MICROBIOLOGY AND PARASITOLOGY

LECTURE/LABORATORY
C. LOUIS PASTEUR (middle and late 1800s)
CHAPTER 1: THE SCIENCE OF MICROBIOLOGY  Germ theory of disease
Microbiology is derived from Greek words mikros (“small”),  He postulated that microorganisms were in the
bios (“life”), and logia or logos (“study of”). environment and could cause infectious diseases.
It is the study of organisms that are so small that they cannot  Developed the process of pasteurization which kills
be seen with naked eye. They are called microorganisms or microorganisms in different types of liquids, and which
microbes. became the basis for aseptic techniques.
 Introduced the terms aerobes and anaerobes and
CATEGORIZATION OF MICROORGANISMS/MICROBES developed fermentation process.
1. CELLULAR – can be prokaryotes or eukaryotes.
 PROKARYOTES (bacteria, cyanobacteria, and D. ROBERT KOCH (middle and late 1800s)
archeans)  Continued Pasteur’s germ theory
 EUKARYOTES (fungi, protozoa, and algae)  Proved that microorganisms caused certain diseases
through a series of scientific steps which led to his
2. ACELLULAR – includes viruses.
formulation of Koch’s postulates.
FIELDS OF STUDY IN MICROBIOLOGY GOLDEN AGE OF MICROBIOLOGY (late 1800s and first
Microbiology is further classified into different fields of study, decade of 1900s
namely: 1. Edward Jenner – discovered vaccine for smallpox
 BACTERIOLOGY – study of bacteria 2. Joseph Lister – developed aseptic surgery
 VIROLOGY- study of viruses 3. Paul Ehrlich – discovered Salvarsan for the
 MYCOLOGY – study of fungi treatment of syphilis and heralded as the “magic
 PARASITOLOGY -study of parasites bullet” of chemotherapy.
 PHYCOLOGY – study of algae 4. Alexander Fleming – discovered penicillin from the
 IMMUNOLOGY – study of immune system and mold Penicillium notatum.
immune response.
MICROSCOPY
IMPORTANCE OF STUDYING MICROBIOLOGY Microscope is an optical instrument that can magnify
 Has an impact in our daily lives as thousands or more organisms a hundredfold or even a thousandfold.
organisms inhibit the human body, and these are called
normal flora or indigenous flora which only produce A. COMPOUND MICROSCOPE
disease in persons with compromised immune systems.  Contains more than one magnifying lens. It can
 Essential in biotechnology and wide range of magnify objects approximately a thousand times their
industries which utilize microorganisms as model original size.
organisms.  Visible light is its main source of illumination.
 Microorganisms are important sources of antimicrobial  Has two magnifying lens: (1) eyepiece, which
agents. contains ocular lens that has a magnifying power of
 Some microorganisms act as saprophytes or 10x, and (2) objective, that is positioned directly
decomposers of waste products and dead organisms above the organism to be viewed.
which is essential in maintaining a balanced ecosystem.
 It led to better understanding of how microorganisms
cause disease, paving the way to better disease
management and control.
 Led for better understanding of the negative instances
in which science can be used.

EVOLUTION OF MICROBIOLOGY

ARCHAELOGISTS AND EVOLUTIONISTS BEHIND

MICROBIOLOGY

A. ROBERT HOOKE (mid-1600s)

 Discovered cell
 His discovery heralded the cell theory that stated
living organisms are made up of cells.

B. ANTON VAN LEEUWENHOEK (1670s)

 A dutch merchant that created a single-lens
microscope that he used to make observations of
microorganisms which he then called animalcules.
 Known as the “Father of Microbiology”
 The first who provided accurate descriptions of
bacteria, protozoa, and fungi.
MICROBIOLOGY AND PARASITOLOGY
LECTURE/LABORATORY
B. BRIGHTFIELD MICROSCOPE structure of the sample with black and white images
 Can magnify an object 1000x – 1500x. Used to and can magnify up to 10,000x.
visualize bacteria and fungi. I. SCANNING PROBE MICROSCOPE
 Specimen appears dark against surrounding bright  Developed by Gerd Binnig and Heinrich Rohrer.
viewer field, hence the name “brightfield”.  Used to study the molecular and atomic shapes of
 Has very low contrast and needs staining for cells to organisms on a nanoscale.
be viewed properly.  A physical probe is used to scan back and forth over
the surface of a sample.
C. DARKFIELD MICROSCOPE  A computer gathers data that are used to generate an
 Utilizes reflected light instead of transmitted light. image of the surface, and can also be used to
Specimen appears bright against dark background. determine the variations in temperature inside the cell
 Ideal for studying specimen that are unstained or as well as its chemical properties.
transparent and absorb little to no light.
 For external details such as the outline or surface.
 Used to view spirochetes. CHAPTER 2: PROKARYOTIC AND EUKARYOTIC CELLS
Prokaryotes are organisms that do not possess a true nucleus
D. PHASE-CONTRAST MICROSCOPE and membrane-bound organelles (e.g., bacteria).
 Differences in refractive indices and light waves Eukaryotic organisms are those that posses a true nucleus
passing through transparent objects assume and membrane-bound organelles; usually multicellular
different phases. organisms and include plants, animals, fungi, parasites, and
 Introduced by Frits Zernike algae.
 Has contrast-enhancing optical technique to Viruses are acellular organisms that possess only DNA or
produce high-contrast images of specimens that RNA, and dependent on host cells for their replication and are
are transparent. considered as obligate intracellular parasites.
 Includes tissue slices, living cells in culture, and
subcellular particles (nuclei and organelles).

E. DIFFERENTIAL INTERFERENCE MICROSCOPE

 Similar to phase-contrast except that it utilizes two
beams of light instead of one and has higher
resolution.
 Developed by Georges Nomarski in 1952
 Useful in examining living specimens

F. FLUORESCENCE MICROSCOPE
 Makes use of UV light and fluorescent dyes called
fluorochromes.
 Specimen appears shine against dark background.
 Can be used to visualize structural components of
small specimens.
 May be used to visualize genetic material of the cell
(DNA and RNA).

G. CONFOCAL MICROSCOPE
 Also known as confocal laser scanning microscope or
laser confocal scanning microscope.
 Object is scanned with laser into planes and regions.
 Used to produce a three-dimensional image and
useful in the study of cell physiology.

