Microbiology - Download as DOC by niusheng11

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                                                           Microbiology
                                                             ********
        -Introducti on: M icrobiology is a branch of Biology deals with study of micro organisms.
        -Micro org anisms: are present everywhere in the earth includes air, soil, water, p lants, animal, hu mans and dead materials
        -Micro org anisms: are unicellular and Milticellular
        -So me of them are pathogenic (causing disease) and most of them are non -pathogenic.
        -Micro org anisms: are very small to be seen only through microscope
        -Antory Van Leeuwenhork ( 1675 netherlands) who observed bacteria and protozoa( micro organisms) first with this
sample microscope. so he is a father of microbio logy.
        -The microorganisms or microbes are classified based on the presence of nucleus. These are Prokaryotic micro organisms,
Eukaryotic micro organis ms and virus.

                             Prokaryotic                                                           Eukaryotic
-The nucleus and membrane bound organelles are not                     -Nucleus and memb rane bound organelles
  present                                                                (mitochonchondri) endoplasmic reticu lu m and
-The side of the cell is 0.2-2µm                                         Golg i body are present.
-The genetic material is freely distributed in the                     -The cell size is 2-20µm
  cytoplasm.                                                           -The genetic material is present in the nucleus
-The ribosome 70s. S=Svedberg unit: to measure the                     -The 80s ribosome is present
  size o f ribosome. Eg : Bacteria                                        Eg: fungi and protozoa


- the virus is also considered as microorganis m but it is call acellur and non cellular organis m.

           Bacteria
-It is a prokaryotic microorganism the size range between 0.2-0.5 µm
-Most of them are nonpathogenic because it doesn‟t contain virulent factor properties (toxic co mponents) and some of them are
pathogenic (contains virulent factors).
-Most of the bacteria can live in extreme condition and can change the environment.

         Morphology of B acteria
- There shapes are many shapes of bacteria including Cocci, Bacilli and Spirochetes

   I. Cocci or Coccus: some o f the bacteria are look like spherical shape or round shape, such type of bacteria are called Cocci they
are different type of Cocci based on the number of cell and arrangement.
          a) Mono Cocc us: single cell
          b) Di pl ococcus noncapsul ated: two cell joined together to form this structure (pair) and it don‟t have membrane which
                   surrounded the cell.
          c) Di pl ococcus encapsul ated: two cells joined together with memb rane coated over the cell.
          d) Streptococcus some bacteria look like chain like structure is called Streptococcus
          e) Staphylococcus the bacteria look like clusters of grape.

   II. B acilli or Bacillus : most of the bacteria are look like rod shape or cylinder shape. This is called bacilli, there are several ty pe
- Mono B acillus:               single rod shaped
- Di pl o B acillus:               two rods joined together to form this shape
- Flagellated B acillus:                        some bacteria have flagella (hair like structure) present in the cell wall which help the
bacteria move fro m one place to another place.
- Coccobacillus:             it look like round as well as rod such type of bacteria are called coccusbacillus.

- Comma shaped bacillus: some bacteria look like co mma shape
- S porbearing bacillus: some bacteria can release the spore which is highly resistant to live in extreme condition and can live for
more than too fears such type is called spore bearing bacillus.
- Strepto bacillus: chain like arrangement

   III. S pirochetes: the bacteria look like spiral shape structure




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                                                       Classification of Bacteria
   The classification of bacteria is base on the cell wall. There are:
                   I.       Thick walled bacteria
                   II.      Thin cell walled
                   III.     Wall less bacteria

   I. Thick wall bacteria
         Some bacteria are having thick and rig id cell wall is made up of peptidoglycan layer (polysaccharide+peptid) it provides
protection to the bacteria. There are two types of thick cell walled bacteria.

          Gram positi ve bac teria and Gram negati ve bacteria
   The gram positive bacteria and gram negative bacteria can be observed or identified by Gram staining technique.( Hans Christian
Gram 1884) in the technique the Gram positive appears like vio let color or b lue color after added the reagent. The gram negative
bacteria appear like pink color or red co lor after adding the reagent.


                                                   Gram staining technique
   Take bacteria sample (blood or saliva) then put the blood sample into the slide and make a thin film (smear) then
 add crystal violet after that wait for 2 minutes followed by add water then add gram iodine and wash with water.
 Then add alcohol followed by with water. Finally add safranin wait for 60 seconds wash with water. Take the slide
 and keep it into violet color is gram positive. If it pink or red color is gram negative.


         Gram positi ve bacteria
   -   It contains more than 40 layers of pepti dogl ycan in the cell wall give more rig id (strong) and provides protectio n of the
       bacteria.
   -   The cell wall also contain Fi brillar layer wh ich acts as a toxic co mponent (virulent factor).
   -   The cell wall contain Teichoic aci d and Li poteichoic aci d wh ich give support to the cell wall.

       Gram negati ve bacteria
   -   The cell wall of the gra m negative bacteria contain single layer of pepti dglycan
   -   The cell wall also contain Lipopol ysacchari de wh ich acts as a virulent factor.

   Gram positi ve bacteria are two shape normally:
       1. Gram positi ve cocci
                 Ex. Staphylococcus species, streptococcus species, entorococcus faecalis
       2. Gram positi ve rods
                 Ex. Bacillus species, clostridium species, corynebacterium diphtheriae

   Gram negati ve bacteria are two shape normally:
          a. Gram negative cocci: Ex. Neisseria species,
          b. Gram negative rods:
Ex. Salmonella species, shigella species, Escherichia coli, Vib rio cholerae, Campy lobacteria jejuni,
     Pseudomonas species, Helicobactor pylori, Klebsiella pneumoniae, Proteus species, Bacteroides pertusis,
    Brucella species, Yersinia species, Fronciesella tulerensis, Legionella pneumophila, Haemophilus
    influenzae.

         Aci d Fast Bacteria
   Acid fast is the name of the staining technique to identify some bacteria.

                                          Acid Fast staining method
 Take bacteria sample→ make thin smear→ add carbal fuchsin+ phenol→ keep this slide in boiling water
 for few minute→ wash with water→ add acid(3%)- Alcohol(97%)→ wash with water→ add Methylene
 blue→ wash with the slide. Keep this slide and through microscope. If it look like Reddish color confirm
 that the bacteria is acid fast bacteria.

-The acid fast bacterial cell wall contain single layer of peptidoglycan, Fatty acid and waxes.
-The Fatty acid and waxes acts as virulent factor of bacteria wich cause diseases of the humans.
         Ex. Myobacteriu m tuberculosis, Myocobacteriu m leprae, Nocardia species.

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   II. Thin cell wall bacteria:
         Some of bacterial is very thin and it is flexib le in nature
Ex. Spirochetes

   III. wall less bacteria
         The wall less bacteria which do not have the cell wall.

                                                    Structure Properties of B acteria
Cell wall: the outer layer of the bacteria wh ich is made up of peptidoglycan. It protects the bacgteria.
Cytoplas mic membrane: it is a layer which surround the cytoplasm. It acts as a permeab le layer and it allowed the inside to xic
                            components to go outside and cause diseases to the humans body.
Ri bosome : the synthesis of protein take place in ribosome.
Chromosome: it contain DNA (Deo xy Ribose Nucleic Acid ) as a genetic natural.
Plasma: it is an extrachronosomal circular DNA which contains ß-lactamase enzy me provide to some antib iotic like penicillin.
Inclusion: it is an energy stored material which give energy to live the bacterial cell.

