• Amount
  • Chemical
  • Physical
• Time
• Temperature
  • Every 10 degrees, rate of rxn doubled
  • time needed for cidal cut in half

• Load
• Kind of organism
  • G+ vs G-
  • Spores vs Vegetative
• Previous history of organism
  • young
  • mature
  • old

• Penetration
  • density
  • inactivation
    • colloids
    • pH

any particle too big to form into solution but small enough to be suspended

Ex:

• blood
• feces
• vomit
• bacteria
• india ink

• in kidneys
• break down carbapenem

protein oxidation

(700-1500 C)

At 1000 C: only protein oxidation occurs and all organic material is burned

sterilize

kills prions also by autoclave - 132 C for 1 hour

metal or glass and can only be dry material

160 C for 2 hours

• all water for enzymatic hydrolysis is removed
• occurs in first few mins
• NOT enough to sterilize

• destroys 3D structure of protein
• liquid to solid
• can occur with dry heat (increase temp and time)

• boiling
• free flowing steam
• steam under pressure
• high vacuum sterilization
• pasteurization

disinfects

but kills spores after 5-9 hours

disinfects

less water log too!

1. Use big tank
2. Pressure increased to 15 lb/in^2 for 15 mins
3. Kills everything but prions, which need 132 C for 1 hour

Pasteurization: disinfects or sterilizes?

what else is it?

examples of its use?

disinfects

heat labile

• milk
• beer
• apple cider
• orange juice

1. Batch (holding) stir milk
   • Old temp: 61.7 C for 30 mins
     • killed mycobacterium bovis (TB) but not Coxiella burnetti
   • New temp: 62.9 C for 30 mins
2. Flash
   • 71.6 C for 15 secs

• Scrubbing
• Filtration
• Sedimentation

use of soap or bland soap

reduces surface tension, therefore stuff comes off

reduces number but bacteria can still multiply

acts as surfactant - surface acting agent

it is a labile (easily removable; unstable)

residual action of the germicide: sticks to skin and continues to work

has lower bacterial number bc bacteria can't multiply

• standard
• removes ALL eukaryotic cells
• SOME prokaryotic pass through

• Standard
• "STERILIZES" solution
• Removes ALL eukaryotic
• Removes ALMOST ALL prokaryotic
• MYCOPLASMA & VIRUSES slip through

• Removes MOST viruses
• Easily clogs up
• PRIONS & VIROIDS slip through

• Removes viruses
• Can't filter out prions and viroids

naked RNA

tiny pieces of intron RNA with exons cut out

1. Desiccation
2. Cold Temperatures
3. Osmotic Pressure
4. Sunlight

• Staphylococcus aureus in CEREAL if liquid is added
• Salmonella in DRIED POWDERED EGGS if left to sit out for 3 months

Staphylococcus chloroforms like E. coli and Salmonella

resistant due to slime layer

Mycobacterium tuberculosis - TB

resistant due to waxy coat

Both!

• cidal - eukaryotic cells
• static - bacteria (population doesn't grow)

• brine has high salt concentration (30%) and used to be used to preserve meats
• sugars (in jelly) has high sugar concentration (50-60%) used to preserve fruit
• halophiles LIVE in salty environments (36%) and are not pathogenic
• saccharophiles LIVE in sugared environments (70%) and are not pathogenic

ultraviolet light (100-400 nm)

infrared & microwaves

• DNA forms pyrimidine dimers
• Too much radiation - causes mutation; death occurs in vegetative cells and spores
• poor penetration

gamma rays

cathode rays

x-rays

• If DRY: protein OXIDATION
• If WET: protein COAGULATION

• Creates hyperactive ions and
• Uses that energy to strike DNA and break bonds between bases
• Results in mutation
• Cold sterilizing

1. no need to heat up organisms
2. can be used for anything that is heat labile
3. no change in chemistry and breakdown of chemical compounds

1. penetrating - except lead and thick concrete
2. comes from radioactive cobalt 60
3. sterilizes thick things and packaged meat
4. does NOT affect prions

1. High intensity electron beams
2. Any electric insulator stops them
3. Non-penetrating, but if they do, they STERILIZE
4. Blocked by glass

1. Very effective
2. Very penetrating
3. Too dangerous for routine use

1. Denature Protein
   1. Protein coagulation
   2. Non-specific chemical combination
2. Disrupt lip-protein membranes (mostly cell membranes)
3. Suppress cell wall synthesis
4. Antimetabolites (competitive/non-competitive inhibitors)
5. Inhibit nucleic acid synthesis

Protein coagulants

• destroys anything with proteins
• broad spectrum - works against G-, G+, prob viruses, protozoa, fungi, and helminthes

1. Alkalis and Acids
2. Phenols
3. Non-Phenols
4. Salts of Heavy Metals
5. Alcohols

• strong base
• protein coagulant
• used for nematodes - dissolves whole worm without harming the eggs

1. Effective in presence of organic matter (blood,feces,vomit)
2. Strongly microbiocidal against vegetative bacteria - TB
3. It is an analgesic (pain reliever)
4. Surgical disinfectant against Staph/Strep-cocci
5. Used as preservative for vaccines

