthcare or hospital workers
fomites like bed linens, contaminated clothing
 Clinical Findings (Note: Refer to your textbook for the descriptions)
 Folliculitis -
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  Furuncle -
 Carbuncle -
 Sty or Hordeolum -
 Impetigo -
 Staphylococcal scalded skin syndrome ( SSSS / Ritter’s disease) -
 Laboratory Diagnosis
 by microscopic examination of Gram-stained specimen and culture.
 Treatment And Prevention
 Beta-lactam antibiotics like penicillin – treatment of choice
 S. aureus, readily develops resistance to penicillin & other penicillin derivatives like methicillin and
nafcillin.
 Oxacillin - only penicillin-derived antibiotic that has remained active against S. aureus.
 Patient Care
 Use Standard Precautions for skin, burn, and wound infections if they are minor.
 Contact Precaution if major, SSSS
 Standard Precautions for infections caused by methicillin-resistant S. aureus (MRSA); add Contact
Precautions if wounds cannot be contained by dressings.

Staphylococcus epidermidis

 It's a part of the skin's normal flora

 frequently linked to "stitch abscess," UTI, and endocarditis.
 it causes infections in people who utilize prosthetic equipment.

STREPTOCOCCI

Streptococcus pyogenes

 are Gram-positive cocci, group A beta-hemolytic (cause complete hemolysis of blood)

 M protein--- major virulence factor (anti-phagocytic)
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  Produces enzymes and toxins responsible for the pathogenesis of infections caused by the organism
 Mode Of Transmission
 Soft tissue infections are acquired through direct contact with an infected person or fomite.
 Clinical Findings: (Note: Refer to your textbook for the descriptions)
 Pyoderma (impetigo) -
 Erysipelas (St. Anthony’s fire) -
 Cellulitis -
 Necrotizing fasciitis -
 Complications
 Acute glomerulonephritis- non-supporative, immune-mediated complications and skin infections
 Rheumatic fever- usually associated with S. pyogenes throat infection
 Laboratory Diagnosis
 Microscopy
 Culture
 Bacitracin test
 Treatment And Prevention
 Penicillin- drug of choice
 Erythromycin or cephalosporin are alternative drugs in case of penicillin allergy.
 Patient Care
 Use Standard Precautions for skin, burn, and wound infections if they are minor or limited, and Contact or
Droplet Precautions if they are major.

Pseudomonas aeruginosa

Image:antimicrobe.org

 Gram negative bacillus; arranged in pairs; encapsulated.

 produces water soluble pigments like pyocyanin and is resistant to most antibiotic.
 opportunistic aerobic pathogen;
 Antibiotic resistance
 prevalent source of hospital-acquired infections, (Nosocomial infection)
 Virulence - adhesins, toxins, enzymes
 Mode of Transmission - colonization of injured skin
 Clinical Findings - (Note: Refer to your textbook for the descriptions)
 Blue-green pus; sweet grape -like odor -
 Folliculitis -
 Secondary infection to acne and nail infection -
 Osteochondritis -
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  ocular keratitis in contact lens wearers, endocarditis and osteomyelitis in IV drug users
 external otitis (swimmer's ear) in healthy people, and severe external otitis in diabetics.
 Many persons with cystic fibrosis die of respiratory failure caused by P. aeruginosa infection.
 P. aeruginosa frequent infects extensive skin burns, which can lead to sepsis.
 Laboratory Diagnosis Gram stain; Culture
 Treatment - Sensitivity is done
 Prevention - Prevent contamination of sterile equipment and cross - contamination

