HES032 (Microbiology and Parasitology)

STUDENT ACTIVITY SHEET BS NURSING / SECOND YEAR

Session # 12

LESSON TITLE: Bacterial Infections of Humans Part 1 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 signs Engelkirk, P., & Engelkirk, J. (2015). Burton's
th
and symptoms, pathogen, reservoir(s), and mode(s) of Microbiology for the Health and Sciences. 10 ed.,
transmission. Philadelphia: Lipincott Williams & Wilkins

Daily Productivity Tip:

Maybe you should take a shower first today. Showering refreshes your mind and helps you feel more calm
and relaxed.

LESSON PREVIEW / REVIEW (5 minutes)

Recall from the last session the differences between German measle and hard measle.

Now, you can proceed with today’s session.

MAIN LESSON (50 minutes)

A. Bacterial Infections of the Skin

1. Acne
Acne is a common condition in which pores become clogged with dried sebum, flaked skin, and bacteria, which leads to the
formation of blackheads and whiteheads (collectively known as acne pimples) and inflamed, infected abscesses.
Acne is most common among teenagers.

Pathogens: Propionibacterium acnes and other Propionibacterium spp.

Reservoirs and Mode of Transmission: Infected humans serve as reservoirs, although acne is probably not transmissible.

2. Anthrax (Wool Sorter’s Disease)

Affects the skin (cutaneous anthrax), lungs (inhalation or pulmonary anthrax), or gastrointestinal tract (gastrointestinal
anthrax), depending on the portal of entry of the etiologic agent.

Pathogen: Bacillus anthracis

Reservoirs and Mode of Transmission: Reservoirs include anthrax-infected animals, as well as spores that may be
present in soil, animal hair, wool, animal skins and hides, and products made from them. Transmission occurs via entry of
endospores through breaks in skin, inhalation of spores, or ingestion of bacteria in contaminated meat.

3. Gas Gangrene (Clostridial Myonecrosis)

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Gases released from the infecting pathogens cause pockets of gas to develop in the infected tissue. Tissue destruction
occurs rapidly, often necessitating amputation of the infected anatomic site.

Pathogens: Clostridium perfringens (most common), other Clostridium spp.

Reservoirs and Mode of Transmission: Soil is the primary reservoir. Humans become infected when soil containing
clostridial spores enters an open wound.

4. Leprosy (Hansen disease)

There are two forms of leprosy: (a) lepromatous leprosy, characterized by numerous nodules in skin and possible
involvement of the nasal mucosa and eyes and (b) tuberculoid leprosy, in which relatively few skin lesions occur. Peripheral
nerve involvement tends to be severe, with loss of sensation.

Pathogen: Mycobacterium leprae

Reservoirs and Mode of Transmission: Infected humans serve as reservoirs; M. leprae is present in nasal discharges
and is shed from cutaneous lesions. The exact mode of transmission has not been clearly established. The organisms may
gain entrance through the respiratory system or broken skin. Leprosy does not appear to be easily transmitted from
person to person.

5. Staphylococcal Skin Infections (Folliculitis, Furuncles, Carbuncles, Abscesses, Impetigo, Impetigo of the
Newborn, Scalded Skin Syndrome)

Folliculitis—(minor infection of hair Papules or pustules that are pierced by a hair and
follicles) surrounded with redness
Furuncle (boil) Abscess that begins as a red nodule in a hair
follicle that ultimately becomes painful and full of
pus
Carbuncle Furuncles that coalesce and spread more deeply
to the dermis and subcutaneous tissues; they
usually have multiple sites, which drain to the skin
surface (sinuses)

Pathogen: Staphylococcus aureus (most). Impetigo may also be caused by Streptococcus spp.
Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. Transmission occurs via direct contact with
a person having a purulent lesion or is an asymptomatic carrier. In hospitals, staphylococcal infections can be spread by the
hands of healthcare workers.