                                                       Virulent properties of bacteria
   The pathogenesis of bacteria refers to the presence of virulent factor (toxic co mponent) in the bacteria. The virulent factor is the
main causative thing for diseases. There is several type of viru lent factor.
          i) Adherence factor: the bacteria contain hair like structure called Flagella and Pilus which help he bacteria to adhere the
host cell surface. After adherence the bacteria can release the toxic material and make disease.
          ii) Capsule: it is presents in the cell wall of bacteria which is made up of popolysaccharide which fight against phagocytic
cell (type of immune cell) like M icrophage. Because whenever the bacteria is enter into the body the phagocytic cell immed iately
attack the bacteria and kill is so, if the capsule is present the bacteria can easily live in the human body.
          iii) Exotoxins: it is found in gram positive and gram negative bacteria it is made up of polypebtides and has got two subunit
normally. A-subunit and B-subunit. The function of B-subunit is to bind the host cell after that the subunit release the toxin then the
toxin can easily attack the various organs like Kidneys, heart, liver, lungs act. It also cause hemorrhage (bleeding) and swe lling.
          iv) Endotoxin: it is found in the gram negative bacteria which is made up of Lypopolysaccharids. It cause fever, general
ache and general weakness.
          v) Enzyme: the bacteria contain some enzy mes which act as a to xic enzy mes. The function of this en zy mes is to attacks the
cell membrane, tissue matrix and connective tissues lead to paralysis.
          vi) Enterotoxin: this to xin is present inside the cell of bacteria wh ich attacks the mucus membrane in the intestinal tract
and cause vomiting and diarrhea.
          vii) Cell surface carbohydrates and proteins: the bacteria also contain some toxic carbohydrate and proteins which
attacks the immune cell in the hu man body so that the bacteria can easily attacks the cells.

                                                          Culture of B acteria
   The culture (grow) of bacteria is very important to find the name of the bacteria and with this culture we can choose the antibiotic
to cure the diseases.

   Requirement for Bacteri a Culture
        1. petri dish: it is a glass plate in this we can cure the culture bacteria.
        2. Medium: it is nutrient material which feed the bacteria to grow
        3. Incubation chambar: highly sterilized chambar to keep the culture plate here.
        4. Water: to clean the glass wares
        5. Patient sample: b lood, sputum, stool, urine, mucus, wound tissue…

   Procedure:            Medium pour        Blood sample           put different
                                                                    (antibiotic)                             Zone formation
                                                                                     Incubation for 2 days
                     →                  →                     →                                                      bacteria

      Petridish                                                                  ceftriaxone
     Or petriplate                                                              penicillin
                                                                             Clavithromycin
                                                                        Erythromycin
                                                   Keep it into Microscope and find out




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                                             Gram positi ve cocci bacteri a infection
   I. Staphy l occal infection
         The staphylococcus bacteria are clusters of gram like shape. There are three important staphyloccus species are causing
disease.

   i) Staphylococcus aureus: it is a gram positive cocci bacteria

         Phathogenesis
   1.   Coagulose enzyme: this enzy me is present in the bacteria which stimu lates the prothrombin to clot the blood in the injured
            region and make infections because the prothrombin is acting as a blood clotting factor involve in the blood clotting.
            One the blood is clotted in the injured region the bacteria can make colonies and cause wound infection.
   2.   Catal ase: it is an enzyme which breaks the H2 O2 (hydrogen peroxide) in to H2 O+O2 because the H2 O2 act as a antibacterial
            agent in the body so that the enzyme can attack this H2 O2 and cause infection.
   3.   Protein-A: it is a protein to xic wh ich fight against the immure protein like co mp lement protein.
   4.   Enterotoxin: it cause a diarrhea and vomiting while eating the contaminated or spoiled food and water.
   5.   Toxic shock syndrome toxin: it is a to xin released fro m the bacteria. The function of th is toxin is to make to xic shock in the
            wound regionally especially the vaginal wound.
   6.   Exfoliatin: this is an to xin wh ich attacks the epidermal layer of the skin to make scales in the skin.
   7.   Leukoci din: it is an another toxin which attacks the leukocyte (WBC)

         Disease
   1.   Abscess or wound infecti on: infection in the wound region with pus.
   2.   Gastritis: inflammation in the digestive tract. The sympto m like d iarrhea, vomiting, abdo minal pain, loss of appetite etc.
   3.   Toxic shock syndrome toxin: sever shock pain in the vaginal wound region with the present of pus.
   4.   Folliculitis: inflammat ion with pus in the follicles.
   5.   Staphyl occal scal ded skin syndrome: The inflammatory condition in epidermal layer of the skin. The damage or
        breakdown of the epidermis wh ich make skin scales.
This disease is very common in young children (belo w 5 year).

           Transmission
- Trans mitted fro m contaminated or spoild food and water
- It also transmitted fro m in fected patient to normal person and environment

           Diagnosis
Blood culture and blood smear to find out these bacteria.
   Coagulase test: take citrated plasma (plasma contain sodium citrate) and add the bacterial culture. Keep the tube for incubation
at 31 0 c for 4 hour. If any clot format ion take place confirm that the patient is infected with staphylococcus aureas.

         Treatment: vacomycin is an antibiotic to kill this bacteria.
         Preventi on:   - avoid contact with infected patient
                        - Make yourself proper hygieon
                        - Avoid contaminated food and water

   ii) Staphyl ococcus epi dermi dis: It is a gram positive bacteria

         Virulent factor: Glycocaly x: it is made up of glycoprotein and polysaccharide which is found in the cell wall of
S.epidermid is. the function of glycocaly x is to adhere in the prosthetic (arrificial) heart valves and prosthetic hip and mak e
infections.

        Diseases
1. Endocadi tis:it is an inflammation condition of prosthetic heart valve in the endocosodium of the heart. The S.epidermid is bacteria
          can release the glycocalyx and stick in to prosthetic heart valve and make in fection as well as damage in the valve. This
          condition the patient have symptom like hemorrhage, circu latory problem, serve, chest pain, nausea and heart attack.
2. Prothetic hip infection: the inflammation in the prosthetic hip region especially artificial hip imp lanted patient. The patient have
          symptom like sever joint pain, swelling in the joint etc.
3. Neonated sepsis: it is an inflammatory and infection in the blood of neonate (just born baby or below 1 month baby) the
 S.epidermid is is normally found in the vaginal region, during child birth the bacteria enter through plac enta and spread through out
 the blood and entire organs of the baby to cause this infection. The symptom like hemorrhage, diarrhea, skin rashes, jaundice etc.


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         Transmission: During dental surgery, childbirth the bacteria can easily enter and cause dis ease.
         Diagnosis: Blood culture and blood smear to identify these bacteria.
         Treatment: Vaco mycin + Hentamicin + Rifampin
         Preventi on: During dental surgery, the patient should be treated with Cefazolin (antibiotic). During pregnancy the women
                    should maintain hygiene.

   iii) Staphylococcus saprophyticus: it is gram-positive bacteria

         Virulent factor: p ilus: it is a heir like structure which is present outside the cell wall. The function is to adhere the host cell
surface especially the urinary tract.

         Disease:
   urinary tract infection (UTI), the urinary tract infection consist of urethra, bladder, prostate(non), ureter and kidney. The bacteria
can easily attack the urinary tract and make infection.
   - Urethritis: the inflammation occurs in the urethra
   - Cystitis: the inflammat ion condition in bladder
   - Prostatitis: the in flammation in the prostate region of the man
   - Pyclorephritis: inflammatory in the kidney. The UTI sympto m like pyuria, Nocturia, dysuria, hematuria and foul smell urine

         Transmission: through ascending way to get inside the urinary tract. The unsterilized urinary catheter cause UTI
         Diagnosis: urine culture to find out these bacteria

         Treatment: Norflo xacin (antibiotic) alone or Norflo xacin + Trinethoprin sulfanethoxazole as a co mb ination therapy for
                    sever UTI.

         Preventi on: the urinary catheter should be sterilized properly before insertion. The toilet should be cleaned always
                      especially in hospital.

   II. Steptococcal infecti on
          The streptococcus bacteria are classified in to three group namely

Group A Streptococcus pneumonia: it has α-Hemolytic en zy me that lye hemoglobin and make color change( fro m red to 50/gree
    color) during culture process.
Group B Streptococcus pyogenes, streptococcus agalati as, streptococcus mutans an d streptococcus sanguis: this bacteria have
    ß-hemolyt ic enzy me that make 100% green color during the culture process.
Group C Enteroccus faecels: there will not be any colors change during culture.

   i. Streptococcus pneumoni a: it is a gram positive bacteria look like chain structure.