Clostridium perfringens

Image:http://www.hbo.co.za/hyperbarictherapy

 gram-postive bacillus, anerobic

 producing endospores
 produces four lethal toxins: alpha, beta, iota, and epsilon toxins
 Alpha- most lethal because it causes massive hemolysis, bleeding and tissue destruction
 Mode Of Transmission - Colonization of the skin following trauma or surgery
 Clinical Finding - GAS GANGRENE (Clostridial Myonecrosis).
 - causes soft tissue infections like cellulitis, suppurative myositis and myonecrosis (gas gangrene)
 -Gas gangrene- is a life-threatening infection following trauma or surgery and is characterized by massive
tissue necrosis with gas formation, shock, renal failure, and death within 2 days of onset.
 Laboratory Diagnosis - Microscopic detection of gram-positive bacilli and culture under an anaerobic conditions.
 Treatment And Prevention
 Surgical wound debridement and high-dose penicillin therapy are the main approaches to the
management of the diseases.
 Patient Care. Use Standard Precautions

Bacillus anthracis

 gram-positive bacilli, encapsulated, arranged in long chains

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  large, aerobic, sporeforming
 characteristics: bamboo rod or medusa head appearance
 able to grow slowly in soil types that meet specific moisture conditions. Endospores survived in soil tests for up to
60 years
 virulence factors of B. anthracis are two exotoxins (1) edema toxin, causes local edema (swelling) and interferes
with phagocytosis by macrophages (2) lethal toxin, specifically targets and kills macrophages, which disables an
essential defense of the host. Both toxins share a third toxic component, a cell receptor–binding protein called
protective antigen which binds toxins to target cells and permits entry.
 CLINICAL FINDINGS
1. Anthrax
 bacterial disease caused by bacillus anthracis that can affect skin, lungs, or gastrointestinal tract
depending on the portal of entry of the etiologic agent.
 The disease strikes primarily grazing mammals, such as cattle and sheep
People at risk are those who handle animals, hides, wool, and other animal products
 Three forms of Anthrax disease: (Note: Refer to your textbook for the descriptions)
 Cutaneous anthrax -
 Inhalational (pulmonary) anthrax -
 Gastrointestinal anthrax -
Cutaneous anthrax - results from contact with material
containing anthrax endospores.

Inhalational (pulmonary) anthrax - most dangerous

form of anthrax in humans. Endospores inhaled into
the lungs have high probability of entering
bloodstream.

Gastrointestinal anthrax - caused by ingestion of

undercooked food containing endospores. Sx. are
nausea, abdominal pain, bloody diarrhea. Ulcerative
lesions occur in GIT from mouth, throat to intestines.

Image:pinterestpinoninfographic
 Mode of transmission:
Through inoculation into the open skin from either the soil or infected animal products, ingestion of
infected meat or milk and inhalation of aerosolized spores.
 Laboratory Diagnosis:
 blood test detect both inhalational and cutaneous cases of anthrax within an hour. The peripheral
blood contains a large number of B. anthracis which is easily seen on gram- stain. Spores can be done
using Dorner stain or Wirtz Conklin stain.
 Treatment and prevention - Antibiotics like penicillin or doxycycline are the drugs of choice.
 Vaccination of livestock in endemic areas.; single dose of live, attenuated vaccine is used, which is unsafe
for use in humans.
Vaccine approved for humans: contains inactivated form of antigen toxin to prevent entry of 2 toxins
into the host’s cells
For people who have been exposed to B. anthracis: 3 doses of the vaccine over 4 weeks, along with
antibiotic treatment, are recommended .
 Patient Care. Standard Precautions. Add Contact Precautions for cutaneous anthrax pt. if there is a large
amt. of uncontained drainage. Use soap, water for handwashing; alcohol does not have sporicidal
activity.
******* *******

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B acteria are generally associated with many types of OCULAR INFECTIONS . If left untreated, ocular infections
can harm the structures of the eye, resulting in blindness and visual impairment. This part of the module aimed
to discuss the bacterial profile of ocular infections.

CONJUNCTIVITIS is the inflammation/infection of conjunctiva and may have several clinical findings. An
inflammation/infection of cornea is KERATITIS while the inflammation / infection of conjunctiva & cornea is
KERATOCONJUNCTIVITIS.

