MICROBIAL NUTRITION

• Terminologies
• Requirements for bacterial growth and
their role in microbial physiology
• Types of bacteria according to their
physiologic conditions
MICROBIAL NUTRITION
According to Oxygen
Types of Anaerobes
3. Microaerophile
According to Carbon Dioxide
PHYSIOLOGIC REQUIREMENTS OF
BACTERIA
• According to Nutritional Requirement
1. As to the carbon
PHYSIOLOGIC REQUIREMENTS OF
BACTERIA

• According to Temperature
PHYSIOLOGIC REQUIREMENTS OF
BACTERIA
 TERMINOLOGIES

1. Thermal death time

REQUIREMENTS FOR MICROBIAL
GROWTH

According to pH
REQUIREMENTS FOR MICROBIAL
GROWTH

According to Moisture
REQUIREMENTS FOR MICROBIAL
GROWTH

According to Pressure
PATHOGENESIS
 PATHOGENESIS OF INFECTION

• Terminologies
• Types and routes of infections
• Classifications of diseases
• Host resistance factors vs. infectious agent factors
• Phases of infectious diseases
• True pathogens vs. opportunistic pathogens
• Virulence factors with the bacteria causing diseases and infections
• Epidemiologic steps of an outbreak investigation
 PATHOGENESIS

Pathogenesis is the development of an infection

and disease. Certain virulent agents with
mechanisms of resistance against the host
protective factors are involved in the proliferation
of microorganisms and the progress of diseases.
 INFECTION

• It involves the growth and multiplication of microorganisms that

cause damage to their host
• It is the bodily invasion of pathogenic microorganisms that reproduce,
multiply, and cause diseases through local cellular injury, toxin
secretion, or antigen-antibody reaction in the host
 TYPES OF INFECTIONS

According to Cause
1. Autogenous Infection
• It is caused by a microorganism from the microbiota of the host
2. Iatrogenic Infection
• It is an infection that occurs as a result of a medical treatment or
procedure
 TYPES OF INFECTION
3. Opportunistic Infection
• It is an infection that affects immunocompromised hosts but not the healthy individuals
• The overuse of antibiotics, immunosuppressive drugs, and chemotherapeutic agents may
cause this infection

4. Nosocomial Infection
• It is also known as the hospital-acquired infection
• It is a type of infection that is acquired in a healthcare facility
• Handwashing is still the cornerstone of modern infection control programs
• Common examples: urinary tract infection (UTI), lung infection (pneumonia), surgical
site infection and bloodstream infection
 P R E D I S P O S I N G FA C T O R S T O N O S O C O M I A L I N F E C T I O N S

A. Wide variety of microbes in the hospital environment

B. Weakened or immunocompromised patients
C. Chain of transmission (direct or indirect)
• from health workers to patient
• from patient to patient
• vector-borne transmission
• airborne transmission - inhalation of droplets ≤ 5 μm
(tuberculosis) or inhalation of droplets > 5 μm (pertussis)
• use of fomites (catheters, needles, dressings, beds, and
wheelchairs)
 ACCORDING TO SETTINGS

1. Acute Care
A. Surgical-Site Infection (SSI)
• Infection of a site where a surgical procedure was performed; usually risk is stratified by length of surgery, site of
infection, and degree of anticipated contamination

B. Central Line-Associated Bloodstream Infection (CLABSI)

• bloodstream infection related to the presence of an intravascular device such as a central venous catheter

C. Catheter-Associated Urinary Tract Infection (CAUTI)

• infection of the urinary tract, frequently associated with a urinary catheter

2. Community-Acquired Infection (CAI)

A. Health Care-Associated Infection (HAI)
B. Iatrogenic Infection
• HAIs and iatrogenic infections occur because of instrumentation, increased use of antimicrobial agents, breaks in
aseptic techniques, and lack of hand hygiene
 ACCORDING TO HOST DISTRIBUTION