1. Very caustic
2. Not reliably sporicidal
3. Not effective against hepatitis B
4. Accumulates in the environment

1. phenol
2. cresol
3. ortho-phenylphenol
4. hexachlorophene
5. triclosan

• mixture of cresols
• used to clean areas for pet and horses
• bad since it accumulates in the environment and causes irritation

lysol and insecticides

it is less toxic and more water soluble than cresol

Used to be used in soaps, shampoos, and baby powders

residual action - stays on skin and gets deeper til it becomes neurotoxic

killed 40 babies in france where brains looked like swiss cheese

• soaps
• shampoo
• toothpaste
• kitty litter

Pseudomonas aeruginosa

• non-fermenter
• hard to get rid of

medicine dissolved in alcohol

Ex: mixture of 4% chlorohexidine and 4% isopropyl alcohol

2% chlorohexidine for two minutes on skin

OR:

iodine tincture

betadine

70% alcohol

iodophors

analgesic

antiseptic for membranous surface

1. Inactive in presence of organic matter
2. some are toxic
3. Irritates skin, which delays healing

• crust forms like scan and organisms still grow underneath

1. Mercuric bichloride
2. Thimerosal aka merthiolate
3. Silver nitrate
4. Argyrol
5. Zinc
6. Silver sulfadiazene

thought to cause autism

1. antiseptic
2. antifungal agent
3. preservative for vaccines
4. preservative in eye cosmetics

Silver nitrate: sterilize or disinfect?

What did it use to prevent?

What is it ineffective against?

disinfectant

ophthalmia neonatorum

chlamydia trachomatis

What is silver nitrate ineffective against?

effective?

chlamydia trachomatis

chlamydia and gonorrhea

ophthalmic solutions

mucous surfaces (eyes, nose urethra)

Mode of action of sulfadiazene

What is it used for?

What resistant organism is it good for?

antimetabolite

dressings for burn patients

pseudomonas aeruginosa

1. Iodine tinctures
2. Iodophors
3. Chlorine
4. Sodium hypochlorite
5. Halazone

iodine and alcohol at 1-2% concentration

volatile crystals!

1. ophthalmic neonatorum
2. STDs (gonorrhea and chlamydia) - cheaper

protozoa, especially those with cysts

Ex: beaver fever, giardia

How can something be an ideal antiseptic disinfectant?

Example?

breaks down into oxygen and water, therefore NO TOXIC RESIDUES

hydrogen peroxide

1. formaldehyde
2. glutaraldehyde
3. ethylene oxide

1. dentist offices
2. respiratory therapy equipment
3. cow teats in farm

1. Quaternary ammonium compounds
2. Benzalkonium chloride
3. Cetylpyridinium chloride

G+ bacteria

Has effect on cell wall but not cell membrane

disinfect

no activity against mycobaterium TB, hepatitis B, spores

low toxicity --> used against staph/strep-cocci

1. ophthalmic solutions
2. cosmetics
3. mouthwashes

1. streptococcus pneumonia
2. Gonococcus -meningococcal
3. treponema pallidum - syphilis
4. neisseria gonorrheae - gonorrhea

1. Sodium LAURYL sulfate
2. Bile salts

bile.

found in macconkey's medium (G -)

identifies Streptococcus pneumoniae 

(sensitive to bile)

Why was polymyxins produced by bacteria?

Isolated from what species?

to protect themselves

Bacillus

1. topically - on skin
2. oral - blood and organs
3. IM - intramuscular
4. IV - intravenous (most optimal therapy)

1. Acinetobacter
2. Pseudomonas aeruginosa
3. Klebsiella

1. OTIC infections
2. Ophthalmic infections
3. Skin infections

What is otitis externa?

What is it caused by?

known as swimmer's ear

infection of skin covering outer ear and ear canal

caused by streptococcus, staphylococcus, or speudomonas

Attacks cell membrane by preventing the production of sterols

bacteria dont have steroids in cell membrane so its not effective against them

What is the most common yeast?

what could it cause?

candida albicans -- candiasis

oropharyngeal - thrush

vulvovaginalis - yeast infection in vagina

What is systemic mycosis?

what causes it?

fungal infection that attacks inside body

aspergillosis (dimorphic fungi)

nystatin

amphotericin B

fungicidal and good for severe candidiasis

but very toxic!

1. detergents
2. polymyxins
3. polyene antibiotics
4. azoles

1. Vancomycin (G+)
2. Colistin (G- rods)
3. Nystatin (yeast)

At 25 C, what do dimorphic fungi look like?

35 C?

molds

yeast

1. Imidazole
   1. Clotrimazole
   2. Miconazole
   3. Ketoconazole
2. Triazole
   1. Fluconazole (Diflucan)
   2. Voriconazole

fluconazole (diflucan)

good for yeast infections, but not mold infections

1. Clostridium perfringens (gas gangrene G+)
2. Staphylococcus pyogenes (G+ cocci)
3. Neisseria meningitidis (meningococcus, G-)
4. Treponema pallidum (syphilis, G-)

benzyl penicillin (penicillin G)

phenoxymethyl penicillin (penicillin V)

procaine penicillin

benzathine penicillin

1. Ampicillin
2. Amoxicillin
3. Carbenicillin
4. Tircarcillin

What makes up ampicillin?

