UNIT V: MICROBIAL INFECTIONS UNIT VI: CONTROL AND TREATMENT

1. Infections of the Genitourinary 1. Control of microbial growth with

disinfections and antiseptics
2. Infections of the Central Nervous
System 2. Antibiotics
3. Infections of the Blood 3. Antiviral agents
4. Infections of the Skin and Eyes
UNIT VII: BEST AND THE WORST: IMPORTANT
ISSUES IN MICROBIOLOGY

1. Biotechnology
2. Bioterrorism
UNIT V: CONTROL AND TREATMENT
1. Disinfection and Sterilization

 Activity 7: Anti microbes

 Activity 8: Microscopic examination of Bacteria
 Activity 9: Mycology
MICROBIAL INFECTIONS
GENITOURINARY SYSTEM
BACTERIAL
1. GONORRHEA
✔ A bacterial infection that is
transmitted by sexual contact.
also known as "the clap" or "drip,"
✔ Gonorrhea is an infection
caused by a sexually transmitted
bacterium that infects both males
and females.
Gonorrhea most often affects the urethra,
rectum or throat.
In females, gonorrhea can also infect the
cervix.
✔ Gonorrhea is most commonly spread
during vaginal, oral or anal sex.
But babies of infected mothers can be
infected during childbirth. In babies,
gonorrhea most commonly affects the eyes.
CAUSATIVE AGENT

Neisseria gonorrhoeae
Incubation period : Mode of transmission :
The incubation period, the time from Gonorrhea is passed from one person
exposure to the bacteria until to another by contact with body
symptoms develop, is usually 2 to 5 fluids containing the bacteria during
days. unprotected sexual intercourse.
But sometimes symptoms may not
develop for up to 30 days. Gonorrhea
may not cause symptoms until the
infection has spread to other areas of
the body.
 SIGNS AND SYMPTOMS :

For women For men

a. Increased vaginal discharge a. Painful urination
b. Painful urination b. Pus-like discharge from the tip of
c. Vaginal bleeding between the penis
periods, such as after vaginal c. Pain or swelling in one testicle
intercourse
d. Abdominal or pelvic pain
Diagnosis :
Urine or fluid from the infected area will be
tested for gonorrhea. You may also be tested
for other sexually transmitted infections (STIs) at
the same time. Testing can be done with a Pap
test. As soon as you find out you have
gonorrhea, be sure to let your sex partners
know. Experts recommend that you notify
everyone you've had sex with in the past 60
days. If you have not had sex in the past 60
days, contact the last person you had sex with.
 TREATMENT