Bacterial Infections of the Eyes

BACTERIAL CONJUNCTIVITIS (“PINKEYE”).

 involves irritation, reddening of conjunctiva; edema of eyelids, mucopurulent

discharge,; sensitivity to light; highly contagious
 Pathogens - Common are Haemophilus influenzae subsp. aegyptius and Streptococcus
 pneumoniae, but there are other bacteria as well. (Note: Descriptions of H. influenzae subsp. aegyptius and S. pneumoniae
are located below)
 Patient Care - Standard Precaution.
- Reservoirs and Mode of Transmission. Infected humans. Human-to-human transmission occurs via contact.

Haemophilus influenzae biogroup aegyptius

 known as the Koch-Weeks bacillus; Gram-negative bacterium; rod shape (coccobacillus)

 causative agent of acute and often purulent conjunctivitis;
 caused worldwide seasonal epidemics (summer)
 virulence - pili
 Transmission - mechanical

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Streptococcus pneumoniae
 gram-positive, facultatively anaerobic pathogen, in pairs, encapsulated.
 alpha hemolytic if aerobic; beta hemolytic if anerobic
 lancet shaped
virulence : adhesin, capsule, toxin pneumolysin and IgA protease.

Chlamydia trachomatis

Image:osmosis.org(google.com)

 Gram-negative bacterium and obligate intracellular pathogen.; cell with high lipid.
 susceptible to sulfonamides
 associated with eye infections such as: conjunctivitis, inclusion conjunctivitis, trachoma (Note: Descriptions are located
below)
 Clinical Findings -
 Conjunctivitis
 Also called “ swimming pool conjunctivitis” -
 Transmission: Acquired in non/poor chlorinated swimming pool, In adults,
 occur w/ non-gonococcal urethritis or cervicitis (genital to eyes transfer),
 there is mucopurulent eye discharge
 occurs with pneumonia or chlamydial nasopharyngitis.
 Inclusion conjunctivitis (Chlamydial Conjunctivitis, Paratrachoma)
 Caused by serotypes D to K.;
 In adults, asso w/ genital infection;
 In newborn acquired upon passage in birth canal;
 s/s: swelling of eyelids w/ mucopurulent, keratitis, corneal infiltrates & corneal
vascularization
 Trachoma - (Chlamydia Keratoconjunctivitis).
 Also called as “chronic keratoconjunctivitis.
 Caused by serotypes A,B & C;
 Transmitted eye-to-eye by droplets, fomites & eye-seeking flies. In poor living cond.;
 s/s: follicular conjunctivitis w/ diffuse inflammation involving entire conjunctiva, then
progress to conjunctiva scarring producing in-turned eyelids.; In-turned eyelids causes
constant abrasion of cornea leading to ulceration,scarring, invasion of vessels into cornea &
loss of vision (frequent cause of blindness)

Neisseria gonorrheae
- a kidney bean–shaped, Gram-negative diplococcus
- Also called as gonococcus,. Common cause of STD
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- In neonates- “ophthalmia neonatorum” – acquired upon passage in birth canal.
- In adults, transmitted through finger-to eye contact involving infectious genital secretions
- s/s: redness, swelling of conjunctiva w/ purulent eye discharge
- If untreated – leads to corneal ulceration, perforation & blindness
- PREV (neonate): 1% silver nitrate (Crede’s prophylaxis) after birth or 1% tetracycline eye ointments or 0.5%
erythromycin eye ointments.
******* ********

F 1.
OODBORNE DISEASE can arise from either infection or intoxication. It may leads to: (Note: Refer to your textbook for
description)

Gastritis-
2. Enteritis-
3. Colitis-
4. Gastroenteritis -
5. Hepatitis-
6. Dysentery-

Establishment of infectious disease in digestive system is:

1.Pharmacologic action 2. Local inflammation 3.Deep tissue invasion 4.Perforation

