+ All Categories
Home > Documents > YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial...

YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial...

Date post: 24-Dec-2015
Category:
Upload: lewis-robertson
View: 216 times
Download: 0 times
Share this document with a friend
Popular Tags:
32
YOUR NAME: Dr. ? YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your case … It is too long to include in the “Example Case” tutorial … Even at that, it is only an example and has been pared down for this tutorial … The complete example is available as the MSWord document “06_EXAMPLE CASE STUDY_FAIRGROUND” At the same time that you get the Level 4, you’ll also get the “invitation” to teach a lab class to the 1 st year med students … … And you’ll be expected to completely discuss each type of bacteriology growth media that you
Transcript
Page 1: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

YOUR NAME: Dr. ?YOUR eMAIL ADDRESS: ?CASE: A Day at the Fair. LEVEL 5

This PowerPoint tutorial explains is expected of your answers to Level 5 of your case … It is too long to include in the “Example Case” tutorial … Even at that, it is only an example and has been pared down for this tutorial … The complete example is available as the MSWord document “06_EXAMPLE CASE STUDY_FAIRGROUND”

At the same time that you get the Level 4, you’ll also get the “invitation” to teach a lab class to the 1st year med students …

… And you’ll be expected to completely discuss each type of bacteriology growth media that you used

Page 2: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

Show-n-Tell Day in the Bact Lab!

For each specimen that was ordered (using the "Flamingham General Hospital - Specimen Request Form" [Level 1 / Question 3]), which bacteriological growth media were actually inoculated?

The inoculation protocols, below, explain the media that are always used; keep reading …

YOUR NAME: Dr. ?YOUR eMAIL ADDRESS: ?CASE: A Day at the Fair. LEVEL 5

Page 3: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

FLAMINGHAM GENERAL HOSPITALINOCULATION PROTOCOLS FOR THE ISOLATION OF

BACTERIAL PATHOGENS

This series of inoculation protocols was designed to ensure

that the typical bacterial pathogens, which might infect a particular

body site, are provided with the appropriate nutritional and

environmental conditions for growth. The Director of the

Microbiology Laboratory chose those tests and media because

they will allow the most efficient detection and/or isolation of the

typical bacterial pathogens that are usually associated with each

type of clinical specimen.

Page 4: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

Observations of the pattern(s) of growth on all the media will allow

“Med Techs” [i.e. the skilled, although under-paid “Clinical

Laboratory Scientists”] and clinicians to make appropriate

decisions regarding the choice of any additional tests that will

ultimately lead to the correct identification of the pathogen.

Many bacteria require additional, special media and/or growth

conditions (special mixtures of atmosphere gases, temperature,

etc.) It is not economical to use these in a routine fashion.

A physician’s request (based on clinical history or other factors)

prompts for the special use of these.

Page 5: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

Based upon his/her differential diagnosis, the practitioner may

order additional “differential” and “selective” media that are not

specified in these protocols

Special media and additional tests can also be ordered

from the other clinical laboratories

(already done in Level 1/Questions 5 and 6, and there will be other

opportunities throughout the case.)

Page 6: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

The routine inoculation protocols followed in FGH are below;

these protocols are a list of the media that according to your

hospital’s protocols MUST be used to isolate BACTERIAL

pathogens from EACH SPECIMEN that has been ordered.

EACH SPECIMEN MUST BE INOCULATED ONTO EACH OF

THE MEDIA AS “ASSIGNED” TO THAT TYPE OF SPECIMEN IN

THE TABLES, below.

