INTERNATIONAL SCHOOL OF NURSING AND MIDWIFERY

MICROBIOLOGY
Course outline
1. Concepts of microbiology
2. Classification and types of microorganism
3. Normal flora
4. Characteristics and mode of spread of disease causing microorganisms
5. Pathological effects of microorganisms
6. Simple laboratory tests
7. Infection prevention and control
8. Introduction to immunity
9. Antibodies
10. Principles of immunization

COURSE CONTENT SUMMARY

CONCEPTS OF MICROBIOLOGY
By the end of this topic learners should be able to;
1. Define the term microbiology
2. Explain the key personalities to microbiology
3. Outline the branches of microbiology
4. Explain the importance/ scope of microbiology
5. Outline key areas where microbiology may be applied
6. Outline the qualities of a good specimen
7. Outline the different specimens that are commonly collected in laboratories and the tools
used in specimen collection
8. Describe the procedure for specimen collection, specimen handling and specimen
transportation
9. Describe the common simple laboratory tests done in the laboratory
CLASSIFICATION AND TYPES OF MICROORGANISM
By the end of this session learners should be able to;
1. Give the different classes of microorganisms
2. Differentiate between Prokaryotes and Eukaryotes
3. Describe the structure of bacteria
4. Describe the ways of classifying bacteria
5. Explain the bacterial growth curve
6. Describe bacterial reproduction
7. Describe the medically important genera of bacteria

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NORMAL FLORA
By the end of this presentation learners should be able to;
1. Define a Normal flora
2. Explain the mechanisms of normal flora (How they work)
3. How do normal flora prevent colonization of potential pathogens?
4. With examples describe the location of normal floras (natural habitat)
5. Characteristics and mode of spread of disease causing microorganisms
6. Pathological effects of microorganisms
INFECTION PREVENTION AND CONTROL (IPC)
By the end of this session learners should be able to;
1. Define infection
2. Describe of distribution of microorganisms in a host
3. Describe the stages of infection
4. Describe the routes of transmission of infections in the community
5. Define infection control
6. Components of infection control
7. Describe the principles of infection prevention and control
8. Ways of preventing cross infection
9. Describe the management of health care waste
10. Describe the levels of disease prevention and control
11. Describe the procedure for decontamination
12. Describe the procedure for sterilization
INTRODUCTION TO IMMUNITY
By the end of this presentation learners should be able to;
1. Define immunity
2. Define immunology
3. Describe the types of body defense mechanisms
4. Explain the different types of immunity
5. Describe the elements of natural immunity
6. Antibodies
PRINCIPLES OF IMMUNIZATION
By the end of this presentation learners should be able to;
1. Define immunization
2. Define vaccination
3. Explain the principle of immunization
4. Explain the types of immunization
5. Outline the indications for immunization

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 6. Define vaccines
7. Account for the different types of vaccines giving examples in each type.
VIROLOGY
By the end of this session learners should be able to;
1. Define viruses
2. Define virology
3. Describe the structure of a virion
4. Outline the characteristics of viruses
5. With examples outline the classes of viruses
6. Describe the mode of transmission of viruses (viral infections)
7. Explain the ways of preventing viral infections
8. Explain viral reproduction/ viral replication
9. Explain the different DNA viruses
10. Explain the different RNA viruses
PARASITOLOGY
By the end of this session participants should be able to;
1. Define a parasite, obligate parasite, host, definitive host, intermediate host, reservoir host,
vector, and zoonosis
2. Outline the zoonotic diseases
3. Define parasitology
4. Outline the common parasites and their infective stages with the disease they cause
5. Describe the classification of parasites
MYCOLOGY
By the end of this session learners should be able to;
1. Define a fungi
2. Outline the uses of fungi
3. Describe the classification of fungi
4. Fungal spread/ distribution in the human body
5. Describe the systemic mycoses

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 COURSE CONTENT DETAILED
CONCEPTS OF MICROBIOLOGY
By the end of this topic learners should be able to;
Define the term microbiology
 Is the study of small living organisms (microorganisms) that can’t be seen with naked
eyes except by use of a microscope. OR
 Is the study of living organisms of microscopic size (Louis Pasteur) OR
 It is a science that deals with the causative agents of infectious diseases called microbes
Explain the key personalities to microbiology and history of microbiology
 Microbiology was started with adventure of a microscope by Jansen in 1609.
 The key personalities to microbiology include;
1. Louis Pasteur (1822 – 1895):Father of microbiology;
His key contributions to microbiology were;
 He generated strong evidence to show that microorganisms did exist.
 Showed that microorganisms were maximum in duster air of towns and
minimum in air of hilly areas where human settlement or habitation did
not exist.
 He developed principles and practice of sterilization. Stated that
microorganisms are inactivated;
1) Boiling at 120 degrees cellicius under pressure by Autoclaving.
2) Boiling at 170 degrees cellicius in hot air oven
 He introduced the practice of protecting wounds from airborne microbes
by;
1) Applying antiseptics
2) Dressing
3) Medical practitioners washing their hands with antiseptic solution
before touching patients
 He developed vaccines against chicken pox, cholera and anthrax by using
attenuated suspension of bacteria which was later referred to as
vaccination.
 Controlled diseases of silk worms
 He discovered pastueralisation which is a method of processing beverages
especially milk by controlled heating
2. Robert Koch ( ):Father of bacteriology
His key contributions were;
 Verification of germ theory of disease
 Introduced staining technique for visualization of microorganisms
 Discovery and use of solid medium in bacteriology
 Discovered the causative agents of;
 Koch’s pastulates;

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 He stated that organisms can be accepted as causative agents of disease if
they satisfy the following;
1) The isolate should be found in every case of the disease and under
the conditions which explain the pathological changes and clinical
features.
2) It should be possible to isolate the causative agent in pure culture
from the leision.
3) When pure culture is inoculated into appropriate laboratory animal,
the leision of the disease should be reproduced.
4) It should be possible to reisolate the causative agent in a pure
culture from the leision produced in the experimental animal.
 Exception of Koch’s postulate;
a) Inability to grow trepanemapallidum (cause of syphilis) and
mycobacterium leper (cause of leprosy) on artificial media.
b) Inbility to grow mny viruses and rickettsialpthogens on artificial
media.
Other personalities of importance
3. Antony van leeuwenhoek (1632-1723);- Designed a single lens microscope and
demonstrated a little agents of disease that he called animalecule.
4. Joseph Lister ( 1827-1912);- Discovered that airborne microbes can cause sepsis
in wounds
5. Lord lister (1854);-Used carbolic acid spray on wound during operation. He is
also called the father of antiseptic surgery
6. Hansen (1874);- Described leprosy bacillus
7. Neisser (1879);- Described gonococcus
8. Ogston (1881);- Discovered staphylococcus
9. Loeffler (1884);- Isolated diphtheria bacillus
10. Nicolaier (1884);- Observed tetanus bacillus in soil
11. Frankel (1886);- Described pneumococcus
12. Schoudian and Hoffman;- Discovered the spirochetes of syphilis
13. Roux and Yersin (1888);- Described the mechanism of pathogenesis and
discovered Diphtheria toxin.
14. Loeffler and Frosch (1898);- Observed that foot and mouth disease of cattle was
caused by a microbe-Filter passing virus
15. Walter Reed (1902);- Observed that yellow fever was caused by filterable virus
and that it was transmitted through bite of mosquitoes.
16. Landsteiner and Popper (1909);- Showed that poliomyelitis was caused by
filterable virus
17. Towert (1951) and Herelle (1917);-Discovered lytic phenomenon in bacterial
culture which was later termed as bacteriophage (viruses attack bacteria)
18. Alexander Flaming (1925);- Made accidental discovery that fungus penicilinium
produces a substance that destroys staphylococcus hence discovery of penicillin.