H. ELECTRON MICROSCOPE
 Utilizes a beam of electrons to create an image of the
specimen. Electron beams serves as the source of
illumination and magnets are used to focus the beam.
 First prototype was built by Ernst Ruska.
 The original form was the transmission electron
microscope which produces a two-dimensional,
black and white images, and magnifies objects up to MEDICALLY IMPORTANT MICROORGANISMS
200,000x. Medically important microorganisms are those that have the
 The scanning electron microscope relies on potential or the ability to produce significant clinical disease in
interactions at the surface rather than transmission. It humans.
can magnify bulk samples with greater depth of view
so that the image produced represents the 3D
MICROBIOLOGY AND PARASITOLOGY
LECTURE/LABORATORY
 Viruses are acellular organisms. Their outer surface  Algae are eukaryotic organisms whose outer surface
is called capsid, which is composed of repeating sub- consists primarily of cellulose. They are described as
units called capsomeres. plant-like organisms because most of them have
 They only possess a single nucleic acid, DNA or RNA, chlorophyll and capable of photosynthesis.
but never both.  They don’t possess true roots, stems, and leaves.
 Considered as obligate intracellular parasites.  They don’t cause significant disease in humans.
 They are classified based on the following:
 Type of nucleic acid they possess
 Shape of the capsid (icosahedral, helical,
polyhedral, or complex)
 Number of capsomeres
 Size of the capsid
 Presence or absence of an envelope
 Type of host they infect
 Type of disease they cause
 Target cell or tropism  Diatoms are unicellular algae that inhabit both
 Immunologic or antigenic properties freshwater and saltwater.
 Bacteriophages are a special type of viruses that  Their cell wall contains silicone dioxide that may be
primarily infect bacteria and the largest among utilized in filtration systems, insulation, and as
viruses. abrasives.
 Bacteria are prokaryotic cells with majority having an  Dinoflagellates are also unicellular algae that are
outer covering called the cell wall that is composed important members of the phytoplankton group. They
mainly of peptidoglycan. They possess both DNA and contribute greatly to the oxygen in the atmosphere
RNA. and serve as important links in the food chain.
 They also possess nucleoid instead of true  Responsible for “red tide.” They produce a powerful
nucleus, smaller ribosomes, and lack neurotoxin which when ingested in significant
mitochondria. amounts is responsible for the potentially fatal disease
 May be categorized into (1) gram-negative called paralytic shellfish poisoning.
bacteria with cell wall (e.g., Escherichia coli); (2)
gram-positive bacteria with cell wall (e.g.,
Staphylococcus aureus); (3) acid-fast bacteria CHAPTER 3: BACTERIAL MORPHOLOGY
with lipid-rich cell wall (e.g., Mycobacterium Bacteria are prokaryotic organisms with simpler structures
tuberculosis); and (4) bacteria without cell wall compared with eukaryotic organisms.
(e.g., Mycoplasma).
 They may be classified based on their shape CLASSIFIED INTO THREE BASIC SHAPES
(cocci, bacilli, and spirochetes) 1. Cocci – spherical or round-shaped organisms (e.g.,
Staphylococcus, Streptococcus).
 Fungi are eukaryotic cells with an outer surface  May be arranged singly, in pairs (diplococci), chains
composed mainly of chitin. Their cell membrane is (streptococci), clusters (staphylococci), groups of four
made up mostly of ergosterol. (tetrad), and groups of eight (octad).
 Possessed both DNA and RNA. They have a true 2. Bacilli – rod-shaped organisms (e.g.,Escherichia coli,
nucleus enclosed by nuclear membrane and Salmonella). Some may be very short, resembling elongated
mitochondria that function for ATP production. cocci called coccobacilli (e.g., Haemophilus influenzae).
3. Curved or spiral-shaped – may show variations in their
morphology.
 Vibrio cholerae, the organism causing cholera, is
described as comma shaped. The causative agent of
syphilis, Treponema pallidum, is spiral in shape while
the causative agent of diphtheria, Corynebacterium
diphtheriae, is club-shaped.

 Protozoa are the representatives for parasites. They

are also eukaryotic cells that have an outer surface
called pellicle.
 Infective stage is called cyst while the pathogenic
stage is called trophozoite.
 They possess both DNA and RNA.
MICROBIOLOGY AND PARASITOLOGY
LECTURE/LABORATORY
B. LIPOPROTEIN
ENVELOPE STRUCTURES
A. GLYCOCALYX  Functions to anchor the outer membrane to the
peptidoglycan layer and stabilizes the outer
 Outermost covering of some bacteria. A gelatinous membrane.
substance located external to the cell wall, composed
of polysaccharide or polypeptide, or both. C. PERIPLASMIC SPACE
 A capsule if it is strongly attached to the cell wall and
slime layer if it is loosely attached. The presence of  A fluid filled space between the outer membrane and
the capsule is indicative of the virulence of an
the inner plasma membrane.
organism, which helps in the evasion of phagocytosis.
 It contains enzymes for the breakdown of large non
 Can stimulate an antibody response from the immune
transportable molecules into transportable ones and
system. The capsule serves to protect the organism
enzymes that serve to detoxify and inactivate
from dehydration.
antibiotics.
B. CELL WALL
ACID-FAST CELL WALL
 Sometimes called the murein sacculus. Principal  Unlike gram-positive and gram-negative bacteria, acid
component is peptidoglycan, a.k.a. murein or fast organisms such as Mycobacterium tuberculosis
mucopeptide. possess an outer layer that is lipid rich.
 Multilayered in gram-positive bacteria while single-  The cell wall of acid-fast organisms is composed of
layered in gram-negative bacteria. large amounts of waxes that are known as mycolic
acids.
 Protects bacteria from osmotic damage and plays
important role in cell division.  The inner layer of the cell wall is also made up of
peptidoglycan but because the outermost layer is lipid
SPECIAL COMPONENTS OF GRAM-POSITIVE CELL rich, cell walls of acid-fast organisms are hydrophobic.
WALLS  This is the reason why they cannot be stained using
A. TECHOIC ACIDS the reagents used in gram staining.
 The hydrophobic nature of their cell wall protects them
 Comprise major surface antigens of gram-positive from harsh chemicals such as strong acids and
organisms and can elicit antibody response. detergents.
 In some gram positive-organisms such as
Staphylococcus aureus, teichoic acids function for the PROJECTING STRUCTURES
attachment of the organism to the host cell. A. FLAGELLA
 These also provide tensile strength to gram-positive
bacterial cell walls.  These are threadlike structures made up entirely of
molecules of the protein subunit flagellin. They project
B. POLYSACCHARIDES from the capsule and are organs for motility.
 Classified into four types, namely:(a) monotrichous
 Polysaccharide molecules include neutral sugars such (single polar flagellum); (b) lophotrichous (a tuft of
as mannose, arabinose, rhamnose, and glucosamine. flagella at one end of the bacterium); (c)
amphitrichous (flagella at both ends of the bacterium);
 It also includes some acidic sugars such as glucuronic
and (d) peritrichous (flagella all around the bacterium).
acid and mannuronic acid. Bacteria without flagella are called atrichous.

