ELEMENTARY BACTERIOLOGY AND PROTOZOOLOGY FOR THE USE OF NURSES

By E. GINIM

CONTENTS UNIT 1: INTRODUCTION 1 IMPORTANCE AND RELEVANCE OF MICROBIOLOGY TO NURSING 2 ROLE OF A NURSE IN MICROBIOLOGY 3 HISTORICAL PERSPECTIVE 3 1 IMMUNITY AND VACCINATION MULTIPLE CHOICE QUESTIONS SHORT NOTES ESSAY UNIT 2: GENERAL CHARACTERISTICS OF MICROBES 4 STRUCTURE AND CLASSI?CATION OF MICROBES 4 1 INTRODUCTION 4 1 1 OVERVIEW OF PROKARYOTIC CELL STRUCTURE 4 1 2 OVERVIEW OF EUKARYOTIC CELL STRUCTURE 4 2 STRUCTURE OF PROKARYOTIC CELL 4 2 1 INTRACELLULAR STRUCTURES 4 2 2 EXTRACELLULAR STRUCTURES 4 3 SHAPES OF MICROBES 4 3 1 ADVANTAGES OF SHAPE TO THE CELL 4 4 STRUCTURES INVOLVED IN ATTACHMENT 4 5 CLASSIFICATION OF MICROBES 4 5 1 SCIENTI?C NOMENCLATURE (BINOMIAL NOMENCLATURE) 4 5 2 TAXONOMIC HIERARCHY OF ESCHERICHIA COLI 4 5 3 TWO-KINGDOM CLASSIFICATION 4 5 4 THREE-KINGDOM SYSTEM 4 5 5 FOUR-KINGDOM SYSTEM 4 5 6 FIVE-KINGDOM SYSTEM 4 5 7 CARL WOESE’S THREE-DOMAIN SYSTEM 4 6 UNIVERSAL TREE OF LIFE 4 7 MORPHOLOGICAL CLASSIFICATION 4 8 NUTRITIONAL CLASSIFICATION 4 9 BIOCHEMICAL CLASSIFICATION 4 10 CLASSIFICATION BASED ON STAINING REACTION 4 11 SEROLOGICAL OR ANTIGENIC CLASSIFICATION ESSAYS 5 MORPHOLOGY—SIZE AND FORMS 5 1 INTRODUCTION 5 2 BACTERIAL MORPHOLOGY 5 2 1 SIZE OF BACTERIAL CELLS 5 2 2 SHAPE OF BACTERIAL CELLS 5 2 3 COLONY MORPHOLOGY 5 3 MICROSCOPY 5 3 1 TYPES OF MICROSCOPES 5 4 ANATOMY OF BACTERIA 5 4 1 ARCHITECTURE OF A BACTERIAL CELL 5 4 2 CELL WALL-DEFICIENT BACTERIA 6 FLAGELLA AND MOTILITY—HANGING DROP TECHNIQUE 6 1 BACTERIAL MOTILITY 6 1 1 TYPES OF BACTERIAL MOTILITY 6 2 DETECTION OF BACTERIAL MOTILITY 6 2 1 FLAGELLAR STAINING 6 2 2 MOTILITY TEST 6 2 3 DIRECT MICROSCOPIC EXAMINATION 6 3 IMPORTANCE OF BACTERIAL MOTILITY 6 3 1 CHEMOTACTIC BEHAVIOUR 6 3 2 ROOT COLONIZATION 6 3 3 PATHOGENESIS 6 3 4 TWITCHING MOTILITY 7 COLONIZATION, NUTRITION, AND GROWTH OF MICROBES 7 1 COLONIZATION OF BACTERIA 7 1 1 INVASIVENESS 7 1 2 TOXIGENESIS 7 1 3 ADHERENCE OF BACTERIA 7 1 4 PATHOGENICITY 7 1 5 WOUND COLONIZATION 7 2 MICROBIAL NUTRITION 7 2 1 AUTOTROPHIC BACTERIA 7 2 2 HETEROTROPHIC BACTERIA 7 2 3 SYMBIOTIC BACTERIA 7 2 4 PARASITIC BACTERIA 