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 19. Ruska (1934); - Introduced electronic microscope and hence detailed study of
morphology of viruses was possible.
20. Burmet (1967); - Introduced the concept of immunological surveillance.
Outline the branches of microbiology
 There are five (5) branches of microbiology;
1. Medical microbiology
2. Industrial microbiology
3. Food microbiology
4. Soil microbiology
5. Plant microbiology
Explain the importance/ scope of microbiology
 The following are the importance of microbiology;
1. It is used in diagnosis of disease. It helps in isolation and identification of
causative organism from the pathological lesions.
2. It is used in prognosis of disease. The titers of microorganisms can be used to
determine the effectiveness of treatment or ineffective treatment as well.
3. It gives guidance on treatment. By culturing of organisms in pure form and
performing drug sensitivity testing helps in suggesting the effective drug for
treatment of a particular infection.
4. Determining the source of infection. Laboratory tests can be useful in detecting
outbreaks, epidemics, etc.
5. Helps in detecting new pathogens and emerging diseases
6. It is used in monitoring of response to treatment e.g. Post BS test, TB sputum
analysis at 2, 5, and 6 months, etc.
7. Helps in detecting asymptomatic infections or chronic carrierse.g. COVID 19,
HIV, etc.
8. It is used to monitor the quality of air, water and food.
9. Used in development of newer regimens/ treatment schedules
10. Helps in giving distinction between recent and past infections ( disease
epidemiology)
11. Itis also used in laboratory animals for experimental infections.
Outline key areas where microbiology may be applied
a) Medical applications;
1. Applied in production of vaccines as they are derived from microorganisms and
their products
2. Applied in production of drugs egpenicillins are got from natotium, tetracycline
from streptomycosestexossoil, and streptomycin from streptomycosesgrisens.
3. It is applied in establishment of causative agents of disease (diagnosis).
4. It is applied in providing a proper guide in treatment of patients through culture
and sensitivity.

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 5. It is applied in production of various laboratory reagents especially those used in
serological tests.
b) Food industry:
1. Its applied in preservation of food e.g. pasteurization of milk and boiling
2. Production of vinegar.
c) Bakery:
1. Where yeast is used to produce carbon dioxide which gives bread rising and
porosity.
d) Sewage treatment:
1. Bacteria is used to break large feocal particles into small particles which can even
be less offensive in a process called purification
e) Epidemiological studies:
1. Provides information and data which can be used for research, planning for
microbiology services, references and teaching purposes
Specimen collection, handling and transportation
A specimen: This can be referred to any material collected from the patient with an aim of
establishing the causative agent of disease.
A sample: Is a portion of the specimen required for a particular test procedure.
Examples of common laboratory specimens include;
 Blood
 Stool
 Pus
 Urine
 Semen
 Vomitus
 Cerebral spinal fluid (CSF)
 Swabs e.g. eye swab, high vaginal swab, ear swab, anal swab, etc.
 Fluid specimens from cavities (synovial fluid, Ascites fluid, hydrocele fluid, pleural
effusion fluid, etc.)
 Biopsy
 Autopsy
 Skin snips
 Sputum
 Skin craping
Factors to consider during specimen collection are;
1. Type of specimen
2. Method of collection
3. Time of collection
4. Information about the patient (biographic data, clinical history, etc.)

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Outline the qualities of a good specimen
1. It should be the required specimen for analytical procedure e.g. if sputum is required for
TB test it should not be blood in steady.
2. It should be collected from the right patient. Always cross check the details of the patient
on the request form
3. It should be collected in the right specimen container so as to preserve integrity of the
specimen.
4. It should be of the right quality of analysis. It could be a repeat test or confirmatory test
to be performed and specimen should well be enough.
5. It should be collected within the right time i.e. it may early morning specimen of stool,
urine or sputum in the specified time so as to have a higher concentration of the parasites
or microorganisms.
6. It should be accompanied with right information which is written on the request form.
The information should be matching with that on specimen container.
Outline the common tools used in specimen collection
These include;
1. Sputum mugs
2. Containers e.g. for urine, stool, etc.
3. Syringes and needles
4. Prickers
5. Slides
6. Request forms
7. Containers/ Vacutainers
Containers have three types;
a. Plain containers (red top):
 These contain no anti-coagulants
 Commonly used aresputum container, stool containers, urine containers,
plain bottles, etc.
b. Anti-coagulated containers (purple top):
 These have additives added to prevent blood from clotting or to preserve
anolities of the specimen.
 Commonly used additives include EDTA (Ethyl Diamine Tetra Acetate)
also known as sequestrene, Fluoride oxalate, sodium citrate.
 CPDA (Citrate Phosphate Dextrose Ademine)
c. Sterile containers:
 These are free from absolute microorganisms.
 They are used for collection of specimens or samples for culture, gram
staining, etc.
8. Registers

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Describe the procedure for specimen collection, specimen handling and specimen
transportation for common specimens i.e. Sputum collection, Urine collection, Blood
collection, Venous blood collection, CSF collection, Fluid specimens, Urethral swab and
high vaginal swab.
Sputum collection:
 It is a preferred specimen for diagnosis of respiratory infections.
 Sputum collection involves use of a white mouth container which should be dry, clean,
detergent free, leak proof and screwable.
 It may not necessarily be sterile in some cases except where sterility is indicated e.g.
culture specimens.
 A patient should be given adequate instructions involving obtaining of the specimen. In
this case the patient should be instructed to make a deep cough in order to produce real
sputum but not saliva.
 The best sputum is that obtained after long stay without spitting sputum. This is best
achieved if an early morning specimen is collected just as the patient wakes up before
eating anything or cleaning his or her mouth.
 The specimen should be transported to the diagnostic centre as soon as possible.
 While collecting sputum specimens one is required to practice good coughing manners
such as collecting the specimen in isolation.
Stool collection:
 This specimen is a choice for diagnosis of gastrointestinal infections.
 Collection of this specimen involves providing the patient with a plastic screw top lid
container and instructing the patient to at least collect a spoonful into the container.
 The outside of the container should be kept clean and the specimen should be transported
within a period of one hour to the laboratory.
 The container should be well labelled with the patient’s name and all other details.
 If the specimen is to be cultured a sterile container should be used.
Urine collection:
 Urine is collected from patients to rule out the presence of urinary tract infections or
pregnancy (females). The infections can be bacterial, fungal or parasitic
 During specimen collection, urine may get contaminated with normal flora. Therefore it
is advisable to get a way of doing away with normal flora during specimen collection
(mid-stream urine).
 Normal urine is pale yellow and clear but dark yellow urine may be experienced after a
heavy exercise.
 However abnormal appearance may include;
1) Red cloudy urine; in cases of urinary schistosomiasis (bilharzia), renal bleeding,
malaria, etc.
2) Milky and turbid; In cases of vaginal candidiasis, Bancroft filariasis, gonococcal
urethritis, etc.

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 3) Yellow brown and green brown; which could be due to presence of bilirubin.
This is common in acute viral hepatitis and obstructive jaundice.
4) Cloudy and smell urine; this usually indicates presence of white blood cells.
This is very common in bacterial urinary tract infections or UTIs.
 Types of urine specimen are;
1) Mid-stream urine:
 The patient is instructed to first pass the first flush of urine out and the
second flush is carefully passed into the urine container until required
volume of urine is collected.
 The first flush is to wash away the normal flora that may be inhabiting in
the genitalia.
 Early morning specimens are usually preferred as they have higher
concentration of organisms if present.
2) Catheter specimen of urine:
 This is normally collected from bedridden patients who can’t pass out
urine voluntarily.
 This type of urine is not sterile and is collected by insertion of the urethral
catheter into the patients genital.
 Urine containers should be clean, dry, leak proof and sterile if urine is to
be cultured.
Blood collection:
 This is the commonest specimen and it is collected using two methods i.e. capillary blood
collection and venous blood collection.
a) Capillary blood collection
 Capillary blood is collected when the volume of blood required to perform a test is small.
However there is great possibility of sampling errors when blood can’t flow freely.
 This may lead to dilution of blood sample with tissue fluid (haemodilution).
 It’s not easy to get enough blood especially when more than one test is required.
 Therefore capillary blood can only be used for a few tests.
Procedure for collecting capillary blood:
1) Capillary blood can be collected from the ring finger of a child or adult, the big
toe of the child, the ear lobes and from the heels of an infant up to one year. It can
also be collected from the thumb of the child.
2) Clean the puncture site with 70% alcohol or any other suitable disinfectant.
3) Allow the site to air dry.
4) Make a rapid sufficient deep puncture using a sterile needle or lancet.
5) Wrap away the first drop of blood with a dry piece of cotton and use the next
drops for the required test procedure.
6) Avoid squeezing the punctured site or squeeze lightly if inevitable.
7) After blood collection, apply a dry piece of cotton on the puncture site to stop
bleeding.