Antibiotics are
used to treat
gonorrhea.
 MANAGEMENT:
a. Use a condom every time you have sex. Latex and polyurethane condoms
keep out the viruses and bacteria that cause STIs.
b. Don't have more than one sex partner at a time. The safest sex is with one
partner who has sex only with you. Every time you add a new sex partner,
you are being exposed to all of the diseases that all of that person's
partners may have.
c. Be responsible. Don't have sex if you have symptoms of an infection or if
you are being treated for an STI.
2. Non-Gonorrheal Urethritis
It is an inflammation of the urethra
that is not caused by gonorrheal
infection.
Causative Agent :
The most common bacterial cause of
NGU is Chlamydia trachomatis, but it
can also be caused by Ureaplasma
urealyticum, Haemophilus vaginalis,
Mycoplasma genitalium,
Mycoplasma hominis, Gardnerella
vaginalis, Acinetobacter lwoffi, Ac.
calcoclaceticus and E. coli.
Incubation Period: Vaccine :
7–21 days, compared to 2–5 days for • No Vaccine
gonorrhoea.
Signs and Symptoms :
a. a white or cloudy discharge from the tip of your penis
b. burning or painful sensation when you pee
c. the tip of your penis feeling irritated and sore
d. In women, NGU rarely causes any symptoms
Diagnosis :
a. swab test – a sample of fluid is taken from your urethra using a swab, which
is like a small cotton bud. The swab may have a small plastic loop or cotton
tip at the end; it's not painful, but can feel a little uncomfortable for a few
seconds
b. urine test – you'll be asked not to pee for at least 2 hours before providing a
urine sample as this can help make the test results more reliable
Treatment :
NGU is usually treated with antibiotics, which kill the germs that are causing the
infection. The antibiotics most commonly used to treat NGU are doxycycline,
which is taken twice a day for a week, or macrolide antibiotics, such as
azithromycin, given as a single dose
3. Syphilis
It is a bacterial infection usually
spread by sexual contact.
The disease starts as a painless sore
— typically on your genitals, rectum
or mouth.
 spreads from person to person via
skin or mucous membrane contact
with these sores.
 caused by the
bacterium Treponema pallidum.
Incubation Period Vaccine
average time between infection • No Vaccine
with syphilis and the start of the first
symptom is 21 days, but can range
from 10 to 90 days. Syphilis blood
test results will be negative during
this time.
Mode of Transmission :
Syphilis is transmitted from person to person by direct contact with a syphilitic
sore, known as a chancre. Chancres can occur on or around the external
genitals, in the vagina, around the anus , or in the rectum, or in or around the
mouth. Transmission of syphilis can occur during vaginal, anal, or oral sex.
Signs And Symptoms :
• Syphilis develops in stages, and
symptoms vary with each stage. But
the stages may overlap,and
symptoms don't always occur in the
same order. You may be infected
with syphilis and not notice any
symptoms for years
 PRIMARY SYPHILIS
• The first sign of syphilis is a small sore, called
a chancre. The sore appears at the spot
where the bacteria entered your body.
While most people infected with syphilis
develop only one chancre, some people
develop several of them. The chancre
usually develops about three weeks after
exposure. Many people who have syphilis
don't notice the chancre because it's usually
painless, and it may be hidden within the
vagina or rectum. The chancre will heal on
its own within three to six weeks.
 SECONDARY SYPHILIS
• Within a few weeks of the original chancre
healing, you may experience a rash that
begins on your trunk but eventually covers
your entire body — even the palms of your
hands and the soles of your feet.
• Some people also experience hair loss,