         Virulent factor:
    1.   pilus: help the bacteria to attach into the host cell
    2.   capsule: it is made up by of polysaccharides which fight against phagocytic cell like macrophage
    3.   Pneumolysin: it is an enzy me that invade (attach) the cell memb rane in the respiratory tract it also have hemo lytic action
         and against immune cell.

         Disease
-Pneumonia: the inflammat ion condition in the alveoli reg ion (air sac) of the lung. The sympto m like d ifficu lt to b reath, cold,
         cough, yellow color sputum, fever and malaise.
-Sinusitis: the inflammatory condition in the sinus region. The symptom like sneezing, runny, nose, swollen in the sinus, pain and
         fever.
-Otitis medi a: the S. pneumonia also attack the middle ear (eardru m) and make infection there. The symptom like ear pain, difficult
         to hear the sound and fever.

         Transmission: Through respiratory droplet fro m infect ion patients.
         Diagnosis: Sputum culture, the culture p late will become 50% green colo r fro m red color
         Treatment: Cephalexin (antibiot ic) to kill S. pneumonia + Cetrizene fo r runny nose
         Preventi on: avoid contact with infection patient



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   ii. Streptococcus pyogenes: it is a gram positive look like chain structure.

         Virulent factor
    1.   capsule: have “antiphagocytic”
    2.   streptolysin “s”and “o”: it has hemolytic action. And lyses the hemoglobin mo lecule an important for finding the bacteria
             during blood culture.
    3.   Protein F: Th is protein specifically attach into the fibronectin (a protein is found in the pharynx region) and cause
             inflammat ion in the pharynx region.
    4.   Dnases: it is an enzy me that attach DNA
    5.   Exotoxin: it is also called erythrogenic to xin which make skin rashes (scars) after the scarlet fever
    6.   Hyaluroni dase: the enzy me which attach the hyaluronic acid which is found in the connective tissue like skin and make
             inflammat ion

         Diseases
1. pharyngitis: the inflammatory condition in the pharynx region. The symptom like red color swollen in the pharynx reg ion, sore
     throat, difficult to swallow food, pain in the pharynx region, fever etc.
2. Cellulitis: the inflammat ion in the connective tissue like skin especially the lower arms and lower legs will have infection. The
     symptom like red colour rashes, pain, fever etc.
3. Rheumatic fever: the inflammatory condition in the heart, skin and joint. The patient will have symptom like murmur,
     obstruction in the heart resell, swelling in the joint, pain and fever and skin rashes.
4. Impetigo: the co mmon skin d isease in children. The sympto m b lister in the skin, red rashes, fever, malaise etc

         Transmission :Trans mitted easily fro m infection person to normal person while touching the body and respiratory droplets.

         Diagnosis: blood culture and blood smear with gram staining technique. Physical examination and patient history

         Treatment: Cephalexin (antibiot ic) is an effective drug for streptococcus pyogenes infection.

         Preventtion: - avoid contact with infection patient
                      - Hygiene is important

   iii. streptococcus agal actiae: it is a gram positive bacteria look like chain structure

         Virulent factor: capsul: it has antiphagocytic action

        Disease
1. Neonatal meni ngitis: the sever inflammation in the meninges (membrane which surround brain and spinal cord) region in
     neonatal. The S. agalact iae is found in the vaginal reg ion of the pregnant women and during the child birth the bacteria can
     easily trans into the baby‟s blood to placenta and cause infection in the meningitis. The symptom like hemorrhage, felling
     exited, confusion, fever, poor breath feeding, jaundice, diarrhea and vomiting.
2. Omphalitis: the inflammat ion in the u mbilical cord reg ion in the neonates. It is uncommon in neonates the symptom like pain
     with sever red rashes around the umbilical cord, fever, pus formation in the u mbilical region etc.
3. Endometritis: the inflammation condition in the endometrial reg ion of the uterus due to S.agalactiae bacteria. The symptom like
     excessive vaginal bleeding, excessive vaginal fluid d ischarge, pain and fever.
4. Osteomyelitis: it is a bone or joint infection due to S.agalactiae bacteria. The symptom like server swelling in the joint, pain and
     fever.

          Transmission: this bacteria is main ly transmitted fro m mother to baby during childbirth it can also transmit fro m
theusterilized surgical instru ments.

         Treatment: Ceftriaxons: it is an antibiotic which kill th is bacteria effect ivety

          Preventi on:
  -give ampicillin to mother during the childbirth
  -use sterilized surgical instruction before doing surgery
  -use batadine or bacitracin to wash the u mbilical cord region after childbirth to prevent o mphalit is. The childbirth center or
hospital should be hygienic.



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   iv. Streptococcus mutans and streptococcus sanguis: these are gram positive look like chain structure

         Virulent factor: Glucans: it is a cell surface carbohydrate present in the cell wall of these bacteria. The function of g lucans
is to adhere of attach into the dental region and prosthetic heart valve to cause infection

        Disease
1. Dental caries: the inflammatory condition in the dental region due to S.mutans and S.sanguis. the symptom like bla ck or bro wn
     colour appearance in the dental region, swelling in the guns and tooth loss.
2. Endocarditis: the inflammation in the prosthetic heart valves due to these bacteria. The symptom like murmu r, circulat ory
     problem, ECG abnormalit ies and chest pain.

         Transmission: this bacteria normally present in oral cavity and when ever the oral hygiene is not there can easily make
infection. During dental surgery the bacteria can enter into the blood steam to attach the prosthetic heart valves to cause e ndocarditis


         Diagnosis
-physical appearance of the oral cavity
-blood culture

        Treatment
   -   Streptomycin or Gentamicin of dental caries
   -   Warm salt water gargle is important
   -   Vaco mycin + Gentamicin for endocarditis

        Preventi on
   -   give Ceftriazo lin during dental s urgery
   -   oral hygiene is important

   V. Enterococcus faecalis: it is a gram positive with diplococcus appearance

          Disease
1. Urinary tract infecti on: the infect ion in the urinary tract including urethra, bladder, prostate (men) and kidney. The symptom
      like dysuria, pyuria, nocturia, hematouria, freguency urination, foul s mell urine and back pain.
2. Biliary tract infection: the biliary tract comprise of gallbladder, bile duct and liver. The bile acid are secreted from the liver and
      stored in the gallbladder and bile duct. The function of the bile acids to make d igest the fatty foods. The E.faecalis bacteria can
      easily enter to the biliary tract during gastresinstestinal surgery to cause infection in this region.
3. Acute cholocystitis: the inflammation in the gallb ladder.
4. Cholangitis: the inflammatory in the bile duct. The sympto m of b iliary tract infect ion like jaundice, loss appetite, fell fullness,
      vomit ing, hapatomegaly and liver necrosis.

        Transmission
  The E.faecalis mainly transmitted fro m the unsterilized surgical instruments during gastrointestinal surgery, urinary tract surgery
and unsterilized urinary catheter.

         Diagnosis: urine culture and blood culture

         Treatment:
   -Norflo xacin + Trinethoprin sulfametho xazole for UTI
   -Quinupristin + Dalfoprinstin (two d ifferent antibiotic) for the treatment of b iliary tract infect ion.

         Preventi on
   -   the surgical instruments should be sterilized properly befo re doing the surgery
   -   give Cefazo lin during the surgery
   -   the urine catheter should be sterilized properly and it should be properly inserted in to the urinary tract




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                                                  Gram positi ve rod shaped bacteria
         Pathogenic

   I. Bacillus anthracis: it is a gram positive spore forming rod shaped bacteria look like dru m stick shape. The spore is look like
the round shape structure which can live in the extreme climat ic condition.