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 8) Capillary blood can be collected directly on blood slide, filter papers when
collecting dry blood spots.
b) Venous blood collection:
 This is a method of choice when blood of more than 100ul is required to perform
a test or a range of tests.
 It cn be collected in plain tubes or bottles with or without anti coagulants.
 It should be collected from intravenous line or veins on which intravenous line is
passed.
 With venous blood, whole blood, plasma, serum can be used to perform the tests.
Requirements for obtaining venous blood
 Suitable disinfectant preferably hibitane
 Dry cotton
 Tourniquet
 Sharps container or safety box
 Sterile needle and syringe of the required gauge
 Blood container
 Gloves
Procedure for venous blood collection:
 The ideal position should be when the patient is lying down or sited in a comfortable
chair with arm firmly supported on a table or chair for easy access to phlebotomist.
 The patient should never stand or sit on a high stool during collection of blood.
 The procedure steps are;
1) Apply a tourniquet to the upper arm several inches above the bend ofthe elbow to
enable the veins to be seen or felt.
2) Ask the patient to make a tight fist. This makes the veins palpable.
3) Select a suitable vein for the procedure. Common veins are cephalic, median
cephalic, and median cephalic. In infants scalp veins, femoral veins and external
jugular veins can be used.
4) Clean the puncture site with a suitable disinfectant preferably 70% alcohol and
allow site to air dry.
5) Make a venipuncture with the bowel of the needle directed upwards in the line of
the vein.
6) Steadily withdraw the plunger of the syringe at fairly slow speed.
7) When sufficient blood has been collected, release the tourniquet and instruct the
patient to open the fist.
8) Remove the needle from the vein and immediately press the puncture site with a
dry piece of cotton wool in order to stop bleeding.
9) Dispense the blood carefully into a suitable containers and mix the blood
adequately with coagulants.
10) Label and send for analysis.

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Cerebral Spinal Fluid (CSF) collection:
 CSF is the fluid found in the cerebral spinal column and occupies the sub arachnoid
space.
 It is collected by lumbar puncture (LP) following a high degree of sterility (Refer to
procedure for Lumbar Puncture)
 Collection of CSF should be done by a qualified medical officer and it involves inserting
a wide bore needle between the fourth and fifth lumbar vertebrae while the patient is
sitting in a forward position.
 The position forces the fluid (CSF) to drip and its then taped into appropriate container ie
sterile, with fluoride oxalate and sequestrene.
 Normal CSF should has the following characteristics;
1) It’s clear and colourless
2) Cell count – < 5cells/mm
3) Protein – 15-45mg/ol
4) Glucose –45-75mg/ol
Fluid specimens:
These include;
1) Synovial fluid from joints
2) Ascitic fluid from abdominal cavity/ peritoneal cavity
3) Pleural fluid from pleural cavity
4) Pericardial fluid from the pericardial sac
5) Hydrocele fluid from sac surrounding the testis
6) Lymph node fluid from lymph nodes, etc.
Collection of these fluids should be carried out by a technical medical worker and its by
aspiration of the content and dispensing it in appropriate containers.
The containers should be labelled and transported for analysis.
Basic principles for specimen collection and transportation:
1. Select the appropriate type of specimen and container as per the intended purpose.
2. Clinical specimens should be appropriately collected to avoid contamination with normal
flora.
3. Where possible collect specimens before antibiotic therapy is instuted.
4. Collect the appropriate quantity of the specimen as required for the diagnostic test.
5. Handle all specimens with care to avoid contamination.
6. Label specimens with patient’s information i.e. Name, age, sex, ward, etc.
Urethral swab and high vaginal swab;
 These are also referred to as Uro-genital specimens.
 Urethral swabs are collected from male patients.
 The procedure involves the following;

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 1) Clean the urethral opening with a swab moistened with ster.
2) Gently massage the urethral and collect the discharge on the swab or make the
smear of the discharge on the slide.
3) Transport the specimen for analysis as soon as possible
NB: Urethral swab is important in diagnosis of Gonorrhea.
 Collection of the High vaginal swab involves the following;
1) Ask the patient to pass out urine before specimen collection at least two hours
2) Inserting a sterile vaginal speculum to aid the viewing of the internal genitalia.
3) Insert a sterile high vaginal swab in the vagina.
4) The contents are collected by gently rotating the swab.
5) Transport the specimen for analysis as soon as possible.
Safe transportation of specimens
 This may involve transporting specimens within the health facility (short distance) or
between laboratories at different levels.
 Specimens are usually carried by hands and in this case they should be placed upright in
racks before transporting them.
 The racks should be adequately disinfected after delivering these specimens while the
accompanying request forms should be transported separately from the specimens.
 Transportation of specimens for longer distances should involve packaging of specimens
(ripple packaging) and even labelling it.
 The criteria for packaging depends on the degree of infection.
 Specimen containers should be tightly closed and there is no leakages.
 In case there are several containers to be transported, each specimen container should be
wrapped with sufficient packaging material.
 The outer container (secondary container) should be labelled ‘biological specimen’ or
‘Highly infectious’ or should be labelled with a biological symbol.
 Fix clearly a written delivery address to the outer container.
 Avoid delays in specimen transportation.
Describe the common simple laboratory tests done in the laboratory
These include;
1. Malaria Rapid Diagnistic Test (m RDT)
2. Blood smear (BS)
3. Urinalysis
4. Urine HCG
5. Sputum Analysis
6. Gene Xpert
7. Stool Analysis
8. HIV antibody test
9. HIV-DNA- PCR test (DBS)

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CLASSIFICATION AND TYPES OF MICROORGANISM
By the end of this session learners should be able to;
Give the different classes of microorganisms
Microorganisms are classified into four types;
1. Bacteria– Bacteriology
2. Viruses – Virology
3. Parasites – Parasitology
4. Fungi and mycoses – Mycology
Differentiate between Prokaryotes and Eukaryotes
SN Eukaryotes Prokaryotes
1. Reproduce by mitosis Reproduce by binary fission
2. Have nucleus No nucleus
3. Have membrane bound No membrane bound organelles
organelles e.g. Mitochondria
4. Do not have Pilli Have Pilli
5. Cell membrane not covered by Cell membrane covered by cell wall
cell wall
6. Have multiple linear DNA Have a single circular DNA
7. Have both sexual and asexual Reproduction is asexual only
reproduction cycles

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BACTERIOLOGY
 This refers to the study of bacteria.
Bacteria:
 These are single-celled (unicellular) microorganisms with cell walls but lack organelles.
Describe the structure of bacteria and functions of bacteria
STRUCTURE OF BACTERIA