Page 7: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

Abbreviations of the Names of TESTS and GROWTH MEDIA(Complete Descriptions of Each Medium Can Be Found in “Question 5C)

A Disk – Bacitracin-Impregnated Filter Paper Disk (To Identify Group A Strep)- Blood Agar Incubated in an Anaerobic ChamberBROTH – Brain Heart Infusion Broth BLOOD – Agar Containing 5% (vol/vol) Sheep RBCs (Red Blood Cells)CAMPY - Campylobacter AgarCHOC - Chocolate AgarEMB – Levine’s Eosine Methylene Blue AgarHE - Hektoen Enteric Agar- MacConkey Agar/SORB – MacConkey Agar with SorbitolMTM - Modified Thayer Martin AgarPEA - PhenylEthylene Alcohol Blood AgarSELENITE - Selenite BrothSMEAR – Smear of the Clinical Specimen on a Microscope Slide - for a Gram StainSS – Salmonella-Shigella Agar THIO BROTH – Thioglycholate Broth - for Anaerobes– Trypticase Soy AgarV AGAR – Gardnerella vaginalis Agar – Agar Containing 5% (vol/vol) Horse RBCs

Note: Certain specimens [e.g. Blood, CSF, etc] should also be sent to the Chemistry and Serology laboratories for additional, NECESSARY testing!

Page 8: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

- Based on Level 1 / Question 3A in this example, the

ETIOLOGICAL DIAGNOSIS (“Specimen Request Form”), you

requested specimens of BLOOD and STOOL.

Page 9: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

Specimen Request Form

X Blood CSF Catheter Tip Bone Marrow Dialysis Fluid Miscellaneous Specimen (e.g. Aspirate, Abscess, Fluid, Tissue, Wound, Ulcer, etc.) *

* Specify source of sample

EENT - Upper Respiratory Eye Ear Nose, Nasopharnyx Throat

Genital – Urinary Tract Ulcer Swab Vaginal Swab Cervical Swab Midstream Urine Catheter Urine Urethral Swab

Lower Respiratory Tract Sputum Alveolar/Bronchial * Aspirate*

Gastro – Intestinal Tract X GI Stool Vomitis

Page 10: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

INOCULATION PROTOCOLS FOR THE ISOLATION OF BACTERIAL PATHOGENSSOURCE/TYPE OF SPECIMEN MEDIUM and SPECIAL INSTRUCTIONS

BLOOD ** An Automated (Anaerobic and Aerobic)

Blood Sample System, e.g. “BACTEC”

will be used in addition to these media

NO SMEAR – This Specimen is NOT Routinely Gram Stained

BLOOD

CHOC

MACANA Note: The Serology, Hematology, and Clinical Chemistry Laboratories, and perhaps

others should also analyze this specimen.

CEREBRAL SPINAL FLUID (CSF)* * First CENTRIFUGE, Then Culture the

SEDIMENT

SMEAR - TO BE GRAM STAINED

BLOOD

CHOCMACTHIO BROTHNote: The Serology, Hematology, and Clinical Chemistry Laboratories, and perhaps

others should also analyze this specimen.

CATHETER TIP DIALYSIS FLUID BONE MARROW

SMEAR - TO BE GRAM STAINED

BLOOD

CHOC

THIO BROTH

MISCELLANEOUS SPECIMEN ** e.g. Wound, Abscess, Tissue Biopsy,

Synovial Fluid, Catheter Tip, Bone

Marrow, etc...

SMEAR - TO BE GRAM STAINED

BLOOD

BLOOD - ANAEROBIC 37oC INCUBATOR

CHOC

PEA

PEA - ANAEROBIC 37oC INCUBATOR

MAC

ANA - If an Anaerobe Is Suspected

BHI - If Specimen Did Not Arrive in Transport Broth

Page 11: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

EYEEAR

SMEAR - TO BE GRAM STAINED

BLOOD

CHOC

MAC

MTM - EYE Culture only

NOSENASOPHARNYXTHROAT

Only upon physician's request: SMEAR - TO BE GRAM STAINED

BLOOD -CO2 INCUBATOR

CHOC - CO2 INCUBATOR

SPUTUMALVEOLAR/BRONCHIAL *LOWER RT ASPIRATE** First CENTRIFUGE, Then Culture the

SEDIMENT

SMEAR - TO BE GRAM STAINED

* Request Special Medium and a second SMEAR if there is a suspicion of Tb

BLOOD

CHOC

MAC

URINE - MIDSTREAM URINE - CATHETER

If Midstream Urine - NO SMEAR – This Specimen is NOT Routinely Gram Stained

If Catheter Urine - SMEAR - TO BE GRAM STAINED BLOODMAC (or EMB)