6. Streptococcal Skin Infections

Infection Description Etiologic agent

Impetigo Erythematous (red) lesions that may be Nonbullous— group A streptococci
bullous (less common) or nonbullous (Streptococcus pyogenes)
Bullous— Staphylococcus aureus
Scarlet fever (scarlatina) pink-red rash, most obvious on the Group A streptococci (Streptococcus
abdomen, sides of the chest, and in pyogenes)
skin folds.
Erysipelas an acute cellulitis with fever Group A streptococci (Streptococcus
constitutional symptoms, and hot, pyogenes), sometimes groups B, C,
tender, red eruptions (sometimes or G streptococci
referred to as St. Anthony’s fire).
Necrotizing fascitis infection of the fascia overlying the Group A Streptococcus (GAS)
muscles, often with involvement of the
overlying soft tissue.

Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. Transmission occurs from person to
person via large respiratory droplets or direct contact with patients or carriers. Transmission rarely occurs by indirect contact
through objects.

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B. Viral and Bacterial Ear Infections

1. Otitis Externa (External Otitis, Ear Canal Infection, Swimmer’s Ear)

An infection of the outer ear canal with itching, pain, a malodorous discharge, tenderness, redness, swelling, and impaired
hearing. Otitis externa is referred to as “swimmer’s ear” because it often results from swimming in water contaminated with
Pseudomonas aeruginosa.

Pathogens: The usual causes of otitis externa are the bacteria Escherichia coli, Pseudomonas aeruginosa, Proteus
vulgaris, and Staphylococcus aureus. Fungi, such as Aspergillus spp. are less common causes of otitis externa.
Reservoirs and Mode of Transmission: Reservoirs include contaminated swimming pool water, sometimes indigenous
microflora, or articles inserted into the ear canal for cleaning out debris and wax.

2. Otitis Media (Middle Ear Infection)

Otitis media often develops as a complication of the common cold. Manifestations can include persistent and severe
earache, temporary hearing loss, pressure in the middle ear, and bulging of the eardrum (tympanic membrane). May lead to
rupture of the eardrum, bloody discharge, and pus. Severe complications, including bone infection, permanent hearing loss,
and meningitis, may occur.

Pathogens: Otitis media may be caused by bacteria or viruses. The three most common bacterial causes are
Streptococcus pneumoniae (a Gram-positive diplococcus), Haemophilus influenzae (a Gram-negative bacillus), and
Moraxella catarrhalis (a Gram-negative diplococcus). Viral causes include measles virus, parainfluenza virus, and RSV.
Reservoirs and Mode of Transmission: Otitis medias is probably not communicable.

C. Bacterial Infections of the Eyes

1. Bacterial Conjunctivitis (“Pinkeye” Conjunctivitis)

Bacterial conjunctivitis involves irritation and reddening of conjunctiva, edema of eyelids, mucopurulent discharge, and
sensitivity to light. The disease is highly contagious.

Pathogens: Hemophilus influenzae subsp. Aegyptius (most common) and Streptococcus pneumoniae
Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. Human-to-human transmission occurs via
contact with eye and respiratory discharges, contaminated fingers, facial tissues, clothing, eye makeup, eye medications,
ophthalmic instruments, and contact lens-wetting and lens-cleaning agents.

2. Chlamydial Conjunctivitis (Inclusion Conjunctivitis, Paratrachoma)

In neonates, acute chlamydial conjunctivitis with mucopurulent discharge may result in mild scarring of conjunctivae and cornea.

Pathogens: Chlamydia trachomatis, a Gram-negative bacterium and obligate intracellular pathogen.

Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. Transmission occurs via contact with
genital discharges of infected people, contaminated fingers to eye, infection in newborns via an infected birth canal, or non-
chlorinated swimming pools (“swimming pool conjunctivitis”).

3. Trachoma (Chlamydia Keratoconjunctivitis)

Trachoma is a highly contagious, acute, or chronic conjunctival inflammation, resulting in scarring of cornea and conjunctiva,
deformation of eyelids, and blindness.

Pathogens: certain serotypes (serovars) of Chlamydia trachomatis

Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. Transmission occurs via direct contact
with infectious ocular or nasal secretions or contaminated articles. The disease is also spread by flies serving as
mechanical vectors.

