PHMP Midterms
PHMP Midterms
PHMP Midterms
1. Sterilization
- the removal or destruction of ALL living
microorganisms.
2. Commercial Sterilization
- Sufficient heat treatment to kill endospores of
Clostridium botulinum in canned food.
3. Sanitization
- Treatment is intended to lower microbial counts on FACTORS AFFECTING EFFECTIVENESS
eating and drinking utensils to safe public health
levels. 1. Microbial load
- associated with grains reflects the environmental
4. Disinfection conditions in which the crop was grown
- Destruction of vegetative pathogens on inanimate
objects. 2. Environmental influences
- (i.e., temperature)
5. Antisepsis
- Destruction of vegetative pathogens on living 3. Presence of organic matter
tissue. - (food residues) on the surface can interfere with
the antimicrobial activity of sanitizers and
disinfectants by reducing the level of activity or by
Other related terms protecting the microorganisms from attack by
acting as a physical barrier.
“Cide" - meaning to kill; treatment that causes death
of microorganisms. 4. Suspending medium
- Biocide or germicide - kills microorganisms in - the propagation of microorganisms or of living
tissue cells in special media conducive to their
general
growth
- Fungicide — kills fungi
5. Time of exposure
"-stat or -stasis" - meaning to stop or to steady; - Period in a sterilization process during which items
treatment that inhibits growth and multiplication of are exposed to the sterilant at the specified
microorganisms. sterilization parameters.
- Fungistatic - inhibits mold
- Bacteriostat -Inhibits multiplication of 6. Microbial characteristics
bacteria. - texture, transparency, and color or pigmentation.
3. Pasteurization
- It uses a high temperature for a short time (720C
Dry Heat Sterilization for 15 seconds) to destroy the pathogens without
altering the flavor of the food.
- This is applicable for substances unaffected at a
temperature of 1480C to 2600C in the oven, at an
exposure time of 45 minutes.
- This method kills spores, as well as vegetative
forms of microorganisms.
- This method is ideal for sterilizing glasswares,
metalwares, and anhydrous oils.
- The principle of sterilization involved is the
oxidation of microorganisms by heat.
2. Inspissation
- It is a fractional method of sterilization at 60
Moist Heat Sterilization
degrees Celsius in an oven, alternated with
intervals at room temperature or incubation for 2
- This is more effective than the dry heat method. to 3 days.
- The principle of sterilization is the coagulation of
the cell protein of the microorganism. 3. Filtration
- The passage of liquid or gas through a filter with
1. Autoclaving (steam under pressure) pores enough to retain microbes.
- It is the most effective method of moist heat - Microbes can be removed from air by high
sterilization. efficiency particulate air filters.
- It can destroy the spore formers. - Membrane filters composed of nitrocellulose or
- The temperature used is 121 C with a pressure of cellulose acetate are commonly used to filter out
15 psi for 15-30 minutes exposure. bacteria, viruses and even large proteins.
- Example: HEPA FILTER - can reduce the amount
of airborne allergens.
4. Cold
- The effectiveness of low temperatures depends on
the microorganisms and the intensity of the
application.
- Microorganisms do not reproduce at ordinary
refrigerator temperatures (00 to 70C)
- Many microbes survive (but do not grow) at the
subzero temperatures used to store food.
5. Desiccation
- In the absence of water, microorganisms cannot
grow but can remain viable.
2. Boiling
- Viruses and endospores can resist decolorization.
- Boiling point of water is 1000 C. At this
temperature, vegetative pathogens, viruses, some
6. Osmotic pressure
- Microorganisms in high concentrations of salts Evaluating a Disinfectant
and sugars undergo plasmolysis.