OR

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Characteristics of bacteria are;
1. Multiply by binary fission- a process where by a cell divides into two identical daughter
cells which are also able to grow and divide at the same rate as the parent cell with the
same genetic constitution.
2. They are unicellular and micro-cellular.
3. They are widely distributed in the soil, air, water and various body parts
4. Bacteria are of genera Bacillus and clostridium undergo spore formation.
Functions of different parts of bacteria;
1. Nucleus: This is the most essential part of bacteria cell. It contains DNA that controls all
cell activities e.g. reproduction, genetic information, etc.
2. Cytoplasmic membrane: This contains lipo proteins that is selectively permeable and
act as osmotic barriers. It regulates transport of food and waste products from and into the
cell.
3. Cell wall: This is surrounded by mucoid structure – polysaccharide in nature which is
produced in large amounts from the capsule.
4. Flagella: These are appendagesattached onto the surface of the microorganism that aid
movement.
5. Capsule: Some bacteria produce a thick outer protective known as a capsule which helps
in resisting destruction by the body’s phagocytic cells.
6. Pilli: These are small hair like appendages found on the surface of bacteria. They help
bacteria to attach on surfaces of a mammalian cells and transfer genetic material from
tone bacterium to another hence aiding in causing disease.
7. Ribosomes: These are small particles found in the cytoplasm that are used to produce
proteins required for reproduction and growth.
8. DNA: This is responsible for governing cell processes and reproduction.
CLASSIFICATION OF BACTERIA
Describe the ways of classifying bacteria
There are three ways of classifying bacteria;
1. By morphology
2. By growth requirements
3. By staining properties
MORPHOLOGY
When bacteria are viewed under a light microscope, the following morphology are seen;
1) Round shape: These are referred to as cocci or coccus;
 After reproduction they attain different shapes i.e.;
i. Diplococci: These occur in pairs e.g. Neisseria gonorrhea
ii. Streptococci: These occur in chains e.g. streptococcus pyogens
iii. Staphylococci: These occur in clusters e.g. staphylococcus aureus.

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 2) Comma shape: These are referred to as vibrios e.g. Vibrio cholera
3) Bar shape: These are known as Bacillus e.g. Bacillus anthrax.
4) Spiral shape: These are referred to as spirilla e.g. Trepanema Pallindum
5) Filamentous shape:

GROWTH REQUIREMENTS
By growth properties, bacteria are sub classified based on two factors ie;

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 1. Temperature;
 Under this factor, there are three groups of bacteria:
1) Psychrophilic: These are bacteria that can grow best at low temperature
of below 20 degrees Celsius e.g. Lister moncytogens can grow at 4
degrees Celsius.
2) Mesophilic: These bacteria grow at temperatures between 20-40 degrees
Celsius with optimal temperature being 37 degrees Celsius (for most
organisms).
3) Thermophilic: These bacteria grow at an optimal temperature above 40
degrees Celsius e.g. Bacillus steothermphilus.
2. Gaseous requirements;
 Under this factor, bacteria is classified into five groups;
1) Obligate/ Strict aerobes: These can only grow in oxygen environment
e.g. Mycobacterium tuberculosis.
2) Obligate/ Strict anaerobes: These can only grow in absence of oxygen.
E.g. Clostridium tetani.
3) Carboxyphillic organisms: These grow in environment consisting of 5-
10% carbon dioxide e.g. Neisseria meningitis and Neisseria gonorrhoeae
4) Facultative anaerobes: These grow either in the presence or absence of
carbon dioxidee.g. Escherichia Coli.
5) Micro aerophilic: These can grow best in a trace of oxygen e.g.
Streptococci pyogens, streptococci pneumonia, and Haemophilus
influenza.
STAINING PROPERTIES
 Bacteria staining is the process of colouring the colourless bacterial structural
components using stains (dye).
 The principle of staining is to identify microorganisms selectively by using dyes,
fluorescence and radioisotope emission.
 Gram stain reaction was developed by Christian Gram who discovered that most bacteria
can be differentiated by gram reaction based on their differences in cell wall structure.
 The principle of gram stain is based on the thickness of the cell wall of bacteria and the
PH of the protoplasm.
 Gram stain classifies bacteria into two groups;
1) Gram positive bacteria:
Properties of Gram positive bacteria are;
 Have thick and more rigid cell wall because of large amounts of
peptidoglycans
 When stained with acetone alcohol, it takes up a crystal violet colour.
 Live well in acidic PH
 Have increased acidity for alkalinic dyes e.g. crystal violet
2) Gram negative bacteria:
Properties of Gram negative bacteria are;

18
 Have a thin cell wall because of less amounts of peptidoglycans
 They lose colour on staining (discolouration)
 They grow well in alkaline PH
 Have affinity for acidic dyes e.g. neutral red

19
20
21
ACID FAST BACILLI:
 There are bacteria with a fatty layer around their cell wall which is made up of mycolic
acid.
 This layer can’t be stained by gram stain and can only be stained by ZeihlNelseen (ZN
staining technique). These include;
1) Mycobacterium tuberculosis: This stains strongly with acid fast because it has
more mycolic acid.
2) Mycobacterium laprae: This stains weakly with acid fast because it has little
mycolic acid.
NB: Spirochetes can’t readily be stained and can be diagnosed by dark field microscopy. These
include;
1) Trepanema pallidum
2) Borrellia species
3) Lepto spirilla
BACTERIA GROWTH AND REPRODUCTION
Explain the bacterial growth curve

22
Bacteria growth curve:
 Bacteria requires a number of factors to grow. These are;
1) Chemical factors;
 Carbon dioxide
 Oxygen
 Nitric oxide
 Sulphur
 Phosphorus
2) Physical factors;
 Temperature ranges
 PH
 Osmotic pressure
 Moisture
 Nutritive values e.g. irons and vitamins
 The patterns of bacterial growth is divided into four (4) phases;
1) Lag phase
2) Log phase/ Exponential phase
3) Stationary phase
4) Decline phase
Illustration of bacterial growth curve

Lag phase:
 The bacteria is adapting to the new environment.
 The rate of growth is slow.
 There is increase in metabolic rate and enlargement in cell size

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Log phase/ Exponential phase:
 The rate of growth is maintained as in lag phase as conditions remain favorable.
 Metabolic rate in this phase is rapid and reaches its peak because of availability of
nutrients
Stationary phase:
 During this phase the number of cells being produced is almost equal to those that are
dying.
 This is attributed to;
i. accumulation of toxic products
ii. Limited space
iii. Competition for food and nutrients.
 It is during this stage where some bacteria end up producing spores in order to survive the
harsh conditions.
Decline phase:
 During this phase the number of bacteria dying exceeds those being produced.
 This also represents the decline in bacterial cells.
 The decline may be attributed to;
i. Completion of nutrients (starvation)
ii. Build-up of waste toxic materials
iii. Death of almost all bacterial cells.
Bacteria reproduction
Describe bacterial reproduction
 Bacteria reproduce by binary fission- a process in which the parent cell breaks up into
two daughter cells with the same genetic constitution as the parent cell.
 Generation time- is the time taken for bacteria to double its number. This varies between
species and may depend on physical and chemical factors of growth.
 Binary fission occurs in five stages;
1) Bacterial cell in stationary phase
2) Elongation of the bacterial cell and DNA replication
3) Inward growth of the cell wall and cytoplasmic membrane
4) Separation of the daughter cells
5) Bacterial cell growth.

24
25
Describe the medically important genera of bacteria
The important medical bacteria and their diseases are;

26
Factors that aid/ facilitate bacteria to cause disease are;
1) Capsule secretion:The capsule helps the bacteria from being engulfed and destroyed by
body’s phagocytic cells. It also prevents action of anti-bacterial agents.
2) Possession of a Pilli: This helps the bacteria to attach to cells and tissues of the host.
3) Production of toxins: Some bacteria produce toxins that are capable of causing body
changes in the host. Toxins can lead to rigor, chills, fever, and shock. These can be
exotoxins (produced when the organism is alive) or endotoxins (produced when the
organism is dead) e.g. tetanus
4) Production of extracellular enzymes: The enzymes assist in breakdown of fibrin which
is the protective barrier in the host e.g. enzyme kinase

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MEDICALLY IMPORTANT GENERA OF BACTERIA
These are;
1. Genus straphylococci
2. Genus shigella
3. Genus salmonella
4. Genus pseudomonas
5. Genus Escherichia
6. Genus clostridium
7. Genus vibrio
8. Genus trepanema
9. Genus Bordettella
10. Genus Haemophilus
11. Genus Helicobacter pylori
12. Genus Brucella
13. Genus mycobacterium
14. Genus Neisseria
15. Genus mycoplasma
16. Genus bacilli