1. Local Infection
• It means signs and symptoms are confined in one area
• Some examples are infected wounds, boils, and abscesses
2. Focal Infection
• It starts as a local infection before spreading to the other parts of the body
• Some examples are tooth infection, tonsillitis, appendicitis, and wound infections
caused by Clostridium tetani
3. Systemic Infection (Generalized Infection)
• It means the microbes spread throughout the body via blood or lymph (general
invasion)
KINDS OF SYSTEMIC INFECTIONS

A. Bacteremia
• It is the presence of bacteria in the blood
• The organisms invade the bloodstream without active
multiplication
• The highest concentration of bacteria in the blood occurs
before the fever spikes
BACTEREMIA AS TO SOURCE/ORIGIN

Primary Bacteremia
• It occurs when bacteria are present in an endovascular source, such as
an infected cardiac valve or an infected intravenous catheter

Secondary Bacteremia
• It happens when bacteria arise from an infected extravascular source,
such as the lungs in patients with pneumonia
 BACTEREMIA AS TO DURATION

Transient Bacteremia
• It occurs when bacteria enter the bloodstream for a brief period following a dental or
medical procedure; and subsequently the organisms ar immediately cleared by the host
immune system specifically reticuloendothelial system without presenting any serious
symptoms
Intermittent Bacteremia
• It is characterized by the presence of infections, such as abscess in any part of the body, or
certain clinical manifestation, such as meningococcemia, gonococcemia, or pneumonia,
resulting in periodic released of the microorganisms from the primary site of infection into
the blood
Continuous Bacteremia
• It is the consistent presence of bacteria in the blood, originating from an intravascular and
 KINDS OF SYSTEMIC INFECTIONS

B. Septicemia
• It is the active multiplication of the invading bacteria in the blood
• Examples of Biomarkers for Sepsis: CRP, D-dimer, LPS-binding protein, procalcitonin,
lactate, neutrophil gelatinase-associated lipocalin, copeptin, and endocan
C. Pyemia
• It is a condition wherein pus-producing organisms repeatedly invade the bloodstream
and become localized at different parts of the body
D. Toxemia
• It is the presence of toxins in the blood
• Bacteria are localized in one area, but they produce a toxin that spreads and gets
absorbed by the body cells.
 EXTENT OF INFECTION
1. Primary Infection
• It is the initial infection that causes the illness
• An example is the common cold

2. Secondary Infection
• It is caused by opportunistic pathogens after the primary infection has weakened the host’s
immune system
• Some examples are pneumonia and bronchitis that may develop from a common cold

3. Latent Infection (Silent Phase)

• It is clinically silent inside the body and causes no noticeable illnesses in the host. Then, a severe
and acute infection manifests
 EXTENT OF INFECTION
4. Mixed Infection
• It is caused by two or more organisms
• An example is a wound infection

5. Acute Infection
• It is a type of infection that develops rapidly and usually with a short duration
• An example is a whooping cough

6. Chronic Infection
• It is an infection which progresses slowly from weeks to a period of years
 ROUTES OF INFECTION

1. Direct Transmission
• Congenital: Streptococcus agalactiae, Neisseria gonorrhoeae, and Treponema pallidum
subsp. Palladium
• Sexual contact: N. gonorrhoeae, T. pallidum subsp. Pallidum, and Chlamydia trachomatis
• Infectious respiratory secretions or droplets: Streptococcus pyogenes and Neisseria
meningitidis
• Hand-to-hand transmission: Rhinovirus

2. Indirect Transmission
• Fomites: Bed and wheelchair
• Water: Salmonella, Shigella, and Vibrio
• Require arthropod vectors: Borrelia, Francisella, and Yersinia
 CLASSIFICATION OF INFECTIOUS DISEASE

1. Communicable or Contagious Disease

• It spreads from one host to another, either directly or indirectly
• Examples: Tuberculosis, herpes, flue, and chickenpox

2. Non-communicable Disease
• It does not spread from one host to another
• It is caused by external microbes (true pathogens) or by opportunistic
pathogens living inside the body
• Example: Tetanus and botulism (both caused by true pathogens)
 CLASSIFICATION OF DISEASE
(ACCORDING TO OCCURRENCE)

