NEET MDS Lessons
General Microbiology
DISINFECTION AND STERILIZATION
• Sterilization is the best destruction or com removal_of all forms of micro organisms.
• Disinfection is the destruction of many microorganisms but usually the b spores.
• Antisepsis is the destruction or inhibition of microorganisms in living tissues thereby limiting or preventing the harmful effect of infection.
• Astatic Agent would only inhibit the growth of microorganisms (bacteriostatic, fungistatic, sporostatic).
• Acidal agent would kill the microorganism (bactericidal. virucidal, fungicidal)
• Sterilants are the chemicals which under controlled conditions can kill sporinQ bacteria.
NUTRITION OF BACTERIA
Nutrients
Chemoheterotrophs: nutrient source is organic material
Bacteria also requires a source of minerals.
Oxygen
On this basis bacteria have been divided into four groups.
Obligate Anaerobes: These grow only under conditions of high reducing intensity. These bacteria catalase peroxidase, superoxide dismutase and cytochrome systems
Clostridium and Bacteroides are important examples.
Facultalive Anaerobes. These can grow under both aerobic and anaerobic conditions and include members of family enterobacteriaceae and many other bacteria.
Obligatory Aerobes. These cannot grow unless oxygen is present in the medium. Pseudomonas belong to this group.
Microaerophillic. These organisms can grow under conditions with low oxygen tension. Clostridium tetani is an important example.
The strict anaerobes are unable to grow unless Eh is as low as 0.2 volt
Temperature
• On the basis of temperature requirements, three groups of bacteria are recognised.
• Psychrophilic : Growth in the range of —5 to 30°C with an optimum of 10-20
• Mesophillic : bacteria grow best at 20-40°C with a range of 10-45°C.
• Medically important bacteria belong to this group
• Myco. leprae is one such important example and it can grow only at reduced temperature such as footpad of mouse
• Thermophillic organisms prefer high temperature (25-80°C) for growth and yield maximum growth at 50-60°C
pH : Most pathogenic bacteria require a pH of 7.2-7.6 for their own optimal growth.
CHEMICAL AGENTS
Chlorine and iodine are most useful disinfectant Iodine as a skin disinfectant and chlorine as a water disinfectant have given consistently magnificent results. Their activity is almost exclusively bactericidal and they are effective against sporulating organisms also.
Mixtures of various surface acting agents with iodine are known as iodophores and these are used for the sterilization of dairy products.
Apart from chlorine, hypochlorite, inorganic chioramines are all good disinfectants but they act by liberating chlorine.
Hydrogen peroxide in a 3% solution is a harmless but very weak disinfectant whose primary use is in the cleansing of the wound.
Potassium permanganate is another oxidising agent which is used in the treatment of urethntzs.
Formaldehyde — is one of the least selective agent acting on proteins. It is a gas that is usually employed as its 37% solution, formalin.
When used in sufficiently high concentration it destroys the bacteria and their spores.
Classification of chemical sterilizing agents
Chemical disinfectant
Interfere with membrane functions
• Surface acting agents : Quaternary ammonium, Compounds, Soaps and fatty acids
• Phenols : Phenol, cresol, Hexylresorcinol
• Organic solvent : Chloroform, Alcohol
Denatures proteins
• Acids and alkalies : Organic acids, Hydrochloric acid , Sulphuric acid
Destroy functional groups of proteins
• Heavy metals : Copper, silver , Mercury
• Oxidizing agents: Iodine, chlorine, Hydrogen peroxide
• Dyes : Acridine orange, Acriflavine
• Alkylating agents : Formaldehyde, Ethylene oxide
Applications and in-use dilution of chemical disinfectants
Alcohols : Skin antiseptic Surface disinfectant, Dilution used 70%
Mercurials : Skin antiseptic Surface disinfectant Dilution Used 0.1 %
Silver nitrate : Antiseptic (eyes and burns) Dilution Used 1 %
Phenolic compound : Antiseptic skin washes Dilution Used .5 -5 %
Iodine : Disinfects inanimate object, Skin antiseptic Dilution used 2%
Chlorine compounds : Water treatment Disinfect inanimate objects , Dillution used 5 %
Quaternary ammonium Compounds : Skin antiseptic , Disinfects inanimate object, Dilution Used < 1 %
Glutaraldehyde: Heat sensitve instruments, Dilution used 1-2 %
Cold sterilization can be achieved by dipping the precleaned instrument in 2% solution of gluteraldehyde for 15-20 minutes. This time is sufficient to kill the vegetative form as well as spores ofthe organisms that are commonly encountered in the dentistry.
Ethylene oxide is an a agent extensively used in gaseous sterilization. It is active against all kinds of bacteria and their spores. but its greatest utility is in sterilizing those objects which are damaged by heat (e.g. heart lung machine). It is also used to sterlise fragile, heat sensitive equipment, powders as well as components of space crafts.
Evaluation of Disinfectants
Two methods which are widely employed are:
Phenol coefficient test, Kelsey -Sykes test
These tests determine the capacity of disinfectant as well as their ability to retain their activity.
GENETIC VARIATION
Two methods are known for genetic variation in bacteria: mutation and gene transfer.
Mutation : Any change in the sequence of bases of DNA, irrespective of detectable changes in the cell phenotype. Mutations may be spontaneous or induced by various agents which are known as mutagens.
Spontaneous Mutations: Arise from enzymatic imperfections during DNA replications or with transient insertions of transposable elements.
Induced Mutations: Mutation by physical and chemical mutagens.
Physical mutagens ultraviolet rays and high-energy ionizing radiations. The primary effect of UV rays on DNA is the production of pyrmidine dimers whereas ionizing radiations cause single_stranded breaks the DNA molecules.
Chemical mutagens :Affecting nucleotide sequence
(i) Agents which cause error in base pairing (e.g. nitrous acid and alkylating agents).
(ii) Agents which cause errors in DNA replication (e.g. acridine dyes such as acridine orange and profiavine).
(iii) Base analogs which are incorporated into DNA and cause replication errors (e.g. 5-bromouracil)
Gene Transfer
Transformation: Uptake of naked DNA
Transduction : Infection by a nonlethal bacteriophage
Conjugation : Mating between cells in contact
Protoplast fusion
Transformation: Gene transfer by soluble DNA is called as transformation. it requires that DNA be absorbed by the cell, gain entrance to the cytoplasm and undergo recombination with the host genome.
Artificial Transformation(transfection) :Some of the bacteria (such as Escherichia coli) resist transformation until they are subjected to some special treatment such as CaCl2 to make the bacterium more permeable to DNA. Such modified cells can also take up intact double stranded DNA extracted from viruses or in the shape of plasmids. Though the process is same as transformation, it is 9 as transfection because it results in infection by an abnormal route
Transduction :The type of gene transfer in which the DNA of one bacterial cell is introduced into another bacterial cell by viral infection is known as transduction. This introduces only a small fragment of DNA. Because the DNA is protected from damage by the surrounding phage coat, transduction is an easier to perform and more reproducible process than transduction. ,
Two types of transduction are known.
- Generalized transduction When a bacteriophage picks up fragments of host DNA at random and can transfer any genes
- Specialised transduction: phage DNA that has been integrated into the host chromosome is excised along with a few adjacent genes, which the phage can then transfer.
After entry into the host cell, the phage DNA gets incorporated into the host chromosome in such a way that the two genomes are linearly contiguous (lysogeny). The phage genome in this stage is known as prophage, The host cell acquires a significant new property as a consequence of lysogeny because it becomes immune to infection by homologous phage. This is hence called as lysogenic conversion and endow toxigenicity to Corynebacterium diphtheriae
Abortive Transduction :phage DNA fails to integrated into the host chromosome, the process is called as abortive transduction The phage DNA does not replicate and along with binary fission Of the host it goes into one of the daughter cells.
Conjugation :This is defined as the transfer of DNA directly from on bacterial. .cell to another by a mechanism that requires cell-to-cell contact.
The capacity to donate DNA depends upon the possession of the fertility (F) factor. The F pili also retard male-male union. Concomitant with effective male-female pair formation, the circular DNA bearing the F factor is converted to a linear form that is transferred to the female cell in a sequential manner. DNA replication occurs in the male cell and the newly synthesized, semiconserved DNA molecule remains in the male. This ensures postmating characters of the male.
Conjugation in Different Bacteria: Unusual form of plasmid transfer, called phase mediated conjugation has been reported to occur with some strains of Staphylococcus aureus.
Protoplast Fusion: Also called as genetic transfusion. Under osmotically buffered Conditions protoplast fusion takes place by joining of cell membrane and generation of cytoplasmic bridges through which genetic material can be exchanged.
Transposons: Transposons Tn are DNA sequences which are incapable of autonomous existence and which transpose blocks of genetic material back and forth between cell Chromosome and smaller replicons such as plasmids. insertion sequences (IS ) are another similar group of nucleotides which can move from one chromosome to another
Genetic material. IS and Tn are collectively also known as transposable elements or Jumping genes. These are now recognised to play an important role in bringing about vanous types of mutations.
Precipitation Reaction
This reaction takes place only when antigen is in soluble form. Such an antigen when
comes in contact with specific antibody in a suitable medium results into formation of an insoluble complex which precipitates. This precipitate usually settles down at the bottom of the tube. If it fails to sediment and remains suspended as floccules the reaction is known as flocculation. Precipitation also requires optimal concentration of NaCl, suitable temperature and appropriate pH.
Zone Phenomenon
Precipitation occurs most rapidly and abundantly when antigen and antibody are in optimal proportions or equivalent ratio. This is also known as zone of equivalence. When antibody is in great excess, lot of antibody remains uncombined. This is called zone of antibody excess or prozone. Similarly a zone of antigen excess occurs in which all antibody has combined with antigen and additional uncombined antigen is present.
Applications of Precipitation Reactions
Both qualitative determination as well as quantitative estimation of antigen and antibody can be performed with precipitation tests. Detection of antigens has been found to be more sensitive.
Agglutination
In agglutination reaction the antigen is a part of the surface of some particulate material such as erythrocyte, bacterium or an inorganic particle e.g. polystyrene latex which has been coated with antigen. Antibody added to a suspension of such particles combines with the surface antigen and links them together to form clearly visible aggregate which is called as agglutination.
Application of precipitation reactions
Precipitation reaction Example
Ring test Typing of streptococci, Typing of pneumococci
Slide test (flocculation) VDRL test
Tube test (flocculation) Kahn test
Immunodiffusion Eleks test
Immunoelectrophoresis Detection Of HBsAg, Cryptococcal antigen in CSF
COMPLEMENT
The complement system primarily serves to fight bacterial infections.
The complement system can be activated by at least three separate pathways.
1) alternative pathway -
- The alternative pathway of complement activation starts with the spontaneous hydroysis of an internal thioester bond in the plasma complement component C3 to result in C3(H2O).
- The smaller cleavage products C3a, C4a, C5a, sometimes called "anaphylatoxins", act as phagocytes, they cause mast cell degranulation and enhance vessel permeability, thereby facilitating access of plasma proteins and leukocytes to the site of infection
- alternative pathway provides a means of non-specific resistance against infection without the participation of antibodies and hence provides a first line of defense against a number of infectious agents.
2) Lecithin Pathway
The lectin pathway of complement activation exploits the fact that many bacterial surfaces contain mannose sugar molecules in a characteristic spacing. The oligomeric plasma protein mannan-binding lectin (MBL; lectins are proteins binding sugars) binds to such a pattern of mannose moieties, activating proteases MASP-1 and MASP-2 (MASP=MBL activated serine protease, similar in structure to C1r and C1s). These, by cleaving C4 and C2, generate a second type of C3 convertase consisting of C4b and C2b, with ensuing events identical to those of the alternative pathway.
3) classical pathway
The classical pathway usually starts with antigen-bound antibodies recruiting the C1q component, followed by binding and sequential activation of C1r and C1s serine proteases. C1s cleaves C4 and C2, with C4b and C2b forming the C3 convertase of the classical pathway. Yet, this pathway can also be activated in the absence of antibodies by the plasma protein CRP (C-reactive protein), which binds to bacterial surfaces and is able to activate C1q.
Pharmacology cross reference: humanized monoclonal antibody Eculizumab binds to complement component C5, inhibiting its cleavage and preventing activation of the lytic pathway. This is desirable when unwanted complement activation causes hemolysis, as in paroxysmal nocturnal hemoglobinuria or in some forms of hemolytic uremic syndrome. For the lytic pathway's importance in fighting meningococcal infections, Eculizumab treatment increases the risk of these infections, which may be prevented by previous vaccination.
BIOLOGICALLY ACTIVE PRODUCTS OF COMPLEMENT ACTIVATION
Activation of complement results in the production of several biologically active molecules which contribute to resistance, anaphylaxis and inflammation.
Kinin production
C2b generated during the classical pathway of C activation is a prokinin which becomes biologically active following enzymatic alteration by plasmin. Excess C2b production is prevented by limiting C2 activation by C1 inhibitor (C1-INH) also known as serpin which displaces C1rs from the C1qrs complex (Figure 10). A genetic deficiency of C1-INH results in an overproduction of C2b and is the cause of hereditary angioneurotic edema. This condition can be treated with Danazol which promotes C1-INH production or with ε-amino caproic acid which decreases plasmin activity.
Anaphylotoxins
C4a, C3a and C5a (in increasing order of activity) are all anaphylotoxins which cause basophil/mast cell degranulation and smooth muscle contraction. Undesirable effects of these peptides are controlled by carboxypeptidase B (C3a-INA).
Chemotactic Factors
C5a and MAC (C5b67) are both chemotactic. C5a is also a potent activator of neutrophils, basophils and macrophages and causes induction of adhesion molecules on vascular endothelial cells.
Opsonins
C3b and C4b in the surface of microorganisms attach to C-receptor (CR1) on phagocytic cells and promote phagocytosis.
Other Biologically active products of C activation
Degradation products of C3 (iC3b, C3d and C3e) also bind to different cells by distinct receptors and modulate their functions.
Immunofluorescence
This is precipitation or complement fixation tests. The technique can detect proteins at concentrations of around 1 µg protein per ml body fluid. Major disadvantage with this technique is frequent occurrence of nonspecific fluorescence in the tissues and other material.
The fluorescent dyes commonly used are fluorescein isothocyanate (FITC). These dyes exhibit fluorescence by absorbing UV light between 290 and 495 nm and emitting longer wavelength coloured light of 525 nm which gives shining appearance (fluorescence) to protein labelled with dye. Blue green (apple green) fluorescence is seen with FITC and orange red with rhodamine.
Enzyme Immunoassays
These are commonly called as enzyme linked immunosorbent assays or EL1SA. It is a simple and versatile technique which is as sensitive as radioimmunoassays. It is now the
technique for the detection of antigens, antibodies, hormones, toxins and viruses.
Identification of organisms by immunofluorescence
Type of agent Examples
Bacterial Neisseria gonorrhoeae, H. influenzae ,Strept pyogenes, Treponema pallidum
Viral Herpesvirus, Rabiesvirus, Epstein-Barr virus
Mycotic Candida albicans
Enzymatic activity results in a colour change which can be assessed visibly or quantified in a simple spectrophotometer.