Objectives come from your Unit 3 sheet  and the content/examples come from the PowerPoints . ⸻ UNIT 3 COMPLETE STUDY GUIDE (Based strictly on your slides + objectives) ⸻ CHAPTER 11 — CONTROLLING MICROBIAL GROWTH Difference Between Antisepsis, Disinfection, Sanitization, Sterilization, Degerming, Decontamination Sterilization Complete destruction of all microbial life including viruses and endospores. Examples from slides: • Surgical instruments • Syringes • Packaged foods Endospores must be destroyed for something to be considered sterile.  ⸻ Disinfection Destroys most vegetative pathogens on nonliving surfaces. Examples: • Disinfecting medical equipment • Hospital surfaces ⸻ Antisepsis Use of antimicrobial chemicals on living tissue. Examples: • Skin prep before surgery • Cleaning wounds ⸻ Degerming Mechanical removal of microbes by scrubbing. Example: • Handwashing ⸻ Sanitization Reduces microbial numbers to public health safe levels. Examples: • Cleaning food preparation surfaces • Restaurant sanitation ⸻ Decontamination General removal of microbes from objects or surfaces. Example: • Cleaning contaminated hospital equipment ⸻ Difference Between Static and Cidal Cidal Kills microbes. Example Bactericidal antibiotics. ⸻ Static Stops growth but does not kill. Example Bacteriostatic antibiotics. ⸻ Variables That Influence Effectiveness of Antimicrobial Methods 1. Population size Large populations require more time to kill. 2. Nature of microbes Some microbes are more resistant. Example: Bacterial endospores. 3. Temperature Higher temperature increases killing. 4. Concentration of agent 5. Contact time 6. Organic matter present Example: Blood or mucus interfering with disinfectants. 7. Mode of action of agent 8. Biofilms Biofilms protect microbes from antimicrobials.  ⸻ Most Resistant vs Least Resistant Microbes Most resistant: Bacterial endospores Reason: Thick protective layers. ⸻ Less resistant: • Mycobacteria • Gram-negative bacteria • Gram-positive bacteria • Fungi • Viruses Endospores are the target of sterilization methods.  ⸻ Mechanisms of Antimicrobial Agents Agents work by damaging: Cell wall Example Detergents and alcohol disrupt cell wall. ⸻ Cell membrane Effects • Loss of permeability • Leakage of molecules ⸻ Proteins Agents denature proteins. Examples • Heat • Alcohol • Strong acids ⸻ DNA and RNA Example Radiation damaging DNA. ⸻ Practical Concerns When Choosing Control Method Consider: • Does item require sterilization or disinfection? • Can item tolerate heat, pressure, radiation, chemicals? • Cost effectiveness • Safety • Ability of agent to penetrate surfaces.  ⸻ PHYSICAL AND MECHANICAL METHODS ⸻ Pasteurization vs Sterilization Pasteurization: Reduces microbial numbers but does not sterilize. Used for: Milk and beverages. Sterilization: Destroys all microbes including endospores. ⸻ Boiling Kills many pathogens but may not destroy endospores. ⸻ Autoclaving Uses steam under pressure. Conditions from slides: 121°C 15 minutes 15 psi Mechanism: Denatures proteins and disrupts metabolism.  ⸻ Most Rigorous Heat Method Incineration (dry heat) Burns microbes completely. ⸻ Ionizing Radiation vs UV Radiation Ionizing radiation Examples: Gamma rays X-rays Effect: Destroys DNA and proteins. Highly penetrating. ⸻ UV radiation Example: Germicidal lamps. Mechanism: Forms pyrimidine dimers (thymine dimers). Effect: DNA replication blocked.  ⸻ Filtration Removes microbes from liquids or air. Examples: • Water purification • Milk filtration • Air filtration systems • HEPA filters • N95 masks HEPA filters remove 99.97% of particles.  ⸻ Osmotic Pressure High salt or sugar removes water from microbes. Examples: Salt: Cured meats Sugar: Jams and jellies Causes plasmolysis and prevents growth.  ⸻ Cold and Drying Cold: Slows microbial metabolism but rarely kills microbes. Drying (desiccation): Removes water necessary for microbial metabolism. Example: Freeze drying (lyophilization).  ⸻ CHEMICAL METHODS ⸻ Characteristics of Good Chemical Antimicrobials • Rapid action • Effective at low concentrations • Broad spectrum • Stable • Non-toxic to tissues • Affordable • Effective in presence of organic matter  ⸻ Major Chemical Agents ⸻ Halogens Examples: • Chlorine • Iodine Common example: Household bleach (sodium hypochlorite) Mechanism: Oxidizes cellular molecules and damages enzymes.  ⸻ Phenols Mechanism: Disrupt cell membranes and denature proteins. Examples: Phenolic disinfectants. ⸻ Alcohols Examples: • Ethanol • Isopropanol Mechanism: Denature proteins and disrupt membranes. Common use: Hand sanitizers. ⸻ Quats Quaternary ammonium compounds. Mechanism: Disrupt membranes. Example: Lysol wipes ⸻ Peroxides Example: Hydrogen peroxide. Mechanism: Forms reactive oxygen molecules that damage cells. ⸻ Detergents / Surfactants Mechanism: Break down lipid membranes. Examples: Soap and cleaning detergents.  ⸻ CHAPTER 12 — ANTIBIOTICS ⸻ Alexander Fleming Discovered penicillin in 1928 from the fungus Penicillium.  ⸻ Characteristics of a Good Antimicrobial Drug • Selective toxicity • High therapeutic index • Targets unique microbial structures • Effective against pathogen • Minimal harm to microbiota  ⸻ Selective Toxicity Ability of a drug to kill microbes without harming host cells. Example: Penicillin targets bacterial cell walls, which human cells lack. ⸻ Susceptibility Tests ⸻ Kirby-Bauer Disc diffusion test. Antibiotic discs placed on bacterial culture. Zone of inhibition measured. Results: Sensitive Resistant  ⸻ MIC Minimum inhibitory concentration. Smallest drug concentration preventing visible growth. ⸻ MBC Minimum bactericidal concentration. Smallest concentration that kills bacteria. ⸻ Therapeutic Index TI = toxic dose / therapeutic dose Example from slides: TI of 10 safer than TI of 1.1.  ⸻ Antibiotic Mechanisms ⸻ Cell Wall Inhibitors Example: Penicillin Mechanism: Prevents cross-linking of NAM-NAG peptidoglycan. Cell bursts due to osmotic pressure. Other examples: • Methicillin • Cephalosporins  ⸻ Cell Membrane Disruption Examples: • Polymyxin • Daptomycin • Colistin Mechanism: Creates pores causing leakage.  ⸻ Protein Synthesis Inhibitors Example: Tetracycline Mechanism: Blocks 30S ribosomal subunit. Other examples: • Erythromycin • Azithromycin • Chloramphenicol  ⸻ DNA / RNA Inhibitors Example: Fluoroquinolones Examples: • Ciprofloxacin • Levofloxacin Mechanism: Inhibit DNA gyrase. ⸻ Metabolic Pathway Inhibitors Example: Sulfa drugs Block folic acid synthesis. Example drug: Bactrim.  ⸻ Drugs for Eukaryotic Pathogens ⸻ Antifungals Examples: • Fluconazole • Amphotericin B • Azoles Target ergosterol in fungal membranes. ⸻ Antiprotozoal Drugs Examples: • Metronidazole • Chloroquine ⸻ Antihelminthic Drugs Examples: • Pyrantel • Mebendazole • Ivermectin  ⸻ Antiviral Drugs Targets: • Viral attachment • Viral transcription/translation • Viral assembly or release Examples: Acyclovir Blocks viral DNA replication. Tamiflu Prevents influenza virus release.  ⸻ HIV Drugs Target steps in HIV replication: 1 Reverse transcriptase 2 Integrase 3 Protease 4 Viral attachment Combination therapy prevents resistance. ⸻ Antibiotic Resistance ⸻ How Resistance Develops • Mutation • Natural selection • Overuse of antibiotics ⸻ Mechanisms of Resistance • Drug-destroying enzymes • Efflux pumps • Target modification • Reduced permeability  ⸻ CHAPTER 13 — MICROBIOTA ⸻ Normal Microbiota Microorganisms living on body surfaces without causing disease. Examples from slides: Skin: Staphylococcus epidermidis Gut: Escherichia coli Breast milk microbes: • Bifidobacterium • Lactobacillus • Streptococcus • Clostridium  ⸻ Benefits of Microbiota • Produce vitamins • Digest food • Stimulate immune system • Produce neurotransmitters • Prevent pathogen colonization  ⸻ Dysbiosis Imbalance in microbiota. Associated diseases: • Diabetes • Obesity • Cancer • Asthma • Allergies • Heart disease  ⸻ Microbiota Development Microbiota develop: 1 During birth 2 Through breast milk 3 Environmental exposure Stable microbiome forms by age 3. ⸻ Probiotics vs Prebiotics Probiotics: Live microbes that improve microbiota. Example: Yogurt. ⸻ Prebiotics: Food that feeds beneficial microbes. Examples: • Garlic • Onions • Asparagus • Agave • Artichokes  ⸻ Fecal Microbiota Transplant Transfer of microbiota from healthy donor. Used for: Clostridioides difficile infections Success rate: 70–90%.  ⸻ Virulence Factors Examples: Adhesion structures: Capsules, fimbriae Exoenzymes: Hyaluronidase Coagulase Biofilms increase resistance.  ⸻ Toxins ⸻ Exotoxins Secreted protein toxins. Examples: • Cytotoxins • Neurotoxins • Enterotoxins ⸻ Endotoxins Found in gram-negative bacteria. Example: LPS containing lipid A. Effects: • Fever • Inflammation • Shock  ⸻ CHAPTER 14 — EPIDEMIOLOGY ⸻ Epidemiology Study of disease frequency, distribution, and control in populations.  ⸻ Epidemiological Terms Index case: First identified patient. Incidence: Number of new cases. Prevalence: Total existing cases. Mortality rate: Deaths in a population. Case fatality rate: Deaths among infected individuals.  ⸻ Disease Occurrence Sporadic: Random cases. Endemic: Constant presence. Outbreak: Localized increase. Epidemic: Large regional increase. Pandemic: Worldwide epidemic.  ⸻ Healthcare-Associated Infections (HAIs) Common examples: • CAUTI Catheter-associated urinary tract infection • CLABSI Central line bloodstream infection • Surgical site infections • Ventilator associated infections  ⸻ Causes of HAIs • Low patient immunity • Antibiotic resistant organisms • Invasive procedures • Healthcare worker transmission Example: Healthcare workers moving between patients.  ⸻ Prevention of HAIs • Medical asepsis • Surgical asepsis • Universal precautions • Infection control officers Examples: • Needlestick precautions • Surface decontamination • Barrier protection  ⸻ If you want, I can also give you the 20–30 questions your professor is MOST likely to put on the exam from these slides. Micro professors tend to repeat the same exact conceptual questions every semester, and your slides have some really obvious ones.