muscle aches, a fever, a sore throat and
swollen lymph nodes. These signs and
symptoms may disappear within a few
weeks or repeatedly come and go for as
long as a year.
 LATENT SYPHILIS
• If you aren't treated for syphilis, the disease
moves from the secondary stage to the
hidden (latent) stage, when you have no
symptoms. The latent stage can last for
years. Signs and symptoms may never return,
or the disease may progress to the third
(tertiary) stage.
 TERTIARY SYPHILIS
• About 15% to 30% of people infected with
syphilis who don't get treatment will develop
complications known as late (tertiary)
syphilis. In the late stage, the disease may
damage your brain, nerves, eyes, heart,
blood vessels, liver, bones and joints. These
problems may occur many years after the
original, untreated infection.
 NEUROSYPHILIS
• At any stage, syphilis can spread and,
among other damage, cause damage to
the brain and nervous system (neurosyphilis)
and the eye (ocular syphilis).
 CONGENITAL SYPHILIS
• Babies born to women who have syphilis
can become infected through the placenta
or during birth. Most newborns with
congenital syphilis have no symptoms,
although some experience a rash on the
palms of their hands and the soles of their
feet.
• Later signs and symptoms may include
deafness, teeth deformities and saddle nose
— where the bridge of the nose collapses.
However, babies born with syphilis can also
be born too early, be born dead (stillborn) or
die after birth
 PREVENTION
a. Abstain or be monogamous. The only certain way to avoid syphilis is to not
have (abstain from) sex. The next-best option is to have mutually
monogamous sex in which both people have sex only with each other and
neither partner is infected.
b. Use a latex condom.
c. Avoid recreational drugs. Misuse of alcohol or other drugs can inhibit your
judgment and lead to unsafe sexual practices.
 DIAGNOSIS
a. Blood tests can confirm the presence of antibodies that the body
produces to fight infection. The antibodies to the syphilis-causing bacteria
remain in your body for years, so the test can be used to determine a
current or past infection.
b. Cerebrospinal fluid. If it's suspected that you have nervous system
complications of syphilis, your doctor may also suggest collecting a sample
of cerebrospinal fluid through a procedure called a lumbar puncture
(spinal tap)
 MEDICATION
a. The preferred treatment at all stages is penicillin, an antibiotic medication
that can kill the organism that causes syphilis.
b. Penicillin is the only recommended treatment for pregnant women with
syphilis.
4. Vaginosis
 is an abnormal vaginal condition that is
characterized by vaginal discharge and
results from an overgrowth of atypical
bacteria in the vagina.
It is not a true bacterial infection but rather
an imbalance of the bacteria that are
normally present in the vagina.
Causative agent: Incubation Period :
a. Gardnerella vaginalis  average of 4-7 days,
b. Mobiluncus and Prevotella (with a range of 3-10 days)
Mode of Transmission :
BV is linked to an imbalance of “good” and “harmful” bacteria that are
normally found in a woman's vagina.
Having a new sex partner or multiple sex partners, as well as douching, can
upset the balance of bacteria in the vagina.
Vaccine :
Gynevac-a vaccine,
containing lactobacillus
for therapy and
prevention of bacterial
vaginosis and related
diseases.
Signs and Symptoms :
a. Thin, gray, white or green vaginal discharge
b. Foul-smelling "fishy" vaginal odor
c. Vaginal itching
d. Burning during urination
Diagnosis :
a. vaginal secretions under a microscope, looking for "clue cells," vaginal cells
covered with bacteria that are a sign of bacterial vaginosis.
b. Test your vaginal pH. Your doctor may check the acidity of your vagina by
placing a pH test strip in your vagina.