7 2 5 MAJOR ELEMENTS 7 3 MICROBIAL GROWTH 7 3 1 GROWTH FACTORS 7 3 2 UPTAKE OF NUTRIENTS BY BACTERIA 7 3 3 GROWTH CURVE 7 3 4 CONTINUOUS CULTURE 7 3 5 SYNCHRONOUS GROWTH 7 4 INFLUENCE OF ENVIRONMENTAL FACTORS ON MICROBIAL GROWTH 7 4 1 WATER ACIDITY AND SOLUTES 7 4 2 TEMPERATURE 7 4 3 OXYGEN REQUIREMENT 7 4 4 PH 7 4 5 PRESSURE 7 4 6 RADIATION 8 CULTURE MEDIA 8 1 INTRODUCTION 8 2 HISTORY OF CULTURE MEDIA 8 3 IMPORTANCE OF CULTURE MEDIA 8 4 COMMON COMPONENTS USED IN CULTURE MEDIA 8 4 1 AGAR 8 4 2 PEPTONES 8 4 3 WATER 8 4 4 EXTRACTS 8 4 5 BODY FLUIDS 8 5 CLASSIFICATION OF CULTURE MEDIA 8 5 1 CLASSIFICATION BASED ON CONSISTENCY 8 5 2 CLASSIFICATION BASED ON NUTRITIONAL COMPONENTS 8 5 3 CLASSIFICATION BASED ON FUNCTIONAL USE 8 6 PREPARATION AND STORAGE OF CULTURE MEDIA 9 LABORATORY METHODS FOR THE IDENTI?CATION OF MICROORGANISMS 9 1 GOOD LABORATORY PRACTICES (GLP) 9 2 FIVE I’S IN A MICROBIOLOGY LABORATORY 9 2 1 INOCULATION 9 2 2 INCUBATION 9 2 3 ISOLATION 9 2 4 INSPECTION 9 2 5 IDENTIFICATION 9 3 MOLECULAR TECHNIQUES AND TYPING 9 3 1 SPECIES IDENTIFICATION 9 3 2 TYPING 9 3 3 GENOTYPING 9 4 BIOCHEMICAL IDENTIFICATION TECHNIQUES 9 4 1 BIOCHEMICAL TESTS 10 STAINING TECHNIQUES 10 1 DEFINITION AND PROTOCOL 10 1 1 USES OF STAINS 10 1 2 SOME COMMONLY USED STAINS 10 1 3 STAINING BACTERIA 10 2 SIMPLE STAINING 10 2 1 STAINING OF BACTERIA FROM THE COLONY 10 2 2 STAINING OF BACTERIA FROM THE BROTH 10 3 DIFFERENTIAL STAINING 10 3 1 GRAM STAINING 10 3 2 ACID-FAST STAINING 10 3 3 ENDOSPORE STAINING 10 3 4 CAPSULE STAINING 10 3 5 METACHROMATIC GRANULE STAINING (ALBERT’S STAINING) 10 3 6 FLAGELLA STAINING 10 3 7 CALCOFLUOR WHITE STAINING UNIT 3: INFECTION CONTROL 11 SOURCES, PORTALS, AND TRANSMISSION OF INFECTIONS 11 1 INTRODUCTION 11 2 CLASSIFICATION OF INFECTIONS 11 3 SOURCES OF INFECTIONS 11 3 1 HUMANS 11 3 2 ANIMALS 11 3 3 INSECTS 11 3 4 SOIL AND WATER 11 3 5 FOOD 11 4 PORTALS OF ENTRY AND EXIT 11 5 MODES OF TRANSMISSION OF INFECTIONS 12 ASEPSIS, DISINFECTION, AND STERILIZATION—TYPES AND METHODS 12 1 INTRODUCTION 12 2 ASEPSIS 12 2 1 PRACTICE OF ASEPTIC TECHNIQUES 12 3 STERILIZATION AND DISINFECTION 12 4 TYPES OF STERILIZATION 