1. Genus straphylococci:
2. Genus shigella:
3. Genus salmonella:
4. Genus pseudomonas:
5. Genus Escherichia:
6. Genus clostridium:
7. Genus vibrio:
8. Genus trepanema:
9. Genus Bordettella:
10. Genus Haemophilus:
 Common species are;
1) H. Influenza
 It is a gram negative, rod shaped and facultative anaerobe.
 Its habitat is the Upper respiratory tract.
 Its commonly transmitted by inhalation
 It commonly cause meningitis in children <5years, epiglottitis,
otitis media, chronic bronchitis, sinusitis, and pneumonia.
 Prevention is mainly by vaccination using Heamophilus influenza
type b vaccine (Hib).
2) H. Ducreyi
 This causes chancroid which is sexually transmitted infection
 Also known frequent cause of genital ulceration

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  Has increased risk for HIV transmission
11. Genus Helicobacter pylori:
12. Genus Brucella:
13. Genus mycobacterium:
14. Genus Neisseria:
15. Genus mycoplasma:
16. Genus bacilli:

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NORMAL FLORA
By the end of this presentation learners should be able to;
1. Define a Normal flora
2. Explain the mechanisms of normal flora (How they work)
3. How do normal flora prevent colonization of potential pathogens?
4. With examples describe the location of normal floras (natural habitat)
5. Characteristics and mode of spread of disease causing microorganisms
NORMAL FLORA
Definition of a Normal flora
 These are organisms which live on or within the body without causing disease under
normal circumstances unless they are transferred from their natural habitat to another.
 Normal flora in the body are predominantly bacteria but also include some fungi.
Classification of normal flora
 Normal flora are classified into three classes namely;
1. Symbionts:
 These are microorganisms that usually benefit the person infected with
them. I.e. like normal flora of the intestines help to synthesis vitamin k
which is helpful in clotting of blood for the person in case of hemorrhage
or injury.
2. Opportunists:
 These are microorganisms that can become pathogenic only when suitable
opportunity arises.
 They usually occur following weakening of the host’s immune system
(immunosuppressed) or after transfer of the microorganisms from their
usual natural habitat to another part of the body.
 Examples include;
1) Escherichia coli can cause UTIs when transferred from GUT to
urinary tract
3. Commencials:
 Commensalism: Is an association between two organisms in which one
species obtains food or other benefits from the other without either
harming or benefiting the letter
 These are organisms that neither benefit nor causes harm to the host.
 Examples include;
1) Candida albicans on the skin

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Ways through which normal flora prevents disease from pathogens
How do normal flora prevent colonization of potential pathogens?
 There are several ways through which normal flora are able to prevent disease from
pathogens. These include;
1. By maintaining the PH levels in the sites they occupy thus suppressing the growth
of other organisms. E.g. lactobacillus acidophilus maintains acidic PH in the
vaginal canal that discourages growth of other organisms.
2. By production of fatty acids which have antibacterial activity. This is common
with normal flora of the skin.
3. Presenting themselves in large numbers and with full occupation of their
ecological niches leaving no room for the growth of other organisms. E.g. Normal
flora of small intestines.
4. Production of factors or substances with antibacterial activity like colicins,
bacteriocins and waste products in the GUT that discourage the growth of other
organisms.
Common normal flora and their natural habitats
With examples describe the location of normal floras (natural habitat)

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32
Modes of Spread of Disease causing microorganisms
Microorganisms spread from the infected person to a healthy person in the following ways.
a) Direct transmission/ Spread
The pathogens of diseases infect a healthy person directly without an intermediate agent. It can
take place by various means such as,
1. Direct contact between the infected person and the healthy person: Diseases like
small pox, chicken pox, syphilis, gonorrhoea spread through direct contact.
2. Droplet infection: The infected person throws out tiny droplets of mucus by coughing,
sneezing or spitting. These droplets may contain the pathogen. By inhaling the air
containing the droplets, a healthy person may get the infection. Diseases like common
cold, pneumonia, influenza, measles, tuberculosis and whooping cough spread through
droplet infection.
3. Contact with soil contaminated with disease-causing viruses, bacteria etc.
4. Animal bite: Viruses of rabies are introduced through the wound caused by the bite of
rabid animals, especially dogs. The virus is present in the saliva of the rabid animals.
b) Indirect transmission/ spread:
The pathogens of certain diseases reach the human body through some intermediate agents. It
can take place by
vario---------------------------------------------------------------------------------------------us means,
which are as follows:
1. Vectors such as houseflies, mosquitoes, and cockroaches. Examples: Houseflies carry
the causative organisms of cholera on their legs and mouth parts from the faeces and
sputum of infected persons to food and drinks and contaminate them. When this
contaminated food is taken by a healthy person, he gets the infection. Similarly,
mosquitoes carry virus of dengue and malarial parasite which causes malaria.
2. Air-borne: The pathogens may reach humans with air and dust. The epidemic typhus
spreads by inhalation of dried faeces of infected fly.
3. Object borne (Fonite borne) :Many diseases are transmitted through the use of
contaminated articles, such as clothes, utensils, toys, door handles, taps, syringes and
surgical instruments, etc.

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 4.
5. Water borne: If potable water (drinking water) is contaminated with pathogens of
diseases such as cholera, diarrhea, hepatitis or jaundice, it reaches a healthy person upon
consuming such water.
Pathological effects of microorganisms
INFECTION PREVENTION AND CONTROL (IPC)
By the end of this session learners should be able to;
1. Define infection
2. Describe of distribution of microorganisms in a host
3. Describe the stages of infection
4. Describe the routes of transmission of infections in the community
5. Define infection control
6. Components of infection control
7. Describe the principles of infection prevention and control
8. Ways of preventing cross infection
9. Describe the management of health care waste
10. Describe the levels of disease prevention and control
11. Describe the procedure for decontamination
12. Describe the procedure for sterilization

INFECTION PREVENTION AND CONTROL (IPC)

Definition of infection
 This refers to inversion of the tissues of the body by microorganism which then multiply
and causes disease.
Classification of infection
 Infections are classified in several ways and these are;
1. According to distribution of microorganisms in a host:
 Here infection classified in three ways;
1) Localized infection (Local infection):
 This is where the signs of infection are confined in one area
e.g. wound infection
2) Focal infection/ Disseminated infection:
 This is where organisms originally confined in one area
spread and affect other body parts

34
  For example Pulmonary Tuberculosis confined in the
pulmonary system may spread to other body parts to
become extra pulmonary tuberculosis.
3) Systemic infection:
 This is where the infection affects the whole body.
 Examples include;
i. Septicemia: This refers to invasion of the blood
stream with microorganisms and usually actively
multiplying.
ii. Bacteremia: This is where bacteria invades the
blood stream usually with no active multiplication.
iii. Toxemia: This is where bacteria produces toxins
which spread throughout the body and are absorbed
by the body cells.
iv. Pymia: This is where pus forming bacteria invades
blood stream and localizes at different parts causing
metastic areas of infection
2. According to the class/ category of infection:
 The stages of infection include;
1) Primary infections:
 This is the first disease noted in the illness.
2) Secondary infections:
 This is the infection that arises when the body has been
weakened by the primary infection e.g. Pneumonia,
Tuberculosis in HIV positive patients.
3) Mixed infections:
 This occurs when the disease is caused by two or more
organisms e.g. a wound infection organism such as
clostridium tetani, staphylococcus aureus, streptococcus
pyogens may be isolated from a single wound infection.
3. According to the source of infection:
 The sources of infections are divided into two i.e. community acquired
infections and Hospital acquired infections (nosocomial infections)
1) Community acquired infections:
 These are acquired within the community but may include
infections incubating during the time of admission.
 Routes of transmission of community acquired infections
are;
i. Fecal-oral route e.g. Cholera, typhoid fever, polio,
dysentery, etc.
ii. Sexualroute e.g. HIV, Syphilis, Gonorrhea
iii. Airborne route (inhalation) e.g. measles, flu, etc.