- Molds and yeasts are more capable of growing in In the use-dilution test, bacterial (S.choleraesuß, S.
materials with low moisture or high osmotic aureus, and P. aeruginosa) survival in the
pressure than bacteria are. manufacturer's recommended dilution of a disinfectant is
determined. In the filter paper method, a disk of filter paper
7. Radiation is soaked with a chemical and placed on an inoculated
- Use of short wavelength, high-intensity radiation to agar plate; a clear zone of inhibition indicates
destroy microorganisms. This radiation can come effectiveness.
in the form of gamma or X-rays that react with
DNA resulting in a damaged cell. Non-ionizing
radiation uses longer wavelengths and lower
energy.
Types of Radiation
4. Alcohols
Chemical Methods of Microbial Control - Alcohols exert their action by denaturing proteins
and dissolving lipids.
- In tinctures, they enhance the effectiveness of
Principles of Effective Disinfection
other antimicrobial chemicals.
- Aqueous ethanol (60% to 90%) and isopropanol
The presence of organic matter, degree of contact with
microorganisms, and temperature should be considered. are used as disinfectants.
6. Surface-Active Agents
- Surface-active agents decrease the tension
between molecules that lie on the surface of a
liquid; soaps and detergents are examples. Two types of medication in selective toxicity:
- Soaps have limited germicidal action but assist in 1. Healthy Human Cells
the removal of microorganisms through scrubbing. 2. Mutated Cells
- Acid-anionic detergents are used to clean dairy
Chemotherapy: The use of drugs to treat a disease/
equipment. microorganisms
- Broad term for drugs that can kill a specific type of
7. Quaternary Ammonium Compounds cell
- Quats are cationic detergents attached to NH4+. - A form of antimicrobial drug
By disrupting plasma membranes, they allow Chemotherapeutic agents: Include chemicals that
cytoplasmic constituents to leak out of the cell. combat disease in the body.
They are most effective against gram-positive
Antineoplastic agents - Anticancer medication
bacteria. - Targets cancer cells without killing healthy cells
Paul Ehrlich developed the concept of chemotherapy to Sulfanilamide - Derived from a dye
treat microbial diseases.
- First commercially available antimicrobial drug
- Father of Chemotherapy
- One of the few scientists that wanted to find a - Marketed Sulfanilamide as (Prontosil)
treatment for treponema pallidum infection - One of the first medications to arrive in the
(Syphilis) that can affect your genitals and even philippines
the CNS (Neurosyphilis). - Not an antibiotic
- Tried 606 Compounds for syphilis
- Compound 606 (Salvarsan) an arsenic
compound capable of killing treponema pallidum
without killing healthy cells
- Compound 606 (Salvarsan) is the first selective The History of Chemotherapy
toxicity drug.
- Also known as Arsphenamine or Magic Bullet Alexander Fleming discovered the first
antibiotic,penicillin,in 1928; its first clinical traits were done
Compound 606 (Salvarsan) - contains harmful in 1940.
metalloids that can produce adverse drug reaction which - Accidentally discovers penicillin while creating
is no 100% safe culture media
- Stepping stone for future selective toxicity drug - Penicillin came from penicillium notatum or the
- Proved that selective toxicity is possible mold in his culture media
- It is not an antibiotic (synthesized in a lab) - Was about to discard the culture sample but was
helped by two scientist to create the treatment
Action of Antimicrobials
Antitubercular Drugs
Isoniazid (INH) and ethambutol inhibit cell wall synthesis
in mycobacteria by interfering with mycolic acid synthesis
or incorporation.
Lipopeptides
Rifamycin
Inhibits mRNA synthesis; it's used to treat
Inhibitors of Cell Wall Synthesis tuberculosis.
- First treatment for TB
Cephalosporins - Inhibit cell wall synthesis and - Antibiotic
are used against penicillin resistant strains.
- Derived from Streptomyces griseus
2nd,3rd and 4th generations are more effective - Discovered by Selman Waksman
against gram-negative bacteria.
R I P E S (Rifampicin, Isoniazid, Pyrazinamide,
Polypeptide - Such as Bacitracin inhibit cell wall Ethambutol, Streptomycin) - effective cure for TB
synthesis primarily in gram-positive bacteria.