12 4 1 PHYSICAL STERILIZATION 12 5 TYPES OF DISINFECTION CONCLUSION 13 CHEMOTHERAPY AND ANTIBIOTICS 13 1 INTRODUCTION 13 2 HISTORY OF ANTIBIOTICS 13 3 GENERAL PROPERTIES OF AN IDEAL ANTIBIOTIC 13 4 CLASSIFICATION OF ANTIBIOTICS 13 4 1 BASED ON TARGET ORGANISM 13 4 2 BASED ON SPECTRUM OF ACTION 13 4 3 BASED ON CIDAL AND STATIC ACTIVITY 13 4 4 BASED ON ORIGIN 13 4 5 BASED ON MODE OF ACTION 13 5 ANTIFUNGAL DRUGS 13 6 ANTIVIRAL DRUGS 13 7 ANTIPROTOZOAL DRUGS 13 8 ANTIBIOTIC RESISTANCE 14 STANDARD SAFETY MEASURES AND BIOMEDICAL WASTE MANAGEMENT 14 1 BIOMEDICAL WASTE MANAGEMENT 14 1 1 COLLECTION AND SEGREGATION OF WASTES 14 1 2 CONTAINMENT AND LABELLING 14 1 3 TRANSPORTATION 14 1 4 TREATMENT OF BIOMEDICAL WASTE 14 1 5 DISPOSAL 14 1 6 RECORD MAINTENANCE 14 2 RISK ASSESSMENT 14 2 1 PATHOGENICITY 14 2 2 ROUTE OF TRANSMISSION 14 2 3 INFECTIOUS AGENT STABILITY 14 2 4 INFECTIOUS DOSE 14 2 5 SUSCEPTIBILITY OF THE HOST 14 2 6 CONCENTRATION AND VOLUME OF THE PATHOGEN 14 3 STANDARD SAFETY MEASURES 14 3 1 CONTAINMENT 14 3 2 PERSONAL PROTECTIVE EQUIPMENT 14 3 3 BIOLOGICAL SAFETY CABINETS 14 3 4 FACILITY AS A BARRIER 14 3 5 BIOSAFETY LEVELS 15 HOSPITAL ACQUIRED INFECTION AND HOSPITAL INFECTION CONTROL PROGRAMME 15 1 INTRODUCTION 15 1 1 OCCURRENCE OF INFECTIONS 15 1 2 MICROBIAL CAUSES 15 2 EPIDEMIOLOGY OF NOSOCOMIAL INFECTIONS 15 2 1 NOSOCOMIAL INFECTION SITES 15 2 2 URINARY TRACT INFECTIONS 15 2 3 SURGICAL SITE INFECTIONS 15 2 4 NOSOCOMIAL PNEUMONIA 15 2 5 NOSOCOMIAL BLOODSTREAM INFECTIONS 15 2 6 SKIN AND SOFT TISSUE INFECTIONS 15 2 7 OTHER NOSOCOMIAL INFECTIONS 15 3 INFECTION CONTROL PROGRAMMES: PROTOCOLS 15 3 1 NATIONAL PROGRAMMES 15 3 2 HOSPITAL PROGRAMMES 15 3 3 INFECTION-CONTROLLING RESPONSIBILITY 15 4 NOSOCOMIAL INFECTION SURVEILLANCE 15 4 1 OBJECTIVES UNIT 4: PATHOGENIC ORGANISMS 16 BACTERIA 16 1 STAPHYLOCOCCUS 16 1 1 GENERAL PROPERTIES 16 1 2 CULTURAL CHARACTERISTICS 16 1 3 BIOCHEMICAL PROPERTIES 16 1 4 MODE OF TRANSMISSION 16 1 5 VIRULENCE FACTOR 16 1 6 PATHOGENESIS 16 1 7 LABORATORY DIAGNOSIS 16 1 8 PREVENTION AND TREATMENT 16 2 STREPTOCOCCUS 16 2 1 INTRODUCTION 16 2 2 GENERAL PROPERTIES 16 2 3 CULTURAL CHARACTERISTICS 