CERVICAL VAGINALGENITAL ULCERURETHRAL

SMEAR - TO BE GRAM STAINED

BLOODCHOC

MTM

V AGAR

STOOLVOMITIS

NO SMEAR – This Specimen is NOT Routinely Gram StainedUpon Special Request - EXAMINATION FOR LYMPHOCYTES BLOODMACHESSCAMPY - Incubate at 42oCSELENITE - Place Remaining Specimen on Swab in Selenite Broth

Page 12: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

STOOLVOMITIS

NO SMEAR – This Specimen is NOT Routinely Gram StainedUpon Special Request - EXAMINATION FOR LYMPHOCYTES BLOODMACHESSCAMPY - Incubate at 42oCSELENITE - Place Remaining Specimen on Swab in Selenite Broth

BLOOD ** An Automated (Anaerobic and Aerobic) Blood Sample System, e.g. “BACTEC” will be used in addition to these media

NO SMEAR – This Specimen is NOT Routinely Gram Stained BLOODCHOCMACANA Note: The Serology, Hematology, and Clinical Chemistry Laboratories, and perhaps others should also analyze this specimen.

Page 13: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

- So, for a BLOOD specimen, the lab must inoculate the patient's

sample on the following media: BLOOD, CHOC, MAC, ANA, and

no gram-stain will be performed (NO SMEAR)

- For the STOOL specimen, the lab must inoculate the patient's

sample on the following media: BLOOD, MAC, HE, SS, CAMPY,

SELENITE and no gram-stain will be performed (NO SMEAR)

- So overall, only the following media will be inoculated with the

patient's specimens: BLOOD, CHOC, MAC, ANA, HE, SS,

CAMPY, SELENITE and no gram-stain will be performed (NO

SMEAR)

Page 14: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

So now answer the following question - For each specimen that was ordered (using the "Flamingham General Hospital - Specimen Request Form" [Level 1/Question 3]), which bacteriological growth media were actually inoculated?

- Return to the series of "Bacteriology Inoculation Protocols" that are above and Delete all of the table(s) regarding any specimen(s) that you did NOT request using the "Flamingham General Hospital - Specimen Request Form"

- Then from the lists of tests/media associated with the specimens that were Retained, highlight (or underline, whatever) the media in the list below that were actually inoculated in the lab:

NO SMEARTSABLOODBLOOD - ANAEROBIC

37oCCHOCPEAPEA - ANAEROBIC 37oCMAC (or EMB)

ANA BHI BROTHTHIO BROTH MTMV AGAR

HESSSELENITE BROTHCAMPY - 42oCENTEROCOCCUS AGAR

Page 15: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

Oh no! You’re already so busy and don’t need another responsibility!

Dr. S. Kraut is ill. She is the president of the "Association of Fermenters for the Next Millennia." A suspected food-borne illness associated with her "Pickle-Of-The-Month Club" will prevent her from her duties in the clinical labs. So tomorrow, you have been assigned to fill in for her by guiding a group of 1st year medical students through the clinical labs. You will have to lecture to your students about the diagnostic process and will use your current patient as an example.

During your introductory comments to the students, the lab techs will be laying out all of the plates/broth tubes associated with your patient. You will then discuss how each medium will hopefully provide valuable evidence regarding the cause of your patient's illness. You had better be prepared!

So, based on your initial differential diagnosis, what do you expect to observe on the plates? You must understand what will happen on every medium for each of your "Most Likely Suspects." You do not wish to be embarrassed in front of the students, and more importantly are concerned about your patient. (You will actually get the most important of those results in either level 2 to 4 of this case study.)

