- called bodily invasion of pathogenic

microorganisms to reproduce and

CONTENT OUTLINE multiply, then eventually cause disease
 INFECTION
- TYPES OF INFECTION
- TYPES OF INFECTION ACCORDING
TO HOST DISTRIBUTION
- EXTENT OF INFECTION
TYPES OF INFECTION (ACCORDING TO CAUSE )
- ROUTE OF INFECTION
1. AUTOGENOUS INFECTION
 DISEASE
o Infection from the host
- CLASSIFICATION OF DISEASE
2. IATROGENIC INFECTION
ACCORDING TO OCCURRENCE
o From medical treatment or procedure
- ROUTE OF INFECTION
- EFFECTS OF INFECTIOUS DISEASE o (E.g. catheterization)
- PHASES OF INFECTIOUS DISEASE 3. OPPORTUNISTIC INFECTION
- GENERAL CLASSES OF PATHOGENIC o affects immunocompromised hosts (not an
MICROORGANISMS individual with a normal immune system)
- HOST MICROBE RELATIONSHIP o (E.g. chemotherapeutic drugs)
 VIRULENCE 4. NOSOCOMIAL INFECTION
- FACTORS INFLUENCING MICROBIAL o Hospital-acquired infection
VIRULENCE o Can be prevented through proper
- HOST RESISTANCE FACTORS handwashing
o TWO TYPES OF IMMUNITY - through local cellular injury, they will
o DIFF BODY SITES AND secrete toxin through antibody reaction
THEIR MICROBIOTA of the body
- INFECTIOUS AGENT FACTORS
- ROUTE OF TRANSMISSION 4 COMMON TYPES OF NOSOCOMIAL
 EPIDEMIOLOGY
- FACTORS CONTRIBUTING INFECTION
EPIDEMIOLOGY 1. Urinary tract infection
o TYPES OF CARRIER 2. Lung infection (Pneumonia)
PATHOGENESIS 3. Surgical site infection
 after surgery
4. Blood stream infection
PATHOGENESIS  Ex. blood extraction, hemodialysis,
- development of infection and disease phlebitis, iv infusion set gets dislocated
- There are certain virulence agent with
mechanism of resistance against those PREDISPOSING FACTORS OF NOSOCOMIAL
protective factors that are involved in INFECTION
the proliferation of microorganisms and 1. Variety of microorganisms in the hospital
the progress of disease. 2. Immunocompromised patients
3. Chain of transmission
4. Fomites – inanimate objects (equipments)
INFECTION
5. Air-borne diseases
- Growth and multiplication of 6. Vector-borne transmission – mosquitos
microorganisms that cause damage to
the host cell
  Caused by opportunistic pathogen
TYPES OF INFECTION (ACCORDING TO HOST  Happens when the immune system
DISTRIBUTION ) weakens due to primary infection
1. LOCAL INFECTION  Normal flora itself would attack
o Confined in one area 3. LATENT INFECTION (Silent phase)
o Ex. boils, abscesses, acnes  clinically silent inside the body
2. FOCAL INFECTION  cause no noticeable illness to the host
o From local spreads to other  eventually, a severe and acute infection
o Ex. Tonsillitis, wound infection by will manifest
Clostridium tetani, etc.  Ex. asymptomatic type polio infection
3. SYSTEMIC INFECTION 4. MIXED INFECTION
o Infection spreads through blood and  two or more infection (or organism)
lymph  Ex. wound infection
5. ACUTE INFECTION
 develops and progresses slowly (e.g.
woofing cough)
6. CHRONIC INFECTION
 infection develops slowly but long
lasting
 Ex. tuberculosis

4 TYPES OF SYSTEMIC INFECTION

1. Bacteremia
 Presence of bacteria in the blood
DISEASE
 bacter – bacteria; emia – blood
 bacteria invade bloodstream without
multiplying
 “the highest concentration of bacteria
in the blood occurs before the fever
strikes”
2. Septicemia
 Sepsis - active multiplication of
bacteria in the blood
3. Pyemia
 Pye – pus; emia – blood
 Pus producing organisms invade blood
4. Toxemia
 Presence of toxin in the blood

EXTENT OF INFECTION - Specific illness or disorder that is

1. PRIMARY INFECTION characterized by a recognizable set of
 Initial infection that causes the illness symptoms, which are attributable to
(e.g. cold)
2. SECONDARY INFECTION
 hereditary, infection,
environment
diet, or  mother to fetus
 S. agalactiae, N. gonorrhoeae
and syphilis
1.2. Sexual Contact
 C. trachomatis, N. gonorrhoeae
and syphilis
1.3. Infectious respiratory droplets
 N. meningitidis
1.4. Hand to hand transmission
 Rhinovirus
o causes common cold
o has many serotype
2. INDIRECT TRANSMISSION
2.1. Fomites
 inanimate objects
2.2. Water
 Salmonella, Shigella and Vibrio
o Causes diarrhea or cholera
2.3. Arthropod vectors
 Borrelia (caused by tick or
garapata) , Francisella and
Yersinia

CLASSIFICATION OF INFECTIOUS DISEASE

1. COMMUNICABLE
CLASSIFICATION OF DISEASE OR (ACCORDING
CONTAGIOUSTO
DISEASE EFFECTS OF INFECTIOUS DISEASE
OCCURRENCE) 1. SIGNS
 Spread from one host to another
1. SPORADIC DISEASE  Objective changes that can be
(directly or indirectly)
- occasionally measured
 Ex. tuberculosis, herpes, flu, and
2. ENDEMIC DISEASE  Ex. fever (measured using
chickenpox
- constantly present thermometer), redness, swelling, and
2. NON-COMMUNICABLE DISEASE
3.  EPIDEMIC paralysis
Does not spread from one host to
- another
Affects large number of people in 2. SYMPTOMS
a short span
by of time microbes or  Subjective indications of the disease in
 Usually caused external
4. PANDEMIC DISEASE a person
opportunistic pathogen inside the body
- Affects across large region around  Subjective - (complains of patient)
the world  Ex. Pain and malaise

3. SYNDROME
 Group of signs and symptoms
ROUTE OF INFECTION  Ex. Acquired Immune Deficiency
1. DIRECT TRANSMISSION syndrome (AIDS)
1.1. Congenital
PHASES OF INFECTIOUS DISEASE
1. INCUBATION PERIOD
- Time between the exposure to
pathogen and onset of symptoms
2. PRODROMAL PERIOD
- Appearance of signs and symptoms
3. CLINICAL OR ILLNESS PERIOD
- Peak characteristic of sign and
symptoms of an infection
4. DECLINE PERIOD
- Period in which the signs and symptoms
begin to subside
5. CONVALESCENCE OR PERIOD OF RECOVERY
- Period in which the surviving host is
recuperating towards full recovery
GENERAL CLASSES OF PATHOGENIC
MICROORGANISMS
1. TRUE PATHOGENS
- Organisms are able to invade the tissue
of healthy individual
- Normally found outside the host
2. OPPORTUNISTIC PATHOGENS
- Normally do not cause disease in their
natural habitat to a healthy person
- Cause disease if the host is
immunocompromised (or if they enter
a different part of the body)
- The normal flora causes infection when
immunocompromised
- Ex. Neisseria meningitidis and
Escherichia coli
HOST MICROBE RELATIONSHIP
1. SYMBIOSIS
- two organisms living in close proximity
2. MUTUALISM
- both organisms benefit from each other
3. COMMENSALISM
- One organism benefits while there is no
beneficial or harmful effect to the other
4. PARASITISM
- One organism (parasite) benefits at the
expense of its host.
VIRULENCE
- ability of microorganisms to cause
disease
- it is the degree of pathogenicity
- Organisms that can establish infection
with a relatively low infection dose.
More virulent than those that requires
high dose for infection.
FACTORS INFLUENCING MICROBIAL
VIRULENCE
1. Toxic factors
- toxins are produced by microorganisms
causing tissue and cellular damage
- Ex. Diphtheria toxin, tetanospasmin,
botulism toxin
2. Enzymatic factors
- aid in the spread of infection or disease
- Ex. Hyaluronidase, Coagulase,
Leucocidin, collagenase
3. Cellular structure
- E.g. capsule of bacteria can resist
phagocytosis (engulfment of
microorganisms)
HOST RESISTANCE FACTORS
1. PHYSICAL BARRIER
- Skin serves as the physical and chemical
barrier to microorganisms
- Ex. stricture of urethral opening, the
flushing action of urination and thick
mucus plug in the cervical opening
2. CLEANSING MECHANISM
- Nasal hair, cough-sneeze reflex and cell
lining of trachea
3. ANTIMICROBIAL SUBSTANCE
- Lysozymes: destroy bacterial cell wall
- Bile salts: disrupt bacterial membranes
TWO TYPES OF MICROBIOTA: (No. 4)
1. RESIDENT MICROBIOTA
- Temporarily inhabit, multiply in and
colonize an area for months or years
2. TRANSIENT MICROBIOTA
- Inhabit (do not multiply) and
colonize an area until they are
eliminated.
 Different body sites and their respective

4. INDIGENOUS/ NORMAL MICROBIAL FLORA TWO TYPES OF IMMUNITY:

OR MICROBIOTA
- Microorganisms commonly found on or 1. NATURAL/ INNATE IMMUNITY
in the body sites of healthy person.  Skin, cough reflex, flushing action of
- Also known as microbiota urine, pH of vagina, acidic pH of
5. PHAGOCYTOSIS stomach
- phago – eat; cyto –cell
2. ADAPTIVE/ ACQUIRED IMMUNITY
- process in which certain cells called
phagocytes engulf and dispose of  Antibody
microorganisms and cell debris
- endocytosis – engulf microorganisms TWO TYPES OF ADAPTIVE/ ACQUIRES
and digest IMMUNITY
- except Bacillus, Klebsiella
a. HUMORAL (ANTIBODY-MEDIATED)
pneumoniae, Streptococcus
IMMUNITY
pneumoniae which are encapsulated
 Action of soluble proteins called
bacteria that can resist phagocytosis
antibodies occur on body fluid
6. INFLAMATION
and surface of B-lymphocyte
- Serves as a reinforcement
b. CELLULAR (CELL-MEDIATED)
mechanism against microbial survival
IMMUNITY
and proliferation in tissue and
 Action of specific kind of T-
organs.
lymphocyte that directly attack
- Signs: swelling, redness, burning
sensation, pain in the affected areas
a. redness (rubor);
b. swelling (tumour);
c. heat (calor; only applicable to the INFECTIOUS AGENT FACTORS
body's extremities); 1. ADHERENCE
d. pain (dolor) and; - Organisms must penetrate the mucus layer
e. loss of function (functio laesa). and attach to the epithelium
- Components of inflammation: - main adhesins in bacteria: common pilli and
phagocytes, neutrophil, macrophage, surface polysaccharide
complement system (classical, 2. PROLIFERATION
alternative), coagulation system, - Pathogen must multiply, following its
primary and secondary hemostasis, attachment to host cells
cytokines - Inhibitors: antibody, lactoferrin and
a. attract different cells to help fight lysozymes
infection 3. TISSUE DAMAGE
7. IMMUNO RESPONSE - Either through performed toxins or
- Provides the human host with the disruption of the normal functioning of
ability to create a specific protective the intestinal cells
response against microorganisms 4. PRODUCTION OF TOXINS
- Fades due to radiation or
chemotherapy
 EPIDEMIOLOGY
TWO CLASSIFICATIONS OF TOXINS (No. 4)

1. EXOTOXINS
- Study of occurrence, distribution and
- One of the
causes most lethal
of disease substances
and injury
- Gram positive bacteria
- Do not require bacterial death to be
FACTORS CONTRIBUTING
released to circulation TO
- Example: Clostridium botulinum,
EPIDEMIOLOGY
Corynebacterium diptheriae,
1. CARRIER
Staphylococcus aureus and
- person or animal that
Streptococcus pyogenes harbour and spread
organisms
2. ENDOTOXINS but does not become ill himself
2. LIKELIHOOD
- Composed OFofBECOMING ENDEMIC ]
the lipopolysaccharide
-- organism
Present only is inconstantly
gram negative present
bacteriain a
- Released when bacteria die and their
FOUR TYPES OF CARRIER:
cell wall undergo lysis
-1. Toxicity
CASUAL/isACUTE/
due to TRANSIENT
LIPID A portion of LPS
CARRIER
- LPS- mayHarbors
elicit fever, chills, hypotension,
microorganisms temporarily
for a few days or weeks
granulocytosis, thrombocytopenia, and
2. disseminated
CHRONIC CARRIER intravascular coagulation
-Note:
Remain infectedshock
endotoxic for a result
relativelyof long
time, sometimes its entire life.
gram negative septicemia
3. CONVALESCENT CARRIER
b.
5. INVASION - Individual recovered from infection but
continues to harbour large number of
- Process of penetrating and growing
pathogen
in tissue
4. ACTIVE CARRIER
- Small parts of tissue penetration or - Individual who has an overt clinical case
deep tissue penetration of a disease
6. DISSEMINATION
- Spread of microorganisms to distant
population
body sites
3. LIKELIHOOD OF BECOMING EPIDEMIC
- affects significant large number of people in
ROUTE OF TRANSMISSION a short period of time.
1. Airborne transmission - Ex. Influenza
2. Transmission by food and water 4. LIKELIHOOD OF BECOMING PANDEMIC
3. Close Contact - affects huge population across large regions
4. Cuts and bites like countries and continent.
5. Arthropods - Ex. COVID 19
6. Zoonoses 5. INCIDENCE RATE
- Number of times a new event occurs in a
given period of time
6. INCUBATION PERIOD
 - time between exposure and onset of
symptoms

7. MORBIDITY RATE
- number of cases of a disease in a specified
population during defined time interval
- measures the infectiousness of an organism
8. MORTALITY RATE
- number of death due to a disease in a
population BIOLOGICAL SAFETY CABINET
9. RESERVOIR
CLASS I CABINET
- source of an infection
- Open-fronted cabinet with negative
pressure
- Room air —----> sterilized using HEPA filter
CONTENT OUTLINE - Only air to be exhausted is sterilized
 BIOLOGICAL SAFETY CABINET
- CLASS I, II, AND III CABINETS
 CLASSIFICATION OF BIOLOGIC AGENTS
- BIOSAFETY LEVELS 1, 2, 3, AND 4
AGENTS
 CATEGORIES OF POTENTIAL
INFECTIOUS AGENT OF BIOTERRORISM
- CATEGORIES A, B, AND C
 LABORATORY HANDLING
 PERSONAL PROTECTIVE EQUIPMENT - Used for biosafety levels (BSL) 2 and 3
 INFECTIOUS CONTROL agents
- HAZARDOUS WASTE
- DISPOSAL OF HAZARDOUS WASTE
- CLASS II CABINET
- Also known as Laminar flow BSC
BIOSAFETY IN MICROBIOLOGY - Most commonly used BSC
LABORATORY - Sterilized air using HEPA filter flows over
the infectious material and the air to be
BIOLOGICAL SAFETY CABINET exhausted
- Used for biosafety levels (BSL) 2 and 3
- Device that enclose a working area to agents
protect workers from aerosol exposure - 2 types of Class II cabinet
and infectious disease agents. o Class II A: has fixed opening; 70% of
- Air that contains the infectious material the air recirculated
is sterilized thru:
 Heat
 UV light
 Passage through a high-
efficiency particulate (HEPA)
resistance filter
 o Class II B: used for chemicals,
radioisotopes and carcinogens.
CLASSIFICATION OF BIOLOGIC
AGENTS

Most hospital clinical microbiology BIOSAFETY LEVEL 1 AGENTS

laboratory technologist use Class II BSC - No known potential for infecting healthy
people
- For academic purposes
- Ex: Bacillus subtilis and Naegleria gruberi

BIOSAFETY LEVEL 2 AGENTS

- Agents acquired by ingestion and
exposure to percutaneous and mucous
membrane
- All common agents of infectious diseases
- Ex: HIV, Bacillus anthracis, Yersinia pestis,
Salmonella sp. and Shigella sp.

Difference between Class I and Class II: BIOSAFETY LEVEL 3 AGENTS

- Potential agent for aerosol transmission
Class I: Only air to
- Must have extra precaution in processing
be exhausted is
sterilized. lethal pathogen
- Ex: Mycobacterium tuberculosis,
Class II: Sterilized
Francisella tularensis, Brucella spp.,
air using HEPA
Coxiella burnetti, St. Louis encephalitis
filter flows over the
and systemic fungi
infectious material
and the air to be
exhausted BIOSAFETY LEVEL 4 AGENTS
- Life-threatening infections
CLASS III CABINET - Needs maximum containment and
- Provides the highest level of safety to the decontamination of all personnel and
worker materials before leaving the area.
- Air coming into and going out of the - Example: arbovirus, arenavirus, filovirus
cabinet is sterilized using HEPA filter. and smallpox virus
- Infectious material within is handled with
rubber gloves CATEGORIES OF POTENTIAL
Used for INFECTIOUS AGENT OF
biosafety levels BIOTERRORISM
(BSL) 4 agents
CATEGORY A
- Agent that poses the greatest public
health threat
- Easily transmitted and highly infectious
 - Examples: smallpox, Bacillus anthracis and MUST REMOVED BEFORE leaving the work
Francisella tularensis area and MUST BE DISPOSED in PPE-
assigned areas.
Difference between biosafety levels and
categories INFECTIOUS CONTROL
Biosafety levels
HAZARDOUS WASTE
are organisms
- These are substances, which singly or in
that can be
combination, have a significant threat or
processed inside
hazard to human or to the environment
the laboratory.
and require special handling, processing
Categories can
or disposal
be used as agent
- Flammable, explosive, reactive, corrosive,
for bioterrorism
carcinogenic, bio concentrative in nature,
irritant to the skin, oxidizer

CATEGORY B DISPOSAL OF HAZARDOUS WASTE

- Moderate morbidity and low mortality
- Not easily transmitted
- Examples: Coxiella burnetti, Burkholderia
pseudomallei and Rickettsia sp.
CATEGORY C
- Emerging pathogens
- Examples: viruses that causes yellow fever
and dengue hemorrhagic fever.
LABORATORY AIR-HANDLING
SYSTEM
- Should be under negative pressure
- Move air from lower to higher risk areas
- Maximum precaution
- Ex: Mycobacterium tuberculosis
o All materials contaminated with
potentially infectious agents must
be decontaminated before
disposal using an autoclave,
incinerator or alternative waste
treatment methods.
o Pipettes, swab and other glass
objects should be placed inside a
firm cardboard container before
disposal.
o Sharp objects (needles and
scalpels) place in containers that
are autoclaved and incinerated.

PERSONAL PROTECTIVE
EQUIPMENT (PPE)
- Laboratory coat
- Gloves
- Mask
- Goggles
- Face shield