IMPORTANCE OF MICROBIOLOGY FOR NURSES/MIDWIVES

Microbiology is the science which covers various information regarding

infection, host system and control methods. In regard to nurses, they are involved
in control of infection in hospitals. The main objective is to learn and excel in
knowing information about microorganisms, their disease, treatment and
preventive measures. The applications of microbiology in nursing practice include:

1. Nosocomial infection - Nosocomial infection is known as hospital infection.

Nurses need to know information about patients susceptible to infection, like
children, old people and immune compromised individuals.

2. Immunization- Learn basic information about history of immunization. Vaccine

types such as attenuated, inactivated, subunit and toxoid vaccines, safety issues and
risk.

3. Immune hypersensitivities- Information regarding hypersensitivity, allergic

reaction and types of infection.

4. Immune responses- Basic information about nonspecific and specific defenses

of host.

a. Nonspecific – 1st line defense. E.g. skin, mucous membrane, chemicals

b. Nonspecific – 2nd line defense. E.g. phagocytosis, complement, interferon,

inflammation, fever.

c. Specific – 3rd line defense. E.g. lymphocytes, antibodies.

5. Specific immune response and lab techniques- Understanding basics of

humoral and cell-mediated immunity. Information about microbial antigens,
different classes of antibodies and their general role. General information about
agglutination and precipitation reactions in serological test. E.g. blood typing and
ELISA test.

6. Basic Epidemiology- Information learnt about incidence, prevalence and

reservoir. Disease transmission modes like contact, vehicle and vector.

7. Basic disease information- Information learnt about the affected body system.
E.g. respiratory disease. Longevity/severity – acute, chronic, sub acute and latent.
Extent of body affected – local and systemic. State of host when affected – primary
and secondary.

8. Controlling microbial growth- Controlling microbial growth through chemical

methods. Physical methods like heat, cold, filtration and radiation. Antibiotics –
their mechanism of actions, toxicity, spectrum of activity and antibiotic resistance.

CLASSIFICATION OF MICROORGANISMS

MICROORGANISMS

Microorganisms are microscopic organisms which that exist as single cells or cell
clusters. Microorganisms are two types they are pathogenic microorganisms and
non-pathogenic microorganisms. Classification of living organisms According to
the Carl Woese system of classification, organisms arranged according to their
molecular characteristics and cellular characteristics. Woese devised three
classification groups called Domains. A domain is larger than a kingdom. Domains
consist of
1. Eubacteria

2. Eukarya

3. Archaea

1.Eubacteria- Bacteria comes under this domain and it possesses the following
characteristics such as prokaryotic cells; membrane is made up of unbranched fatty
acid chains, cell wall contain peptidoglycan. E.g. for bacteria are mycoplasmas,
cyanobacteria, gram positive bacteria and gram negative bacteria.

2.Eukarya- Eukarya are eukaryotic cells. Eukarya membrane is made up of

unbranched fatty acid chains, cell wall contain no peptidoglycan. Eukarya is
subdivided into the following kingdoms.

a. Protista - they are simple, unicellular eukaryotic organisms. Examples are slime
molds, euglenoids, algae and protozoans.

b. Fungi - fungi are unicellular or multicellular organisms with eukaryotic cell.

Examples are sac fungi, club fungi, yeasts and molds.

c. Plantae – plants are multicellular organisms with eukaryotic cell type.

d. Animalia – animals are multicellular organisms composed of eukaryotic cell.

Examples are sponges, worms, insects and vertebrates.

3.Archaea- Archaea are prokaryotic cells. Its membrane composed of branched

hydrocarbon chains.
Cellular structure

There are two kinds of cells. These are prokaryotic and eukaryotic cells. Bacteria
are prokaryotic organisms. Animals, plants, algae, fungi and protozoa are
eukaryotic organisms.