Page 16: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

Oh no! You’re already so busy and don’t need another responsibility!

In preparation for your prediction of which organisms will be on the culture media, review what you have done and learned so far:

1) Initially evaluated the patient for the syndrome(s) that are associated with his/her illness.

2) Considered all the "Most Likely Suspects" associated with the syndrome(s).

3) Ordered specimens that should shed light as to the cause of the illness.

4) Inoculated those specimens on the most appropriate media (using the inoculation protocols, above) for bacterial pathogens most likely to be in the patient's specimen(s).

Page 17: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

FYI:Types of Growth Media for the

Isolation and Identification of Bacteria from Specimens

GENERAL PURPOSE MEDIA Nutrient media (e.g. TSA) that support the growth of many microorganisms

ENRICHMENT MEDIA

Supplemented nutrient media (e.g. TSA) to which necessary growth factors (e.g. blood, serum, or extracts [e.g. yeast]) have been added to encourage the growth of many fastidious bacteria Uses: To isolate bacteria from CSF, pleural fluid, sputum, and wound abscesses

SELECTIVE MEDIA

Culture media to which specific substances (e.g. dyes, chemicals, etc.) have been added to favor the growth of one group of bacteria while inhibiting the growth of other groups Uses: To allow recovery of organisms in the presence of contaminating microbiota

DIFFERENTIAL MEDIA

Culture media to which specific substances (e.g. dyes, specific sugars, etc.) have been added to result in “diagnostically useful” growth or visible changes in the media after incubation Uses: To distinguish between different groups of bacteria based on their biological characteristics - allows identification of organisms by specific chemical reactions

Page 18: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

GROWTH & APPEARANCE OF SUSPECTED PATHOGENS ON

ROUTINE BACTERIOLOGIC MEDIA

So now answer the following question - Demonstrate that the

specimens that were ordered and tests/media specified by the

“INOCULATION PROTOCOLS FOR THE ISOLATION OF

BACTERIAL PATHOGENS” are adequate, i.e. that those

tests/media are sufficient to allow the detection of all the usual

suspect bacteria that you listed in the DIFFERENTIAL

DIAGNOSIS from Level 1.

Page 19: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

Based the answers below on –

your “enlightened” differential diagnosis(comments/corrections on Level 1/Question 2 from the chief of infectious

diseases)

and the actual specimens that were ordered and were

worked-up in the bacteriology laboratory (as listed at the beginning of level 2, perhaps not the specimens you had

originally considered in Level 1/Question 3).

Page 20: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

For the following series of media table boxes, refer this info that

you prepared above,

NO SMEAR

TSA

BLOOD

BLOOD -

ANAEROBIC 37oC

CHOC

PEA

PEA - ANAEROBIC

37oCMAC (or EMB)

ANA

BHI BROTH

THIO BROTH

MTM

V AGAR

HE

SS

SELENITE BROTH

CAMPY - 42oC

ENTEROCOCCUS

AGAR

Page 21: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

Then:

- Delete each table box regarding any medium that is not required

by the FGH protocols

- Retain only the table box(es) regarding the media that must be

inoculated. Fill in those boxes as directed in the instructions.

Then for EACH Microbe and EACH Test/Medium - State your

Anticipated Observation and Explain why that observation might

occur

Page 22: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

Then for EACH Microbe and EACH Test/Medium - State your Anticipated

Observation and Explain why that observation might occur.

- This will require thought and effort; the info isn’t always easy to find. The

appropriate pages of the “Clinical Microbiology” chapter in an introductory

microbiology textbook (and/or other similar resources) should be consulted.

Search the internet using the genus and species names and/or use reference

texts available in many college libraries - e.g.:

KONEMANN’S Color Atlas and Textbook of Diagnostic Microbiology

or , RYAN, et al.’s SHERRIS- Medical Microbiology, An Introduction to

INFECTIOUS DISEASES

or MURRAY et al.’s The Manual of Clinical Microbiology

Page 23: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

- But in some situations, you will not find the exact answers (unless

you extensively investigate several books and the internet).

