Micropara

• Prokaryotes


  • Approximately 0.2 – 2micrometers wide and 1-6micrometers long
• Bacterial Shapes


  • Cocci (spheres)
  • Bacilli (rods)
  • Spirillia (spirals)
  • Vibrios (comma-shaped)

  
• Robert Koch


  German physician, defined the procedure (Koch's postulates) providing that a specific organism causes a specific disease
• Medical Significance of Understanding Bacteria


  • Production of therapeutic proteins
  • Production of DNA vaccines
  • Production of vitamins
  • Use of microbial metabolites as antimicrobial agents and other types of therapeutic agents
  • Agricultural applications
  • Food technology
  • Production of chemicals
  • Biomining
  • Bioremediation
• Salmonella Typhosa is an aerobic, gram negative, motile non-encapsulated and non-spore, pathogenic only to man, easily survives in natural habitat (H2O or inorganic materials)
• Typhoid Fever


  An acute illness associated with fever involving primarily the lymphoid tissues (Peyer's patches) in the small intestine
• Mode of Transmission of Typhoid Fever

  Direct and Indirect
• Incubation Period of Typhoid Fever

  5 – 40 days (average of 10 – 20days)
• Source of Infection for Typhoid Fever

  Chiefly by carriers, recovered (stool urine - for years.) infected oyster or shellfish - offshore sewage disposal depots
• Period of Communicability for Typhoid Fever


  Until the bacteria are present in the stool it is communicable
• Clinical Signs and Symptoms of Typhoid Fever

  • Skin eruption/Rose spots – pink papules
  • Low grade fever - increase gradually to 40 – 41 C. "Remittent"
  • Episodes of chillness – non-specific treatments after febrile state
  • Diarrhea is an accompanying symptom; vomiting is also noted
  • Abdominal pain w/ distention
  • Tenderness at R/L hypochondriac (hepatomegaly / splenomegaly)
  • Severe toxic – apathetic, sustained pyrexia and rapid pulse
  • Marked abdominal symptoms – slight abdominal distention, tenderness, constipation or diarrhea
  • "Sordes" – thick dirty brown collection of dried mucus and bacteria
  • Gradual decline in fever/symptoms
  • Toxicity increases, Loss of weight
  • Pyrexia persist and delirious state emerges (typhoid psychosis)
  • Abdominal distention is pronounced
  • Pea soup Diarrhea
  • Patient is week with thready pulse, tachypnea and crackle
• Common Complications of Typhoid Fever


  Intestinal hemorrhage (bleeding) and perforation
• Standard Gold Test for Typhoid Fever

  Blood Serum Agglutination Test (Antibody titer)
• Treatment Modalities for Typhoid Fever

  Specific / Drug of choice: Chloramphenicol, Fluroquinolones
• Common Nursing Managements for Typhoid Fever

  • Bed rest, Enteric Isolation, Hygiene (meticulous oral care), completeness to medication, fluid replacements
• Preventive Measures/Health Education for Typhoid Fever

  • Isolation of patient- enteric precautions
  • Care of exposed person
  • Vaccines – 1SC followed by 2nd SC 4 or more weeks later. Booster injection every 3 years for selected individuals. (TY21a)
  • Employ sanitary waste disposal
  • Avoid eating fresh vegetable not properly washed
  • Ensure food handlers use hand washing facility
  • Carriers must not become food handlers
• Mycobacterium tuberculosis does not gram stain because of its waxy cell wall, called an acid fast bacillus
• Tuberculosis (TB)


  A disease caused by Mycobacterium tuberculosis
• Mode of Transmission of Tuberculosis

  Direct, Indirect, Airborne
• Incubation Period of Tuberculosis

  1. 10 week to demonstrate significant lesion or tuberculin reaction
• Source of Infection for Tuberculosis

  nasopharyngeal secretions
• Period of Communicability for Tuberculosis


  Non-infectious within 2-4 weeks of adequate antibiotic therapy
• Clinical Signs and Symptoms of Tuberculosis


  • Starts with flu-like symptoms
  • Night sweats
  • Fever
  • Weight loss
  • Fatigue
  • Chest Pain
  • Persistent Cough
  • Bloody sputum
• Pathogenesis of Tuberculosis


  Grows in the lungs and stimulates macrophages which phagocytize them, but don't destroy them. Cell-mediated response is triggered because it is now endogenous. Lungs develop small nodules, called tubercles. These tubercles grow until the center of the tubercle will begin to decay, This decay is the consistency of cottage cheese and is called caseous necrosis. In some, the lesions scar and calcify. Sometimes the blood vessels will erode, and the TB can get into the circulatory system, which can then invade any organ in the body
• Screening Tests for Tuberculosis


  • Chest X-ray (DOH 2020)
  • Mantoux
  • TB skin test
• Diagnostic Test for Tuberculosis


  Xpert MTB/RIF assay - A nucleic acid amplification (NAA) test
• Treatment Modalities for Tuberculosis

  • Isoniazid (INH)
  • Rifampicin
  • Ethambutol
  • Pyrazinamide
  • Streptomycin
• Duration of Treatment for Tuberculosis

  Typically for 6 months if no symptoms, 1 yr. if active TB
• We have had in the last 3 yrs. A rise in multi-drug resistant TB organisms
• Active untreated pulmonary TB has a 50% mortality rate at 2 yrs.
• Based on mortality, pulmonary TB is the deadliest pathogen. 1/3 of the world's population is infected
• Common Nursing Managements for Tuberculosis


  • Strict adherence to treatment regimen
  • Supportive care: adequate rest, adequate nutrition, pregnant exposure
• Preventive Measure for Tuberculosis

  Vaccination - BCG (Bacillus Calmette-Guérin) given at birth at deltoid area via intradermal
• Neisseria gonorrhea is a Gram negative diplococcus [two] "the gonococcus" that is usually seen inside phagocytes
• Gonorrhea


  A disease caused by Neisseria gonorrhea
• Mode of Transmission of Gonorrhea

  Sexual contact, Oral - fellatio, cunnilingus, Anal gonorrhea, Blood Transfusion, Vertical transmission
• Incubation Period of Gonorrhea

  1. 3 days after direct contact
• Source of Infection for Gonorrhea

  Reproductive discharges, blood
• Period of Communicability for Gonorrhea


  As long as the bacteria are present in the secretions
• Clinical Signs and Symptoms of Gonorrhea

  • Male Presents as urethritis - Painful urination, Foul smelling exudate, Itching
  • Female - May be inflammation of the cervix and uterine tubes, More than 80% of females are asymptomatic, Untreated in females can lead to PID (Pelvic Inflammatory Disease)