Prokaryotic cells – A prokaryotic cell is a cell that does not have a true nucleus.
The nuclear structure is called a nucleoid. The nucleoid contains genetic material
and usually single circular molecule of DNA. A prokaryotic organism such as
bacterium lacks membrane bound nucleus and membrane bound organelles.
Eukaryotic cells – A eukaryotic cell is larger and more complex structure than a
prokaryotic cells. It is found in animals, plants, algae, fungi and protozoa. The cell
contains membrane bound organelles. Each organelle performs a specialized
function. It also contain membrane bound nucleus where cell’s DNA is organized
into chromosomes.
 SIZE OF BACTERIA

Bacterial species are varying in size. The smallest bacterium (Mycoplasma) is

about 0.3µm in diameter, approximately the size of the largest viruses
(poxviruses). Nanobacteria or ultramicrobacteria is the smallest bacterium their
size range from around 0.2µm to less than 0.05µm in diameter. Escherichia coli is
a bacterium of about 1.1 to 1.5 µm wide and 2.0 to 6.0µm long. Most spherical
bacteria have diameters of 0.5 to 2 µm and rod shaped cells are generally 0.2 to 2
µm wide and 1 to 10µm long.

BACTERIAL SHAPE

Bacteria found in different shape (Fig. 2.1). They are

1. Cocci – round or oval cells.

2. Bacilli – rod shaped cells.

3. Spirilla – non flexuous spiral forms.

4. Vibrios – curved or comma-shaped rods.

5. Spirochaetes – slender and flexuous spiral forms.

6. Mycoplasmas – cell wall absent, so bacteria found as round or oval cells.

7. Actinomycetes – branched filamentous bacteria.

BACTERIAL ARRANGEMENT
Some bacteria are arranged in groups are (Fig. 2.2 & 2.3)

1. Diplococci – cocci arranged in pairs.

2. Streptococci – cocci arranged in chains.

3. Stapylococci – cocci arranged in clusters.

4. Coccobacilli – both length and width are approximately same in the bacteria.

5. Streptobacilli – bacilli arranged in chains.

6. Chinese letter or Cuneiform pattern – resemble like chinese letter.

7. Tetrad – cocci arranged as four cells.

8. Sarcina – cocci arranged as cluster of eight cells

 STRUCTURE OF BACTERIA

Bacteria are prokaryotic cells. Bacteria are classified into gram positive and gram
negative cells. Bacterial cell covered by a chemically complex cell wall. A plasma
membrane is present. The genetic material is found in the centre called nucleoid.
Ribosomes and larger masses are called inclusion bodies are scattered around in
the cytoplasmic matrix. Outside to the cell wall, capsule or slime layer is present
(Fig. 2.4).
Glycocalyx

Glycocalyx is a sticky, sugary envelope composed of polysaccharides and/or

polypeptides that surround the cell. Glycocalyx is found in one of two states:

1. Capsule – capsule firmly attach to cell surface. Capsules are composed of

polysaccharides made of single or multiple types of sugar residues. Capsule can
protect bacteria. Capsules promote adherence and colonization. Capsules are
identified by negative staining and quellung reaction.

2. Slime layer – a slime layer is a zone of diffuse, unorganized material of

gelatinous layer. It is loosely attach to cell surface.

Cell wall

The cell wall is the rigid structure that lies outside the plasma membrane. Cell wall
gives shape and protect from osmotic lysis. Cell wall is made of peptidoglycan
which gives shape and strength to the cell.

Cell membrane or plasma membrane

Cell membrane contains both protein and lipids. In the plasma membrane, lipids
form a bilayer. The outer surface of lipids is hydrophilic and inner region are
hydrophobic. Plasma membrane serves as a selectively permeable barrier. It allows
particular ions and molecules to pass, either into or out of the cell. Cytoplasmic
matrix The cytoplasmic matrix is the substance lying between the plasma
membrane and the nucleoid. The matrix contain water and ribosomes. Substance
found in the matrix are inclusion bodies, ribosomes and plasmid. a. Inclusion
bodies – it contain granules of organic or inorganic material. These bodies are used
for storing carbon compounds, inorganic substances and energy.
Ribosomes – Ribosomes are complex objects made of both protein and ribonucleic
acid (RNA). They are the site of protein synthesis. Ribosomes found in bacteria are
called 70S ribosomes. 70S divided into two subunits such as 50S and 30S.
Nucleoid- The bacterial chromosome is located in an irregularly shaped region
called nucleoid. Nucleoid contains DNA.