(Based strictly on your slides + objectives)

CHAPTER 11 — CONTROLLING MICROBIAL GROWTH

Difference Between Antisepsis, Disinfection, Sanitization, Sterilization, Degerming, Decontamination

Sterilization
Complete destruction of all microbial life including viruses and endospores.
Examples from slides:

  • Surgical instruments

  • Syringes

  • Packaged foods
    Endospores must be destroyed for something to be considered sterile.

Disinfection
Destroys most vegetative pathogens on nonliving surfaces.
Examples:

  • Disinfecting medical equipment

  • Hospital surfaces

Antisepsis
Use of antimicrobial chemicals on living tissue.
Examples:

  • Skin prep before surgery

  • Cleaning wounds

Degerming
Mechanical removal of microbes by scrubbing.
Example:

  • Handwashing

Sanitization
Reduces microbial numbers to public health safe levels.
Examples:

  • Cleaning food preparation surfaces

  • Restaurant sanitation

Decontamination
General removal of microbes from objects or surfaces.
Example:

  • Cleaning contaminated hospital equipment

Difference Between Static and Cidal

Cidal
Kills microbes.
Example
Bactericidal antibiotics.

Static
Stops growth but does not kill.
Example
Bacteriostatic antibiotics.

Variables That Influence Effectiveness of Antimicrobial Methods

  1. Population size
    Large populations require more time to kill.

  2. Nature of microbes
    Some microbes are more resistant.
    Example:
    Bacterial endospores.

  3. Temperature
    Higher temperature increases killing.

  4. Concentration of agent

  5. Contact time

  6. Organic matter present
    Example:
    Blood or mucus interfering with disinfectants.

  7. Mode of action of agent

  8. Biofilms
    Biofilms protect microbes from antimicrobials.

Most Resistant vs Least Resistant Microbes
Most resistant:
Bacterial endospores
Reason:
Thick protective layers.
Less resistant:

  • Mycobacteria

  • Gram-negative bacteria

  • Gram-positive bacteria

  • Fungi

  • Viruses
    Endospores are the target of sterilization methods.

Mechanisms of Antimicrobial Agents

Agents work by damaging:

Cell wall
Example
Detergents and alcohol disrupt cell wall.

Cell membrane
Effects

  • Loss of permeability

  • Leakage of molecules

Proteins
Agents denature proteins.
Examples:

  • Heat

  • Alcohol

  • Strong acids

DNA and RNA
Example
Radiation damaging DNA.