SPECIAL COMPONENTS OF GRAM-NEGATIVE CELL B. PILI OR FIMBRIAE

WALLS
A. OUTER MEMBRANE
 These are rigid surface appendages found on many
gram-negative bacteria. They are fine and short in
 A bilayered structure where the inner leaflet is comparison with flagella.
composed of a lipopolysaccharide (LPS).  Their structural protein subunits are called pilins. Pili
 Has special protein channels that allow the passage may also function for motility.
of small or low molecular weight hydrophilic  They function for adherence to cell surface (common
substances such as sugars and amino acids. pili) or attachment to another bacterium during a form
 LPS has a complex glycolipid called lipid A, of bacterial gene exchange called conjugation (sex
responsible for endotoxin activity. Located at the outer pili).
leaflet of the outer membrane.
 The inner core is a polysaccharide made up of repeat C. AXIAL FILAMENTS
units. This repeat unit is also called the O antigen,
which is unique for every species of bacteria. Axial filaments are also called endoflagella and are found in
spirochetes (e.g., Treponema pallidum causing syphilis). These
are composed of bundles of fibrils, the structures of which are
similar to flagella.
MICROBIOLOGY AND PARASITOLOGY
LECTURE/LABORATORY
 They arise from the ends of the bacterial cell and NUTRITIONAL REQUIREMENTS
spiral around the cell. The filaments rotate producing A. CARBON
movement of the outer sheath of the spirochetes
propelling them forward.  Makes up the structural backbone or skeleton of all
organic molecules.
CYTOPLASMIC MEMBRANE  Autotrophs utilize inorganic compounds (e.g., carbon
Also called cell membrane or plasma membrane, the dioxide) and inorganic salts as their sole carbon
cytoplasmic membrane is located beneath the cell wall. It is source.
sometimes called the cell sac because it encloses the  Heterotrophs make use of organic substances such
cytoplasm of the cell. as sugars or glucose as their carbon source.
 For both, their energy may be derived from either light
(photolithotrophs and photoorganotrophs) or the
INTERNAL STRUCTURES
oxidation of inorganic substances (chemolithotrophs
A. NUCLEOID
and chemoorganotrophs).
 Most medically important bacteria are
 Bacteria have no true nucleus that is surrounded by a
chemoorganotrophs.
nuclear membrane. Its genetic material is packaged in
a structure called the nucleoid. Bacteria possess a B. NITROGEN, SULFUR, AND PHOSPHORUS
single, circular, double-stranded DNA.
 Necessary for the synthesis of cellular materials such
B. MESOSOMES
as proteins and nucleic acids.
 Approximately 14% of the dry weight of a bacterial cell
 The mesosome functions for cell division. It is also
is nitrogen and about 4% is sulfur and phosphorus.
involved in the secretion of substances produced by
bacteria.
C. INORGANIC IONS
C. RIBOSOMES
 These include magnesium, potassium, calcium, ion,
and trace elements (e.g., manganese, zinc, copper,
 The ribosomes function for protein synthesis. Unlike
and cobalt).
eukaryotic ribosomes, bacterial ribosome is smaller
 Magnesium stabilizes ribosomes, cell membranes,
(70S).
and nucleic acids.
D. GRANULES OR INCLUSION BODIES  Potassium is for normal functioning and integrity.
 Calcium contributes to the resistance of bacterial
endospores.
 These are found in certain bacteria and serve for
storage of food and energy (e.g., metachromatic  Iron is a component of cytochrome, a component of
granules of Corynebacterium diphtheriae or much electron transport chain.
granules of Mycobacterium tuberculosis).
D. GROWTH FACTORS
E. ENDOSPORES
 To promote the growth and development of the
 Endospores are structures produced by many bacterial cell. These include vitamin B complex and
bacteria when they are placed in a hostile amino acids.
environment.
PHYSICAL REQUIREMENTS
 It is composed of dipicolinic acid which confers
A. MOISTURE/WATER
resistance to heat, drying, chemical agents, and
radiation; making it very difficult to destroy.
 Serves as the medium from which the bacteria
 The process of spore production is called sporulation, acquire their nutrients.
and this occurs when the environmental conditions
are detrimental to the bacteria. B. OXYGEN
 When environmental conditions become favorable,
the endospores revert to their vegetative state through  Used for cellular respiration and serve as the final
a process called germination. electron acceptor.
 Some gram-positive, but never gram negative,  Microorganisms that utilize molecular oxygen for
bacteria form spores. energy production are referred to as aerobes. Strict
aerobes are organisms that strictly require oxygen for
growth.
CHAPTER 4: BACTERIAL GROWTH REQUIREMENTS  Microbes that cannot survive in the presence of
Growth involves an orderly and organized increase in the sum oxygen are called obligate anaerobes.
of all components of the organism.  There are organisms that can grow and survive
under both aerobic and anaerobic conditions. These
Microbial growth is concerned with increase in the number of
are called facultative organisms.
cells and not an increase in the size of organism.
 Most medically important bacteria are facultative.
Bacterial colony is composed of thousands of cells.
Some organisms are able to grow at low oxygen
MICROBIOLOGY AND PARASITOLOGY
LECTURE/LABORATORY
tension but their rate of grow this diminished. These  As a consequence, some bacterial cells may die.
are called microaerophiles.
 There are some organisms though that may require D. DEATH OR DECLINE PHASE
the addition of carbon dioxide to enhance their
growth. These are called capnophiles.  This is the period of rapid cell death where the
number of dead cells is greater than the number Of
C. TEMPERATURE living cells.

 Enhanced enzyme activity requires certain CHAPTER 5: NORMAL FLORA OF THE HUMAN BODY
temperatures. Microbial ecology is the study of the relationships between
 Microbes are classified into three groups based on microorganisms and their environment. Normal flora consists of
their temperature requirements, namely: the group of organisms that inhabit the body of a normal
 Thermophiles - grow best at temperatures healthy individual in the community.
higher than 40 °C
 Mesophiles - require an optimal temperature These indigenous flora may be non-pathogenic or pathogenic
of 20 °C–40 °C; and, and may at times behave as opportunistic pathogens.
 Psychrophiles, which require an optimum
temperature of 10 °C–20 °C.
2 TYPES OF FLORA
 Most medically important bacteria are
1. RESIDENT FLORA. Organisms that are relatively of fixed
mesophiles.
types and are regularly found in a given area of the body at a
D. Ph (POWER OF HYDROGEN) given age.
2. TRANSIENT FLORA. Inhabit the skin and mucous
 Another requirement of bacteria is the extent of acidity membrane temporarily for hours, days, or weeks and are
or alkalinity of their environment, which is referred to derived from the environment.
as the pH.
 Microorganisms that grow best in pH 8.4–9.0 are OTHER BENEFICIAL EFFECT OF NORMAL FLORA
1. Normal flora can prevent pathogenic organisms from
called alkalophiles.
attaching to and penetrating the skin and other tissues by
 Those that grow best in pH 6.5–7.5 are called
producing mucin which make it difficult for the pathogenic
neutrophiles.
organisms to attach to the tissues to produce disease.
 Most medically important bacteria are neutrophiles.
2. Normal flora in the intestines aid in the digestion of food by
The pH of most human tissues are 7.0–7.2. Certain
producing enzymes such as cellulase, galactosidase, and
bacteria require a pH less than 6.0. These bacteria
glucosidase.
are called acidophiles.
3. Intestinal flora also help in the metabolism of steroids.
D. OSMOTIC CONDITIONS
NORMAL FLORA ON DIFFERENT SITES OF THE BODY
 Organisms that require high salt concentrations for
A. SKIN
growth are called halophiles (e.g., diatoms and
dinoflagellates) and those that require high osmotic  The skin is the part of the human body that is in
pressure for optimal growth are called osmophiles.
constant contact with the environment, making it the
most exposed to microorganisms. There are certain
BACTERIAL GROWTH CURVE
factors that eliminate non-resident flora from the skin.
 (1) lysozyme in the skin; (2) acidic pH of the skin due
A. LAG PHASE
to sweat; (3) free fatty acids in sebaceous secretions;
and (4) the constant sloughing off the skin.
 This is the period of adjustment for the bacteria in the
new environment.  The skin may be divided into three regions:
 Bacteria attain their maximum size toward the end of  axilla, perineum, and toe webs;
the lag phase. This lasts for 1 to 4 hours.  hand, face, and trunk; and
 upper arms and legs.
B. LOG/LOGARITHMIC/EXPONENTIAL PHASE

 This period is characterized by rapid cell division,

resulting in an increase in the number of bacteria.
 The average duration of this phase is about 8 hours.

C. WORKING PHASE

 This is considered as the period of equilibrium.

 During this period, the rate of growth slows down,
nutrients start to deplete, and toxic wastes begin to
accumulate.
MICROBIOLOGY AND PARASITOLOGY
LECTURE/LABORATORY
transient flora; and
B. MOUTH AND RESPIRATORY TRACT  Production of potentially pathogenic end products
metabolism that are toxic to transient flora.
 The tongue and buccal mucosa are inhabited mostly
by Streptococcus viridans group, which includes S.
mutans, S. milleri, S. salivarius, and S. sanguis.