16 2 4 BIOCHEMICAL PROPERTIES 16 2 5 MODE OF TRANSMISSION 16 2 6 PATHOGENESIS 16 2 7 LABORATORY DIAGNOSIS 16 2 8 TREATMENT 16 3 NEISSERIA 16 3 1 INTRODUCTION 16 3 2 NEISSERIA GONORRHOEAE 16 3 3 NEISSERIA MENINGITIDIS 16 4 CORYNEBACTERIUM 16 4 1 GENERAL PROPERTIES 16 4 2 CULTURAL CHARACTERISTICS 16 4 3 BIOCHEMICAL PROPERTIES 16 4 4 MODE OF TRANSMISSION 16 4 5 PATHOGENESIS 16 4 6 LABORATORY DIAGNOSIS 16 4 7 TREATMENT 16 5 ENTEROBACTERIACEAE 16 5 1 INTRODUCTION 16 5 2 ESCHERICHIA 16 5 3 KLEBSIELLA 16 5 4 PROTEUS 16 5 5 SHIGELLA 16 5 6 SALMONELLA TYPHI 16 6 MYCOBACTERIUM 16 6 1 GENERAL PROPERTIES 16 6 2 MYCOBACTERIUM TUBERCULOSIS 16 6 3 MYCOBACTERIUM LEPRAE 16 7 VIBRIO CHOLERAE 16 7 1 GENERAL PROPERTIES 16 7 2 CULTURAL CHARACTERISTICS 16 7 3 BIOCHEMICAL PROPERTIES 16 7 4 MODE OF TRANSMISSION 16 7 5 PATHOGENESIS LABORATORY DIAGNOSIS PROPHYLAXIS AND TREATMENT 16 8 SPIROCHAETES INTRODUCTION SIZE AND STRUCTURE HABITAT 16 9 MYCOPLASMA MORPHOLOGY AND GENERAL CHARACTERISTICS CULTURAL CHARACTERISTICS BIOCHEMICAL REACTIONS SUSCEPTIBILITY TO PHYSICAL AND CHEMICAL AGENTS ANTIGENIC PROPERTIES PATHOGENICITY TREATMENT AND PROPHYLAXIS 16 10 RICKETTSIA 16 10 1 GENERAL CHARACTERISTICS 16 10 2 CULTURAL CHARACTERISTICS 16 10 3 PATHOGENESIS 16 10 4 LABORATORY DIAGNOSIS 16 10 5 TREATMENT 16 11 CHLAMYDIA 16 11 1 CLASSIFICATION 16 11 2 GENERAL CHARACTERISTICS 16 11 3 DEVELOPMENTAL CYCLE 16 11 4 CULTURAL CHARACTERISTICS 16 11 5 PATHOGENESIS 16 11 6 LABORATORY DIAGNOSIS 16 11 7 TREATMENT 17 VIRUSES 17 1 GENERAL PROPERTIES OF VIRUSES STRUCTURE OF VIRUSES REPLICATION OF VIRUSES CLASSIFICATION OF VIRUSES 17 2 HERPESVIRIDAE 17 2 1 MORPHOLOGY 17 2 2 HERPES SIMPLEX VIRUS 17 2 3 VARICELLA ZOSTER VIRUS 17 2 4 EPSTEIN–BARR VIRUS 17 2 5 CYTOMEGALOVIRUS 17 3 PICORNAVIRIDAE 17 3 1 ENTEROVIRUSES 17 3 2 RHINOVIRUSES 17 3 3 HEPATOVIRUS (HEPATITIS A VIRUS) 17 4 RHABDOVIRIDAE 17 4 1 RABIES VIRUS 17 4 2 HOST RANGE AND GROWTH CHARACTERISTICS 17 4 3 PATHOGENESIS 17 4 4 CLINICAL FEATURES 17 4 5 IMMUNE RESPONSE 17 4 6 LABORATORY DIAGNOSIS 17 4 7 POST-EXPOSURE TREATMENT AND PROPHYLAXIS 17 4 8 RABIES VACCINE 17 5 RETROVIRIDAE 17 5 1 HUMAN IMMUNODEFICIENCY