Bacterial infections :
1. Bacterial enterocolitis (food poisoning): Bacterial food poisoning is defined as an illness caused by the consumption
of food contaminated with bacteria or bacterial toxins
- . Bacteria cause are: Bacillus cereus, Staph. aureus, Clostridium perfringes, Vibrio parahemolyticus
2. Gastroenteritis (Diarrhea): is an inflammation of the lining of the intestines.
- Bacterial are; Escherichia coli, Salmonella sp. Shigella sp,Yersinia enterocolitica, Vibrio cholera, Clostridium perfringes,
Clostridium difficile, Bacillus anthracis, Mycobacterium tuberculosis

GIT
BACTERIAL INFECTIONS
BACTERIAL ENTEROCOLITIS ( Food poisoning ) 3 mechanisms of Food poisoning
1.Ingestion of preformed toxin- present in contaminated food. S/s dev hrs consisting of explosive diarrhea,
abd pain. Staph aureus, Vibrio. Clostridium perfringes

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 2.Infection by toxigenic organisms- involves secretory enterotoxin, dysentery
3.Infection by enteroinvasive organisms- proliferate, invade, destroy epithelial cells- dysentery.

Bacillus cereus Staphylococcus aureus Clostridium perfringes Vibrio parahemolyticus

Gm (+) aerobic rod Impt cause of food Aneobic Gm (+) Marine organism
Poisoning Sporeforming rod Curved Gm -)
coccobacillus
2 distinct forms: Enterotoxin are produced Enterotoxin producer Produces enterotoxin
Emetic type: When organism grow in Similar to cholera toxin
Fried rice Carbo or protein food
Diarrheal type- meat
Dishes & sauces
Emetic form is self Ingestion of Ingestion of food Ingestion of raw seafood
Limiting. recovery contaminated contaminated w/soil containing spores
Shellfish oysters
w/n 24 hrs. S/s begin Foods, salads, custards, reheated food Lab Dx: culture.
after ingestion of rice Milk products Like meat dishes It is halophilic
occasionally pasta
Diarrheal type- Vomiting w/ nausea is more Watery diarrhea, abdl No antibiotic treatment
enterotoxin preformed or Common than diarrhea. Cramps. Vomiting not Mild, self limiting
or produced in small No fever. Common. Resolves n 24
intestine Tx: No antibiotic therapy Hrs
Tx: No antibiotic tx Required. Mgt: supportive No antibiotic therapy
Required. Self limiting. Tx: supportive
Rice should not be
Kept warm for long
periods

DIARHHEA
Escherichia Salmonella Shigella Yersinia Vibrio Clostridium Clostridium Bacillus M. tuber
coli sp. sp enterocolitica cholera perfringes difficile anthracis culosis
Gm (-) motile Gm (-) Gm(-) rod Gm(-) urease Comma- Toxin Anerobic MOT: TB of GIT
Encapsulated rod Encapsulated non motile Producing Shaped producing Gm (+) Ingestion When it is
Normal flora Motile rod non encap Rods Motile rod organisms Spore forming Of improperly
Swallowed
Most commom Has 3 S. MOT: w/ polar flage enterotoxin Rod Cooked meat
After being
Cause of UTI Antigens Dysenteriae In gestion of llum Most common From infected
& sepsis food Cause of animals Coughed
Up from
Travellers Cell wall O Has shiga (meat & dairy Prolonged MOT: food Nosocomial S/S Lung lesion
diarrhea Flagellar H toxin Products) Hypersecretion (meat & Diarrhea Vomiting Or by M.
Capsular Vi contaminated Of water
Gravies) bovis

Serves as S.typhi MOT: By feces of MOT: water Contaminated MOT: Abdominal When it is
Fecal index Transmitted Food Domestic Food By dirt or Fecal oral Pain Ingested
For contami Only by Finger Animals Flies Feces, Route Bloody
By unpas
nation of Humans Flies Fomites “rice watery” Enteritis Hospital Diarrhea
Teurized
water Ingestion of Fomites Watery to Stool Necroticans Personnels Dx: exam of