Pili and fimbriae- The short, fine, hair like appendages called fimbriae. They are
only visible in an electron microscope.

Flagella- Flagella are threadlike locomotor appendages extend from plasma

membrane and cell wall. Flagella used for bacterial motility.

Spore

Spore are resting stage of bacteria. Spores are resistant to environmental stresses
such as as heat, ultraviolet radiation, gamma radiation, chemical disinfectant and
desiccation. Sporulation is the process of development of spores.

FACTORS INFLUENCING GROWTH

The growth of microorganisms is greatly influenced by chemical and

physical nature of their surroundings. Some of the factors influence growth of
organisms is

1.Solutes and water- Microorganisms can be affected by changes in the osmotic

concentration of the surroundings. Selectively permeable membrane separates
microorganisms from the environment.

2.Nutrition- Bacteria require water, carbon, nitrogen, organic substance like

glucose, inorganic salts like sodium, potassium, magnesium, calcium, phosphates,
sulphates for growth and multiplication.
3.Temperature- Bacterial growth is stimulated at optimum temperature.
Microorganims has the minimum and maximum growth temperatures. Based on
temperature, the microorganims are classified into

a.Psychrophiles - psychrophiles grow well at 00C and have a optimum growth

temperature of 150 C or lower, maximum is around 200 C. Examples are
Pseudomonas, Vibrio, Bacillus and Anthrobacter.

b.Mesophiles – mesophiles are microorganisms with optimum temperature around

20 – 450 C, minimum temperature of 15 to 200 C and maximum is about 450 C or
lower. Almost all pathogen are mesophiles, they have constant temperature 37 0 C.

c. Thermophiles – Thermophiles are microorganisms grow at temperature of 500C

or higher. Their growth minimum is around 450 C and optimum temperature
between 55 and 650 C.

4. Moisture

Moisture is an important factor required for the growth of bacteria. About 80% of
the bacterial body weight contains water, if microorganisms are dried; they lose
their structure and functions.

5. Oxygen concentration Aerobe is an organism able to grow in the presence of

atmospheric oxygen. Organisms that grow in the absence of oxygen are called
anaerobes. Organisms strictly require or completely dependent on atmospheric
oxygen is called obligate aerobes. Facultative anaerobes are organisms able to act
like aerobes in the presence of oxygen, but able to survive when conditions are
anaerobic. Aerotolent anaerobes are organisms that are anaerobic but can survive
aerobic conditions.
6.pH

pH is a measure of the hydrogen ion activity of a solution. pH is defined as the

negative logarithm of the hydrogen ion concentration. Each microorganisms has
definite pH. According to pH condition, microorganisms can be classified into

a. Acidophiles – acidophiles are organisms which grow between pH 0 to 5.5.

b. Neutrophiles - neutrophiles are organisms which grow between pH 5.5 to 8.0.

c. Alkalophiles – alkalophiles are organisms which grow between pH 8.5 to 11.5.

BACTERIAL GROWTH

Microorganisms reproduce mainly by budding or binary fission.

In binary fission, the cell elongates and chromosomal DNA is replicated, then cell
wall and cell membrane move inward and begins to divide, cell wall forms at the
centre and later, cell separate into two daughter cells.

Budding is a small outgrowth from bacterium and enlarges until it reaches the size
of the daughter cell. Cell separates, forming two identical cells.