Practical Concerns When Choosing Control Method
Consider:

  • Does item require sterilization or disinfection?

  • Can item tolerate heat, pressure, radiation, chemicals?

  • Cost effectiveness

  • Safety

  • Ability of agent to penetrate surfaces.

PHYSICAL AND MECHANICAL METHODS

Pasteurization vs Sterilization

Pasteurization:
Reduces microbial numbers but does not sterilize.
Used for:
Milk and beverages.

Sterilization:
Destroys all microbes including endospores.

Boiling
Kills many pathogens but may not destroy endospores.

Autoclaving
Uses steam under pressure.
Conditions from slides:
121°C
15 minutes
15 psi
Mechanism:
Denatures proteins and disrupts metabolism.

Most Rigorous Heat Method
Incineration (dry heat)
Burns microbes completely.

Ionizing Radiation vs UV Radiation

Ionizing radiation
Examples:
Gamma rays
X-rays
Effect:
Destroys DNA and proteins.
Highly penetrating.

UV radiation
Example:
Germicidal lamps.
Mechanism:
Forms pyrimidine dimers (thymine dimers).
Effect:
DNA replication blocked.

Filtration
Removes microbes from liquids or air.
Examples:

  • Water purification

  • Milk filtration

  • Air filtration systems

  • HEPA filters

  • N95 masks
    HEPA filters remove 99.97% of particles.

Osmotic Pressure
High salt or sugar removes water from microbes.
Examples:
Salt:
Cured meats
Sugar:
Jams and jellies
Causes plasmolysis and prevents growth.

Cold and Drying
Cold:
Slows microbial metabolism but rarely kills microbes.
Drying (desiccation):
Removes water necessary for microbial metabolism.
Example:
Freeze drying (lyophilization).

CHEMICAL METHODS

Characteristics of Good Chemical Antimicrobials

  • Rapid action

  • Effective at low concentrations

  • Broad spectrum

  • Stable

  • Non-toxic to tissues

  • Affordable

  • Effective in presence of organic matter

Major Chemical Agents

Halogens
Examples:

  • Chlorine

  • Iodine
    Common example:
    Household bleach (sodium hypochlorite)
    Mechanism:
    Oxidizes cellular molecules and damages enzymes.

Phenols
Mechanism:
Disrupt cell membranes and denature proteins.
Examples:
Phenolic disinfectants.

Alcohols
Examples:

  • Ethanol

  • Isopropanol
    Mechanism:
    Denature proteins and disrupt membranes.
    Common use:
    Hand sanitizers.

Quats
Quaternary ammonium compounds.
Mechanism:
Disrupt membranes.
Example:
Lysol wipes

Peroxides
Example:
Hydrogen peroxide.
Mechanism:
Forms reactive oxygen molecules that damage cells.

Detergents / Surfactants
Mechanism:
Break down lipid membranes.
Examples:
Soap and cleaning detergents.

CHAPTER 12 — ANTIBIOTICS

Alexander Fleming
Discovered penicillin in 1928 from the fungus Penicillium.

Characteristics of a Good Antimicrobial Drug

  • Selective toxicity

  • High therapeutic index

  • Targets unique microbial structures

  • Effective against pathogen

  • Minimal harm to microbiota

Selective Toxicity
Ability of a drug to kill microbes without harming host cells.
Example:
Penicillin targets bacterial cell walls, which human cells lack.

Susceptibility Tests

Kirby-Bauer
Disc diffusion test.
Antibiotic discs placed on bacterial culture.
Zone of inhibition measured.
Results:
Sensitive
Resistant

MIC
Minimum inhibitory concentration.
Smallest drug concentration preventing visible growth.

MBC
Minimum bactericidal concentration.
Smallest concentration that kills bacteria.

Therapeutic Index
TI = toxic dose / therapeutic dose
Example from slides:
TI of 10 safer than TI of 1.1.

Antibiotic Mechanisms

Cell Wall Inhibitors
Example:
Penicillin
Mechanism:
Prevents cross-linking of NAM-NAG peptidoglycan.
Cell bursts due to osmotic pressure.
Other examples:

  • Methicillin

  • Cephalosporins

Cell Membrane Disruption
Examples:

  • Polymyxin

  • Daptomycin

  • Colistin
    Mechanism:
    Creates pores causing leakage.