E. GENITOURINARY TRACT

 The urinary tract is sterile above the distal1 cm of the

urethra. In the anterior urethra, the predominant flora
isolated are S. epidermidis, enterococci, and
diphtheroids.
C. CONJUNCTIVA  In both males and females, Mycobacterium
smegmatis may be found as normal commensals in
 The normal flora in the conjunctivae are very scanty their secretions.
because they are held in check by the flow of tears  In addition, Gardnerella vaginalis, bacteroides, and
that contain lysozyme. The lysozyme may interfere alpha streptococci may be found in penile urethra.
with the cell wall synthesis of organisms. The female urethra is either sterile or contains
Staphylococcus epidermidis.

D. DIGESTIVE TRACT

 The esophagus contains transient mouth flora. CHAPTER 6: MEDICAL AND SURGICAL ASEPSIS
 Minimal bacteria may be found in the stomach due to
the relatively hostile environment in the stomach. D. INFECTION CONTROL
 Bacteria that may be found in the stomach are those Major concern that’s constantly addressed:
that may be swallowed with the food or those that are
dislodged from the mouth.  Antiseptic – chemical solution inhibiting
 One of these is Helicobacter pylori, the most common microorganism growth (alcohol, iodine)
cause of duodenal ulcer.  Chain of infection – how one acquires infectious
 The number of bacterial flora differs between the agents: reservoir, mode of transmission, and portal of
small intestine and large intestine. In the small entry to susceptible host
intestine, scanty flora may be found due to the  Contamination – contact of sterile/aseptic with
constant peristaltic movement of the intestines. microorganism. Ex. medical aseptic-disease-
producing organisms & sterile-unsterile
 Most of the bacteria cultured in the small intestine
 Decontamination – physical/chemical means to
include streptococci, lactobacilli, and Bacteroides
remove, inactivate, destroy pathogens
which are all transient.
 Disinfection – physical/chemical; destroy pathogens
 Intestinal flora play important roles in the body:
excluding spores
 Synthesis of vitamin B complex and vitamin K;
 Healthcare-associated infection – acquired during
 Conversion of bile into bile acids;
hospital admission; most common is UTI
 Competition with transient flora for nutrients;
 Iatrogenic infection – from undergoing diagnostic
 Prevention of colonization of the intestines by
tests or therapeutic procedures
MICROBIOLOGY AND PARASITOLOGY
LECTURE/LABORATORY
 Mode of Transmission – manner of infectious worn are punctured, reduce chances of disease
organism is acquired transmission
 Occupational exposure – exposure to infectious - healthcare environment is susceptible to:
agent of a healthcare worker during their work methicillin-resistant S. aureus (MRSA),
 Personal Protective Equipment – used to protect vancomycin-resistant Enterococcus (VRE),
from infections: gloves, masks, gowns, goggles penicillin-resistant Streptococcus pneumoniae
 Standard precautions – measures for prevention
against infection done for 15s with 10s rinse; for HCW  longer handwashing,
 Sterilization – pathogens and spores are destroyed; lathering at least twice, fingernails cleaning on:
physical and chemical
- beginning and end of each shift
ASEPSIS: condition of an individual and environment is free of - hands get visibly soiled
any microorganisms; goal is to protect patient from hospital- - contact with possible source of microorganisms
acquired or nosocomial infections and prevent spread of (body fluids, mucous membrane, non-intact skin,
pathogenic microorganisms contaminated objects)
- before and after performing invasive procedures
SEPSIS: clinical condition an individua develops a systemic - before removing gloves if visibly soiled and each
reaction to bacterial infection from localized infection in one time glove is removed
part of the body
: vigorous scrubbing, friction, areas with bacterial load:
FACTORS PLAYING A ROLE IN THE OCCURRENCE OF interdigital spaces and under the nail bed
INFECTION
: best way to prevent spread of communicable diseases is
 Suppression of immune system, prolonged duration of health education
illness, procedures that patients undergo in a
healthcare facility (insertion of catheters, intravenous PPE
lines, endotracheal tubes and use of antibiotics) GLOVES - most commonly used; serve as protective barrier:
Pathogenic organisms causing nosocomial infection: examination (may be sterile or not) and surgical gloves
Escherichia coli, staphylococcus aureus, pseudomonas (sterile)
aeruginosa, candida albicans, and enterococcus WHO guidelines on glove use: not to replace proper hand
Primary site of infection: surgical wounds, urinary & hygiene; worn if contact with body fluids, mucous membranes,
respiratory tract, bloodstream open wounds, infectious materials is anticipated; removed and
disposed after patient care; changed if moving from
Pathogens may be introduced via: contact with hospital contaminated to not; reusing is not recommended
personnel, environment, equipment (respiratory machines,
catheters, IV lines/needles) WHO glove recommendation: before sterile procedure, contact
with patient and surroundings where precautions are
Asepsis classification: warranted, contact with …

1. Medical “clean” asepsis – absence of disease- Removal of gloves: hand hygiene is indicated, after contact
causing microorganisms; reduce spread of infection; with patient, surrounding, and contaminated site, glove is
aims reduction of organism number and prevent damaged, contact with …
spread in general clinical setting: hand hygiene,
administration of medications, preparation of skin prior MASKS: covers mouth and nose; tied with minimal gaps open;
to subcutaneous medication administration not touched when worn; replaced when soiled; hand hygiene
2. Surgical “sterile” asepsis – absence of all when disposal after use
microorganisms (area and location of surgical STERILE GOWNS: can be in form of apron or gown; fluid-
procedure): applied when skin is not intact and when resistant a/g is recommended when there’s a risk for body
internal structures are exposed; wound care, invasive substances, always worn with gloves and other PPE; clean,
procedures, IV administration, catheter insertion non-sterile a/g are sufficient for skin protection and soiling
General aseptic procedures: frequent handwashing of h- prevention; disposable, single-use gowns used to protect HCW
personnels, safe disposal of contaminated items, regular during procedures where splashing of body fluids
checking and emptying of surgical drains, prompt cleaning : lengths of sleeves depend on specific procedure being
of soiled areas, proper labelling of containers for date and performed
time of disposal
: fluid-resistant, single-use, long-sleeved, full-body gowns
Handwashing: frequent source of m-organisms causing are worn: when risk of contact of skin to broken skin, extensive
infection are from hands of hc-workers skin to skin contact; contact with body substances that can’t be
- most basic means of preventing pathogen spread contained (diarrhea, vomit)
that HCW follows to: reduce flora on skin, protect Sterile parameters: front of sterile gown is sterile from chest
if they have breaks and cuts on skin and if gloves down to level of sterile field; sleeves are sterile 2 inches above
MICROBIOLOGY AND PARASITOLOGY
LECTURE/LABORATORY
elbow to cuff, circumferentially; back of the gown, neck, sleeve Bacteriostatic agent – inhibits bacterial growth; p/c
cuffs, underarms are not sterile
Disinfection – process which most microbial forms or
inanimate objects are killed excluding saprophytes and
bacterial spores  reduction in number = can’t produce
ISOLATION PRECAUTIONS: isolation is a process of infection
separating an individual with an infectious disease from the
rest. Centers for Disease Control and Prevention Sporicidal, fungicidal, viricidal – destroy spores, fungi, virus
CDCuniversal precautions – proper handwashing, PPE
usage, proper handling and disposal of secretions and Sterilization – killing m-organisms, including spores
excretions, proper handling of soiled linen and equipment,
PHYSICAL METHODS OF STERILIZATION
environmental control, prevention of injury from sharp devices,
patient placement Heating: most common method; rate of killing  thermal
death time; mechanisms: formation of single-strand breaks in
TRANSMISSION-BASED PRECAUTIONS:
bacterial DNA, coagulation and denaturation of proteins,
1. contact precautions – prevent spread of infection accumulation of toxic levels of electrolytes, alteration of cell
through touching patients or items in the room where membrane structure
infectious agents (fomites) may be deposited 
Factors affecting process of sterilization via heating:
Methicillin-resistant Staphylococcus aureus,
respiratory syncytial virus, agents that cause diarrhea Nature of heat (moist > dry heat), temperature and time
(viral or bacterial), open wounds; all must wear (increased temperature = decrease in sterilization time),
gowns and glove number (more number = higher heat and longer time) and
2. droplet precautions – for droplets caused by nature of microorganisms (spore-forming are more difficult to
coughing and sneezing: ex. influenza, mumps, or destroy), type of material (depends on sensitivity of material
pertussis (whooping cough); with distance of 3 feet/90 to heat; heat-resistant require higher temperature), presence
cm.-; masks of organic material (e.g., fats, proteins, sugars require higher
3. airborne precautions – e.g., chicken pox, measles, temperature)
tuberculosis; those with such are place in negative air
pressure where air is sucked out “reverse isolation” Types of heat