1. Sporadic Disease - occurs occasionally

2. Endemic Disease - is constantly present in a particular
location or population
3. Epidemic Disease - it affects a large number of people
in a given population within a short span of time
4. Pandemic Disease - it affects populations across large
countries and continents globally
 EFFECTS OF INFECTIOUS DISEASE

1. Signs
• These are objective changes that can be measured
• Examples: Fever, redness, swelling and paralysis
2. Symptoms
• These are subjective indications of a disease
• Examples: Pain and malaise
3. Syndrome
• It is a group of signs and symptoms that are associated with a disease
 PHASES OF INFECTIOUS DISEASES

1. Incubation Period
• It is the time between the exposure to a pathogenic organism and the onset of
symptoms
2. Prodromal Period
• It is the appearance of the signs and symptoms
3. Clinical or Illness Period
• It is the period in which the signs and symptoms begin to subside as the host’s
condition improves
4. Decline Period
• It is the period in which the surviving host is recuperating towards full recovery
 STRATEGIES FOR PREVENTING INFECTIOUS DISEASES

1. Preventing Transmission
• Isolate sick persons
• Avoid direct contact with infected persons
• Wear personal protective equipment, like face mask and gloves
2. Controlling Microbial Reservoirs
• Sanitation and disinfection
• Food preservation
• Water and sewage treatment
• Vector and pest control
3. Minimizing Risk
• Vaccination
• Use of antiseptics
 CLASSIFICATION OF PATHOGENIC MICROORGANISMS

1. True Pathogens
• These organisms are able to invade the tissue of healthy individuals through some
inherent ability-causing various diseases
2. Opportunistic Pathogens
• These organisms normally do not cause diseases in their natural habitat
• They cause disease if the host is immunocompromised, if they enter a different
part of the body outside their habitats, or enter sterile sites such as the brain and the
blood vessels
Examples: Neisseria meningitidis and Escherichia coli
• Neisseria meningitidis is usually harmless in the respiratory tract but may still
cause meningitis to the host
 HOST-MICROBE RELATIONSHIP

1. Symbiosis - is the association of two organisms living in close

proximity
2. Mutualism - is a symbiotic relationship in which one organism
benefits from each other
3. Commensalism - is a relationship in which one organism benefits
while there is no beneficial or harmful effect to the other organism
4. Parasitism - is a relationship in which one organism (parasite)
benefits at the expense of its host
 TERMINOLOGIES
1. Biofilm Production
• It is a complex interaction among the host, indwelling device, and bacteria. It is a key
component in bacterial pathogenesis
• Examples of organisms capable of biofilm formation: S. aureus, K. pneumoniae, P.
aeruginosa, coagulase-negative staphylococci (CoNS), and Candida albicans (fungi)

2. Pathogenicity
• It pertains to the ability of a pathogenic agent to produce a disease in a susceptible individual

3. Pathogenicity Islands
• These are genomic regions found in pathogenic microorganisms where virulence factors are
encoded
 VIRULENCE

Virulence
• It is the ability of the microorganisms to cause diseases
• It is the degree of pathogenicity
• A very pathogenic microorganism or a rapidly progressive
condition is considered when there is a high virulence factor
• Organisms that can establish infection with a relatively low
infective dose are considered more virulent than those that require
high numbers for infection
 FACTORS INFLUENCING MICROBIAL
VIRULENCE
1. Toxic factors
• Toxins are substances produced by pathogenic microorganisms causing tissue and cellular damage
• Examples: Diphtheria toxin, tetanospasmin, botulism toxin, enterotoxin, and streptococcal
erythrogenic toxin

2. Enzymatic factors
• These are produced by bacteria that aid in the spread of infection and disease
• Examples: Hyaluronidase, coagulase, collagenase, streptokinase, hemolysin, and lecithinase

