1. The document discusses the laboratory diagnosis of Salmonella, which causes enteric fever and gastroenteritis in humans. Blood culture is the best specimen for diagnosis in the first week, while stool and urine cultures are optimal in later weeks.
2. Serological tests like the Widal test detect antibodies against Salmonella, while rapid tests like Typhidot and IDL Tubex detect IgM antibodies.
3. Isolation of Salmonella from stool requires plating on selective media followed by biochemical tests and serotyping using slide agglutination to identify the serovar. Antimicrobial susceptibility testing helps guide treatment.
The genus Shigella exclusively infects human intestine.
Shigella dysenteriae is the causative agent of bacillary dysentery or shigellosis in humans.
It is a diarrheal illness which is characterized by frequent passage of blood stained mucopurulent stools.
The four important species of the genus Shigella are:
Shigella dysenteriae
Shigella flexneri
Shigella sonnei
Shigella boydii.
The genus Shigella exclusively infects human intestine.
Shigella dysenteriae is the causative agent of bacillary dysentery or shigellosis in humans.
It is a diarrheal illness which is characterized by frequent passage of blood stained mucopurulent stools.
The four important species of the genus Shigella are:
Shigella dysenteriae
Shigella flexneri
Shigella sonnei
Shigella boydii.
What is Klebsiella? Klebsiella is a Gram-negative rod-shaped bacteria, which belongs to a family of bacteria called the Enterobacteriaceae.
As the channel name suggests, our channel will be a perfect lounge for the malayali medicos..we wil be covering videos which will be like lecture classes related to the subjects biochemistry and microbiology in which we are specialised.. It will be a better learning experience for the students especially for those who are not able to understand and follow the normal classes in college..we assure the students that you will get a basic idea regarding the topic and extra reading can be done from the reference textbooks..
Maneesha M Joseph
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Haemophilus is the name of a group of bacteria. There are several types of Haemophilus. They can cause different types of illnesses involving breathing, bones and joints, and the nervous system. One common type, Hib (Haemophilus influenzae type b), causes serious disease. It usually strikes children under 5 years old
Isolation and identification of salmonella &e.coliNoman Ch
This presentation is made by concerning three books. The data used in this is mainly revolve about poultry point of view.
REFERENCE
Isolation and identification of avian pathogen(AAAP)
What is Klebsiella? Klebsiella is a Gram-negative rod-shaped bacteria, which belongs to a family of bacteria called the Enterobacteriaceae.
As the channel name suggests, our channel will be a perfect lounge for the malayali medicos..we wil be covering videos which will be like lecture classes related to the subjects biochemistry and microbiology in which we are specialised.. It will be a better learning experience for the students especially for those who are not able to understand and follow the normal classes in college..we assure the students that you will get a basic idea regarding the topic and extra reading can be done from the reference textbooks..
Maneesha M Joseph
MSc MLT (Microbiology)
Assistant Professor
Baby memorial college of allied Health science
Kozhikode
Our Partner Channel
Health & Voyage channel link - https://youtu.be/nzKqRVjlwc0
#Klebsiella
#Medical
#Microbiology
#Biochemistry
#Mallu Medicos Lounge
##MalluMedicosLounge
#MLT
#Channel introduction
#HealthAndVoyage
#New Youtube Channel introduction
#Klebsiella pneumoniae
The PPT is mainly all about Mycobacterium Tuberculosis. Agents causing the disease Tuberculosis, pathogenesis, laboratory diagnosis, treatment and prophylaxis. It was made for both BSc and MSc students.
Haemophilus is the name of a group of bacteria. There are several types of Haemophilus. They can cause different types of illnesses involving breathing, bones and joints, and the nervous system. One common type, Hib (Haemophilus influenzae type b), causes serious disease. It usually strikes children under 5 years old
Isolation and identification of salmonella &e.coliNoman Ch
This presentation is made by concerning three books. The data used in this is mainly revolve about poultry point of view.