Protein Synthesis Inhibitors
Example:
Tetracycline
Mechanism:
Blocks 30S ribosomal subunit.
Other examples:

  • Erythromycin

  • Azithromycin

  • Chloramphenicol

DNA / RNA Inhibitors
Example:
Fluoroquinolones
Examples:

  • Ciprofloxacin

  • Levofloxacin
    Mechanism:
    Inhibit DNA gyrase.

Metabolic Pathway Inhibitors
Example:
Sulfa drugs
Block folic acid synthesis.
Example drug:
Bactrim.

Drugs for Eukaryotic Pathogens

Antifungals
Examples:

  • Fluconazole

  • Amphotericin B

  • Azoles
    Target ergosterol in fungal membranes.

Antiprotozoal Drugs
Examples:

  • Metronidazole

  • Chloroquine

Antihelminthic Drugs
Examples:

  • Pyrantel

  • Mebendazole

  • Ivermectin

Antiviral Drugs
Targets:

  • Viral attachment

  • Viral transcription/translation

  • Viral assembly or release
    Examples:
    Acyclovir
    Blocks viral DNA replication.
    Tamiflu
    Prevents influenza virus release.

HIV Drugs
Target steps in HIV replication:
1 Reverse transcriptase
2 Integrase
3 Protease
4 Viral attachment
Combination therapy prevents resistance.

Antibiotic Resistance

How Resistance Develops

  • Mutation

  • Natural selection

  • Overuse of antibiotics

Mechanisms of Resistance

  • Drug-destroying enzymes

  • Efflux pumps

  • Target modification

  • Reduced permeability

CHAPTER 13 — MICROBIOTA

Normal Microbiota
Microorganisms living on body surfaces without causing disease.
Examples from slides:
Skin:
Staphylococcus epidermidis
Gut:
Escherichia coli
Breast milk microbes:

  • Bifidobacterium

  • Lactobacillus

  • Streptococcus

  • Clostridium

Benefits of Microbiota

  • Produce vitamins

  • Digest food

  • Stimulate immune system

  • Produce neurotransmitters

  • Prevent pathogen colonization

Dysbiosis
Imbalance in microbiota.
Associated diseases:

  • Diabetes

  • Obesity

  • Cancer

  • Asthma

  • Allergies

  • Heart disease

Microbiota Development
Microbiota develop:
1 During birth
2 Through breast milk
3 Environmental exposure
Stable microbiome forms by age 3.

Probiotics vs Prebiotics

Probiotics:
Live microbes that improve microbiota.
Example:
Yogurt.

Prebiotics:
Food that feeds beneficial microbes.
Examples:

  • Garlic

  • Onions

  • Asparagus

  • Agave

  • Artichokes

Fecal Microbiota Transplant
Transfer of microbiota from healthy donor.
Used for:
Clostridioides difficile infections
Success rate:
70–90%.

Virulence Factors
Examples:
Adhesion structures:
Capsules, fimbriae
Exoenzymes:
Hyaluronidase
Coagulase
Biofilms increase resistance.

Toxins

Exotoxins
Secreted protein toxins.
Examples:

  • Cytotoxins

  • Neurotoxins

  • Enterotoxins

Endotoxins
Found in gram-negative bacteria.
Example:
LPS containing lipid A.
Effects:

  • Fever

  • Inflammation

  • Shock

CHAPTER 14 — EPIDEMIOLOGY

Epidemiology
Study of disease frequency, distribution, and control in populations.

Epidemiological Terms
Index case:
First identified patient.
Incidence:
Number of new cases.
Prevalence:
Total existing cases.
Mortality rate:
Deaths in a population.
Case fatality rate:
Deaths among infected individuals.

Disease Occurrence
Sporadic:
Random cases.
Endemic:
Constant presence.
Outbreak:
Localized increase.
Epidemic:
Large regional increase.
Pandemic:
Worldwide epidemic.

Healthcare-Associated Infections (HAIs)
Common examples:

  • CAUTI
    Catheter-associated urinary tract infection

  • CLABSI
    Central line bloodstream infection

  • Surgical site infections

  • Ventilator associated infections

Causes of HAIs

  • Low patient immunity

  • Antibiotic resistant organisms

  • Invasive procedures

  • Healthcare worker transmission
    Example:
    Healthcare workers moving between patients.

Prevention of HAIs

  • Medical asepsis

  • Surgical asepsis

  • Universal precautions

  • Infection control officers
    Examples:

  • Needlestick precautions

  • Surface decontamination

  • Barrier protection

If you want, I can also give you the 20–30 questions your professor is MOST likely to put on the exam from these slides.
Micro professors tend to repeat the same exact conceptual questions every semester, and your slides have some really obvious ones.