         Virulent factor:
1. Capsule: it has antiphagocytic action
2. Anthrax toxic: it co mprises of three portion ulcer contain protective antigen, edema factor and lethal factor.
* Protective antigen: it helps the toxin to binds with host cell surface.
*Edema factor: the function is to make edema (swelling) in tissue
*Lethal factor: it is responsible for causing cell death or necrosis

        Disease
   The B.anthrasis cause anthrax d isease. There are three type of anthrax disease.
    1. Inhalational anthrax: There is inflammat ion in the lung due to B.anthracis. the B.anthracis spore normally found in the
        soil and can directly enter in to the respiratory tract while inhalat ion. It can also transmitted fro m the B.anthracis infected
        animal. Sy mpto m like chest pain, cough, fever, yello w coloured sputum and general weakness.
    2. Gastrointestinal anthrax: The server inflammation in the gastro intestinal tract due to bacillus anthracis contaminated
        vegetables, fruits and animal meat. The symptom like abdo minal cramps, bloody vomit ing, bloody diarrhea, abdominal
        pain and loss of appetite.
    3. Cutaneous anthrax: The bacillus anthracis spores can easily enter into the skin (cutaneous) region when there is an injury
        which cause server inflammation over there. The symptoms like ulcer in the skin, redness and blister ( pus is filled in small
        lesion)

          Transmission: The bacillus anthracis spores are easily transmitted fro m the soil, contaminated vegetable, fruits, in fection
meat, air (by inhalation) and fly bite.

         Diagnosis:         - blood, sputum, stool and wound culture to find out this bacteria
                            - chest x‟ray to find out the lung infection

        Treatment
   -   Ciproflo xacin o r do xycycline o r vacomycin or Erythromycin for the treat ment of B.anthracis infection
   -   Erythromycin cream for contaneous anthrax

         Preventi on
   -   wash vegetables and fruits before eat
   -   cook properly and make more than 100 0 c of meat to prevent fro m B.anthracis gastrointestinal anthrax
   -   the wound must be maintain p roperly
   -   keep away fly b ite

    II. Clostri dium tetani: it is a gram positive spore forming rod bacteria it look like dru m stick shape and the inside spore look
like spherical or round shape.

          Virulent factor: Tetanos pas min it is exoto xin and also calls neurotoxin because it attacks the nervous system and cause
infection. Th is bacterial spores are present in the soil, if any injury or wound in the body can easily enter and penetrate in to the neral
blood flow then the toxin is released from the spores and directly blocks the release of glycine and GA BA (Gamma A mino Butyric
Acid) neurotransmitter. This neuron transmitters are involving in the muscle relaxation (inhib itory neuron transmitters) when this
toxin is blocking these neuron transmitter the patient will get server muscle contraction (spasm).

       Disease
       Tetanus: the server muscle contraction or muscle spasm due to tetanospasmin released from C.tetani bacteria
which blocks the cilycin and GABA. The symptom like server muscle stiffness unconsciousness and felling exitation.

        Transmission
        The C.tetani spores normally found in soil, if any injury or wound in the body this bacteria can easily enter and
cause disease.
        Diagnosis: blood culture, CSF culture and physical appearance

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        Treatment:
    -Tetanus immunoglobulin injection (antibody)
    -vacomycin or ceftriaxone+ Metronidazole
    -Valium injection (antispasmodic drug)
    -most important the patient has to admit immediately and should be treat at least 1 week or 10 days.

        Prevention
DPT vaccine: it contains three vaccines namely, Diphtheria pertusis and tetanus vaccine prevent from those three
diseases.

    III. Clostri dium botulinum
It is gram positive spore forming rod bacteria look like dru m stick structure.

         Virulent factor: B otulinum toxi n: it is an neurotoxin and also called as exoto xin. Th is toxin specifically attacks acetyl
choline neuron transmitter in the myoneural junction lead to flaccid paralysis. Because the acetyl choline is an imp ortant
neurostransmitter for muscles contraction.

          Disease: Botulism: this is the rare condition that the stopped muscle contraction due to C.botulinu m and the patient will
not be able to contract the muscle. If the lung muscle is stopped to contract the patient will go to fatal condition. The bot ulism is also
called as flaccid paralysis and there are three type of botulism.
*Food borne botulism: the paralysis due to ingestion of contaminated foods especially improperly preserved food (Tin or Cans
food)
*wound botulism: this bacteria can also enter through wound and cause paralysis is called wound botulism.
*Infant botulism: the in fant is getting paralysis due to ingestion of contaminated honey. The symptom like muscle weakness dry
mouth, slurred speech, difficult to swallo w foods, difficult to move body, vomiting and diarrhea.

         Transmission: fro m the soil, can enter to the wound and cause disease. It is also transmitted fro m contaminated food
including honey.

           Diagnosis:
-Elisa technique (enzy me lin ked immuno sorbent assay) to check the botulinum to xin found in blood.
-Physical appearance
-collect ing patient history from the relat ive

         Treatment:
-Botulinu m antito xin: it is an antibody getting fro m the horse that attacks specifically the botulinu m to xin
-Vaco mycin or ceftriaxone
-Metronidazole
-make respiratory facility to supply oxygen
-Hu man botulinu m immunoglobulin for infant botulis m
-most importantly the patient has to admit immed iately

         Preventi on:
-Avoid contaminated foods and honey
-use quality food products including tin or cans foods
-the wound properly cleared and closed it with band-acid
-the food must be cooked properly before eat

   IV. Cl ostridium perfri ngens: It is a gram positive spore forming rod shaped bacteria and the size range between 1 -4µm.

         Virulent factor:
1. α-toxin: it is an exoto xin which contain lecithinase enzyme which damage mammalian cell memb rance, erythrocytes, leukocytes
and patelets.
2. Enterotoxin: it attacks the mucus membrance and to release the fluid and intracellular proteins. The patient will g et diarrhea and
vomit ing due to enterotoxin.
3. Degradati ve enzyme : the C-parfringens contain Dnase which attaks DNA, proteases which damage proteins, hyaluronidase
enzy me that brak the collagen.
   The most important degradative enzy me is to make gas formation in the tissue.
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          Disease:
   1. gas gangrene: the formation of gas in the necrotic tissue or dead tissue due to C.perfringens. the gas gangrene tissue will not
have blood circulation, vasoconstriction and increased vascular permeab ility. The gas includes Hydrogens 5,9%, CO2 7,4 %, N2 74%
and O2 16% found in the gas gangrened tissue. The gas gangrene happens due to burn injury, accidental and surgical wound
whenever the C.perfringens enter in this regions will produce gas formation and make the cell to die the symptom like swelling or
edema, pain, pus formation (rare), loss of sensation and fever. If it is not treated immediately the patient will die .
   2. food poisoning : the ingestion C.perfringens contaminated food will lead to server gastro intestinal problem including diarrhea,
vomit ing, abdominal pain, fell fullness and loss of appetite .
   3. clostridial endometitis: the neurotic tissue formation in the uterus region due to improper treat ment or surgery with abortion
the improperly cleaned fetus will leads to necrotic tissue with gas formation ( gas gangrene) will lead to fatal. If the doctor using
unsterilized surgical instruments will cause this disease.

         Symptom: Excessive vaginal bleeding, excessive vaginal fluid discharge with pus, server pain and fever.

         Transmission: the bacteria is normally found in the soil, air hospital environ ment and contaminated food will cause disease

         Diagnosis: blood, wound, stool culture, x-ray and CT-scan to see the gas gangrene in the GI-tract and uterus.

        Treatment:
   -   wound debridement (surgical removal of necrotic t issue)
   -   Clindamycin is also administer while doing the surgery

         Preventi on
   -   wound maintain ( use antiseptics like Betadine)
   -   give Cefdiniv (antibiotic) to accidental case
   -   avoid contaminated food
   -   look properly before eat

   V. Clostri dium difficle: It‟s a gram positive rod shaped spore forming bacteria

        Virulent factor:
 1. Toxin-A: it is also called enteroto xin that make inflammation in the GI tract
 2. Toxin-B: it is also called exoto xin or cytotoxin which attacks the protein synthesis in human body.