35
 iv. Vector born route e.g. malaria, sleeping sickness,
etc.
v. Trans-placental route e.g. Syphilis, Toxoplasmosis,
etc.
vi. Direct contact e.g. Ebola, Hepatitis, Covid 19, etc.

2) Hospital acquired infections (Nosocomial infections):

 These are infections acquired from the hospital when the
person is admitted or visited the hospital for any reason.
 These infections include; Pneumonia, Urinary tract
infections, antibiotic associated diarrhea, surgical wound
infections, etc.
 Sources of hospital acquired infections include;
i. Very ill patients
ii. Inadequately sterilized equipment
iii. Hospital staff who provide care to patients
iv. Occasional hospital visitors, etc.
 Routes of transmission for hospital acquired infections
are;
i. Contact with infected person
ii. Inhalation
 People at risk of nosocomial infections include;
i. People with compromised immunity e.g. HIV
patients
ii. People with broken skin e.g. due to burns,
accidents, etc.
iii. Patients on immunosuppression drugs
iv. Patients undergoing surgery e.g. women in labour
and delivery
v. Patients undergoing catheterization, etc.
vi. Health workers not following infection prevention
and control guideline e.g. Use of PPEs
vii. Overcrowding of patients on hospital beds
viii. Prolonged hospital stay e.g. before operation, on
admission, etc.
ix. Overuse or improper use of catheters
x. Increased number of patients with compromised
immunity.
 Prevention of hospital acquired infections is by:
i. Prevention of infections among health workers e.g.
through immunization against TB, COVID 19,
Hepatitis B, etc.

36
 ii. Isolating infectious cases of patients e.g. COVID
19, Yellow fever, Ebola, Cholera, etc.
iii. Adhering to infection control guideline e.g. hand
washing, gloving, wearing masks, proper sterilizing
of equipment, etc.
iv. Limiting the risk of endogenous infections by
promoting optimal antimicrobial uses,
v. Protecting patients with proper use of prophylactic
antimicrobial agents, nutrition and immunizations.
vi. Conducting health education talks to patients,
attendees and staff CMEs
vii. Surveillance of infections for proper prevention and
controlling of outbreaks.
Types of sources of infections
 There are two types of sources:
1. Endogenous infections:
 These are infections that arise from person’s own normal flora.
2. Exogenous infections:
 These are infections that arise from external sources e.g. environment.
Stages of infections
 In general there five stages of diseases/ infections;
1. Invasion stage:
 This refers to the entry time of the organisms causing disease into the
human host.
2. Incubation period stage:
 This is the time between infection and onset of signs and symptoms of
illness or disease
 The shorter the incubation period the rapid the disease will spread.
3. Prodrome stage:
 This refers to the first signs and symptoms of an infection. In most times
it’s non-specific.
4. Clinical illness stage:
 This is characterized by most detectable signs and symptoms. They are
usually specific and point to a particular infection.
5. Resolution stage:
 During this stage, human host recovers from the infection.
 However, there are sometimes when the infection causes no harm to the
host. This is usually because of the host’s body defense mechanism.
Terms used in Host and Infection
 A Susceptible host: Is a host that is prone/ at risk/ predisposed to an infection.

37
  Causative agent: These are microorganisms that cause disease. These can be viruses,
bacteria, fungi, parasites, etc.
 The port of entry: This refers to the route/ path by which pathogens invade a susceptible
host. This can be via the skin, mucus membrane, genital tract, airway, oral cavity, etc.
 The portal of exit: This is the path/ route by which infective agents leaves the reservoir
host. In most cases it’s the same route of their entry.
 The reservoir of infection: Is an animal or place in which the particular organisms live
and multiply.
 Route of transmission: Is the way in which organisms (causative agents) leaves the
reservoir to infect the susceptible host.
INFECTION CONTROL
Definition of infection control
 This is the procedure or protocol designed to limit cross infection in health care delivery
environment.
Principles of infection prevention and control
 There are three principles of IPC. These are;
1. Protect yourself (Healthworker)
2. Protect the patient
3. Protect the environment
Components of infection control
 These are;
1. Limit transmission of organisms between patients by adequate hand washing, use
of gloves whenever attending to new patients.
2. Protect the patient with appropriate use of vaccination, nutrients, etc.
3. Limit the risk of endogenous infections by minimizing invading bacteria and
promoting optimal bacterial use.
Cross infections:
 This refers to the transfer of infections from one person to another who originally had no
pathogens of that kind.
Ways of preventing cross infection
1. Hand washing before and after attending to patients.
2. Use of sterile equipment when attending to patients.
3. Proper disposal of waste after defecation.
4. Wrapping away spillages after decontamination
5. Use of protective wears e.g. gloves, masks, etc.
6. Isolation of infectious patients.
Levels of disease prevention and control

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  There are three levels of disease prevention namely;
1. Primary disease prevention:
 This involves preventing the diseases before it occurs.
 It aims at improving the overall health of the population.
 It is achieved through; Immunization,
2. Secondary disease prevention:
 This involves giving treatment to the infected (case management) using
appropriate guidelines of providing treatment of cases.
 It aims at getting the sick cure or improve.
3. Tertiary disease prevention:
 This involves providing support and rehabilitative services to the sick or
affected individuals to stop or minimize pain or suffering.
 It may also looks at helping individuals to cope with the illness and
prevent further complications especially terminally ill patients.
 It aims at alleviating suffering.

DISINFECTION AND STERILISATION

Decontamination

39
  Is the process of killing or removing harmful microorganisms from non-living objects
using chemicals called disinfectants.
 Examples of disinfectants include;
1. JIK
The procedure for decontamination
Sterilization
 Is the process that involves destruction or elimination of all visible microorganisms
including their spores.
 Methods of sterilization
 There are two methods of sterilization; Physical and Chemical methods of
sterilization i.e.
1) Physical method of sterilization:
This can be through;
i. Heat method
ii. Filtration
iii. Radiation
2) Chemical method of sterilization:
 This includes use of antiseptics and disinfectants
 An antiseptic: Is a chemical used to kill or inhibit the
growth of microorganisms
 Examples of antiseptics include;
i. Chlorhexidine solution
ii. Povidone –iodine
iii. Chloroxylenol
iv. Isopropyl alcohol
v. Hydrogen peroxide
vi. Benzalkonium Chloride
vii. Hexachlorophene
 Disinfectant: Is a chemical liquid that destroys bacteria. Or
Any substance that is used primarily on non-living objects
to kill germs
 Examples of disinfectants include;
i. Alcohols
ii. Chlorine compounds
iii. Formaldehyde
iv. Hydrogen peroxide
v. Peracetic acid
PHYSICAL METHODS OF STERILISATION
1. Heat method of sterilization
These are divided into two i.e.

40
 a) Dry heat: This is recommended for heat tolerant items like metals and glass wear.
b) Moist heat: This involves use of autoclave machine or a pressure cooker as
commonly used in hospitals as a method of sterilization.
 Autoclaving: This is the process of sterilizing supplies and equipment
with use of high pressure at temperature of 121 degrees Celsius (250
degrees F) for about 15-20 minutes.
 It is widely used in hospitals because of its efficiency and consumes little
time.
Structure of autoclave machine

Outward appearance of an autoclave machine.

41
  It is made up of three parts;
1. A pressure chamber
2. A lid:
 This is fastened by screw clamps and rendered airtight by asbestos washer.
 The lid bears the following;
i. A discharge tap for air and steam discharge.
ii. A pressure gauge - sets pressure at a particular level
iii. A safety Valve – to remove excess steam
3. An electrical heater.
 This is attached to the jacket; that heats the water to produce steam.
Types of autoclave machines
 There are three types of autoclave machines;
1. Gravity displacement type autoclave. It is the mostly common used in laboratories
and hospitals. It may be Vertical type (small volume capacity) or Horizontal
autoclave (large volume capacity)
2. Positive pressure displacement type autoclave
3. Negative pressure (vacuum) displacement type.