3. Cellular structure
• It provides an additional protection to the bacteria like the capsule which resists phagocytosis
• Examples of encapsulated bacteria: Bacillus anthracis, Klebsiella pneumoniae, and
Streptococcus pneumoniae
 HOST RESISTANCE FACTORS
1. Physical Barrier
• The skin serves as the physical and chemical barrier to microorganisms
• The cellular, outermost layer of the skin and the tightly packed cellular layers underneath provide
an impenetrable physical barrier to all microorganisms unless they are damaged
• Examples: Stricture at the urethral opening, the flushing action of urination, and the thick mucus
plug in the cervical opening

2. Cleansing Mechanism
• The nasal hairs keep out airborne particles that may contain microorganisms
• The “cough-sneeze” reflex contributes to the removal of potentially infectious agents
• The cells lining the trachea contain cilia (hair-like cellular projections) that move the trapped
mucus and microorganisms upward and away from the delicate cells of the lungs
•
 HOST RESISTANCE FACTORS

3. Indigenous Antimicrobial
• Some examples of these substances are lysozymes and bile salts
• Lysozymes destroy bacterial walls while bile salts disrupt bacterial membranes

4. Indigenous Microbiota (Microbial Flora)

• These microorganisms are commonly found on or in the body sites of healthy
persons.
• It is more accurate to refer to the population of microorganisms as “microbiota”
instead of “microbial flora” since the latter is a misnomer that originated from the
time when bacteria were still part of the plant kingdom
 TYPES OF MICROBIOTA

A. Resident Microbiota - temporarily inhabit, multiply

in, and colonize an area for months or years
B. Transient Microbiota - inhabit (but do not multiply)
and colonize an area until they are eliminated by either the
host’s inherent immune defense or competition with the
resident microbiota
 DIFFERENT BODY SITES AND THEIR MICROBIOTA

•A. Skin: Staphylococci, propionobacteria, cutibacteria, and corynebacteria

(diptheroids)
•B. Mouth and Oral Cavity: Viridans streptococci
•C. Upper Respiratory Tract: Viridans streptococci, diptheroids, and
Staphylococcus epidermidis
•D. Nasopharynx: S. aureus, S. epidermidis, and N. meningitidis (asymptomatic
carriers)
•E. Gastrointestinal Tract: E. coli, Bacteroides, Bifidobacterium, Clostridium,
Eubacterium, and anaerobic gram-positive cocci
•F. Urethra: S. epidermidis, diptheroids, and alpha-and non-hemolytic
 HOST RESISTANCE FACTORS
5. Phagocytosis
• It is the process by which certain cells called phagocytes engulf and dispose of microorganisms and cell
debris
• Phagocytes (polymorphonuclear leukocytes and macrophages) ingest and destroy bacteria and other
foreign particles through a process known as endocytosis
• Factors involved in Phagocytosis: Chemotaxis, attachment of the particle to the phagocyte, ingestion, and
killing of the invading organisms
6. Inflammation
• This condition serves as a reinforcement mechanism against microbial survival and proliferation in
tissues and organs
• Some signs that may indicate an inflammation are swelling, redness, burning sensation, and pain in the
affected area
• The components of inflammation are phagocytes, complement system, coagulation system, and cytokines
• Infections caused by anaerobes exhibit purulent appearance with many polymorphonuclear leukocytes
 HOST RESISTANCE FACTORS
7. Immune response
• It provides the human host with the ability to create a specific protective
responses against microorganisms
• The immune system “recalls” all of the encountered microorganisms so
that an immune-mediated defensive response is immediately available in
the second or third time that they come across
• The normal immune system removes the bacteria from the blood within
30 minutes to 45 minutes
• The host’s immune response may be reduced or altered due to
immunosuppresisive drugs, chemotherapy, or radiation
 TYPES OF SPECIFIC IMMUNITY

A. Humoral Immunity
• It is also known as the antibody-mediated immunity
• It is based on the action of soluble proteins called antibodies that occur in the
body fluids and on the plasma membrane of B-lymphocytes

B. Cellular Immunity
• It is also known as the cell-mediated immunity
• It is based on the action of a specific T-lymphocytes that directly attack the host
cells that are infected with viruses, parasites, and cancer cells. The T-lymphocytes
also target the transplanted cells
 TERMINOLOGIES