ASEPTIC MEASURES IN THE OPERATING ROOM 1. moist heat – preferred over dry; rapid killing action;
cause coagulation and denaturation of proteins
Cleaning with detergent germicides, soap, water is done; a. temperatures below 100*C
instrument that will be in direct contact with patient must be i. pasteurization – destroy disease-causing
sterile; surgical instruments are sterilized with an autoclaved or organisms in milk products and beverages:
chemical agents; radiation is seldomly used; sterile drapes
(linens) are used to create a sterile field with the top being : conventional method – milk is heated 60-65*C; rapid
sterile; sterile packages are opened as close to the time of cooling: flash method – 72*C for 15s; rapid cooling to 13*C:
usage; leaning over the contents of packages must be avoided; ultra-high temperature (UHT) – 140*C for 15s and 149*C for
open wounds and cavities must be touched only with gloved 0.5s
hands and sterile forceps; body hair shall be shaved on
ii. vaccine bath – destroy contaminating
surgical site and with disinfecting cleaning; surgical
bacteria in vaccine preparations  heated in
scrubbing use long-acting powerful antimicrobial soap on
water bath at 60*C for 1hour; not sporicidal;
hands and forearms for at least 2-5 minutes; hands are below
only vegetative are killed
elbows during scrub and above after
iii. serum bath – inactivates bacteria
PREVENTION OF INFECTION IN THE COMMUNITY contaminating serum preparations  56*C
for several successive days; vegetative only
Communicable disease spread prevention is best at are killed due to coagulation of proteins in
community level by education on infectious disease particularly the serum
their mode of transmission; includes sanitation techniques iv. inspissation – solidifies and disinfects egg-
(water purification, proper sewage disposal), health practices containing and serum-containing media;
improvement (proper handling, storage, and preparation of uses inspissator heated to 80-85*C for 30
food); they should know the value of immunization and minutes for 3 successive days; first day-
vaccines vegetative forms die and spores that will
germinate die on following days
CHAPTER 7: PHYSICAL AND CHEMICAL METHODS OF
b. temperature of 100*C
STERILIZATION
i. boiling – not sporicidal; killing action can be
Antisepsis – use of chemical agents of living tissues to
enhanced with addition of 2% sodium
prevent m-organism’s spread by inhibiting its growth and
bicarbonate; certain metals and glassware
destroying them
are disinfected for 10-20 minutes w/o
Bactericidal or germicidal agents – agent killing bacteria; opening the boiler’s lid
physical/chemical
MICROBIOLOGY AND PARASITOLOGY
LECTURE/LABORATORY
ii. fractional sterilization “tyndallization” or bacterial DNA; induces formation of thymine-thymine
“intermittent sterilization” – live steam for dimers = lethal frameshift mutations; b,v, yeast can be
30-90 minutes for 3 consecutive days; inactivated w/in secs.; not sporicidal; low penetrance;
sterilize culture media such as thiosulfate- harmful to eyes and skin
citrate-bile salts-sucrose (TCBS) and 2. ionizing radiation – greater penetrance; cause
selenite broth; vegetative forms are killed on formation of free radicals that interact with proteins
first day and spores that will germinate will and nucleic acids = cell death; cause harm to human
be destroyed on the successive days tissues:
c. temperature above 100*C a. electron beams – linear accelerator from heated
i. autoclave “steam under pressure” – most cathode is used to generate high speed electrons; low
efficient method; destroys all microbial forms; penetrance; for sterilizing gloves, dressing packs,
15 psi = 121*C  15-20 minutes; used to food
sterilize those of which that withstand high b. electromagnetic rays (Gamma rays) – from nuclear
temp. and pressure disintegration of selected radioactive isotopes; greater
2. dry heat – effectiveness depends on penetration of penetrance but with longer exposure time; high
heat on material; sterilize materials enclosed in tubes, energy radiation cause damage to nucleic acid; bac,
oils, jellies, powders, and glassware fun, viri, sporicidal; sterilize disposable petri dish,
a. red flame – sterilize articles: bacteriological wire plastic syringe, vitamins, antibiotics, hormones,
loops, straight wires, tips of forceps, searing glassware
spatulas  held over Bunsen burner till red hot
b. open flame (flaming) – uses Bunsen burner or Sonic and Ultrasonic vibrations: frequency of 20000 cps for
alcohol lamp; material is passed over flame 1 hour; disrupt cells; reduce microbial loads
several times but not to red hot; aims to ash
Osmotic Pressure: principle of osmosis; for preservation of
down organisms; only vegetative forms are
fruits in syrup and meats in brine
destroyed
c. incineration – burn organisms to ashes; uses CHEMICAL METHODS OF STERILIZATION
incinerator; soiled dressings, beddings, animal
carcasses, pathological material; used for those : inhibit growth temporarily or permanently:
to be disposed; polystyrene emit dense smoke
1. Concentration and potency of chemical agent
and must not be incinerated
high-bactericidal, low-bacteriostatic: alcohol 50-80% is
d. hot air oven – introduced by Louis Pasteur; uses
bactericidal
oven with 160*C for 1 hour; used for sterilization
2. Duration of exposure
of metallic materials; only method used for
3. Temperature – high-better; however, some chemicals
powders and ointments; disadvantage is that air
have optimal effect at low temp
is a poor conductor of heat = poor penetration to
4. Nature of surrounding medium – pH, presence of
materials; cotton and paper may be charred and
extraneous mats reduce efficacy
glass may be smoky
5. Nature of organism – endospore producing bacteria-
e. infrared rays – uses conveyer belt and passes
resistant to most agents; mycobacterial cell wall-lipid
through a tunnel heated by infrared radiators;
rich-hard penetration; gram-negative bacteria-outer
180*C for 7.5 minutes; for metal and glassware
membrane conferring resistant
Desiccation: deprives m-organisms of moisture; for food 6. Number of organisms and size of inoculum
preservation; destroy vegetative forms; endospores are
A good chemical agent: broad spectrum; fast-acting; active in
resistant to drying
the presence of organic matter; active in any pH; stable; non-
Freezing: not reliable; most pathogenic organisms are toxic/allergenic/irritative/ corrosive; soluble in water and easy to
resistant to low temperature; for preservation of m-organisms apply; leave antimicrobial film; high penetrating power; not
“lyophilization”/freeze-drying; vacuum-sealed in container expensive-easily available; safe for storage and shipping for
periods of time; no bad odor
Filtration: mechanical sieving separating m-organisms from
the liquid; uses cellulose ester filter, pore size of 0.22-0.45; 3 CLASSFICATION OF CHEMICAL DISINFECTANTS:
smallest bacteria – mycoplasma, rickettsia, chlamydia; used for
(1) Consistency; (2) spectrum of activity; (3) mechanism
lipid sol’n to be destroyed by heat or freezing – serum,
of action
antibiotic, sugar, & urea sol’n; remove bacteria from culture
media Mechanism of action:
High-efficiency Particulate Air – used in COVID-19 Damage to the cell membrane: cause smaller
for filtering airborne particles 0.3 in size, effective by 99.97% molecules to leak out and interferes with active transport and
energy metabolism:
Radiation:
1. Surface active agents – compounds have long-chain
1. ultraviolet light (UVL)/Non-ionizing radiation –
hydrocarbons, fat-soluble, charged ions that are water
range: 200-280 nm (260, best); max absorption of
soluble; concentrates on membrane surface leading
MICROBIOLOGY AND PARASITOLOGY
LECTURE/LABORATORY
to leakage; for vegetative forms, mycobacteria, b. Chlorine – treatment of water; hypochlorite –
enveloped virus; sanitizing dairy and food processing equipment;
a. Cationic agents - detergents where fat-soluble high concentration – pools
portion is positively charged due to quaternary c. Hydrogen peroxide – weak antiseptic; cleans
atom: “quaternary ammonium compounds”; wounds; for contact lenses, surgical devices
effective at alkaline pH: cetrimide and 3. Alkylating agents
benzalkonium chloride a. Aldehydes – damage nucleic acids and spores;
b. Anionic agents – negatively charged agents alkylation of amino-, carboxyl-, hydroxyl-
containing long chain hydrocarbons: soaps and Formaldehyde (formalin) – disinfection; kill
bile salts; remove dirt via emulsification and most mycobacterium tuberculosis and fungi in athlete’s
effective at acidic pH foot
2. Phenolic compounds – disrupts cell membrane, Glutaraldehyde – sporicidal; for cold sterilant in
cause precipitation of proteins, and inactivation of medical equipment: respiratory therapy machine;
enzymes; “coal derivatives” that acts as disinfectants more potent; require alkaline pH for action and
at high-concentration and antiseptic at low; exposure time of 3 hours
bactericidal and fungicidal; good activity against b. Ethylene oxide – sporicidal; gaseous sterilization
mycobacteria and poor on spores and most viruses of heat-sensitives; polyethylene tubes in
anesthesia machines; more potent than
: no longer used for it’s toxic to human cells-used for chemical Glutaraldehyde but slow-acting; flammable with
evaluation of new chemical agents “phenol coefficient test” 10% CO2; eye irritation and mutagenic and
carcinogenic
: cresols (phenol derivatives) more potent and safer (lysol)