         Disease
Pseudomembraneuse colitis: the false membrane formation in the colon region, due to C.difficile this bacteria is normally fo und in
the hospital environment mainly toilet whenever the chronic patien t is talking regular antibiotics will have ulcer formation in the GI
region. When the patients is having the ulcer in the GI tract if the bacteria enter to the ulcer region will make server inflammat ion
over there with the formation of Pseudomembrance (accumu lation of bacteria in the GI region).
Symptom: diarrhea, abdominal pain and abdominal tenderness (fell pain when pressure cones).

        Transmission: This bacterium is found in the hospital environment and can easily transmitted through fecal and oral
contaminated.

          Diagnosis: stool culture and endoscopy ( it is an instrument fixed with camera to easily find out ulcer, tu mor or cancer in
the UI tract.

         Treatment:
   -   stop Ampicilin or Clindamycin immediately
   -   Laproscopic surgery to remove Pseudomembracne
   -   Admin ister with Vaco mycin + Metronidazole
   -   Give portoprozo le or Rebeprozo le (antiu lcer d rug) before food (15mn).

         Preventi on
   -chronic patient give Partopro zole or Omeprozo le or Rabeprozo le with antib iotic
   -the hospital environ ment should be more hygienic always
   -avoid contaminated food



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    VI. Corynebacterium Di phtheriae
It is a gram positive rod shape look like L shape or V shaped appearance

         Virulent factor: Diphtheria to xin: it is an exoto xin which is highly protein paten toxin, have to subunits n amely A and B
subunit. The B-subunit bind to mucus membrane in the throat region as well as skin and then the A -subunit invade the tissue
especially the throat region and skin.

         Disease:
 1. pharyngell and tonsillar di phtheria: the inflammation condition in the pharynx and tonsils region due to the diphtheria toxin
     release from C.d iphtheriae. these toxin also invade the nasal region and cause inflammat ion over there. The symptom like sore
     throat, swollen in the throat region, dry cough, pain and fever. This disease is common in ch ildren.
 2. Cutaneous di phtheria: it is inflammation condition in the skin due to C.diphtheriae. whenever the bacteria enter into the skin
     through injury or wound can attacks the cutaneous layer of the skin and cause infection. The sympt om like skin ulcer, redness
     around the infected region, pain and fever.

         Transmission: this bacteria is easily transmitted fro m infected patient to normal patient through respiratory droplets. It can
also transmitted fro m soil to the wound can cause disease.

         Diagnosis: Mucus or nasopharyngel swab culture to find out this bacteria

         Treatment: Erythro mycin

         Preventi on: DPT vaccine




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                                                           Summaries
                                                       Gram positive bateria
Gram positive bacteria contain 40 layer of pepti doglycan, cell             v. Enterococcus faecalis
wall contain Fi brillar layer act as virulent factor and Teichoic        -Disease: Urinary tract infection, b iliary tract infect ion, acute
and Li poteichoic aci d.                                                 cholocystitis, cholangitis
                                                                         -Treatment: Norflo xac in+ trimethoprim sulfametho xazole for
Gram positi ve bacteria are two shape                                    UTI, Quinupristin+Dalfoprinstin
  * Gram positive cocci
                                                                         * Gram positive       rod s haped bacteria
I. staphy loccal infection
    i. staphyl ococcus aureus                                               I. Bacillus anthracis
-Phathogenesis: coagulose enzyme, catalase, protein-A,                   -virulent factor: capsule, anthrax to xic( protective antigen,
Enteroto xin, to xic shock syndrome to xin, Exfo liat in,Leukocidin.     Edema factor, Lethal factor)
-Disease: Abscess or wound infection, Gastritis, to xic shock            -Disease: Inhalational anthrax, Gastrointestinal anthrax,
syndrome to xin, Fo llicu lit is,staphyloccal scalded skin syndrome.     Cutaneous anthrax
-Treatment: Vaco mycin                                                   -Treatment: Cipro xacin or do xycycline or vaco mycin or
                                                                         Erythromycin, Erythro mycin cream for contaneous anthrax
   ii. staphylococcus epi dermi dis
-virulent factor : Glycocaly x                                              II. clostri dium tetani
-Disease: Endocarditis, Prothetic hip in fection, neonated sipsi.        -virulent factor: tetanospasmin
-Treatment: Vaco mycin+Hentamicin+Refamp icin                            -Disease: Tetanus
                                                                         -Treatment:Tetanus immunoglobulin in jection, Vaco mycin or
   iii. staphylococcus saprophyticus                                     cefriaxon+Metronidazo le, Valiu m
-virulent factor : pilus
-Disease: (UTI) urethritis, cystitis, prostatitis , pyclorephritis          III. cl ostridium botulinum
-Treatment: Norflo xacin or Norflo xacin+Trimethprin                     -virulent factor: Botulinu m
sulfametho xazole                                                        -Disease: botulism (food, wound, infant botulism)
                                                                         -Treatment: Botulinum antito xin, vacomycin or ceftriaxone,
II. streptococcal infection                                              metronidazole, make respiratory facility, human botulinum
                                                                         immunoglobulin for infant botulism
   i. streptococcus pneumoni a
-virulent factor: Pilus, capsule pneumolism                                 IV. cl ostridi um perfringens
-Disease: pneumonia, sinusitis, otitis med ia                            -virulent factor: α-to xin , Enterotoxin ,Degradative en zy me
-Treatment: Cephalexin to kill s.pneumonia+cetrizene for                 -Disease:gas gangrene ,food poisoning ,clostridial endo metitis
runny nose
                                                                         -Treatmen : wound debridemen , Clindamycin
   ii. streptococcus pyogenes
-virulent factor: capsul, streptolysin “s” and “O”, protein-F,              V. Clostri dium difficle
Dnase, Exoto xin, Hyaluronidase                                          -Virulent factor : Toxin-A, Toxin-B
-Disease: Pharyngitis, cellu lit is, Rheumat ic fever impet igo.         -Disease: Pseudomembraneuse colitis
-Treatment: Cephalexin                                                   -Treatment
                                                                            -   stop Ampicilin or Clindamycin immediately
   iii. Steptococcus agal acti ae                                           -   Laproscopic surgery to remove Pseudomembracne
-virulent factor: capsul                                                    -   Admin ister with Vaco mycin + Metronidazole
-Disease: Neonated meningitis,o mphalitis, Endometrit is,                   -   Give portoprozo le or Rebeprozole (antiulcer drug) before
osteomyelitis                                                                   food (15mn).

   iv. Streptococcus mutans and streptococcus sanguis                       VI. Corynebacterium Di phtheriae
-Virulent factor: Glucans                                                -Virulent factor: Diphtheria to xin
-Disease:Dental caries ,Endocarditis                                     -Disease: pharyngell     and tonsillar d iphtheria, Cutaneous
-Treatment                                                               diphtheria
   -    Streptomycin or Gentamicin of dental caries                      Treatment: Erythro mycin
   -    Warm salt water gargle is important                                                  *******************
   -    Vaco mycin + Gentamicin for endocarditis                         Sorry for any mistakes that happen and happy for tell
                                                                         me about my mistakes. You can download it from
                                                                                           www.sovann.co.nr
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                                                 Gram-negative bateria
         Pathogenic gram-negati ve cocci bacteria
   I. Neisseria gonorr hoeae: it is a gram-negative cocci bacteria look like kidney or been shaped structured.

          Virulent factor:
    1.    Ig-A protease: it is a toxic enzy me that specifically attacks the IGA (immunoglobulin -A or antibody-A) which facilitate the
          infection
    2.    Pilus: it is made up of pilin protein which bind with the cell surface to cause infection.

           Disease: this bacteria cause Gonorrea disease or (STD) to the human.
    Gonorrhea in the men: the infection in the genital region like p inis as well as the pelvis region also the symptom like preseminal
flu id discharge, pain, burning sensation, itching, felling uncomfortable, fever and irritation wh ile pass the urine.