DOC for?

penicillin & amino group

UTI by Proteus mirabilis

What makes up amoxicillin?

DOC for?

penicillin & hydroxyl group

UTI by Proteus mirabilis

instances of diarrhea are lower when taken orally

What makes up carbenicillin?

DOC for?

penicillin G & carboxyl group

NOT DOC, only alternate for UTI infections by pseudomonas aeruginosa

What makes up tircarcillin?

DOC for?

penicillin & sulfur ring

Pseudomonas aeruginosa and other infections it causes

2-4x more effective that carbenicillin

What do beta lactamase do?

Name 2 types

Name 3 organisms that have them

inactivate penicillin

penicillinase & cephalosporinase

plasmids, staphylococci, neisseria gonorrhaea

1. Methicillin
2. Oxacillin
3. Cloxacillin
4. Augmentin
5. Zosyn

 amoxicillin & potassium clavulanate

clavulanate- non-competitive inhibitor (suicide substrate)

Piperacillin & Tazobactam

tazobactam - suicide substrate

Absorbed through IV and IM not orally

2-4x more effective that tircarcillin

1. Cephalothin
2. Ceoftiam
3. Moxalactam
4. Cefepime

Discuss which spectrum cephalothin has

what it affects

and one fact about it

Narrow spectrum

affects G+: staphylococcus and streptococcus

chemo prophylactic

Proteus haemophilus

Enterobacteria

Ceftriaxone

Cefotaxime

primaxin

imipenem & cilastatin

What combination of 3 ingredients is used in topical ointments?

polymixin (fights G-)

bacitracin (fights G+)

neomycin

What is the most powerful antibiotic?

where is it extracted from?

vancomycin

streptomyces

1. Para Amino Benzoic Acid
2. Dihydropteroic Acid
3. Dihydropholic Acid
4. Tetrahydropholic Acid
5. Purines, Pyrimidines, Amino Acids

1. Sulfonamides
2. Sulfones
3. Isoniazid
4. Trimethoprim
5. P-AminoSalycylic Acid

1. Sulfisoxazole
2. Bactrim = Sulfamethoxazole + Trimethoprim

1. Uncomplicated UTI (DOC)
2. Pneumonia caused by Pneumocystis jiroveci pneumoniae
3. MRSA (less severe)

multi-drug resistant TB

INF and rifampin

Extreme Drug Resistant TB

resistant to INH, rifampin + fluoroquinilone + injectable aminoglycocides

amikasin

capreomycin

kanamycin

translation

ribosomal step

1. Aminoglycosides
2. Tetracyclines
3. Nitrobenzene derivatives
4. Macrolide
5. Synercid
6. Linezolid (zyvox)

1. Streptomycin
2. Neomycin
3. Spectinomycin
4. Gentamicin
5. Capreomycin, Kanamycin, Amikacin

1. Capreomycin
2. Kanamycin
3. Amikacin

1. Tetracycline
2. Doxycycline
3. Minocycline

1. mild MRSA
2. penicillin substitute
3. G+ infections
4. Rickettsial infections
5. Chlamydial infections
6. "walking pneumonia"
7. lyme disease

What causes aplastic anemia?

What kind of agent is it?

Chloramphenicol

Nitrobenzene derivative (inhibit protein synthesis)

Meningitis (haemophilus influenzae)

*chloramphenicol

typhoid fever (salmonella typhi)

*chloramphenicol

Vancomycin Resistant Enterococci VRE

*chloramphenicol

1. Neisseria gonorrhaea
2. Chlamydia trachomatis
3. pregnant women allergic to B-lactam
4. Mycoplasma pneumonia
5. Bordatella pertussis - whooping cough
6. Legionella pneumophila - legionnaire's disease
7. Mycobacteriam avium - AIDS patients not resistant

1. Mycoplasma pneumonia
2. Diptheria (corynebacterium)
3. Pertussis
4. Ophthalmia neonatorum
5. Nosocomial pneumonia

quinupristin

dalfopristin

Linezolid

alternate for SERIOUS MRSA

1. Acyclovir
2. Azidothymidine AZT
3. Griseofulvin
4. Chloroquine, Primaquine, Quinine
5. Quinolones (Fluoroquinolones)
6. Metronidazole (flagyl)

Acyclovir

used against herpes virus

malaria

cinchona tree

Malaria is a protozoa that is present where?

what does it do?

what enzyme does it inhibit?

red blood cells

it digests hemoglobin

heme polymerase enzyme

ciprofloxacin and moxifloxacin

they interefere with DNA gyrase - enzymes that allow coiling/uncoiling of DNA

1. gonorrhea
2. anthrax
3. pseudomonas aeruginosa

antibiotic associated colitis

inflammation of colon due to taking antibiotics

antibiotics clear out microbial flora in digestive system and clostridium difficile grow in intestinal tract