Antimetabolites
Sulfonamides
Competitively inhibit the synthesis of essential
metabolites such as folic acid.
Inhibit uncoating:
ANTIFUNGAL DRUGS • Amantadine (tx of influenza)
- Pathogenic fungi are often outside the body. Nucleoside and nucleotide analogs, such as acyclovir
and zidovudine, inhibit DNA or RNA synthesis.
- Fungi are eukaryotes and have unique sterols
(ergosterol) in their cell walls.
ANTIPROTOZOAL DRUGS
ANTHELMINTIC DRUGS
Serial Dilutionp
KIRBY-BAUER TEST
Antimicrobial Concerns
After incubation, the diameter of the zone of inhibition is RESISTANCE TO ANTIMICROBIAL DRUGS
used to determine whether the organism is sensitive,
intermediate, or resistant to the drug. - Many bacterial diseases, previously treatable with
antibiotics, have become resistant to antibiotics.
Antimicrobial Resistance
• Relative or complete lack of effect of antimicrobial
against a previously susceptible microbe
• Increase in MIC
Superbugs are bacteria that are resistant to several
antibiotics.
Combination
Additive: 1 + 1 = 2
Synergistic: 1 + 1 = 3
Antagonistic 1 + 1 = 0
Potentiation 1 + 0 = 2
ANTIBIOTIC SAFETY
The risk (e.g., side effects) versus the benefit (e.g., curing UNIT VII: Principles of Disease and Epidemiology
an infection) must be evaluated before antibiotics are used
- Stomach is highly acidic (pH 2-3) and kills most - An organism existing in an area on or in the host
microbes. fills the area and thus serves to prevent the filling
- Some bacteria and yeasts can tolerate passage of the same area by a harmful bacterium.
through stomach; few microorganisms live in - Normal microbiota can benefit the host by
stomach. preventing overgrowth of harmful microorganisms.
- other words, the good bacteria help defend
- Small intestine has some bacteria, but does not against the bad bacteria.
proliferate due to digestive enzymes.
- As it approach colon, more and more bacteria can Resident microbiota
be seen, especially Gram-negative Resident microflora are the more-or-less permanent
- Enterobacter (e.g. Escherichia coli). aColon has members of normal microflora.
an enormous bacterial population (1/3 of feces is
bacteria). Transient microbiota
- Bacteria in colon divide every 12-24 hours on Transient microflora are present only under unusual
average, much slower than laboratory batch circumstances and only transiently present (hours to
culture rates. months).
Genitourinary tract
Opportunistic microorganisms
- Upper urinary tract is usually sterile. Opportunists are members of the normal microflora that do
- Lower part of the urethra gets some bacteria, but not usually cause disease but can be pathogenic under
is frequently "washed out" by urinary flow. certain circumstances like:
- When washout is reduced, more chances of ● Host immunosuppression
urinary tract infections. ● Transfer to other parts of the body
- Vagina has complex microbiota. After women start ● Elimination of microbial antagonism
periods, glycogen is secreted, and lactic acid
bacteria produce lactic acid, maintaining pH 4.5.
Events of Infection
Size of Inoculum
Number of cells that enter through the portal of entry aID
(Infectious Dose): minimum number of cells required to
cause infection. Some organisms require 100's of cells to
cause infection while others require as few as 10.
Predisposing Factors
One that makes the body more susceptible to a disease Incubation period
and may alter the course of the disease. c] Gender - Time interval between the initial infection and the
aClimate and weather aOthers include nutrition, age, first appearance of any signs or symptoms.
fatigue, etc. - The time an infection has begun up to the
occurrence of signs and symptoms.
Endotoxin
Koch’s Postulates
The means, or logic, by which a specific Common Infectious Diseases and Causative
microorganism is classified as the cause of a Microorganisms in the Nervous System
disease.
Definitions:
- Immune System = cells, tissues, and molecules
that mediate resistance to infections.
- Immunology = study of structure and function of
the immune system.
- Immunity = resistance of a host to pathogens and
their toxic effects.