   Gonorrhea in the woman: the N-gonorrhoeae invade the vaginal, vulva and also make infection in the urethra to cause server
inflammat ion. The symptom like excessive vaginal fluid (yello w coloured flu id) discharge, burning sensation, itching, dysuria, pain
and feeling uncomfortable.

  Gonococcal pharyngitis: the inflammat ion in the larynx due to N-gonorrhoeae. This disease is common in the people who have
habit of oral sex with in fection partner.

    Neonatal Conjuncti vi tis: the bacteria can also cause inflammation in the conjunctival region of the eye to cause server infection
in the neonate. This bacteria is transmitted fro m mother to baby and the sympt om like closured eyes, pain, fever and sometime the
loss of eyes will happens when it is not treat immediately.

          Transmission: Mult i sexual contact including oral sex, mother to child

          Diagnosis: physical appearance of the genital region, patient his tory, vaginal flu id culture and seminal fluid culture.

          Treatment: Ceftriaxone is an effective

          Preventi on: avoid mu lti sexual activ ity and use condoms

  II. Neisseria meningitis: it is a gram negative cocci bacteria look like kidney or been shaped s tructure. It is also called
mingococcus bacteria.

           Virulent factor:
   1.    capsul: it has antiphagocyte action
   2.    Ig-A (immunoglobulin-A) and facilitate the infection.
   3.    Endotoxin: it cause inflammat ion, fever and shock.

           Disease: Meningococcal meningit is: it is an in flammation condition in the men inges due to N-mening itidis. the symptom
like stiff neck, headache, confusion, hyperactivity, fever and fat igue.

          Transmission: this bacteria is transmitted through respiratory droplets only.

          Diagnosis: CSF culture, b lood culture, brain MRI

          Treatment: Ceftriaxone

          Preventi on:      - Meningococcal vaccine
                            - avoid contact with infect ion person




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                                             Pathogenic gram negative rod bacte ria

   I. Escherichi a coli (E-coli): it is gram negative flagellated rod shaped bacteria.

          Virulent factor:
   1.   pilus: it is an extra hair like structure to attack the host cell
   2.   capsul: it can protect to the bacteria fro m phagocyte
   3.   Endotoxin: it cause server and shock
   4.   Enteroto xin : it cause watery and sometime b loody diarrhea.

         Disease:
   1.   Traveller’s di arrhea: the diarrhea disorder happens with frequent travelers the E-coli bacteria can easily contaminate food
        and water can make diarrhea.
   2.   UTI: the infection in the urinary tract including urethra, b ladder, ureter and kidney
   3.   Neonatal meningitis: this E-coli bacteria can easily transmit fro m mother to neonate and cause infection in the meningit is

          Transmission:
   -    through contaminated food
   -    mother to child
   -    unsterilized urine catherter
   -    ascending way to enter fro m the contaminated place to urinary tract while passing the urine.


         Diagnosis: CSF culture, u rine culture, stool culture

         Treatment:          -Norflo xacin+ trimethoprin sulfametho xazole for UTI
                             -ceftriaxone for neonate meningit is
                             -Ciproflo xacin + Ornidazole for travels diarrhea
                             -used electrolytes as a rehydration treatment

         Preventi on:        -avoid contaminated food and water
                             -give ampicillin or penicilling to pregnant woman
                             -used sterilized urine catherter

   II. Sal monella typhi: it is a gram positive flagelled rod shaped bacteria. The size of the cell bacteria 0,1-0,3 µm

          Virulent factor:
   1. flagella: it is an extra hair like structure help the bacteria to attack the host cell surface it is also celled „H‟ antigent
   2. Endoto xin : it cause fever and also called „o ‟ antigent
   3. capsul: it is made up of polysaccharide that fight agent phagocytes. It is also called „vi‟ antigent

         Disease: typhoi d fever it is a high body temperature due to S-typhi. The body temperature between 100 0 F – 105 0 F with
diarrhea rarely. The fever will be there for 7-14 days. The symptom like fat igue, malaise, bodyache, vomiting sensation, loss of
appetite and abdominal pain (rarely).

         Transmission: through contaminated food and water

         Diagnosis: blood culture, WIDL test ( it is a blood test to find out the S.typhi found in the patient bloody.

         Treatment:          - cip roflo xacin for 10-12 days
                             -Ornidazo le fo r diarrhea
                             -Electro lytes as a rehydration treatment

        Preventi on:
-Capsular polysaccharide vaccine for typhoid fever
-Avoid contaminated food and water




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   III. Vi brio cholerae: it is a gram-neagative camma shaped

         Virulent factor: choleragen: it is an enterotoxin also called cholera to xin it invade the mucus memb rane in the GI tract lead
to massive of fluid (water) and ions in the form of diarrhea.

        Disease: Cholera: it is an acute diarrhea condition due to v.cholerae. the symptom like watery diarrhea, abdominal cramps,
weigh loss. Weakness, anoexia etc.

         Transmission: transmission maninly throght fecal and oral contamination that mean contaminated food and water as well
as from the feces and this bacteria can spread.

            Diagnosis: stool culture

            Treatment:       - oflo xacin + Orn idazo le
                             - Electrolytes

            Preventi on:     - avoid contaminated food and water
                             - keep the patient toilet mo re clear

   IV. Shigella dysenteriae: it is a gram negative rod shaped bacteria

            Virulent factor: shigatoxin: it is an entero toxin attacks the mucus membrane to cause bloody diarrhea

            Disease: dysentery it is an acute diarrhea disorder which excessive release of the fluid and ions in the form of b loody
diarrhea.

         Transmission: transmission maninly throght fecal and oral contamination that mean contaminated food and water as well
as from the feces and this bacteria can spread.

            Diagnosis: stool culture

            Treatment:       - oflo xacin + Orn idazo le
                             - Electrolytes

            Preventi on:     - avoid contaminated food and water
                             - keep the patient toilet mo re clear


   V. Campylobacter jejuni : it is a gram- negative microaerophilic rod and bacilli bateria

            Virulent factor: enterotoxin: it invade the mucus membrane in the stomach and small intestine lead to water and blood
diarrhea.

         Disease: Campylobacterosis: it is an inflammation condition in the gastro intestinal region due to c.jejuni. it is also called
as gastroenteritis. The symptom like hamatochezia, abdominal distension, abdominal cramps, anoerexia and watery diarrhea.

        Transmission: This bacteria normally present in the animal feces. If the person who ingest the animal feces contaminated
food and water will get infection.

            Diagnosis: stool culture

            Treatment:       -oflo xacin or ciproflo xacin + Ornidazole or metronidazole
                             - Electrolytes

        Preventi on:
   -   avoid contamination food and water




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   VI. Helicobacter pyl ori: it is a flagellated mono bacillus gram negative bacteria

          Virulent factor:
   1.    Fl agellar: for attachment to the GI t ract (especially stomach and duodenum)
   2.    Urease enzyme: it convert the urea in to ammonia fro m the GI region. One amononia is formed it will damage the mucus
         memb rane and also neutralizes the HCL in the stomach which facilitate the bacteria can live long time in the stomach to
         cause infection.

         Disease:
Gastric ulcer and duodenum ulcer: the inflammat ion in the stomach and duodenum due to H.pylori. the symptom li ke b leeding,
server addominal pain, loss of appetite, vomiting while brush, diarrhea (sometime) constipation (rarely) and burning sensation.

          Transmission: through contaminated food and water

          Diagnosis: Endoscopy and tissue scopy, serological to find out urease enzyme found in the blood

          Treatment:
   - Clarithro mycin + Metronidazole + Rabeprazole (or) Oflo xacin + Ornidazole + pantoprazole (10-12 days)

          Preventi on: - avoid contaminated food and water.