Growth is a complex process involving different stages

1. Entry of basic nutrients into the cell.

2. Conversion of these nutrients into energy and vital cell constituents.

3. Replication of the chromosomes.

4. Increase in size and mass of the cell.

5. Division of the cell into two daughter cells.

Generation time -The generation time is the amount of time needed for a cell to
divide. Generation time varies among organisms and depends upon the
environment and temperature of their environment. Some bacteria take about 24
hours to divide, others organisms need 1 to 3 hours.

Viable count -It is the enumeration of living cells. These cells can have
multiplication.

Total count- It is the count of both living and dead cells is termed total count.

PATHOGENS AND NON PATHOGENS

Microorganisms are of two types. They are pathogenic and nonpathogenic

microorganisms.

Pathogens- An infection is caused by the disease-causing microorganism known

as pathogens. Some pathogens infect humans, but not other animals and plants.
Some pathogens that infect animals or plants also infect humans. Mycobacterium
tuberculosis is the bacterium that causes tuberculosis. This bacterium transmits
infection through droplets of respiratory secretion or dry sputum from infected
person to uninfected person.

Non-pathogens- Non-pathogens do not cause disease and they are helpful in

different ways. Some microbes are able to maintain homeostasis in human body
and are used in the production of food and other commercial products. For
example, flora are microorganisms found in intestines that helpful in the digestion
of food and play role in formation of vitamins such as vitamin B and vitamin K.
moreover, it helps in breakdown of large molecules into small molecules.
NORMAL FLORA

The term normal flora is used to describe microorganisms that are found in
various body sites in normal, healthy individuals. The normal floras are also called
commensals. Commensals are the microorganisms which live in complete
harmony with the host without causing any damage to the body. Residents are
strains that have an established niche at one of the many body parts, which occupy
indefinitely. Transient flora comes from the environment and inhabit from the
body parts by competition from residents or by the host’s innate or immune
defense mechanisms. Transient flora are inhabited for short period. Origin of
normal flora.The human fetus is sterile until the birth membranes ruptures. After
birth, the infant is exposed to the flora of the mother’s genital tract, to the skin, and
respiratory flora of those handling delivery and to organisms in the environment.
During the infant’s first few days of life, the flora can colonize particular sites in
the body and exposed to a broader range of organisms. Normal flora at different
parts Mouth and teeth – Staphylococci, other viridans Streptococci,Streptococcus
mutans, Spirochaetes, Actinomycetes, Fusobacteria and yeast. Paranasal tissues –
Streptococcus pneumoniae, Fusobacteria, Haemophilus influenzae, Actinomycetes,
Bacteriodes, Peptococci and Propionibacterium. Throat – Streptococcus
pneumoniae, Streptococcus pyogenes, Haemophilus influenzae, other Haemophilus
spp, Corynebacteria, Neisseriae, Fusobacteria, Bacteriodes spp and Candida. Skin
flora – Staphylococcus, Streptococcus, Micrococci, Corynebacteria,
Propionibacterium and yeast. Upper bowel – Escherichia coli,other
Enterobacteriaceae, Enterococci and yeast.

Lower bowel – Escherichia coli and other, Enterobacteriaceae, Enterococci,

yeasts, Actinomycetes, Bacteriodes, Clostridium, Bifidobacteria and Eubacteria.
Perineum and Urethra – skin flora + lower bowel flora + mycoplasmas. Adult
Vaginal flora – Lactobacilli, Streptococci, Corynebacteria, Mycoplasmas,
Peptococci, Actinomycetes, and yeast. Role of normal flora in disease Many
species among the normal flora are opportunists as they can cause infection it
reaches sufficient numbers or host defense mechanisms are lowered. E.g. Strains of
E.coli can reach the urinary bladder by ascending the urethra and cause acute
urinary tract infection, occur mainly in sexually active women. Beneficial role of
normal flora Organisms of the normal flora play an important role in the
development of immunologic competence. The normal flora can block extraneous
pathogen and their ability to infect the host. The flora can digest cellulose to usable
form and provides many vitamins including 70% of the animal’s vitamin B
requirement.