Note:
A normal vaginal pH is moderately acidic, typically ranging between 3.8 and 4.5.
Treatment :
a. Metronidazole (Flagyl, Metrogel-Vaginal, others). This medicine may be taken as a
pill by mouth (orally). Metronidazole is also available as a topical gel that you insert
into your vagina.
b. Clindamycin (Cleocin, Clindesse, others). This medicine is available as a cream
that you insert into your vagina.
c. Tinidazole (Tindamax). This medication is taken orally.
VIRAL
1. Genital Warts
 are soft growths that appear on the
genitals. They can cause pain, discomfort,
and itching. Genital warts a sexually
transmitted infection (STI)

Causative agent : venereal warts or

condylomata acuminata. They are caused by
the human papillomavirus (HPV)
Incubation Period : Vaccine :
• 2 to 3 months, with a range of 1 Gardasil vaccine
to 20 months for genital warts. It The vaccine is used in girls and boys
can take up to 10 years for a and young adults ages 9 to 26 for
high-risk HPV infection to prevention of genital warts caused by
develop into cancer HPV types 6 and 11.
Mode of Transmission :
Genital warts can spread from one person to
another during vaginal or anal sex. The virus can
be spread by skin to skin contact so it can be
passed on by close genital contact. ... Warts can
be easily spread from the genital area to the area
around the anus without having anal sex
Diagnosis :
a. PAP test For women, it's important to have regular pelvic exams and Pap
tests, which can help detect vaginal and cervical changes caused by
genital warts or the early signs of cervical cancer.
b. HPV test. only a few types of genital HPV have been linked to cervical
cancer. A sample of cervical cells, taken during a Pap test, can be tested
Treatment :
Genital wart treatments that can be applied directly to your skin include:
a. Imiquimod (Aldara, Zyclara). This cream appears to boost your immune
system's ability to fight genital warts
b. Podophyllin and podofilox (Condylox)
c. Trichloroacetic acid
d. Sinecatechins (Veregen)
2. Herpes
Is an infection that affects the external genitalia, anal region, mucosal
surfaces, and skin in other parts of the body. Herpes is a long-term condition.
However, many people never have symptoms even though they are
carrying the virus.
Causative Agent : Incubation Period : Vaccines :
Herpes simplex 4 days (range, 2 to Developing the
virus type 2 12) after exposure. vaccine
(HSV-2)
Mode of Transmission :
The herpes simplex virus, or herpes, is categorized into 2 types: herpes simplex
virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).
HSV-1 is mainly transmitted by oral-to-oral contact to cause oral herpes (which
can include symptoms known as “cold sores”), but can also cause genital
herpes.
HSV-2 is a sexually transmitted infection that causes genital herpes.
Signs and Symptoms :
Most people infected with HSV don't know they have it because they don't
have any signs or symptoms or because their signs and symptoms are so mild.
Symptoms may begin about two to 12 days after exposure to the virus they
may include:
A. Pain or itching. You may experience pain and tenderness in your genital
area until the infection clears.
B. Small red bumps or tiny white blisters. These may appear a few days to a
few weeks after infection.
C. Ulcers. These may form when blisters rupture and ooze or bleed. Ulcers may
make it painful to urinate.
D. Scabs. Skin will crust over and form scabs as ulcers heal
Diagnosis :
a. Viral culture. This test involves taking a tissue sample or scraping of the sores
for examination in the laboratory.
b. Polymerase chain reaction (PCR) test. PCR is used to copy your DNA from a
sample of your blood, tissue from a sore or spinal fluid. The DNA can then
be tested to establish the presence of HSV and determine which type of
HSV you have.
c. Blood test. This test analyzes a sample of your blood for the presence of
HSV antibodies to detect a past herpes infection.
Treatment :
There's no cure for genital herpes. Treatment with prescription antiviral
medications may:
a. Help sores heal sooner during an initial outbreak
b. Lessen the severity and duration of symptoms in recurrent outbreaks
c. Reduce the frequency of recurrence
d. Minimize the chance of transmitting the herpes virus to another
Antiviral medications used for genital herpes include:
a. Acyclovir (Zovirax)
b. Valacyclovir (Valtrex)
Fungal
1. Candidiasis
Is a fungal infection due to any type
of Candida (a type of yeast). When it
affects the mouth, in some countries it
is commonly called thrush.
Signs and symptoms include white
patches on the tongue or other areas
of the mouth and throat. Other
symptoms may include soreness and
problems swallowing.
Incubation Period :
about two to five days

Vaccine : The fungal immunotherapeutic vaccine NDV-3A may be safe and

highly effective when administered to women with recurrent vulvovaginal
candidiasis (RVVC), according to a study recently published in Clinical
Infectious Diseases.May 23, 2018
Mode of Transmission :
can be transmitted through direct or indirect contact with infected individuals
or contaminated surfaces. It can also spread through sexual contact or from a
mother to her baby during breastfeeding if the baby has thrush.
Signs And Symptoms :
a. Itching and irritation in the vagina and vulva.
b. A burning sensation, especially during intercourse or while urinating.
c. Redness and swelling of the vulva.
d. Vaginal pain and soreness.
e. Vaginal rash.
f. Thick, white, odor-free vaginal discharge with a cottage cheese
appearance.
g. Watery vaginal discharge.
Diagnosis :
a. Genitourinary candidiasis - A urinalysis should be performed; evidence of
white blood cells (WBCs), red blood cells (RBCs), protein, and yeast cells is
common; urine fungal cultures are useful.
b. Gastrointestinal candidiasis - Endoscopy with or without biopsy
Treatment :
Mild or moderate genital Candida infections can be treated with a short
course of an over-the counter (OTC) or prescription antifungal cream, pill, or
suppository. You could also be prescribed a single dose of an oral antifungal
medication, such as fluconazole.
2. Tineacruris Jock itch (tinea cruris)
is a fungal infection that causes a red
and itchy rash in warm and moist areas
of the body. The rash often affects the
groin and inner thighs and may be
shaped like a ring. Jock itch gets its
name because it's common in athletes.
It's also common in people who sweat a
lot or who are overweight.
Causative Agent : Vaccine
• Trichophyton rubrum and No vaccine
Epidermophyton floccosum; less
commonly Trichophyton
mentagrophytes and Trichophyton
verrucosum are involved.
Incubation period :
The incubation period varies depending on the type of ringworm. The
incubation period for Tinea capitis is 10 to 14 days, Tinea corporis and
Tinea cruris is 4 to 10 days, and the incubation for Tinea pedis is
unknown.
Mode of Transmission :
Tinea cruris is a contagious infection transmitted by fomites, such as
contaminated towels or hotel bedroom sheets, or by autoinoculation
from a reservoir on the hands or feet (tinea manuum, tinea pedis, tinea
unguium).
 SIGNS AND SYMPTOMS :