You may have to try to “figure it out!”

So also read and consider the components and function of each

medium, and then base your answer on your knowledge of

culturing bacteria on artificial media; make an "educated guess!"

Page 24: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

Cite the major references that you used to answer the questions

below.

? It’s your job to provide this info!

But here are some sites that others have found useful:

.

.

Page 25: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

TESTor

MEDIUM

BRIEF DESCRIPTION OF THE BACTERIOLOGICAL GROWTH MEDIAIn addition to the specific ingredients discussed below, most media contain salts [usually NaCl] and buffers to maintain the pH within the range of neutrality [e.g. phosphate or “Tris”]

Genus species of

”The Most Likely Causes of Illness”

Please follow the correct taxonomic style for writing

Genus species

Observation & Interpretation-

Results of the Test or Growth Medium and Interpretations of the Growth (Or Lack of Growth) on

Culture Media

Page 26: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

TESTor

MEDIUMBRIEF DESCRIPTION OF THE BACTERIOLOGICAL GROWTH MEDIAIn addition to the specific ingredients discussed below, most media contain salts [usually NaCl] and buffers to maintain the pH within the range of neutrality [e.g. phosphate or “Tris”]

Genus species of

”The Most Likely Causes of Illness”

Please follow the correct taxonomic style

for writing Genus species

Observation & Interpretation-

Results of the Test or Growth Medium and Interpretations of the Growth (Or Lack of Growth) on Culture Media

SMEARSMEAR – Smear of the Clinical Specimen on a Microscope Slide - for a Gram Stain GRAM-STAIN distinguishes between Gm- and Gm+ bacteria. - Useful for identification of pathogens and determining effective antibiotic treatment- Include the necessary information regarding a second type of SMEAR if there is a suspicion of Tb

”The Most Likely Causes Of Illness”(i.e. Bacteria being

“Considered” in the Differential Diagnosis)

Observation & Interpretation – What is the MICROSCOPIC appearance of the CELLS? Gram+ or Gram- ... Cellular Arrangement and Morphology?… Is it likely that the organism will be seen in a Gram-stained smear from a patient specimen?

Genus species Observation & Interpretation

TSA(AGAR)

TSA – Trypticase Soy Agar ENRICHMENT MEDIUM - Trypticase Soy Agar – rich basal media containing on an acid hydrolysate of CASEIN [a milk protein] and of SOYTONE [a soy bean protein extract]

”The Most Likely Causes Of Illness”(i.e. Bacteria being

“Considered” in the Differential Diagnosis)

Observation & Interpretation - What is the MACROSCOPIC appearance of the COLONIES? … Does the microbe grow in this medium? … If yes, describe the Colony Size, Color, Texture, and any other SELECTIVE or DIFFERENTIAL Characteristics that can be observed on the medium. … If no, explain why it will not grow.

Genus species

Observation & Interpretation

Page 27: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

BLOODAGAR

BLOOD – TSA Agar Containing 5% (vol/vol) Sheep RBCs (Red Blood Cells)ENRICHMENT MEDIUM - TSA (Trypticase Soy Agar) with the addition of 5% [vol/vol] citrated sheep red blood cells (RBC) as an additional source of nutritionDIFFERENTIAL MEDIUM showing HEMOLYSIS [lysis of the RBCs] -

- [ALPHA] - partial hemolysis resulting in a greenish to brownish halo around a colony

- [BETA] - complete hemolysis resulting in a clearing effect around a colony- [GAMMA] - NO hemolysis – no change in the surrounding medium

If culture requires growth in an ANAEROBIC 37oC INCUBATOR, Explain Why.

”The Most Likely Causes Of Illness”(i.e. Bacteria being “Considered” in the

Differential Diagnosis)

Observation & Interpretation - What is the MACROSCOPIC appearance of the COLONIES? … Does the microbe grow in this medium? … If yes, describe the Colony Size, Color, Texture, and any other SELECTIVE or DIFFERENTIAL Characteristics that can be observed on the medium. … If no, explain why it will not grow.