   VII. klebsiella pneumoniae: it is a gram negative rod shaped encapsulated bacteria

        Virulent factor: 1. capsule: it has antiphagocytic action
2. Endoto xin : it cause fever and shock

          Disease:
    1.    Pneumonia: the in flammation in the alveoli reg ion of the lungs
    2.    UTI: the inflammation in the urinary tract

         Transmission:
this bacteria normally found in the hospital environment and it is transmitted easily through respiratory droplet and unsterliezed
urinary catheter.

          Diagnosis: sputum and urine culture with gram staining procedure to find out this bacteria

         Treatment:
-Norflo xacin + trimethoprin sulfametho xazole
-Cephalexin or Erythromycin → Pneu monia

         Preventi on:
-used sterilized urine catheter and proper insertion is impo rtant
-make hospital environment more hygienic

    VIII. Proteus vulgaris and P.mirabilis
It is maltiflagellated gram negative rod shaped bacteria

          Virulent factor:
    1.    flagella: it help the bacteria to move and adhere in to the host cell surface.
    2.    urease: it is an enzyme that convert the urea into ammonia in the urine then the ammonia will damage the epithelial layer
          in the UT and increase the alkalin PH in the urine lead to stone or calculi formation in the bladder or kidney.

                            Damage epithelial layer→ UTI
   urease→ ammonia
                            increase urine PH → stone format ion




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         Disease:
    1.   calculi: the formation of stone in bladder or kidney due to change in the Ph cause by ammonia the calculi is composed of
         Megnesium ammonia hydro xide, it is also called as stuvite
    2.   UTI: the inflammat ion in the urinary tract

       Transmission:
Through ascending way to enter in to the urinary tract and cause infection

         Diagnosis: urine culture, scan to identify stone

           Treatmetn:
-Norflo xacin with trimethoprin sulfamethoxazole or cefotaxine
-avoid calciu m contain foods
-drin k plenty of water
-laser surgery if the stone size is more then 10 mm

Note( banana stem juice) drink in the morn ing

         Preventi on: avoid urination at contaminated place

   IX. Pseudononas aeruginosa: it is a gram negative rod shaped bacteria

         Virulent factor:
    1.   pili and flagella: help the bacteria to moved and attach
    2.   Exoto xin : it attach the skin tissue and mucus membrane in the respiratory tract and cause infection
    3.   Endotoxin: cause fever and shock

         Disease: 1. wound infection: Abscess or infection in the inju red region due to P.aeruginosa. the symptom are pus shock ,
         pain.
2. Pneu monia, 3sepsi( bacteriaemia): in fection in the blood as well as inflammat ion in the internal organs. The symptom like
jaundice, hemorrhage, weakness fever and bodyache.

         Transmission: through respiratory droplets and wound entry

         Diagnosis: wound, blood, sputum culture

         Treatment:         - cepholexin → pneu monia
                            - ceftriaxone → sepsis and wound infection

         Preventi on: use cefdiniv for wound infection

   X. Haemophilus influenzae: it is a coccobacillus bacteria

         Virulent factor:
1. Ig-A prolease: it is an enzy me that attack Ig A
2. capsule: it act against phagocytes

         Disease: 1. pneu monia, 2.otit is media, 3. sinusitis, 4.mengitis

         Transmission: sputum and CSF culture

         Treatment:       - cephalexin for pneumonia, otitis media, sinusitis
                          -ceftriaxon for meningit is
         Preventi on: capsular polysaccharide vaccine give along with DPT vaccine.




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   XI. B ordetella pertusis: it is a gram negative rod shaped bacteria

         Virulent factor: 1. pili: for attach ment
2. pertussis toxin: it is a portent toxin that attack the ly mphocytes which make in fection in the respiratory tract
3. Adnylate cyclase: it is an enzy me that active against phagocy tes
4. tracheal cytotoxin: it damage the traches

         Disease: pertussis or whooping cough: it very common disease in children that there is an inflammation in the respiratory
tract when the patient have pertussis. This symptom like high pitch sound or bark sound will come wh ile coughing, cough ends with
vomit ing, thick yellow co lor sputum, fever and the cough will be there for 1-4 weeks

          Transmission: through respiratory droplet
          Diagnosis: sputum calture
          Traeatment: Erythromycin
          Preventi on: DPT vaccine

   XII. Brucella abortus, B suis, B melitensis
There are gram negative coccobacillus bacteria also called as zoomotic bacteria. These attacks primarily animals and from the
animals. The hu man will get this bacteria lead to infection.

          Virulent factor: Endotoxin: it invades reticuloendothelial cell like liver, ly mph node, spleen and bone marrow and cause
fever.

         Disease: UNDULANT fever or Brucellosis: it is a fever with inflammat ion condition in the ret iculoendothelial system. It is
an irregular fever that means sudden increase and decrease of body temperature. The other sympto m like ly mphadenopathy,
hepatospleenomegaly ect.

          Transmission:
   -     B.abortus transmitted fro m cattle
   -     B.suis transmitted fro m pig
   -     B.melitensis transmitted fro m goat and sheap

When the person who touches the contaminated animal that mean infected animal meat, ingestion of infected meat and milk.

          Diagnosis: blood culture, Agglutination test is a blood test ( serological test) to check this bacteria

          Treatment: Tetracyclin + Gentamycin

          Preventi on: avoid infection animal meat and milk products

   XIII. Francisella tul areasis: it is a small coccusbacillus gram negative bacteria. This bacteria p rimarily attack the fo x and rodent
(mice, rod, squirrel, etc). fro m those animal it will be transmitted through tick (vector) by bite to the human then the human will get
infection it is also called as zoonotic bacteria.

         Virulent factor: the exact to xin is not clearly understood specially the endotoxin but this organism attack the
recticuloendothelial system.

          Disease: Tularema: it is ulcer formation in the tick bite reg ion of the body in this condition the patient will have symptom
like fever, hemorrhage in the bite region, swelling ly mphadenopathy, hepathospleenomegaly and weakness.

          Transmission: this bacteria is transmitted through tick fro m infection animal to hu mans.

          Diagnosis: it is difficult to culture and can indentified by Agglutination test.

          Treatment: Streptomycin

          Preventi on:      - keep away fro m tick b ite
                            - use insecticides to kill the insects


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                                                   Aci d Fast Bacteria Infection
   1. Mycobacterium tuberculosis: it is acid fast rod shaped bacteria having rich amount of lipid in the cell wall.

           Virulent factor: the viru lent factor are not clear understood but this bacteria have rich of fatty acid and wax in the cell wall
of the bacteria which help the bacteria fro m the phagocytes this bacteria can easily live inside the phagocytes (macrophages) and
mu ltip ly over there and damaged the cell to cause sever granulona or tubercle format ion in the lungs.

           Disease: Tuberculosis or TB: is the granulona or tubercle formation in the lungs, tissue, and other organs of the body
primarily the M.tuberculosis attack the lungs and cause sever infection ( tubercle or granulona or nodule or lesion format ion) there.
This bacteria attack many organs and tissue of the body except pancreas, skeletal muscle, thyroid and heart. Whenever this bacteria
goes will make in fection there and make tubercle formation. The sympto m like init ially cough wit h bloody sputum, chest pain,
difficult to breath, weight loss, weakness, fever, lekaemia (increase WBC count).

   Transmission: through respiratory droplet from the infected person to normal person while coughing and sneezing. When the
person who have weak immune system (immunoco mpro mised patient) will get very easily the TB. It can also attacks old age people,
poor nutrition, regular smoker and children.