a. redness e. rash that gets worse with exercise

b. persistent itching or activity
c. burning sensation f. changes in skin color
d. flaking, peeling, or cracking skin g. rash that doesn't improve or
worsens, or spreads with over-the-
counter hydrocortisone (anti-itch)
cream
Diagnosis :
a. skin scrapings or samples from the
infected area for study under a
microscope.
Treatment :
A. For mild jock itch, your doctor may suggest first using an over-the-
counter antifungal ointment, lotion, powder or spray. Apply the
medication as your doctor recommends for one to two weeks even
if the rash clears up quickly.
B. If you also have athlete's foot, it's usually treated at the same time as
jock itch to reduce the risk of the rash coming back. Severe jock itch
or a rash that doesn't improve with over-the counter medicine may
need prescription-strength creams, ointments or pills.
PARASITIC
1. Trichomoniasis - is a very common sexually transmitted disease (STD). It is
caused by infection with a protozoan parasite called Trichomonas vaginalis.
 Incubation Period : Vaccine
range from 5 to 28 days. No vaccine
Mode of transmission :
typically transmitted through vaginal, oral, or anal sex with an infected
individual. It can also be passed from a mother to her baby at birth, as
evidenced by the discovery of the parasite in the newborn's lungs.
Signs And Symptoms :
a. vaginal discharge, which can be white, gray, yellow, or green, and usually
frothy with an unpleasant smell.
b. vaginal spotting or bleeding.
c. genital burning or itching.
d. genital redness or swelling.
e. frequent urge to urinate.
f. pain during urination or sexual intercourse.
Diagnosis:
a. The diagnosis of trichomoniasis can be confirmed by looking at a sample of
vaginal fluid for women or urine for men under a microscope. Growing a
culture used to be the way to diagnose trichomoniasis.
b. rapid antigen tests
c. nucleic acid amplification
A nucleic acid test is a technique used to
detect a particular nucleic acid
sequence and thus usually to detect and
identify a particular species or subspecies
of organism, that acts as a pathogen in
blood, tissue, urine, etc.
Treatment : The most common treatment for trichomoniasis, even for pregnant
women, is to swallow one megadose of either metronidazole (Flagyl) or
tinidazole (Tindamax).
2. E. Histolytica Infection
Amebiasis is a disease caused by
the parasite Entamoeba
histolytica. It can affect anyone,
although it is more common in
people who live in tropical areas
with poor sanitary conditions.
Incubation Period : Mode Of transmission : Vaccine :
commonly 2-4 fecal-oral route No Vaccine
weeks but may (ingestion of food
range from a and water,
few days to contaminated
years with feces
containing E.
histolytica cysts)
Signs and Symptoms : The symptoms are often quite mild and can include
a. loose feces (poop)
b. stomach pain
c. stomach cramping.
d. Amebic dysentery is a severe form of amebiasis associated with stomach
pain, bloody stools (poop), and fever. Rarely,
e. E. histolytica invades the liver and forms an abscess (a collection of pus)
Diagnosis :
a. A single stool examination has a low sensitivity of detecting the parasite
b. The best diagnostic method is detection of E. histolytica antigen or DNA in
stool