4. Gonococcal Conjunctivitis (Gonorrheal Ophthalmia Neonatorum)

Gonococcal conjunctivitis is associated with an acute redness and swelling of conjunctiva and purulent discharge.
Corneal ulcers, perforation, and blindness may occur if the disease is untreated.

Pathogen: Neisseria gonorrheae

Reservoirs and Mode of Transmission: Infected humans—specifically, infected maternal birth canals—serve as
reservoirs. Transmission occurs via contact with the infected birth canal during delivery. Adult infection can result from
finger-to-eye contact with infectious genital secretions.

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D. Bacterial Infections of the Upper Respiratory

1. Tract Diphtheria
Acute, contagious bacterial disease primarily involves the tonsils, pharynx, bacterial disease primarily involves the tonsils,
pharynx, membranes, skin, conjunctivae, and the vagina. The characteristic lesion is a tough, asymmetrical, adherent gray-
white membrane in the throat, with surrounding inflammation.

Pathogen: Toxigenic (toxin producing) strains of Corynebacterium diphtheriae.

Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. Transmission occurs via airborne droplets,
direct contact, and contaminated fomites.

2. Streptococcal Pharyngitis (Strep Throat)

Strep throat is an acute bacterial infection of the throat with soreness, chills, fever, headache, a beefy red throat, white
patches of pus on pharyngeal epithelium, enlarged tonsils, and enlarged and tender cervical lymph nodes.
Untreated strep throat can lead to complications (sequelae) such as scarlet fever (caused by erythrogenic toxin),
rheumatic fever, and glomerulonephritis.

Pathogen: Streptococcus pyogenes

Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. Transmission occurs human to human by
direct contact, usually hands; aerosol droplets; secretions from patients and nasal carriers; and contaminated dust, lint, or
handkerchiefs; contaminated milk and milk products have been associated with foodborne outbreaks of streptococcal
pharyngitis.

E. Bacterial Infections of the Lower Respiratory Tract Streptococcus pneumoniae -

Rusty Sputum
1. Pneumonia Klebsiella pneumoniae -
Pneumonia is an acute nonspecific infection of the small air sacs (alveoli) and Curant Jelly Sputum
tissues of the lung, with fever, productive cough (meaning that sputum is
coughed up), acute chest pain, chills, and shortness of breath. Pneumonia is
often a secondary infection that follows a primary viral respiratory
infection.
Pathogens: Streptococcus pneumoniae (pneumococcal pneumonia). S. pneumoniae is the most common cause of
pneumonia in the world.
Reservoirs and Mode of Transmission: Infected humans are the most common reservoir. Depending on the pathogen
involved, transmission is by droplet inhalation, direct oral contact, contact with contaminated hands and fomites, or
inhalation of yeasts and fungal spores

3. Legionellosis (Legionnaires’ Disease, Pontiac Fever)

Acute bacterial pneumonia with anorexia, malaise, myalgia, headache, high fever, chills, and dry cough, followed by a
productive cough, shortness of breath, diarrhea, and pleural and abdominal pain.

Pathogen: Legionella pneumophila

Reservoirs and Mode of Transmission: Reservoirs include environmental water sources, such as ponds, lakes, and
creeks; hot-water and air-conditioning systems, cooling towers, and evaporative condensers; whirlpool spas, hot tubs,
shower heads, humidifiers, tap water, and water distillation systems; decorative fountains; and perhaps dust.
Transmission has occurred as a result of aerosols of Legionella spp. that have been produced by vegetable misting devices
in supermarkets. Legionellosis is not transmitted from person to person.

4. Mycoplasmal Pneumonia (Primary Atypical Pneumonia)

Gradual onset with headache, malaise, dry cough, sore throat, and less often, chest discomfort.

Pathogen: Mycoplasma pneumoniae

Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. Transmission occurs via droplet inhalation
or direct contact with an infected person, or articles contaminated with nasal secretions or sputum from an ill, coughing
patient.

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5. Tuberculosis (TB)
Acute or chronic mycobacterial infection of the lower respiratory tract with malaise, fever, night sweats, weight loss, and
productive cough.Shortness of breath, chest pain, hemoptysis (coughing up blood), and hoarseness may occur in advanced
stages.