1. Active Immunization
• It is the protection of susceptible humans and domestic animals from communicable diseases through the
administration of vaccines (vaccination)
• For this type of immunization, vaccines may be prepared from living, weakened (attenuated), or killed
microorganisms, inactivated bacterial toxins (toxoids), purified macromolecules, recombinant vectors (modified
polio vaccine), or DNA vaccines
2. Acquired Active Immunity
• It is the specific response of the host to an invading organism
3. Anamnestic Response
• It is the ability of the B-lymphocytes to recall pathogens during the primary encounter leading to a higher
antibody response on the second encounter
4. Antigen
• It is a high-molecular weight substance that illicit antibody formation
• It is made up of carbohydrates (polysaccharides) or proteins.
• Antigens that are recognized as foreign substances by a host are said to be immunogenic, capable of eliciting an
immune response
 TERMINOLOGIES

5. Antigenic Drift
• It is a minor antigenic change as a result of mutation in the organism strains
• It facilitates the pathogen in avoiding host’s immune system
6. Antigenic Shift
• It is a major genetically determined change in the antigenic property of an organism in which it
becomes unrecognizable by the host’s immune system
7. Antibody
• It is a protein secreted by the plasma cells against an invading antigen or a pathogen
• Major regions: Fab region (antigen-binding site) and Fc region (phagocyte- and complement-
binding site)
• Examples of antibodies: IgG, IgA, IgM, IgD, IgE
8. Complement-fixing Antibodies
• These are antibodies that are attached to the surface of pathogens and kill the bacteria by lysis
 TERMINOLOGIES

9. Cytokines
• These are proteins produced by phagocytes, such as the macrophages and other
cells
• It helps in the stimulation of the immune system to respond against foreign
bodies such as an invading antigen (pathogen)
10. Heterophile Antibody
• It is a type of an antibody that is secreted in response to a molecule which also
reacts against an antigen from an unknown or unrelated source
11. Natural (Innate) Immunity
• It is a non-specific response that activates chemotaxis, or the process by which
phagocytes are directed to the site of replication and engulf the invading organism
 TERMINOLOGIES

12. Neutralizing Antibody

• This type of antibody is attached to the surface of microorganisms and block surface
receptors
13. Opsonizing Antibody
• It is a type of antibody that is attached to the surface of microorganisms and render
pathogens susceptible to phagocytosis
14. Passive Immunization
• It is a transient-type of immunization that is administered to individuals without
fully activating the person’s immune system for the mere purpose of producing the
corresponding antibodies to diseases
• Protection does not require the participation of the recipient’s immune system and
only lasts until the transferred antibodies remain in the recipient’s body.
 INFECTIOUS AGENT FACTORS

1. Adherence
• In order for a microorganism to cause diseases, it must penetrate the mucous layer and attach to the
epithelium
• The host cells must produce the necessary receptors for adhesion
• The main adhesins in the bacteria are the common pili (fimbriae) and surface polysaccharides
2. Proliferation
• In order to establish and cause a disease, a pathogen must multiply, following its attachment to host cells
• Secretory antibody, lactoferrin, and lysozyme inhibit proliferation, and these are produced by the host
• The evasion of phagocytosis is essential for most pathogens to survive and reproduce
3. Tissue damage
• It is a result of either a preformed toxin (Clostridium botulinum, Bacillus cereus, and Staphylococcus
aureus) or the disruption of the normal functioning of the intestinal cells (Escherichia coli, Vibrio
cholerae, Shigella, and Salmonella)
• A disease or an infection is noticeable only if tissue damage occurs
 INFECTIOUS AGENT FACTORS

4. Production of Toxins
A. Exotoxins
• They are mostly present in Gram-positive bacteria
• They are known to be one of the most lethal substances
• These toxins do not require bacterial death to be released into the circulation
• They do not produce fever to the host
• These are either secreted or excreted by living microorganisms
• Some examples are cytotoxins, neurotoxins, and enterotoxins
• Some bacteria that produce this kind of toxins are Clostridium botulinum,
Corynebacterium diphtheria, Staphylococcus aureus, and Streptococcus
pyogenes
 INFECTIOUS AGENT FACTORS