Treatment :
a. Metronidazole, tinidazole and ornidazole for Entamoeba histolytica or
Giardia lamblia intestinal infections.
3. Pediculosis
Is an infestation of the hairy parts of the
body or clothing with the eggs, larvae
or adults of lice. The crawling stages of
this insect feed on human blood, which
can result in severe itching. Head lice
are usually located on the scalp, crab
lice in the pubic area and body lice
along seams of clothing.
 Causative Agent : Vaccine:
Pediculosis is infestation with the • No Vaccine
human head-and-body louse,
Pediculus humanus.
There are two subspecies, the head
louse (P. h. capitis) and the body
louse
Mode of transmission :
Transmitted through direct head-to-head contact with a person with head
lice. Nymphal and adult lice usually die within 24 hours of being stranded
away from the head. There is no significant risk of transmission from the
environment.
Signs and Symptoms :
a. A ticklish feeling on the pubic area
b. An itchy (the result of an allergic reaction to the bug's saliva).
c. Small red bumps on the scalp, neck and shoulders and genital area d
d. The presence of lice on the pubic hair
e. The presence of nits (lice eggs) on shafts of hair.
f. Difficulty sleeping, which can lead to irritability
Diagnosis : The diagnosis of pediculosis is best made by finding a live nymph or
adult louse on the scalp or in the hair or pubic hair of a person. Finding
numerous nits within 6 mm of the scalp is highly suggestive of active infestation
Treatment :
a. Permethrin 1% It was introduced for the first time in the year 1986 as a
scheduled topical agent
b. Malathion 0.5%
c. Lindane 1%
d. Permethrin 5% (Permite)
e. Crotamiton 10%
f. Oral ivermectin
g. Sulfamethoxazole-trimethoprim
h. Benzyl alcohol 5%
4. Scabies is a skin infestation caused by a mite known as the Sarcoptes
scabiei. Untreated, these microscopic mites can live on your skin for months.
They reproduce on the surface of your skin and then burrow into it and lay
eggs. This causes an itchy, red rash to form on the skin
Incubation Period : Signs and symptoms : Vaccine :
It may take 2– a. Itching, often severe
and usually worse at
No Vaccine
6 weeks night.
before itching b. b. Thin, irregular burrow
tracks made up of tiny
occurs blisters or bumps on
your skin.
Mode of transmission :
Scabies is transmitted: primarily via skin contact with an infected person (e.g.
sex partners, children playing, healthcare providers) less commonly via
contact with towels, bedclothes and undergarments, if these have been
contaminated by infested people within the previous 4–5 days
Diagnosis : To diagnose scabies, your doctor examines your skin, looking for
signs of mites, including the characteristic burrows. When your doctor locates
a mite burrow, he or she may take a scraping from that area of your skin to
examine under a microscope.
Treatment :
The 2 most widely used treatments for scabies are permethrin cream and
malathion lotion (brand name Derbac M). Both medications contain
insecticides that kill the scabies mite.
Permethrin 5% cream is usually recommended as the first treatment. Malathion
0.5% lotion is used if permethrin is ineffective.
 MICROBIAL INFECTIONS
GENITOURINARY SYSTEM
• Bacterial • Viral
1. GONORRHEA 1. Genital warts
2. Non-Gonorrheal Urethritis 2. Herpes
3. Syphilis
4. Vaginosis
 MICROBIAL INFECTIONS
GENITOURINARY SYSTEM
• Fungal • Parasitic
1. Candidiasis 1. Trichomoniasis
2. Tineacruris 2. E. Histolytica Infection
3. Pediculosis
4. Scabies
 REMINDER
Final Examination – May 12-17
Lecture - 2 quizzes per week
Laboratory- 1 quiz per week

Note: Genitourinary Microbial Infections Quiz - Wednesday