         Diagnosis:
   - Tuberculin skin test: inject the tuberculin injection contain purified protein derivative (PPD) into the skin and wait for 48-72
      hours. After this duration if any swelling arise in the injected region, you can confirm the patient is TB positive if no swe lling
      the patient is negative.
   - Chest x‟ray or CT scan
   - PCR- test (polymerase chain reaction test) to identify this bacteria found the serum or sputum

         Treatment:
-Rifanpin + Isoniazial + Py razinanide + Ethambutol for 6-12 month
         Preventi on: BCG vaccine (bacilli calmette gurein)

                                                                 Spirochetes
1. Treponeme palli dum: it is spiral shaped bacteria. It doesn‟t have any virulent factor but this bacteria invade the genital region,
pelvis and conjuctive to cause infection. This can also make sever inflammat ion in the many internal organ of the body and to cause
sever infection.
          Disease: syphilis: it is a sexually transmitted disease (STD) cause by T.pallidu m. these are three stage of syphilis
    1. Primary syphilis: when the bacteria is enter into the body the symptom like u lcer in genital and mouth (oral sex) during this
        stage this bacteria will happen between 3-6 weeks.
    2. secondary syphilis: the sever skin rash around the body with swelling in the ly mph node. It happen after 6 weeks.
    3. Tertiary syphilis: this fatal stage, the patient will get sever inflammat ion in the heart, liver, kidney, bone, brain and eyes. The
        patient will get heart attack, liver and kidney failure, paralysis, stroke and blinese.

        Transmission: mu lti sex with mult i partners including vaginal sex, penile sex and oral sex
        Diagnosis: VDRL test: (venecal disease research laboratory test ) to find out the bacteria found in the serum culture in not
       useful.
        Treatment: Penicillin-G injection is effective for all stage of syphilis.
        Preventi on: avoid mu lti sex activity with mu lti partner use condoms

2. Chlamydi a trachomatis: it is a intracellular bacteria. It is not coming under gram positive and negative or acid fast or
spirochetes. There is no virulent factor has been identify. This attack the genital region, pharynx, pelvis, cervix, ly mph no de,
conjuntive and rectum to cause infection.

          Disease: chlemyd ia: it is a sexually transmitted disease (STD) this bacteria attacks the urethra region of both men and
wo men to cause urethritis. It attacks the vaginal region to cause vaginitits. if the infect ion in the penis region is called balanitis. If
the infection in the ly mph node near to the genital region is called ly mphogrnuloma venereum. If the infection is in the anus is called
proctitis. The neonate will get this bacteria fro m the positive mother during child birth will lead to neonatal conjunct ivitis. The
symptom like itching, burning pain, dysuria, excessive penile and vaginal flu id discharge, pyuria, irregular menstrual bleeding,
swelling around the genital region and fever ect.
          Transmission: mu lti sex with mult i partner
          Diagnosis: Agglutination test or Elisa test or PCR test
          Treatment: Azithro mycin or Do xycyclin or levoflo xacin
          Preventi on: avoid mu lti sex activity, use condome

                                                                Page 19
Prepare by S .V    ****************************************************************************************** 09/21/07

          Pathogenic gram negative rod bacteria
   I. Escherichi a coli (E-coli):                                       IX. Pseudononas aeruginosa: it is a gram negative rod
-Virulent factor: pilus, capsul, Endotoxin, Enteroto xin:            shaped bacteria
-Disease: Traveller’s di arrhea, UTI, Neonatal meni ngitis           -Virulent factor:p ili and flagella, Exoto xin, Endoto xin
-Treatment:                                                          -Disease: wound infection, Pneumonia, 3sepsi ( bacteriaemia)
-Norflo xacin+ trimethoprin sulfametho xazole for UTI                -Treatment:       - cepholexin → pneu monia
-ceftriaxone for neonate meningit is                                                   - ceftriaxone → sepsis and wound infection
-Ciproflo xacin + Ornidazole for travels diarrhea                       X. Haemophilus influenzae: it is a coccobacillus bacteria
-used electrolytes as a rehydration treatment                        -Virulent factor: Ig-A prolease, capsule: it act against
   II. Sal monella typhi:                                            phagocytes
-Virulent factor: flagella, Endoto xin, capsul                       -Disease:pneumonia, otit is med ia, sinusitis, mengit is
-Disease: typhoi d fever                                             -Treatment:- cephalexin for pneu monia, otit is media, sinusitis
-Treatment:         -Ciproflo xacin for 10-12 days                               -ceftriaxon for meningit is
                    -Ornidazo le fo r diarrhea
                    -Electro lytes as a rehydration treatment           XI. Bordetella pertusis: it is a gram negative rod shaped
   III. Vi brio cholerae: it is a gram-neagative camma shaped        bacteria
-Virulent factor: choleragen:                                        -Virulent factor: p ili, pertussis toxin, Adnylate cyclase, tracheal
-Disease: Cholera:                                                   cytotoxin
-Treatment:         - Oflo xacin + Orn idazo le                      -Disease: pertussis or whooping cough:
                    - Electrolytes                                   -Traeatment: Erythro mycin
   IV. Shigella dysenteriae: it is a gram negative rod shaped
bacteria                                                                XII. Brucella abortus, B suis, B melitensis
-Virulent factor: shigatoxin:                                        -Virulent factor: Endotoxin
-Disease: dysentery                                                  -Disease: UNDULANT
-Treatment:         - oflo xacin + Orn idazo le                      -Treatment: Tetracyclin + Gentamycin
                    - Electrolytes
   V. Campyl obacter jejuni: it is a gram- negative                     XIII. Francisella tulareasis:
microaerophilic rod and bacilli bateria                              -Virulent factor: the exact to xin is not clearly understood
-Virulent factor: enterotoxin                                        specially the endotoxin but this organism attack the
-Disease: Campylobacterosis                                          recticuloendothelial system.
-Treatment: -oflo xacin or ciproflo xacin + Ornida zole or           -Disease: Tularema: it is ulcer formation in the tick b ite reg ion of
metronidazole                                                        the body in this condition the patient will have symptom like
               - Electro lytes                                       fever, hemorrhage in the bite region, swelling ly mphadenopathy,
   VI. Helicobacter pylori: it is a flagellated mono bacillus        hepathospleenomegaly and weakness.
gram negative bacteria                                               -Treatment: St reptomycin
-Virulent factor: Flagellar, Urease enzyme
-Disease: Gastric ulcer and duodenum ulcer                                             Aci d Fast Bacteria Infection
-Treatment:-         Clarithromycin        +     Metronidazole   +      1. Mycobacterium tuberculosis:
Rabeprazo le(or)Oflo xacin + Ornidazole + pantoprazole (10-12        -Disease: Tuberculosis or TB
days)                                                                -Treatment:
   VII. klebsiella pneumoniae: it is a gram negative rod shaped      -Rifanpin + Isoniazial + Pyrazinanide + Etha mbutol for 6-12
encapsulated bacteria                                                month
-Virulent factor: 1. capsule, Endotoxin:                                                        Spirochetes
-Disease: Pneu monia, UTI                                            1. Treponeme palli dum:
-Treatment:-Norflo xacin+trimethoprin sulfametho xazole              -Disease: syphilis: it is a sexually transmitted disease (STD)
-Cephalexin or Erythromycin → Pneu monia                             cause by T.pallidu m. these are three stage of syphilis
   VIII. Proteus vulgaris and P.mirabilis: It is maltiflagellated    -Primary syphilis, secondary syphilis, Tertiary syphilis:
gram negative rod shaped bacteria                                    -Treatment: Penicillin-G in jection is effective for all stage of
-Virulent factor: flagella, u rease:                                 syphilis.
                              Damage epithelial layer→ UTI           2. Chl amydia trachomatis:
   urease→ ammonia                                                   -Disease: chlemydia:
                              increase urine PH→stone formation      -Treatment: A zithro mycin o r Do xycyclin o r levoflo xacin
-Disease: calculi, UTI
-Trans mission:                                                                                  **********
-Treatmetn:         -Norflo xacin with trimethoprin sulfametho-      Sorry for any mistakes that happen and happy for tell
xazole or cefotaxine, -avoid calciu m contain foods                  me about my mistakes. You can download it from
-drin k plenty of water, -laser surgery if the stone size is mo re
                                                                                       www.sovann.co.nr
then 10 mm                                                                                       Thank you
Note( banana stem juice) drink in the morn ing
                                                             Page 20

								
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