B. Endotoxins
• They are commonly found in Gram-negative bacteria
• They are composed of the lipopolysaccharide portion of the cell wall
• They are released when the bacteria die and their cell walls undergo lysis, which consequently
liberates the endotoxin
• This kind of toxin stimulates the fever center in the hypothalamus
• The toxicity is due to the lipid A portion of the lipopolysaccharide (LPS)
• The LPS may elicit fever, chills, hypotension, granulocytosis, thrombocytopenia, and
disseminated intravascular coagulation
• Endotoxic shock is a result of the Gram-negative septicemia
• The effects of this kind of toxin include change changes in the following: blood pressure,
clotting, body temperature, blood cell circulation, metabolism, humoral and cellular immunity
(activation of both the classic and alternate complement pathways), and resistance to infection
 INFECTIOUS AGENT FACTORS

In the development of fever, five (5) substances are essential:

A. Endotoxin
B. Peptidoglycan
C. Cytokines
D. Interleukin-1 and tissue necrosis factor
E. Acute phase reactants
 INFECTIOUS AGENT FACTORS

In the development of fever, five (5) substances are essential:

A. Endotoxin
B. Peptidoglycan
C. Cytokines
D. Interleukin-1 and tissue necrosis factor
E. Acute phase reactants
 INFECTIOUS AGENT FACTORS

5. Invasion
It is the process of penetrating and growing in tissues
With some organisms, the invasion involves only a few layers of cell
while others involve deep-tissue invasion

6. Dissemination
It is the spread of microorganisms to distant body sites
Certain organisms that survive phagocytosis may be disseminated
rapidly to several body sites.
 ROUTES OF TRANSMISSION

1. Airborne Transmission
• Respiratory spread of infectious disease is common
• Infections of the lower respiratory tract are less common but more serious than those of
the upper respiratory tract
• Secretions are aerosolized by coughing, sneezing, and talking
• Infectious diseases, such as tuberculosis, brucellosis, tularemia, legionellosis, and
plague, may be acquired through inhalation of infectious particles in a liquid droplet
• Droplet nuclei are the small residues from larger droplets and are light enough to
remain airborne for long periods. Some infectious agents may be transmitted by dust
particles that have become airborne
• Other examples of illnesses that can be transmitted in the air are streptococcal sore
throat, sinusitis, acute epiglottis, and diptheria
 ROUTES OF TRANSMISSION

2. Transmission by Food and Water

• Infections occur via the fecal-oral route
• Gastric enzymes and juices in the stomach prevent the survival of most organisms
• Examples of pathogens related to waterborne infections are Salmonella, Campylobacter,
yersinia enterocolitica, Pseudomonas, E. Coli 0157:H7, Legionella, and Aeromomas
3. Close Contact
• It refers to the passage of organism through salivary (herpes simplex), skin (warts,
syphilis), and genital contact (gonorrhea,syphilis, hepatitis)
4. Cuts and Bites
• Cuts and bites cause spread of infection and may progress to debilitating diseases
• Pathogenic staphylococci gain entry through skin cuts and abrasions causing life-
threatening sickness
 ROUTES OF TRANSMISSION

5. Arthropods
• The infectious agents multiply within the arthropod which transmits the microorganisms
while feeding off of a human host
• Diseases like plague and tularemia are passed by arthropod vectors to susceptible host
• Examples of bacteria transmitted by vectors: Yersinia pestis, Francisella tularensis,
Borrelia, Orientia, and Rickettsia
6. Zoonoses
• These are animal-related diseases that depend on the contact with animals or animal by-
product for transmission
• Diseases may be passed through contact with animal secretions (animal bites or scratches,
Pasteurella and Bartonella henselae) and animal carcasses and by-products (aerosolized,
brucellosis and Q fever) or by ingestion of unpasteurized animal products like milk and dairy
(brucellosis)
 ROUTES OF TRANSMISSION