Procedure of autoclaving

42
 1. Fill the lower chamber with water up to the required level.
2. Place the required materials/ items to be sterilized inside the pressure chamber on
perforated tray packed with sufficient packing material.
3. Remember to include the sterilization controls i.e. autoclave tape on the articles to be
sterilized. These should be able to change colour from white to black at the end of
sterilization process which signifies effective process.
4. Close the lid by tightening the screw nuts and set the pressure of an autoclave depending
of the weights supplied by the manufacturer.
5. Adjust the safety valve to the required pressure.
6. Set the time of autoclaving
7. Switch on the power supply and put on the electrical heater
8. At the end of the sterilization process leave the items to cool for at least 30 minutes to 1
hour.
Uses of autoclave
It is used to sterilize the following equipment/article;
1. Surgical instruments
2. Culture media
3. Plastic containers
4. Solutions and water
5. Biohazardous waste
6. Glass wear (autoclave resistible)
2. Filtration
 This involves use of filters to remove microorganisms from particular liquids.
 Filters should be of desirable spore size and they are normally used to remove
bacteria, fungi, parasites and to a lesser extent viruses.
3. Radiation
 This involves use of x-rays and gamma radiations to kill microorganisms.
 Materials such as plastics, disposable needle, gloves are sterilized using this
method.
CHEMICAL METHODS OF STERILISATION
This applies to use of disinfectants and antiseptics.
Classification of antiseptics and disinfectants;
 They are classified into seven groups;
1) Chloride releasing disinfectants:
 Commonest example is sodium hypochloride (JIK) which is widely used
as antiseptic and disinfectant.
 It is active against viruses, bacteria, bacteria spores and protozoa
 Working solution of JIK is 0.5 % especially when it is used for dump
dusting.

43
 2) Alcohols:
 Alcohol is effective at a concentration of 70% especially when it is used a
skin disinfectant.
 Common examples include Ethanol and Isopropyl.
 It is used prior to vein puncture or capillary blood collection since its more
volatile.
3) Halogens:
 Common examples include Iodine.
 This is used as an antiseptic especially when iodine tincture is used to
cleanse skin prior to IV injection and withdraw blood.
 It is also used in treatment of wounds.
 Iodine is effective against viruses, fungi, bacteria, and yeast.
 Iodine comes either as iodine solution or tincture iodine or povidone
iodine.
 Povidone iodine is used for surgical scrubbing when preparing skin for
surgery
 Itis also used for sterilizing equipment
 Iodine solution is commonly used in treatment of wounds.
4) Aldehydes:
 Examples are; Formaldehyde and glutaldehyde
 Normally used in fumigation in the theatre
 Also used in preserving anatomical specimens such as autopsies, biopsies
 They are active against bacteria and their spores, viruses and fungi
5) Oxidizing agents:
 Common example is hydrogen peroxide
 It is used for cleaning wounds at a concentration of 6%, mouth wash at a
concentration of 1.5%
6) Biguanides:
 Example is Chlorihexidine
 His is mainly used in hand washing, surgical scrubbing, and mouth wash.
 It may be combined with cetrimide to increase its effectiveness
7) Ammonium compounds:
 Example is Cetrimide.
 This is actively effective against bacteria, viruses and fungi.
 It can be used in decontaminating instruments.

Preparation of sodium hypochloride solution (0.5% JIK)

44
Diagram of 0.5% JIK
HEALTH CARE WASTE MANAGEMEN
There are two types namely
Hazardous waste
Non hazardous waste
This includes sharp infusion sets, broken glasses
Non hazardous
These include paper boxes, discarded food
SEGREGATION
Segregation of health care waste according to their category and waste containers it is made the
best step to reduce on waste. Adequate waste management receptacles/personal protective
devices supply as disseminated factors
COLLECTION
Proper protective equipment and waste transport utility supply such as waste bins, trolley and
wheel barrow

INTRODUCTION TO IMMUNITY
By the end of this presentation learners should be able to;
Define immunity
Define immunology
Describe the types of body defense mechanisms
Explain the different types of immunity
Describe the elements of natural immunity
Antibodies
PRINCIPLES OF IMMUNIZATION
By the end of this presentation learners should be able to;
Define immunization
Define vaccination

45
Explain the principle of immunization
Explain the types of immunization
Outline the indications for immunization
Define vaccines
Account for the different types of vaccines giving examples in each type.
VIROLOGY
By the end of this session learners should be able to;
Define viruses
Define virology
Describe the structure of a virion
Outline the characteristics of viruses
With examples outline the classes of viruses
Describe the mode of transmission of viruses (viral infections)
Explain the ways of preventing viral infections
Explain viral reproduction/ viral replication
Explain the different DNA viruses
Explain the different RNA viruses

PARASITOLOGY
By the end of this session participants should be able to;
Define a parasite, obligate parasite, host, definitive host, intermediate host, reservoir host,
vector, and zoonosis

46
Parasite: Is an organism which takes its nourishment (feeds) from another without giving
anything in return.
Parasitology: Is the study of parasites in relation to their hosts.
Ecto- parasites: These are parasites that live on the surface of the body of the host or its
superficial tissues e.g. ticks, bed bugs, lice, etc.
Endo -parasites: These are parasites that live inside the body tissues of the host. Eg malaria
parasites, hookworms, jiggers, etc.
A host: Is an organism from which another organism (usually a parasite) takes its nourishment.
A definitive host: Is an organism in which the adult sexually mature stage parasite lives.
An intermediate host: Is an organism in which the parasite lives during the period of its
development only.
An obligate parasite: This is when the organism (parasite) can’t live and reproduce outside the
host.
A facultative parasite: Is parasite that can exist in free or parasitic state in the host.
A reservoir host: Is the organism that harbors the parasite without getting infected until the
parasite invades a susceptible host to cause infection or disease.
A vector: Is a living carrier (vehicle or transporter) of pathogenic organisms from the infected
host to a non-infected host e.g. a female anopheles mosquito that transmits malaria.
Biological vector: This is when there is development of the parasite in that vector.
Mechanical vector: This only aids the transmission of the parasite but there is no parasite
development in the vector e.g. housefly
Zoonosis: These are parasitic infections that are normal in animals but cause disease in humans.
Thus zoonotic diseases are disease transmitted from animals to humans.

Outline the zoonotic diseases

The following are some of the diseases transmitted from animals to humans;
SN Zoonotic disease Carrier animal Cause of disease
1. Brucellosis Cattle, dogs, goats, Brucellaspps

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 pigs and sheep  Brucellaabortus(cattle)
 Brucellacanis(dog)
 Brucellamelitensis(goats and
sheep)
 Brucellasuis(pigs)

2. Rabies Infected domestic Rabies virus

(dogs) and wild
animals (fox).
Commonly is by dogs
3. Salmonellosis Flies (often) - 4 Fs in Salmonella ( Salmonella typhiand S.
contaminated food paratyphiA & B)
and water
4. Lyme disease
5. Anthrax
6. Bovine tuberculosis - Bovine tubercle bacillus
7. African Insect vector - tsetse T.B.Rhodesiense[E.African&S.Eastern
trypasonomiasis fly Africa]----reservoir Animals ( cattle's)
(Sleeping sickness)
T.B .Gambiense[W.Africa]-reservoir
humans & domestic animals

T.B.Brucei[Animals-Nagana]

8. Leishmaniasis
9. Plague
10. Yellow fever Aedes mosquitoes in Flavivirus
forests
11. Ebola and Marburg Infected chimpanzees, Filoviruses
gorillas, and forest
antelopes (alive and
dead).