Pathogens: Mycobacterium tuberculosis

Reservoirs and Mode of Transmission: Infected humans are the primary reservoirs. Transmission occurs via airborne
droplets produced by infected people during coughing, sneezing, and even talking or singing; usually following prolonged
direct contact with infected individuals.

6. Whooping Cough (Pertussis)

Acute bacterial childhood (usually) infection. The coughing often ends in a prolonged, high-pitched, deeply indrawn breath
(the “whoop,” from which whooping cough gets its name).

Pathogen: Bordetella pertussis

Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. Transmission occurs via droplets produced
by coughing.

F. Bacterial Infections of the Oral Region

1. Acute Necrotizing Ulcerative Gingivitis

Acute necrotizing ulcerative gingivitis (ANUG) is also called Vincent’s angina and trench mouth
The term “trench mouth” originated in World War I, where soldiers developed the infection while fighting in trenches. It is
usually the result of a combination of poor oral hygiene, physical or emotional stress, and poor diet. It involves painful,
bleeding gums and tonsils, erosion of gum tissue, and swollen lymph nodes beneath the jaw. It causes extremely bad
breath.

Pathogens: Fusobacterium nucleatum (an anaerobic, Gram-negative bacillus) and Treponema vincentii (a spirochete).
Trench mouth is thought to be noncontagious.

TERMS TO LOOK UP:

TAKE A QUICK BREAK. BREATHE SLOWLY. WRITE FREELY.
Papule
Nodule
Pustule
Bulla
Fascitis
Conjunctivitis
Keratoconjunctivitis
Gingivitis

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):

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1. Nurse Sandra is handling a child with pertussis. During the assessment, the nurse will observed on which of the
following characteristic of the child’s cough?
a. A sour cough
b. A chesty cough
c. A hacking cough that ends with a whooping sound
d. A barking, painful cough
ANSWER:
RATIO:

2. A clinical instructor is providing teachings among nursing students about the stages of pertussis. Which of the following
is the final phase of a pertussis infection?
a. Paroxysmal phase
b. Recovery phase
c. Catarrhal phase
d. Convalescent phase
ANSWER:
RATIO:

3. Leprosy is also called:

a. Hartmann's disease
b. Hansen's disease
c. Humprey's disease
d. Harry's disease
ANSWER:
RATIO:

4. is the most common cause of pneumonia in the world.

a. Chlamydophila pneumoniae
b. Legionella pneumophila
c. Mycoplasma pneumoniae
d. Streptococcus pneumoniae
ANSWER:
RATIO:

5. Gas gangrene is always caused by:

a. Bacillus anthracis.
b. Clostridium spp.
c. Staphylococcus aureus.
d. Streptococcus pyogenes.
ANSWER:
RATIO:

6. Untreated strep throat can lead to the following complications. EXCEPT?

a. scarlet fever
b. infective endocarditis
c. acute glomerulonephritis
d. rheumatic fever
ANSWER:
RATIO:

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7. What do you call an influenza-like, less severe form of legionellosis, is not associated with pneumonia or death?
a. Scarlet fever
b. Parrot fever
c. Rheumatic fever
d. Pontiac fever
ANSWER:
RATIO:

8. It is a highly contagious, acute, or chronic conjunctival inflammation, resulting in scarring of cornea and conjunctiva
a. Gonococcal Conjunctivitis
b. Chlamydia Keratoconjunctivitis
c. Inclusion Conjunctivitis
d. Paratrachoma
ANSWER:
RATIO:

9. This is characterized by numerous nodules in skin and possible involvement of the nasal mucosa and eyes.
a. lepromatous leprosy
b. tuberculoid leprosy
c. leprosy
d. Hansen’s disease
ANSWER:
RATIO:

10. This is referred to as “swimmer’s ear” because it often results from swimming in water contaminated with
Pseudomonas aeruginosa.
a. tinnitus
b. otitis externa
c. otitis media
d. otitis interna
ANSWER:
RATIO:

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:

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 4. ANSWER:
RATIO:

5. ANSWER:
RATIO:
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6. ANSWER:
RATIO:

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RATIO:

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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?

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