5. Arthropods
• The infectious agents multiply within the arthropod which transmits the microorganisms
while feeding off of a human host
• Diseases like plague and tularemia are passed by arthropod vectors to susceptible host
• Examples of bacteria transmitted by vectors: Yersinia pestis, Francisella tularensis,
Borrelia, Orientia, and Rickettsia
6. Zoonoses
• These are animal-related diseases that depend on the contact with animals or animal by-
product for transmission
• Diseases may be passed through contact with animal secretions (animal bites or scratches,
Pasteurella and Bartonella henselae) and animal carcasses and by-products (aerosolized,
brucellosis and Q fever) or by ingestion of unpasteurized animal products like milk and dairy
(brucellosis)
 CARRIER

• It is a person or animal that harbors and spreads a

microorganism that causes a disease or infection but
does not become ill
 TYPES OF CARRIERS

A. Casual/acute/transient carrier - harbors the microorganism

temporarily for a few days or weeks
B. Chronic carrier - remains infected for a relatively long time,
sometimes throughout its entire life
C. Convalescent carrier - is an individual who has recovered from an
infection or a disease but continue to harbor a large number of the
pathogen
D. Active carrier - is an individual who has an overt clinical case of the
disease and is capable to transfer it with or without showing any signs
and symptoms of the sickness
 FACTORS CONTRIBUTING TO EPIDEMIOLOGY

1. Antibiograms
• It is the pattern of susceptibility and resistance of certain bacteria to antimicrobial
agents essential in the monitoring and progress of therapy
2. Infection Rate
• It is the frequency of an infectious disease within a specified population
3. Incidence Rate
• It is the number of times a new event occurs in a given period
4. Likelihood of Becoming Endemic
• The organisms or diseases are indigenous to and/or constantly present in a
geographic area or population
 FACTORS CONTRIBUTING TO EPIDEMIOLOGY

5. Likelihood of Becoming Epidemic

• A disease is considered as epidemic if it affects a significantly large number of people in a
short period of time in geographic area
• The influenza is a classic cause of an epidemic
6. Likelihood of Becoming Epidemic
• A disease is considered pandemic if it affects huge populations across large regions like
several countries or a continent
7. Morbidity Rate
• It is the number of cases of a disease in a specified population during a defined time interval
• It is a measure of the infectiousness of an organism
8. Mortality Rate
 FACTORS CONTRIBUTING TO EPIDEMIOLOGY

9. Outbreak
• It is the sudden increase in the number of rare microorganisms or the occurrence of a
disease
10. Reservoir
• It is the source of an infection, which may be a person, animal, or any object from the
environment
11. Prevalence Rate
• It refers to the number of persons or cases in a population infected with a particular
disease
12. Surveillance
• It is a systematic collection of the data and the analysis and interpretation of the details
 MOLECULAR EPIDEMIOLOGY

• It is the study of the occurrence of genetically-related

infections and diseases
• It utilizes molecular science to identify, locate, and
characterize the etiology or microorganisms, likewise to
generate specific markers to determine the outcome of
the situation in any given community
 OBJECTIVES OF AN OUTBREAK INVESTIGATION

1. To identify the causal agent

2. To determine the mode of transmission
3. To establish contact tracing specifically on the carriers
4. To account for the population at risk
5. To establish the risk factors
 EPIDEMIOLOGIC STEPS OF AN OUTBREAK INVESTIGATION

1. Prepare for field work

2. Establish the existence of an outbreak
3. Verify the diagnosis
4. Construct a working case definition
5. Find cases systematically and record information
6. Perform descriptive epidemiology
7. Develop hypotheses
 EPIDEMIOLOGIC STEPS OF AN OUTBREAK INVESTIGATION

8. Evaluate hypotheses epidemiologically

9. As necessary, reconsider, refine, and re-evaluate
hypotheses
10. Compare and reconcile with laboratory and/or
environmental studies
11. Implement control and prevention measures
12. Initiate or maintain surveillance
 SOURCES

Tille, Patricia M. Bailey and Scott’s Diagnostic Microbiology. 14th ed.

2017.
https://www.who.int/hac/techguidance/training/outbreak
https://www.cdc.gov
THANK YOU!