12. Onchocercaisis Female black flies Onchocerca volvulus, transmitted by a

(River blindness) bite from (Simuliumdamnosum, S.
naeviand S. oodi, etc),
13. Elephantiasis Aedesaegypti WuchireriaBangroft (Filariasis worms).
(Lymphatic mosquito bite
filariasis)

Outline the common parasites and their infective stages with the disease they cause
SN Name of parasite Infective stage Disease caused
1. Giardia lamblia Cysts Giardiasis
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 2. Balontidium coli Cysts Balontidiasis
3. Entamoebahistolytica Cysts Amoebid dysentery
(Amoebiasis)
4. Trichomonas vaginalis Trophozoites
5. Malaria parasits Sporozoites Malaria
6. Toxoplasma gondi Oocysts Toxoplasmosis
7. Cryptosporodiumparvum Oocysts
8. Isospora belli Oocysts
9. Trypanosomes Trypanomastigates Trypanasomiasis
(Sleeping sickness)
10. Leishmania parasites Promastigates Leishmaniasis
11. Teaniaspecias Cysticeria Teania infections
12. Hookworm Filariform larvae
13. Schistosoma species Cercaria
14. Ascarielumbricoides (round worms) Infected eggs
15. Tichuristrichuri (Whipe worms) Infected eggs
16. Enterobiusvermiculoris (pin worms) Infected eggs
17. Strongyloidesstercolis (thread worms) Filariform
18. Fasciola species Metacercia

General routes of transmission of parasitic infections

1. Feacal –oral-route e.g. Entamoeba histolytica, Giardia lumblia, Trichomonas homins,
cryptosporidium parvum, etc.
2. Sexual intercourse e.g. Trichomonus vaginalis
3. Direct skin penetration e.g. Hookworms, schistosoma species
4. Transplacentally (mother-to-child) e.g. Toxoplasma gondi
5. Vector inoculation e.g. malaria parasites, trypanosomes
6. Ingestion of raw or undercooked beef or pork eg Tinea saginata, tinea solium respectively
7. Blood transfusion e.g. malaria parasites.
Describe the classification of parasites
Endo parasites are divided into two sub kingdoms i.e.
1. Protozoa: It is single celled animal with trophozoites and cysts occurring as parasite or in
a free living state.
2. Metozoa: It is a multicellular endo-parasite commonly found in the intestinal tract.
PROTOZOA
This has four classes, i.e.
1. Sarcodina (Amoeba)
 They have a nucleus and karyosomes
 They form cysts by which they are transmitted
 They multiply by binary fission
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  Move by use of pseudopodia
Examples of Sarcodia are;
1) Entamoeba histolytica
2) Entamoeba coli
3) Endolimax nana
4) Iodomoeba bustchi
2. Mastigophora (Flagellates)
 It includes intestinal flagellates (eg Giardia lamblia, trichomonas homins), Uro-
genital flagellates (eg Trichomonas vaginalis) and haemoflagellates (eg
Trypanosomes, leishmania species)
 They move by use of flagella
 Reproduce by binary fission.
3. Ciliata (Ciliates)
 The organism of medical importance under this class is Balontidium coli
 The organism moves by use of cilia
 Reproduces by binary fission
 Have two nuclei in macro and micro nuclei
 It is transmitted through ingestion of cysts
4. Coccidia (Sporozoa)
 Organisms in this class have no appendages for movement
 They reproduce asexually by schizogony and sexually by sporogony
 Members of this class include;
1) Cryptosporidium parvum
2) Plasmodium species
3) Isospora belli
4) Toxoplasma gondi
CLASSIFICATION OF HELMNITHIS (METAZOA)
There are three (3) classes;
1. Nematoda (round worms)
Examples include;
1) Hookworms
2) Ascarislumblicoides (round worms)
3) Trichuris trichuria (whip worms)
4) Strongloides stercolaris (thread worms)
5) Enterobius vermicularis (pin worm)
6) Trichinella spirals
2. Cestoda (teania)
Members of this class are;
1) Teania species
2) Diphyllobothriumlatum
3. Trematodes (flukes)

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 Members of this class are;
1) Fasciola species
2) Schistosoma specie.
Common intestinal protozoa
1. Entamoeba histolytica; Causes Amoeboid dysentery (Amoebiasis)
 This causes a disease – Amobiasis- which is in form of dysentery and liver
abscess
 The parasite has ability to invade and cause lysis of cells.
 It is transmitted through ingestion of cysts in contaminated water and or food
 Therefore the infective form is the cysts.
 Common signs and symptoms are;
1) Bloody diarrhea
2) Abdominal discomfort
3) Flatulence
4) Tenesmus
 Laboratory diagnosis
1) Microspic examination of fresh passed stool for trophozoites (amoeba)
and cysts
 Control measures
1) Proper disposal of human waste
2) Water purification
3) Boiling of water
4) Screening and treating the cases
5) Hand washing
6) Cover food to prevent flies
2. Giardia lamblia; causes Giardiasis
 This is a flagellated protozoa that also forms cysts
 It is transmitted via ingestion of contaminated food or water
 Signs and symptoms are;
1) Abdominal cramps
2) Nausea
3) Flatulence
4) Bloating
5) Malaise
6) Diarrhea
7) Belching followed by taste of wroten eggs
 Laboratory diagnosis
 Stool microscopic examinationfor cysts and flagellated trophozoites with
falling leaf kind of motility
 Prevention is by;
1) Proper disposal of fecal waste
2) Hand washing with soap and water

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 3) Washing raw fruits and vegetables
4) Boiling of water
3. Cryptosporidium parvum
 This is by a coccidiun parasites that causes severe gastro-intestinal infections in
immunocompromised individuals eg HIV AIDS patients with opportunistic
infections
 The disease is transmitted through ingestion of oocysts in contaminated food or
water
 Signs and symptoms
1) Profuse and offensive diarrhea
2) Weight loss
3) Severe dehydration
4) Malaise
5) Severe abdominal pain
6) Bloating
 Laboratory diagnosis
 Microspic examination of fresh stool for presence of oocysts
 Oocysts are Acid Fast when stained with a modified ZN method (stain red
in colour)
 Preventive measures
1) Drinking boiled water
2) Proper disposal of fecal matter.
4. Balontidium coli ; Causes Balontidiasis
 This is a ciliated protozoan that is transmitted through ingestion of contaminated
water or food
 Signs and symptoms
1) No specific signs and symptoms
2) Diarrhea with blood and pus
3) Tenesmus
4) Anorexia
5) Nausea
6) Abdominal pain
 Laboratory diagnosis
 Microscopic examination of stool for trophozoites (amoeba) that move by
aid of pseudopodia
 Preventive measures
1) Proper personal hygiene
2) Hand washing especially after contact with pig feaces
3) Boiling water for drinking
4) Treat infected individuals
5. Toxoplasma gondi; Causes Toxoplasmosis
 This is a coccodian parasite that inhabits blood and tissue in human host
 It causes disease toxoplasmosis especially in the immunocompromised patients

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  Common signs and symptoms
1) Fevers
2) Headache
3) Myolagia
4) It’s a normal flora in animals like cats and oocysts are passed in feaces of
cat. Man gests infected through ingestion of oocysts in under cooked meat
of infected animals or contaminated food with cat feaces that contains
oocysts
5) Transplacental transmission is also possible
 Laboratory diagnosis
 It involves demonstration of antibodies in serum specific for toxoplasma
gondi
 Other methods includes testing for the parasites’ DNA
 Preventive measures
1) Hand washing
2) Proper cooking of meat
3) Avoid contact with cat feaces
4) Screening and treating disease in pregnant women
6. Isosoptera belli.
 This is an intestinal coccidian parasite that causes disease in immunocomprosed
individuals.
 It causes diarrhea and malabsorption
 Transmission is through ingestion of oocysts in contaminated food or water.
 Signs and symptoms
1) Severe and chronic diarrhea
2) Weight loss
3) Foul smell stool
4) Fatigue
 Prevention and control measures
1) Practicing personal hygiene and sanitation
2) Giving prophylactic septrine to HIV positive patients

MYCOLOGY
By the end of this session learners should be able to;
Define a fungi
Outline the uses of fungi
Describe the classification of fungi
Fungal spread/ distribution in the human body

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Describe the systemic mycoses
END OF MICROBIOLOGY

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