: chlorhexidine – topical purposes against gram +

CHAPTER 10: BACTERIA AND DISEASE
: hexachlorophene (chlorinated diphenyl) – greater activity for
Bacteremia – bacteria in blood
gram + similar to chloroxylenols
Commensalism – symbiosis; benefit w/o harm: human body
: triclosan (organic phenyl ether) – for gram + and some gram and normal flora
– including Pseudomonas Contamination – presence of unwanted materials where
they shouldn’t be; may not be harmful
3. Alcohols – disorganize lipid structure of cell Disease – interruption in the normal functioning of a body part
membrane, dehydrates, cause denaturation and Infection – invasion of the body by pathogenic
coagulation of proteins; best at 70% aqueous; irritant microorganisms; not synonymous with disease
and flammable Mutualism – both organism benefits: normal intestinal flora
a. Ethyl alcohol – antiseptic; bactericidal; removes produces vitamin K that’s beneficial to body’s clotting activity;
lipids Parasitism – benefit with harm
b. Isopropyl alcohol – greater bactericidal activity; Pathogenicity – ability of an organism to produce disease
less volatile; fumes – narcosis Pollution – presence of contaminants; cause adverse
c. Benzyl alcohol – preservative biological effects; all pollutants are contaminants but not all
d. Methyl alcohol – fungicidal and sporicidal; for contaminants are pollutants
inoculation hoods Pyemia – pus-producing bacteria in the bloodstream
Septicemia – presence of actively multiplying bacteria in the
Denaturation of cellular proteins: (1) acids and alkalis; (2)
blood from an infection; “sepsis”
alcohol and acetone; (3) phenol and cresols
Symbiosis – prolonged and close interaction between
Modification of the functional groups of proteins and organisms of different species
nucleic acids: Toxemia – toxins in blood
Viremia – viruses in the blood
1. Heavy metals – damage to enzymatic activity; Virulence – describes the degree of pathogenicity of an
precipitates proteins; oxidizes sulfhydryl groups; organism
bacteriostatic > bactericidal Robert Koch  proved that certain microorganisms cause
a. Mercurial (monochrome and Merthiolate) – specific diseases; experimental procedure in 1884 Koch’s
biocidal; antiseptic; viruses at dilution Postulate:
b. Silver compounds (silver nitrite) – bactericidal;
1% silver nitrite for clinical treatment for Suspected organism must be absent-healthy, present-
ophthalmia neonatorum (Crede’s prophylaxis). diseased, and isolated from infected host, grown in pure
Silver sulfadiazine – burn treatment culture; organism from pure culture must produce same
2. Halogens – bactericidal; oxidize sulfhydryl groups of disease as that of the infected source when inoculated to a
enzymes susceptible animal; must be isolated from pure culture from
a. Iodine – best antiseptic; combined with neutral experimentally infected host
carrier polymers producing iodophores (povidone
: conditions fulfilled = concluded that the organism isolated is
iodine and 10% is used for operative skin
indeed the cause of the disease under study
disinfection)
MICROBIOLOGY AND PARASITOLOGY
LECTURE/LABORATORY
: validity of postulate: ability of pathogen to grow in laboratory ii. Droplet spread - droplets are different from
with artificial culture media aerosols; spread few feet before dropping to the
ground
*viruses are obligate intracellular parasites that need to be 2. Indirect contact
grown in living cells: mycobacterium leprae causative agent in i. Airborne transmission – through dust or
leprosy needed to be grown in mice’s pads aerosols (5 microns in size); ex. fungus
Cryptococcus neoformans is transmitted via
Limitation: not every human develops disease from infection;
inhalation of aerosols from pigeon’s feces
one has differing reaction to another due to differing genetic
ii. Vehicle transmission – via food, water, milk,
composition
bio substances, fomites/inanimate objects; carry
Issue: “cultured organisms inoculated into a susceptible an infectious agent passively or provides
animal”  some organisms are species-specific  disease environment that promotes growth
may be for animals only and not to humans and certain
Water  cholera, typhoid Food  fecal-oral transmission
pathogens grown in culture media may be less pathogenic that
(gastroenteritis and food poisoning)
what it’s supposed to be
3. Vector transmission – usually insects:
Factors influencing occurrences of infection: development
i. Mechanical transmission – passive transport
of infectious disease  interaction among: etiological agent,
via insect’s feet or other parts of the body
host, environment
ii. Biological transmission – active transport;
Chain of infection: pathogenic leaves reservoir via portal of organism enters insect vectors  organism
exit  susceptible organism acquires via mode of multiplies in the vector  bites  transmit
transmission  enters through portal or entry  multiplies
Malaria by female Anopheles mosquito as well as dengue,
and cause disease
chikungunya virus, and zika virus
Reservoir: continual source of disease-causing m-organism;
Rat flea bite transmits Yersinia pestis  agent for plague
site of multiplication
Portal of entry: how infectious agent enters a susceptible
1. Animal reservoir: infectious disease animal-human 
host; portal of exit is also a portal of entry into another: ex.
“zoonotic infections”; humans serve as
respiratory tract-rt; blood fluke Schistosoma haematobium 
incidental/dead-end host: anthrax, plaque, rabies
exit-urine enters-skin penetration by infective larvae; hepatitis
2. Human reservoir: may not necessarily manifest with
B and HIV-blood
the disease; harbor-subclinical disease/ harbor-got
well-still harbor-transmits to others  “carriers”: Host: final link of the chain; constitutional or genetic factors
a. Asymptomatic/healthy carriers: infected w/o are factors that affect a host’s susceptibility; ex. sickle cell trait
symptoms – less susceptible to malaria
b. Incubatory carriers: transmit causative agent
during incubation period Immune system can be affected by poor nutritional status,
c. Chronic carriers: harbor for months/longer after chronic intake of alcoholic beverages
initial infection
d. Convalescent carriers: developed disease- How organisms produce disease:
recovered-transmits still
Mechanical: Invasiveness: invasion of epithelial
3. Environment reservoir: water  Entamoeba
surface and penetration of deeper tissues; steps:
histolytica (protozoan parasite-amoebiasis); soil 
fungus Histoplasma capsulatum; plants – kangkong 1. colonization (involves ability of invading organism to
 Fasciola hepatica  larvae – liver damage enter susceptible host and establish itself and is
facilitated by substances that facilitate adhesion to
Portal of exit: route of exit from its host; usually where
specific target cells  adhesins); gram – bacteria
infectious agent is localized; ex. blood fluke Schistosoma
have pili and fimbriae promoting adherence of
haematobium  infects urinary bladder  exits via urine; exits
organism to susceptible cells thus promoting adhesion
via blood-sucking arthropods  Plasmodium spp.  causative
2. ability to evade host immune defense (factors
agent for malaria
allowing evasion:
Mode of Transmission:
capsule  evades phagocytosis
1. Direct contact – common transmission; blood fluke
secretion of enzymes: coagulase by staphylococcus aureus
Schistosoma spp.  water containing snails with
 promotes formation of coagulum within organism may hide
parasite larvae  penetrates skin
to escape detection of immune surveillance cells
i. Person-to-person contact – skin-to-skin, multiply inside macrophages  mycobacterium tuberculosis
kissing, sexual intercourse (gonorrhea, syphilis);  inhibit phagosome-lysosome fusion
saliva  Epstein-Barr Virus an infectious
mononucleosis  “kissing disease” 3. production of extracellular substances that
promotes invasion:
MICROBIOLOGY AND PARASITOLOGY
LECTURE/LABORATORY
Neisseria gonorrhoeae enter-multiply-extruded from host cell- 1. sporadic disease – occurs occasionally
infect another host cell 2. endemic disease – constantly present:low levels
3. epidemic disease – great number of locals in a short
Collagenase enzyme by Clostridium perfringens breakdown period acquires an infectious disease
collagen thus destruct connective tissues  “gas gangrene” 4. pandemic disease – worldwide occurrence involving
at least three regions in the world
Chemical: Toxin Production: toxins are poisonous
substances contributory to disease production: based on severity of duration of a disease:
1. endotoxin – integral components of outer 1. acute disease – develops rapidly lasting for short
membrane of gram – bacteria: Salmonella, time
Shigella, Escherichia coli; exerts effects when 2. chronic disease – develops slowly, occurs in a long
gram – bacteria die and their cell walls undergo time: tuberculosis
lysis = releasing the endotoxin (all endotoxin 3. latent disease – intermittent causative agent:
release same symptoms with different degree); Herpesviridae
disease-specific: diphtheria toxin, botulinum
toxin, tetanus toxin based on extent of host involvement:

Lipopolysaccharide – component for endotoxin activity; further 1. localized infection – at small are of the body: boils
composed of lipid A moiety (toxic activity) and and abscess
polysaccharide moiety (antigenic) 2. systemic/generalized infection – spread throughout
the body via blood/lymph
2. exotoxins – intracellular products of some 3. focal infection – causative agents from localized 
bacteria as part of growth and metabolism which blood/lymph  confined to specific area: infections in
are released into surrounding medium; mainly mouth, sinus, tonsils
proteins and many are enzymes; most are
produced by gram + bacteria; soluble in body 1. primary infection – acute infection causing initial
fluids and thus are diffused into the blood and illness
transported throughout the body 2. secondary infection – caused by opportunistic
pathogens after primary weakened the defense
3 principal types: (1) cytotoxins (kill host cells or after their
3. subclinical/inapparent infection – doesn’t cause
function); (2) neurotoxins (interfere with normal nerve impulse
notable illness
transmission); (3) enterotoxins (affects cell lining the g-tract)

*Diseases by exotoxin-producing bacteria are due to effects of

exotoxin and not the bacteria

Immunologic: some cause disease due to the immune

response of host: hepatitis damage to the liver is due to
immune response against the virus  antibodies are produced
for the virus and cytotoxic T cells are activated = destruction
of hepatocytes

CLASSIFICATION OF INFECTIOUS DISEASE

Behavior within given population:

1. communicable disease – spread host to another,

directly or indirectly: measles, tuberculosis, typhoid
fever
2. contagious disease – rapidly transmitted: measles
and chickenpox
3. fulminant infection – infection resulting to death in
short period of time: meningococcemia – patient dies
STAGES OF INFECTIOUS DISEASE: invasion-disease
after hours
4. non-communicable disease – not spread person to 1. incubation period – time interval between entry and
another: Clostridium tetanus appearance of initial signs and symptoms (6-12 days);
length of period is affected by virulence, number of
Based on source of microorganism/infectious agent:
infecting microorganisms, and resistance of the host
1. exogenous – from outside the body: cholera 2. prodromal period – short period; early, mild,
2. nosocomial – hospital-acquired nonspecific symptoms
3. endogenous – from inside the body: E coli: normal 3. period of illness – period of maximal invasion; period
flora of the colon where disease is most acute; patient manifest signs
and symptoms distinct to disease
Based on the occurrence of the disease:
MICROBIOLOGY AND PARASITOLOGY
LECTURE/LABORATORY
*most bacterial infection show increase neutrophil count and 3. reservoir – harbors parasite that may act as
viral will show lymphocyte increase count additional source of infection to man:
- infection may remain acute and may be acute-
chronic 4. paratenic – serves as transport for parasite so
4. period of decline – “period of defervescence (on and infective stage reach its final host
off occurrence)”; signs and symptoms subside;
vulnerable to secondary infections Sources of exposure to infection/infestation:
5. period of convalescence – marked by recovery;
(1) contaminated soil & water; (2) food containing
normal condition
infective staged parasite; (3) blood-sucking
insects; (4) animal harboring parasite; (5)
another person and his/her contaminated
CHAPTER 11: INTRODUCTION TO PARASITOLOGY environment; (6) one’s self (auto infection)
A relationship where unlike organisms exist together is called
symbiosis. soil contaminated: most common source of infection;
helminths: Ascaris lumbricoides, Trichuris trichiura,
THREE TYPES OF SYMBIOTIC RELATIONSHIPS Strongyloides stercoralis
1. Commensalism – two species live together, and one
species benefits from the other without harming or water: amoebas, intestinal flagellates, larvae of blood
benefitting the other. flukes, eggs of pork tapeworms “Taenia solium”
2. Mutualism – two organisms mutually benefit from
each other. freshwater fish: fish tapeworm “Diphyllobothrium latum”
3. Parasitism – one party or symbiont benefits to the
detriment of the other. raw pork: Trichinella spiralis and T. solium