VIRUSES 17 5 2 LABORATORY DIAGNOSIS 18 FUNGI 18 1 INTRODUCTION 18 2 MORPHOLOGICAL CLASSIFICATION 18 2 1 MOULDS 18 2 2 YEASTS 18 2 3 DIMORPHIC FUNGI 18 3 TAXONOMICAL CLASSIFICATION 18 4 CELL WALL OF FUNGI 18 5 FUNGAL REPRODUCTION 18 6 MYCOSES 18 6 1 SUPERFICIAL MYCOSIS 18 6 2 SUBCUTANEOUS MYCOSIS 18 6 3 DEEP MYCOSIS 18 6 4 OPPORTUNISTIC MYCOSIS 19 PARASITES 19 1 INTRODUCTION 19 2 ENTAMOEBA HISTOLYTICA 19 2 1 LIFE CYCLE 19 2 2 PATHOGENESIS 19 2 3 LABORATORY DIAGNOSIS 19 2 4 TREATMENT 19 3 PLASMODIUM SP 19 3 1 LIFE CYCLE 19 3 2 PATHOGENESIS 19 3 3 LABORATORY DIAGNOSIS 19 3 4 TREATMENT 19 4 PARASITIC HELMINTHS 19 4 1 TAENIA SOLIUM 19 4 2 WUCHERERIA BANCROFTI 20 RODENTS AND VECTORS 20 1 RODENTS 20 1 1 INTRODUCTION 20 1 2 YERSINIA PESTIS 20 2 VECTORS 20 2 1 INTRODUCTION 20 2 2 TICKS 20 2 3 LICE 20 2 4 MITES UNIT 5: IMMUNOLOGY 21 IMMUNITY—CLASSI?CATION 21 1 INTRODUCTION 21 1 1 RECOGNITION 21 1 2 RESPONSE 21 2 TYPES OF IMMUNITY 21 2 1 INNATE IMMUNITY 21 2 2 ADAPTIVE IMMUNITY 21 3 CELLS OF THE IMMUNE SYSTEM 21 3 1 B LYMPHOCYTES 21 3 2 T LYMPHOCYTES 21 4 HUMORAL IMMUNITY 21 5 CELL-MEDIATED IMMUNITY 22 ANTIGEN AND ANTIBODY REACTION 22 1 INTRODUCTION 22 1 1 ANTIGENS 22 1 2 ANTIBODIES 22 2 ANTIGEN–ANTIBODY INTERACTIONS 22 3 TYPES OF ANTIGEN–ANTIBODY INTERACTIONS 22 3 1 PRECIPITATION REACTIONS 22 3 2 AGGLUTINATION REACTIONS 22 3 3 ENZYME-LINKED IMMUNOSORBENT ASSAY 23 HYPERSENSITIVITY REACTION 23 1 INTRODUCTION 23 1 1 ALLERGENS 23 1 2 INCLINATION TO ALLERGIC REACTION 23 2 CLASSIFICATION OF HYPERSENSITIVITY REACTION 23 2 1 ANAPHYLACTIC HYPERSENSITIVITY 23 2 2 TYPE II HYPERSENSITIVITY REACTION 23 2 3 TYPE III HYPERSENSITIVITY REACTION 23 2 4 CELL-MEDIATED HYPERSENSITIVITY 24 SEROLOGICAL TESTS 24 1 INTRODUCTION 24 2 PRECIPITATION 24 3 AGGLUTINATION 24 3 1 WIDAL TEST 24 3 2 ANTI-STREPTOLYSIN O TEST 25 IMMUNOPROPHYLAXIS 25 1 INTRODUCTION 25 2 ACTIVE AND PASSIVE IMMUNITY 25 3 ADJUVANTS 25 3 1 FUNCTIONS OF ADJUVANTS 25 4 VACCINES AND ITS TYPES 25 4 1 LIVE OR ATTENUATED VACCINE 25 4 2 KILLED VACCINES 25 4 3 RECOMBINANT SUBUNIT VACCINE 25 4 4 CONJUGATE VACCINE 25 4 5 TOXOID 25 5 VACCINATION SCHEDULE 25 6 CURRENT APPROACHES IN VACCINES