Genus species

E. coli O157:H7

C. jejuni

Observation & Interpretation

large, mucoid, gamma hemolysis

?

Page 28: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

CHOCAGAR

CHOC - Chocolate Agar ENRICHMENT MEDIUM - TSA (Trypticase Soy Agar) containing 5% [vol/vol] citrated sheep blood that has been heated to 60oC to lyse the blood cells and release HEMIN and NAD [readily accessible sources of additional sources of nutrition]* Especially important for “FASTIDIOUS” microbes, i.e. those which are especially nutritionally demanding]If culture requires growth in a CO2 INCUBATOR, Explain Why.

”The Most Likely Causes Of Illness”

(i.e. Bacteria being “Considered” in the

Differential Diagnosis)

Observation & Interpretation - What is the MACROSCOPIC appearance of the COLONIES? … Does the microbe grow in this medium? … If yes, describe the Colony Size, Color, Texture, and any other SELECTIVE or DIFFERENTIAL Characteristics that can be observed on the medium. … If no, explain why it will not grow.

Genus species

E. coli O157:H7

C. jejuni

Observation & Interpretation

?

?

PEAAGAR

PEA - PhenylEthylene Alcohol Blood Agar ENRICHMENT MEDIUM - Blood Agar SELECTIVE MEDIUM that contains 2.5% [v/v] PHENYLETHYLENE ALCOHOL which inhibits growth of Gm- bacteria (permitting growth of Gm+) DIFFERENTIAL MEDIUM that demonstrates HEMOLYSISIf culture requires growth in an ANAEROBIC 37oC INCUBATOR, Explain Why.

”The Most Likely Causes Of Illness”(i.e. Bacteria being

“Considered” in the Differential Diagnosis)

Observation & Interpretation - What is the MACROSCOPIC appearance of the COLONIES? … Does the microbe grow in this medium? … If yes, describe the Colony Size, Color, Texture, and any other SELECTIVE or DIFFERENTIAL Characteristics that can be observed on the medium. … If no, explain why it will not grow.

Genus species Observation & Interpretation

MACAGAR

MAC - MacConkey Agar SELECTIVE MEDIUM - basal media containing BILE SALTS and CRYSTAL VIOLET to inhibit growth of Gm+ bacteria (permitting growth of enteric Gm-, the Enterobacteriaceae, and related Gm- bacilli)DIFFERENTIAL MEDIUM that contains LACTOSE as the sole carbon source and neutral red dye to differentiate LACTOSE FERMENTERS [various shades of red] from non-lactose-fermenting bacteria [colorless or transparent]

”The Most Likely Causes Of Illness”

(i.e. Bacteria being “Considered” in the

Differential Diagnosis)

Observation & Interpretation - What is the MACROSCOPIC appearance of the COLONIES? … Does the microbe grow in this medium? … If yes, describe the Colony Size, Color, Texture, and any other SELECTIVE or DIFFERENTIAL Characteristics that can be observed on the medium. … If no, explain why it will not grow.

Genus species

E. coli O157:H7

C. jejuni

Observation & Interpretation

?

?

And so on for all the other media …

Page 29: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

Thanx for not falling asleep!

Page 30: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

Note to the Doctor: There are certain human pathogens that will

continually reappear in your differential diagnoses.

The goal of this question is to make you understand how the

standard culture media function and how they facilitate the

diagnosis of bacterial infectious diseases, or aid in the diagnostic

process by "ruling-out" various bacteria as the cause of the

patient's illness.

Page 31: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

title

Page 32: YOUR NAME: Dr. YOUR eMAIL ADDRESS: ? CASE: A Day at the Fair. LEVEL 5 This PowerPoint tutorial explains is expected of your answers to Level 5 of your.

Recommended