Microbiology

Microbiology: Study of microorganism. Microorganism are of four types

Virus
Can only survive in a favorable condition Causes disease like common cold, AIDS, Chicken pox

Fungus
Unicellular or multi-cellular. Exmp; Candida Causes diseases like Candidiasis, Aspergillosis.

Protozoa
Unicellular. Exmp; Plasmodium sp, Endameba sp. Causes diseases like, Malaria, Amebiosis .

Bacteria
Unicellular. Exmp; E coli, S pneumoniae. Causes many diseases. Some are helpful like Lactobacillus. Can survive in Hot and Cold temp. Can multiply fast.

Algae
Unicellular or Multicellular. Usually not harmful. Exmp; Coccolithophore

Bacteria Classification Cell wall structure

Bacteria are different in terms of there cell wall structure. Different staining is used to identify bacteria. Gram staining: Gram positive- Appears in Violet color after staining. Has thick cell wall. Staphylococcus, Streptococcus. Gram negative- Appears in Red color after staining. Has thin cell wall. Has hard capsule on the top of the cell wall. E coli, Pseudomonus Zeihl Neelson staining: Acid fast bacteria are identified through this method. They have Mycolic acid layer at the top of the cell wall. Mycobacterium tuberculae. Atypical Bacteria: No defined cell wall. Chlamydia, Mycoplasma. Aerobic: Needs Oxygen for survival. Ex; Streptococcus aureus. Anaerobic: Survives in Oxygen free medium. Facultative- Actually Aerobic but can survive in Oxygen free medium. Pseudomonus. Obligatory- Survives only in Oxygen free medium. Bacteroid

Oxygen requirement

Shape/ Morphology

Round: Cocci, Streptococci. Rod: Bacilli, E coli. Coiled: Spirochaete, Coma: Vibrio, Vibrio cholerae Rod with tapered end: Fusoform. Fusobacterium. Any shape: Pleomorphic, Treponoma.
Harmful: Pathogen, Clostridium. Helpful: Comensal

Pathogenecity

Bacteria

Infection:
Invasion and multiplication of Pathogenic micro organism in body.

Nosocomial infection:
Infection that occurs after 48hrs of hospital admission. Nosocomial or Hospital acquired infections are very difficult to treat as they are caused by tough pathogen. Common Hospital pathogens: Staph aureas, Klebsiella, E coli, Pseudomonus, Acinetobacter etc.

ICU: Intensive care unit, Serious and life-threatening diseases are treated in ICU.

Common ICU infections

Urinary Tract Infection(UTI), Nosocomial Pneumonia(HAP), Intra abdominal infection(IAI), Skin and skin structure infection(SSSI), Septicemia(Infection of blood), CNS infection like Meningitis, Endocarditis (infection of Heart) Febrile Neutropenia

All hospital and ICU related infections are serious infections and should be treated with adequate antibiotic therapy to avoid mortality.

Antibiotics

Chemical substance that kills or inhibits the growth of bacteria.

Penicillin (Amoxycillin/Cloxacil lin/Piperacillin) Cephalosporins (Cefixime,Cefepime) Monobactums (Aztreonum) Carbapenems (Imepenem/ Meropenem)

Linezolid

Vancomycin Tiecoplanin

Glycopep tides

Oxazolidi nones

b-lactam

Colistine

Polymixi ns

Antibiotics

Macroli des Quinolo nes

Azithromycin Roxythroimycin

Aminoglyc osides
Amikacin Gentamycin

Tetracycli nes/Glyc ecyclines

Doxycycline Tigecycline

Ciprofloxacin Gemefloxacin Levofloxacin Prulifloxacin

DNA Synthesis inhibitors: Quinolones

Cell wall synthesis inhibitors b-lactams Glycopeptides

DNA Cell Wall Cell membrane Folic Acid Ribosome

Protein synthesis inhibitors Macrolides Aminoglycosides Tetracyclines Oxazolidinone Chloramphenicol Damage cell membrane Polymixins

Folic acid synthesis inhibitors Co-trimaxazole

Bacterial Cell

Some common aspects on Antibiotics

Spectrum of coverage: The ability of an antibiotic to kill or inhibit a particular type of
pathogen. oNarrow spectrum: Effective only against either Gm+ve or Gm-ve. oBroad spectrum: Effective against both Gm+ve and Gm-ve oExtended Spectrum: Effective against Gm+ve,Gm-ve, Anerobes.

Tissue concentration: It signifies the concentration of the drug which reaches the
tissue.

MIC: Minimum inhibitory concentration. Minimum amount of drug required to inhibit the 90% growth of bacteria. Often called as MIC 90
PAE: Post Antibiotic Effect: Effect of antibiotic after the last dose, even after the drug concentration falls below MIC.

Drug Resistance: When bacteria are able to survive even in the presence of
Antibiotics. Bacteria cause resistance through different mechanisms like producing enzymes. Exmp: Bacteria produces b-lactamase enzyme in presence of b-lactam antibiotic. ESBL: Extended spectrum b-lactamase that makes the 3rd Gen Cephalosporins and Monobactum ineffective. b-lactamase inhibitors: Clavulanic acid, Sulbactum, Tazobactum. oMDR: Multi drug resistant pathogen that is resistant to 3 or more number of antibiotics. oPan Drug Resistant: Bacteria that are resistant to most of the Antibiotics. oSome common Resistant pathogen: MRSA (Methicillin resistant Staphylococcus aures). Resistant to all b-lactam antibiotics. VRSA (Vancomycin resistant Staphylococcus aures). VRE Vancomycin resistant Enteroccocci MDRSP Multi drug resistant Streptococcus pneumoniae MDRAB Multi drug resistant Acenetobacter baumanni CRKP Carbapenem resistant Klebsiella pneumoniae