- Immune response = collective and coordinated
response to the introduction of foreign substances
in an individual mediated by the cells and
molecules of the immune system.
Immune System
1. Organs
2. Cells
3. Molecules
Immune System:
(1) organs Innate Immunity: Mechanisms
- Mechanical barriers/surface secretion
- Skin, acidic pH in stomach, cilia
- Humoral Mechanisms
- Lysozymes, basic proteins, complement,
interferons.
- Cellular defense mechanisms
- Natural killer cells, neutrophils, macrophages,
mast cells, basophils, eosinophils.
Immune System:
(2) cells
- Lymphocytes
- T-lymphocytes
- B-lymphocytes, plasma cells
- Natural killer lymphocytes
- Monocytes, Macrophage
- Granulocytes
- Neutrophils
- Eosinophils
- Basophils
Immune System:
(3) molecules
- Antibodies
- Complement
- Cytokines
- Interleukins
- Interferons
Innate Immunity:
First line of defense
- Based on genetic make-up
- Relies on already formed components
- Rapid response: within minutes of infection Adaptive Immunity:
- Non-specific Second line of response
- Same molecules/cells respond to a range of - Based upon resistance acquired throughout life
pathogens - Relies on genetic events and cellular growth
- Has no memory - Responds more slowly, over few days
- Same response after repeated exposure. - Is specific
- Does not lead to clonal expansion. - Each cell responds to a single epitope on an
antigen
- Has anamnestic memory
- Repeated exposure leads to faster, stronger
response.
Adaptive Immunity:
Mechanisms
- Cell mediated immune response (CMIR) 1. T-cell
- T-lymphocytes - Recognizes peptide antigen on
- Eliminate intracellular microbes that survive macrophage in association with major
within phagocytes or other infected cells histo-compatibility complex (MHC) class
- Humoral Immune Response (HIR) - Identifies molecules on cell surfaces.
- B-lymphocytes - Helps body distinguish non-self materials
- Mediated by antibodies 2. T-cell goes into effectors cells stage that is able to
- Eliminate extra-cellular microbes and their toxins kill infected kills.
Antibodies (immunoglobulins)
- Belong to the gamma-globulin fraction of serum lgG
proteins • 70-75% of total immunoglobulin
- Y-shaped or T-shaped polypeptides • Secreted in high quantities in secondary
- 2 identical heavy chains exposures
- 2 identical light chains • Cross the placenta
- Five kinds of antibodies • Major functions /
- lgG, lgM, lgA, lgD, lgE applications
• neutralize microbes and
toxins
• opsonize antigens for phagocytosis
activate the complement
• protect the newborn
• participate in agglutination and precipitation reactions
lgM
• Secreted initially during primary infection
• Major functions / applications
• secreted first during primary exposure
• activates the complement
• used as a marker of recent infection
Immunoglobulin
lgA
• Monomeric in serum (lgA1)
• Dimeric with secretory component in the lumen of the
gastro-intestinal tract and in the respiratory tract (lgA2)
• Major function / application
• neutralizes microbes and toxins
•Sero-diagnosis of tuberculosis
lgM - lgG sequential response
•Synthicial respiratory virus tests
lgD
• Monomeric
• Extremely scarce (<0.2% of total immunoglobulin)
• Major functions / applications
• present on the surface of B lymphocytes
• functions as membrane receptor
• role unclear
• has a role in antigen stimulated lymphocyte
differentiation
lgE
• Mediates type I hypersensitivity
• Monomeric
• Major functions / applications Immunoglobulin
• associated with anaphylaxis
• plays a role in immunity to helminthic parasites
Antigen
A substance that reacts with antibody molecules and
antigen receptors on lymphocytes
Immunogen
An antigen that recognized by the body as non-self and
stimulates and adaptive immune response
Immunodeficiency
Immune response helps individuals defend against: ● has an impaired function of immune system
Hypersensitivity reactions
• Type 1 -Anaphylaxis