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 Food & water Bloody Bloody Severe Bloody Are impt Specimen Milk pro
Contaminated Mucoid diarrhea Dehydration diarrhea Intermedia & culture Ducts.
By human Diarrhea & shock ries
S/S:
& animal wastes
Abd’l
pain
Has pili Enterocolitis With S/S suggest Tx: Water Culture Lab:ELISA DOC: Chronic
Capsule Typhoid or tenesmus Appendicitis Fluid & Under Diarrhea Ciprofloxacin diarrhea
Endotoxin Enteric fever Arthralgia Electrolyte Anaerobic Watery to
enterotoxin Septicemia replacement conditions bloody
Antibiotic tx Lab Dx: Typhoid Lab Dx Lab Dx Tx: Tx: Antibiotic Doxycycline DOC::
Not usually Culture EMB or Culture Culture of Tetracycline Penicillin Associated Is alternative RIPES
Indicated Mc conkey’s EMB or Specimen Pseudo Drug.
Prevntion
In diarrheal Agar Mc conkey’s From rectal Membranous Control
BCG vaccine
E.coli disease Isolation: Agar Swabs with “ Colitis. Measures:
st
Urine- 1 2wks Cold Clindamycin Immunization Pasteuriza
st
Blood-1 -3 wkrd
Enrichment” nd
2 -3rg gen Of domestic Tion of
Stool- 2nd-4th wk Self-limiting cephalosporins animals milk
Do not
Serology: require
Widal
Test

Tx: 3rd gen Ciprofloxacin Antibiotic Tx:

cephalosporins therapy metronidazole

MOUTH
1.Dental caries(tooth decay)- Streptococcus mutans
Periodontal disease-inflammation of structures that support teeth
Gingivitis-
Periodontitis- chronic gum disease can cause bone destruction & tooth loss
Acute necrotizing ulcerative gingivitis or Vincent’s disease or Trench mouth
Causative agent: Prevotella intermedia. Treatment : Metronidazole

Let us ascertain your understanding.

What being described below?
No. Questions Choices
1.1. With tenesmus V. Cholera Salmonella Shigella
2.2. Prevention include vaccination with BCG vaccine M. tuberculosis Shigella E.coli

3.3. Prevention include Pasteurization of milk M. tuberculosis V. Cholera Salmonella

4. Causes Traveller’s diarrhea Yersinia Salmonella E.coli

5. Causes Typhoid fever Cholera Salmonella Shigella

6.4. Control measure is Immunization off domestic animals B. anthracis Shigella E.coli
7.5. Causes Severe Dehydration & shock B. Anthracis Cholera C. difficile

******* ********

SUPPLEMENTAL LECTURES IN VIDEO FORMAT:

Video Title
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 Bacteria
Group A Streptococci – Microbiology | Lecturio

Diarrhea – Infectious Diseases | Lecturio

Staphylococci – Microbiology | Lecturio

Group A Streptococcus (GAS) – Infectious Diseases | Lecturio

Congrats and Thank you for your efforts Future RNs. The following are key terms related to this week's content.
Look for the some in a proactive manner.

Meningeal Infection

An infection of the protective membranes that cover the brain and spinal cord, known collectively as the meninges.

Staph Infection

An infection caused by any one of several harmful species or subspecies of bacteria of the genus Staphylococcus.

Urogenital Disease

Disease of the organs involved in the excretion of fluids and reproduction.

ASSIGNMENT: Answer your textbook : Microbiology and parasitology. A textbook and laboratory
manual for the health science (2nd edition) by Dr. Bartolome and Dr. Quiles. On pages 285- 286 (skin), 377-
378 (eyes) pages 341 - 343 (GIT).

Bartolome and Quiles. (2020) Microbiology and Parasitology: A Textbook and Laboratory Manual for
the Health Sciences. 2nd Edition. C&E Publishing House. Quezon City. QR65. B37 2020
Engelkirk, Paul G. (2019). Burton's Microbiology for the health sciences, 8th ed. . Philadelphia :
LWW.616.01 E3 2007
Tortora, G.J. (2014) Microbiology. Pearson: Singapore. 616.9041 T63 2014
Useful Link: https://courses.lumenlearning.com/microbiology/

Credit: Dr. Leila Ferrer

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