2 IMPORTANT ELEMENTS IN PARASITISM beef: T. saginata

1. Parasite
MODES OF TRANSMISSION: most common
2. Host
transmission  fecal-oral of most intestinal parasites
CLASSIFICATIONS OF PARASITES
Intestinal flukes: Trichinella spiralis, Taenia solium,
A. ECTOPARASITE
Taenia saginata, Diphyllobothrium latum

(1) bite of blood-sucking insect vectors  malaria,

 Outside, invasion – infestation
leishmaniasis, trypanosomiasis, filariasis; (2)
B. ENDOPARASITE inhalation of eggs  Enterobius vermicularis; (3)
transplacental or congenital infection 
 Inside host: helminths; infection Toxoplasma gondii, Plasmodium; (4)
Based on independency from host: transmammary infection  Strongyloides,
Ancylostoma; (5) sexual intercourse 
1. facultative parasites -independent of host
Trichomonas vaginalis
2. obligate parasites – dependent of host;
majority that infects humans portals of exit of parasites: most common  anus;
urine  T. vaginalis, Strongyloides stercolaris,
Based on mode of living:
Schistosoma haematobium; sputum  A. lumbricoides
1. permanent parasites – in host at early life-
Mechanisms of Disease Production by Parasites:
maturity
2. intermittent parasites – visit for feeding; non-path Pathogenesis  dynamics of disease process
3. incidental parasites – harbors unusual host
4. transitory parasites – larva develops at host; Parasites damages host through:
adult is free-living
1. trauma/physical damage – site or at portal of entry
5. erratic parasites – harbor in unusual organ
2. Lytic necrosis – enzymes produced by parasites for
Hosts:
them to digest food may cause harm to host tissues
1. definitive – harbor adult parasite/sexual
- Entamoeba histolytica –protozoan; release enzyme
stage/phase
that lyses tissues for nutrition; enables penetration to
2. intermediate – harbor larva/asexual stage tissues
MICROBIOLOGY AND PARASITOLOGY
LECTURE/LABORATORY
3. Stimulation of host tissue reaction – animal
parasites provoke host tissue reactions in the form of
cellular proliferation and infiltration; may involve systemic
increase of cells, especially those in blood (circulating
eosinophils); blood fluke  Schistosoma japonicum –
liver cancer and Clonorchis sinensis – biliary ducts
cancer

4. Toxic and allergic phenomena

“immunopathology” : proteins and other metabolites
by parasites hypersensitivity / allergic reactions due
to antibody production
Allergic reaction on pinworm Enterobius vermicularis at anus

LAB DIAGNOSIS of PARASITIC INFECTIONS

Specimen collection, handling, transport:
Specimen – varies by portal of entry and exit
Daily shedding of diagnostic forms may not occur 
multiple specimens for detection  collection of three
5. Opening of pathways for entry of other pathogens specimens every other day (amoebiasis  six
into the tissues: parasites damages may favor entry specimens for 14 days)
and proliferation of organisms

GENERAL LIFE CYCLE OF PARASITES: simple to Timing  protozoans  fresh specimen: diagnostic
complex; components in the life cycle: source of stage is trophozoite, in liquid stool  30 min. after
infection, mode of transmission, infective stage collection *formed stools w cyst forms  24 hours
(morphologic form that infects humans), pathogenic
stage (morphologic form – clinical manifestations) , Preservatives may be added: formalin, polyvinyl alcohol,
diagnostic stage (morphologic form – detected via sodium acetate formalin, modified polyvinyl alcohol
labs): definitive or intermediate hosts
Stool specimen – water-tight container; 2-5 g
CLASSIFICATION OF PARASITES:
Microscopic Examination: fresh specimens; stages:
1. single-celled protozoa -subkingdom protozoa
2. multicellular protozoa – subkingdom metazoa 1. direct wet preparations or direct wet mount –
3. parasitic protozoa – classified based on motility to detect motile protozoan trophozoites: cysts,
and more of reproduction: amoeba and ova, oocysts, larvae
flagellates (Phylum Sarcomastigophora); 2. concentrated methods – aggregate parasites
sporozoa (Phylum Apicomplexa); ciliates into small volume; remove debris that’d interfere;
(Phylum Ciliophora) used both fresh and preserved specimen;
parasitic helminths: phyla: Nemathelminthes trophozoites do not survive the procedure:
(roundworms) and Platyhelminthes (flatworms)  floatation and sedimentation
classes Trematoda (flukes) and Cestoda (tapeworms) i. sedimentation (Formalin-Ethyl Acetate
Sedimentation Procedure) – based on
parasitic protozoa  binary fission except sporazoa gravity; parasites are heavier = settle in
(sexual and asexual and no organ for motility) sediment; Ethyl Acetate + saline-washed
flagellates  has one or more whiplike flagella to move formalin-fixed sample  centrifuged; easy to
amoeba  moves by pseudopia perform, good recovery for parasites; has
ciliates  has rows/patches of cilia for locomotion more fecal debris than floatation technique
ii. zinc sulfate floatation technique –
parasite is lighter = floats; zinc sulfate w
MICROBIOLOGY AND PARASITOLOGY
LECTURE/LABORATORY
1.18-1.20 - concentrating sol’n; able to 1. sputum – Paragonimus westermani,
remove more fecal debris = cleaner Strongyloides stercolaris, E. histolytica, ascaris
preparation; denser helminth may not float lumbricoides larva; hookworm larva
3. permanent stains – final step in ME; sample on 2. eye scrapings – Acanthamoeba keratitis, T.
slide and dried after stain; stains: Wheatly gondii, Loa loa
trichrome (widely used), iron hematoxylin 3. mouth scrapings and nasal discharge – E.
(demonstrate morphology of intestinal protozoa), gingivalis, Trichomonas tenax, Naegleria fowleri
modified acid-fast stain for Cryptosporidium 4. skin strips – skin fluid w/o bleeding obtained for
motile microfilariae
OTHER SPECIMENS AND LAB PROCEDURES 5. xenodiagnoses – for Chagas disease uninfected
reduviid bug takes blood meal from infected patient
Duodenal material: collected via Nasogastric Tube and examined for Trypanosoma cruzi z
(NGT)/ enteric capsule test (Entero-test) (made to
swallow gelatin with coil of weighted yarn – capsule
dissolves and yarn is pulled after 4 hours – bile-stained
material is then microscopically examined  permanent
stains); examined immediately; >2mL; centrifuged before
ME of sediment

Sigmoidoscopy material: collect and examine mat.

from colon: Entamoeba histolytica  biopsy may be
done

Cellophane Tape or Scotch Tape Preparation: detect

eggs of pinworms Enterobius vermicularis; parasite
migrates to anus to lay eggs at night  must be done in
the morning before defecation or washes; detects
tapeworm taenia spp.

Blood: detect blood-borne parasites: Leishmania,

Trypanosoma, Plasmodium, filarial worms: blood from
fingertip/earlobe (w/o anticoagulant) and standard
venipuncture (with); malaria  thick (screening
purposes) and thin (species identification) blood smear
for 1 hour collection; may be stained with Wright’s stain
or Giemsa stain

Cerebrospinal Fluid: used to diagnose certain amoebic

infections; immediately examined for motility detection of
parasites; wet preps for naegleria, Acanthamoeba,
Trypanosoma, toxoplasma gondii, Taenia solium,
echinococcus

Tissue and biopsy specimens: detect Leishmania, T.

gondii, trypnosoma, T. solium, trichinella spiralis in
tissues; for amoebic liver abscess

Genitourinary secretions: for blood fluke Schistosoma

haematobium in urine; Trichomonas vaginalis; urine
samples are centrifuged:sediments examined; saline-wet
preps for trophozoites

OTHERS: