BIRAO, JOHN CARLO P.

BSN 2-A3

HES032 (Microbiology and Parasitology)

STUDENT ACTIVITY SHEET BS NURSING / SECOND YEAR
Session # 13

LESSON TITLE: Bacterial Infections of Humans Part 2 Materials:

LEARNING OUTCOMES: Book, pen, notebook, and paper

At the end of the lesson, the nursing student can:

1. Name at least five (5) bacterial disease of medical Reference:
importance;
2. Correlate a particular bacterial disease with its major Engelkirk, P., & Engelkirk, J. (2015). Burton's
th
signs and symptoms, pathogen, reservoir(s), and Microbiology for the Health and Sciences. 10 ed.,
mode(s) of transmission. Philadelphia: Lipincott Williams & Wilkins
3. Differentiate the carbohydrate fermentation of Neisseria
spp.

Daily Productivity Tip:

Work in 90-minutes increments. You may use a work timer to keep track.

LESSON PREVIEW / REVIEW (5 minutes)

Let us recall last session by filling in the table below:

Anthrax Leprosy Tuberculosis

Pathogens
Reservoirs and Mode of
Transmission

Great! Today’s discussion is a continuation of the previous session. Let’s begin.

MAIN LESSON (50 minutes)

A. Bacterial Infections of the Gastrointestinal Tract

1. Bacterial Gastritis and Gastric Ulcers

Gastritis is suspected when a person has upper abdominal pain with nausea or heartburn. People with duodenal ulcers may
experience gnawing, burning, aching, mild-to-moderate pain just below the breastbone, an empty feeling, and hunger. The
pain usually occurs when the stomach is empty.

Pathogen: Helicobacter pylori

Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. Transmission probably occurs via
ingestion; presumed to be either oral–oral or fecal–oral transmission.

After colonization, the H pylori infection persists for years and perhaps decades
or even a lifetime. Destruction of the epithelium is common, and glandular
atrophy may occur. H pylori thus is a major risk factor for gastric cancer.

2. Campylobacter Enteritis
Campylobacter enteritis is an acute bacterial enteric disease, ranging from asymptomatic to severe, with diarrhea, nausea,
vomiting, fever, malaise, and abdominal pain.

Pathogens: Campylobacter jejuni, Campylobacter coli (less common)

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Reservoirs and Mode of Transmission: Reservoirs are animals including poultry, cattle, sheep, swine, rodents’ birds,
kittens, puppies, and other pets. Most raw poultry is contaminated with C. jejuni, thus necessitating proper methods of
cleaning and disinfecting in the kitchen. raw milk, or water; contact with infected pets or farm animals; or contaminated
cutting boards.

3. Cholera
Cholera is an acute, bacterial diarrheal disease with profuse watery stools (resemble ―rice water‖) occasional vomiting, and
rapid dehydration. If untreated, circulatory collapse, renal failure, and death may occur.

Pathogens: Vibrio cholerae serogroup 01 and 0139.

Reservoirs and Mode of Transmission: Reservoirs include infected humans and aquatic reservoirs (copepods and other
zooplankton). Transmission occurs via the fecal–oral route, contact with feces or vomitus of infected people, ingestion of
fecally contaminated water or foods (especially raw or undercooked shellfish and other seafood), or mechanical
transmission by flies.

4. Salmonellosis
Salmonellosis is gastroenteritis with sudden onset of headache, abdominal pain, diarrhea, nausea, and sometimes vomiting.
Dehydration may be severe. Salmonellosis may develop into septicemia or localized infection in any tissue of the body.

Pathogens: Salmonella enterica

Reservoirs and Mode of Transmission: Reservoirs include a wide range of wild and domestic animals, such as poultry,
swine, cattle, rodents, reptiles (e.g., pet iguanas and turtles), pet chicks, dogs, and cats. Infected humans (e.g., patients,
carriers) are also reservoirs. Transmission occurs via ingestion of contaminated food (e.g., eggs, unpasteurized milk, meat,
poultry, raw fruits and vegetables), fecal–oral transmission from person to person, food handlers, or contaminated water
supplies.

5. Typhoid Fever (Enteric Fever)

Typhoid fever is a systemic bacterial disease with fever, severe headache, malaise, anorexia, a rash on the trunk in about
25% of patients, nonproductive cough, and constipation. The ingested salmonellae reach the small intestine, from which
they enter the lymphatics and then the bloodstream.

Pathogen: Salmonella typhi (also known as the typhoid bacillus)

Reservoirs and Mode of Transmission: Infected humans serve as reservoirs for typhoid and paratyphoid; Some people
become carriers following infection, shedding the pathogens in their feces or urine. Transmission occurs via the fecal–oral
route; food or water contaminated by feces or urine of patients or carriers; oysters harvested from fecally contaminated
waters; fecally contaminated fruits and raw vegetables; or from feces to food by mechanical transmission by flies.

6. Shigellosis (Bacillary Dysentery)

Shigellosis is an acute bacterial infection of the lining of the small and large intestine, producing diarrhea (as many as 20
bowel movements a day) with blood, mucus, and pus.

Pathogens: Shigella dysenteriae (Group A; most severe), Shigella flexneri (Group B), Shigella boydii (Group C), and
Shigella soneii (Group D; most common)
Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. People become infected by direct or
indirect fecal–oral transmission from patients or carriers; fecally contaminated hands and fingernails; or fecally
contaminated food, milk, and drinking water. Flies can mechanically transfer organisms from latrines to food.

7. Gastroenteritis caused by Other Bacteria

Bacillus cereus Two distinct forms: Fried-rice syndrome

Emetic type (associated with fried rice)
Diarrheal type (associated with meat
dishes and sauces)
Clostridium perfringens (most common produces entertoxin in the host after Meats and gravies are typical
cause of food poisoning is the type A) ingestion. As a result, a relatively mild, foods associated with this type
self-limited (usually 24-hour) of food poisoning.
gastroenteritis occurs, often in
outbreaks in hospitals.

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 Clostridium botulinum produces the most potent neurotoxin Infant botulism: babies
which blocks the release of acquired the organism by
acetylcholine, causing flaccid paralysis. ingestion of spores found in
The risk from home- honey and corn syrup (Floppy
canned foods can be Spores are widely distrubuted in soil. Baby Syndrome)
reduced if the food is
boiled for more than In most cases, adult patients
20 minutes before who develop botulism have
consumption. ingested the preformed toxin in
food (home-canned tomato
products and canned,
creambased foods are often
implicated).

Clostridium difficile As many as 25% of cases of antibiotic- Pseudomembranous colitis

associated diarrhea are caused by C.
difficile infection. Although many antibiotics have
been associated with
The diarrhea may be watery or bloody, pseudomembranous colitis, the
and the patient frequently has most common are ampicillin
associated abdominal cramps, and clindamycin and more
leukocytosis, and fever. recently, the fluoroquinolones.

8. Escherichia coli-associated Diarrheal Diseases

Enterotoxigenic (ETEC) produces enterotoxin causing watery common cause of traveler’s diarrhea;
diarrhea infects all ages
Enteroaggregative (EAEC) acute and chronic diarrhea (>14 days in infects primarily young children
duration)
Enteroinvasive (EIEC) invade the intestinal mucosal epithelial very difficult to distinguish from
cells causing a a disease very similar to Shigella spp. and other E. coli strains
shigellosis
Enteropathogenic (EPEC) adherence to the mucosal cells of the diarrhea in infants, particularly in
small bowel causing watery diarrhea large urban hospitals
Enterohemorrhagic (EHEC) or produces cytotoxin (toxins that has contains most common serotypes
Serotoxigenic or Shiga toxin- many properties similar to the Shigella 0157 :H7 that have been isolated
producing E.coli (STEC) toxins) causing watery often bloody from patients with diarrhea or
diarrhea hemolytic uremic syndrome

Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. Transmission occurs via the fecal–oral
route; ingestion of fecally contaminated food or water.

B. Bacterial Infections of the Genital Tract (Sexually Transmitted Diseases)

Gonococcal Ophthalmia
1. Gonorrhea Neonatorium
Present as asymptomatic mucosal infection, ophthalmia neonatorum, urethritis,
Infection of the eye in newborns, is
proctitis, pharyngitis, epididymitis, cervicitis, Bartholin gland infection, pelvic
acquired during passage through an
inflammatory disease, endometritis, salpingitis, peritonitis, and disseminated infected birth canal. If untreated,
gonococcal infection. results in blindness.

Pathogen: Neisseria gonorrheae (Gonococcus or GC) Treatment: 1% Tetracycline

Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. ointment, 0.5% Erythromycin
Transmission occurs via direct mucous membrane-to-mucous membrane ointment, 1% Silver nitrate eye drops
contact, usually sexual contact; adult-to-child (may indicate sexual abuse); and within 1 hour of delivery.
mother- to-neonate during birth.

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2. Genital Chlamydial Infections, Genital Chlamydiasis
Most common sexually transmitted disease. Diseases include trachoma, Neisseria gonorrheae
inclusion conjunctivitis, nongonococcal urethritis, salpingitis, cervicitis, and Chlamydia
pneumonitis of infants, and lymphogranuloma venereum (LGV). trachomatis cause Pelvic
Inflammatory Disease
Pathogen: Chlamydia trachomatis (PID) in women
Reservoirs and Mode of Transmission: Infected humans serve as
reservoirs. Transmission occurs via direct sexual contact or mother-to-
neonate during birth.

3. Syphilis
A treponemal disease that occurs in four stages:
(a) primary syphilis – painless lesion (hard chancre)
(b) secondary syphilis - skin rash (especially on the palms and soles) about 4–6 weeks later.
(c) long latent syphilis – a long latent period as long as 5-20 years.
(d) tertiary syphilis – granulamatous lesions (gummas), damage to the CNS, cardiovascular system, visceral organs,
bones, sense organs, and other sites. Damage to the CNS or heart is usually not reversible.

Pathogen: Treponema pallidum

Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. Transmission occurs via direct contact with
lesions, body secretions, mucous membranes, blood, semen, saliva, and vaginal discharges of infected people, usually
during sexual contact; blood transfusions; or transplacentally from mother to fetus.

C. Bacterial Infections of the Urinary Tract (UTI)

A patient with a UTI presents with dysuria (difficulty or pain on urination), lumbar pain, fever, and chills.

Escherichia coli Most common cause of UTI

Staphylococcus saprophyticus UTI in young women

D. Bacterial Infections of the Central Nervous System

1. Bacterial Meningitis
Infection within the subarachnoid space or throughout the leptomeninges is called meningitis. Based on the host’s
response to the invading microorganism, meningitis is divided into two major categories: purulent (usually bacterial) and
aseptic meningitis (usually viral).

Pathogen: Streptococcus agalactiae (neonates), Streptococcus pneumoniae (adult), Haemophilus influenzae type B
(infant less than 2 years old), Nesseria meningitidis (adolescent)
Reservoir and Transmission: Transmitted through respiratory droplets. For organisms to reach the CNS (primarily by the
blood-borne route), host defense mechanisms must be overcome.

Furthermore, meningitis can be classified as either an acute or a chronic disease in the onset and overall progression
within the host.

REMEMBER: Neisseria spp. and M. catarrhalis (previously known as N. catarrhalis):

Neisseria gonorrheae ferments GLUCOSE only

Neisseria meningitidis ferments GLUCOSE and MALTOSE
Neisseria lactamica ferments GLUCOSE, MALTOSE, LACTOSE
Neisseria sicca ferments GLUCOSE, MALTOSE, SUCROSE/FRUCTOSE
Moraxella catarrhalis DO NOT ferment any of these carbohydrates.

The two pathogenic species of Neisseria are N. gonorrhoeae (sexually transmitted) and N.
meningitidis (causes bacterial meningitis)

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 2. Tetanus

Tetanus is an acute neuromuscular disease induced by a bacterial exotoxin called tetanospasmin, with painful muscular
contractions, primarily of the masseter (the muscle that closes the jaw) and neck muscles, spasms, and rigid paralysis.

Pathogen: Clostridium tetani

Reservoirs and Mode of Transmission: Reservoirs include soil contaminated with human, horse, or other animal feces.
Person-to-person transmission does not occur.

E. Bacterial Infections of the Cardiovascular System

1. Infective Endocarditis
It is characterized by the presence of vegetations (combinations of bacteria and blood clots) on or within the endocardium,
most commonly involving a heart valve. The two most common types of infective endocarditis are acute bacterial
endocarditis and subacute bacterial endocarditis (SBE).

Pathogen:
Acute bacterial endocarditis - Staphylococcus aureus (the most common cause), Streptococcus pneumoniae, Neisseria
gonorrhoeae, Streptococcus pyogenes, and Enterococcus faecalis.
Subacute bacterial endocarditis - α-hemolytic streptococci of oral origin (viridans streptococci), Staphylococcus
epidermidis, Enterococcus spp., and Haemophilus spp.

2. Rickettsial Infections

Infection Pathogen Reservoir and Transmission

Spotted fever rickettsiosis (formerly Rickettsia rickettsi Reservoirs include infected ticks on
called Rocky Mountain spotted fever) dogs, rodents, and other animals.
Transmission occurs via the bite of
A tick-borne rickettsial disease invading an infected tick. Person-toperson
the endothelial cells (cells that lines the transmission rarely occurs—through
blood vessels) blood transfusion.
Endemic Typhus Fever (murine typhus Rickettsia typhi Reservoirs include rats, mice,
fever and fleaborne typhus) possibly other mammals, and
infected rat fleas. Transmission
occurs from rat to flea to human.
Person-to-person transmission does
not occur.
Epidemic Typhus Fever Rickettsia prowazeki Reservoirs include infected humans
and body lice (Pediculus humanus)
Transmission occurs from human to
louse to human.

3. Other Bacterial Infections of the Cardiovascular and Central Nervous System

Infection Pathogen Reservoir and Transmission

Lyme Disease (Lyme borreliosis) Borrelia burgdorferi Ticks, rodents (especially deer
mice), and mammals (especially
Lyme disease is the most common deer) serve as reservoirs.
arthropod-borne disease in the United Transmission occurs via tick bite.
States Person-toperson transmission does
not occur
(a) early distinctive stage
(b) early systematic manifestations
(c) neurological and cardiac
abnormalities

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 Plague Yersinia pestis Reservoirs include wild rodents
(especially ground squirrels in the
Bubonic plague - named for the swollen, United States) and their fleas, and,
inflamed, and tender lymph nodes rarely, rabbits, wild carnivores, and
(buboes) that develop. domestic cats. Transmission is
usually via flea bite (from rodent to
Pneumonic plague - is highly flea to human). Transmission may
communicable, involves the lungs. also occur as a result of handling
tissues of infected rodents, rabbits,
Septicemic plague - may lead to septic and other animals, as well as droplet
shock, meningitis, and death. transmission from person to person
(in pneumonic plague).
Tularemia (Rabbit Fever) Francisella tularensis Reservoirs include wild animals
(especially rabbits, muskrats, and
beavers), some domestic animals,
and hard ticks. Transmission occurs
via tick bite; ingestion of
contaminated meat or drinking
water, entry of organisms into a
wound while skinning infected
animals, inhalation of dust, or animal
bites. Person-to-person
transmission does not occur.

TAKE A QUICK BREAK. BREATHE SLOWLY. WRITE FREELY. TERMS TO LOOK UP:

Enteritis
Diarrhea
Dysentery
Gastritis
Ulcer
Chancre
Meningitis
Endocarditis
Cervicitis
Pneumonitis
Trachoma

You may refer in Burton’s Microbiology for the

Health and Sciences, 10th ed. (Chpater 17)

CHECK FOR UNDERSTANDING (30 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.
You are given 30 minutes for this activity (20 points):

1. What organism causes Rocky Mountain spotted fever?

a. Rickettsia helvetica
b. Borrelia burgdorferi
c. Ehrlichia chaffeensis
d. Rickettsia
ANSWER: D
RATIO: RICKETTSIA CAUSES ROCKY MOUNTAIN SPOTTED FEVER

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2. Which of the following organisms causes fever, headache, fatigue, myalgia, and buboes?
a. Borrelia burgdorferi
b. Staphylococcus aureus
c. Yersinia pestis
d. Bacillus anthracis
ANSWER: C
RATIO: YERSINIA PESTIS IS AN ORGANISM THAT CAUSES HEADACHE, FATIGUE, FEVER, MYALGIA AND BUBOES.

3. Which of the following describes the classification of Neisseria gonorrhoeae?

a. Gram negative diplococcus
b. Gram positive diplococcus
c. Gram positive rod
d. Gram negative rod
ANSWER: A
RATIO: THE NEISSERIA GONORRHOEAE IS A GRAM NEGATIVE DIPLOCOCCUS

4. Which of the following is the most common arthropod-borne disease?

a. Lyme disease
b. plague
c. Rocky Mountain spotted fever
d. tularemia
ANSWER: A
RATIO: OPTION A IS THE MOST COMMON ANTHROPOD-BORNE DISEASE WHICH IS THE LYME DISEASE

5. Which of the following diseases is not caused by a spirochete?

a. Lyme disease
b. plague
c. relapsing fever
d. syphilis
ANSWER: B
RATIO: PLAGUE IS CONSIDERED NOT CAUSED BY A SPIROCHETE

6. Which of the following associations is incorrect?

a. Lyme disease : tick
b. plague : rat flea
c. Rocky Mountain spotted fever : tick
d. typhoid fever : mosquito
ANSWER: D
RATIO: TYPHOID FEVER IS NOT CAUSED BY A MOSQUITO BUT BY A SALMONELLA TYPHI BACTERIA

7. Tetanus is an acute neuromuscular disease induced by a bacterial exotoxin called?

a. tetanospasmin
b. neurotoxin
c. cytotoxin
d. endotoxin
ANSWER: A
RATIO: TETANOSPASMIN IS A BACTERIAL EXOTOXIN ON A TETANUS

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8. What is the etiologic agent of typhoid fever?
a. typhoid bacillus
b. Rickettsia prowazekii
c. Rickettsia typhi
d. salmonella typhi
ANSWER: D
RATIO: SALMONELLA TYPHI IS THE ETIOLOGIC AGENT OF TYPHOID FEVER

9. What is the etiologic agent of endemic typhus?

a. typhoid bacillus
b. Rickettsia prowazekii
c. Rickettsia typhi
d. Vibrio typhi
ANSWER: C
RATIO: RICKETTSIA IS THE ETIOLOGIC AGENT OF ENDEMIC TYPHUS

10. What is the etiologic agent of epidemic typhus?

a. typhoid bacillus
b. Rickettsia prowazekii
c. Rickettsia typhi
d. Vibrio typhi
ANSWER: B
RATIO: OPTION B IS THE BEST ANSWER

RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.

1. ANSWER:
RATIO:

2. ANSWER:
RATIO:

3. ANSWER:
RATIO:

4. ANSWER:
RATIO:

5. ANSWER:
RATIO:

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 6. ANSWER:
RATIO:

7. ANSWER:
RATIO:

8. ANSWER:
RATIO:
__

9. ANSWER:
RATIO:

10. ANSWER:
RATIO:

LESSON WRAP-UP (5 minutes)

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

Exit Ticket: One-minute paper

a. How do you feel about today’s session? __ Happy __ Satisfied __ Sad __ Confused

b. What question(s) do you have as we end this session?

th
Reading Assignment: For the next session, read chapter 20 of Burton’s Microbiology for the Health Siences, 10 ed.

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