REFERENCE
Isolation and identification of avian pathogen(AAAP)
Have you ever encountered a Salesforce bug? Ever wonder how salesforce.com fixes a bug and how you can track the progress? We invite all admins, developers, partners, and power users to join us on a behind the scenes journey following a bug through salesforce.com support and engineering. Learn how you can use the public known issues site to track bugs affecting your organization.
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Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
2. Introduction
The genus Salmonella consists of bacilli that
parasitise the intestines of a large number of
vertebrate species and infect human beings,
leading to enteric fever, gastroenteritis,
septicemia with or without focal suppuration
and the carrier state
4. Laboratory diagnosis of Enteric fever
• Typhoid fever + Paratyphoid fever
• Typhoid fever – S.Typhi
• Paratyphoid fever – S.Paratyphi A, B, and C
5. • Confirmed case of typhoid fever is
defined(WHO), as a patient with fever (> 38°C)
that has lasted for at least three days, with a
laboratory confirmed positive culture of
S.Typhi.
• Probable case of typhoid fever is a patient
with fever (> 38°C) that has lasted for > 3 days,
with a positive serodiagnosis or antigen
detection test but without S.Typhi isolation.
• Chronic carrier is determined as excretion of
S.Typhi in stools or urine for longer than one
year after the onset of acute typhoid fever.
9. Blood culture
• Volume of blood :
10 to 15 ml from adults and adolescents , 2 to 4
ml in children
• Ratio of blood to bile broth: 1:10
• Or add saponin to BHI broth with 0.05% SPS
• Inoculate the blood immediately
• Transport immediately, never store under 15degC
• Incubate as soon as possible
11. • When blood culture bottles are not available,
direct plating of blood buffy coat from 5 to
10ml sterile heparinised blood onto columbia
agar plates containing 0.05% saponin is
recommended(Wain, J et al)
12. • Check for turbidity and evidence of growth
after 1,2,3 and 7 days
• Bottles showing signs of growth – Do culture
on solid media
• Subculturing done in Mac Conkey agar and
Blood agar
• On day 7, all the bottles subcultured before
being discarded as negative
13. • Casteneda`s method
• Blood agar – Non hemolytic, 2 to 3mm,
smooth white colonies
• Mac Conkey agar – non lactose fermenting
colonies
• Confirmed by biochemical reactions and slide
agglutination test with high titre sera
14. Slide agglutination test - Serotyping
• Prepare a milky suspension of overnight slope
culture with saline
• Place a drop in clean glass slide
• Check autoagglutination
• Add diagnostic sera in the following order for
serotyping
15. 1. Salmonella polyvalent O (Groups A-G)
2. Salmonella polyvalent H phases 1 and 2
serum and polyvalent H phase 2 serum
3. Individual Salmonella O group sera O2 – O13
4. Single factor H sera
Unusual Serotype ?
Send to National Salmonella Reference Centre
Central Research Institute, Kasauli
16. Rapid detection tests from culture
• MUCAP test – 4 methylumbelliferyl caprylate
test – rapid identification of Salmonella strains
directly from agar plates
• The substrate combines with Salmonella C8
esterase – releases the umbelliferone –
strongly fluoresent at 365 nm
• Apply a drop the reagent directly over the
suspected colonies on agar plat and observe
under a wood`s lamp within 5 minutes
• 100% sensitivity and specificity
17. • OBIS Salmonella test – Oxoid Biochemical
Identification System – rapid colorimetric spot
test
• For the determination of PYRase and NPA
activity
• Sample from the colony on an agar plate and
applied to the PYR and NPA test areas on the
card
• Drop of buffer solution added to both test
areas, after 5 minutes, one drop PYR reagent
added in PYR test area, NPA reagent in NPA
area
20. Clot culture
• Allow the blood to clot and serum pipetted off
and used for widal test
• Clot is broken up with sterile glass rod and
added to bottle of bile broth
• Add streptokinase (alternative)
• Higher rate of isolation than blood cultures
(bactericidal action of the serum is obviated)
21. Serum
• 1 to 3 ml of blood inoculated into a tube
without anticoagulant
• Second sample should be collected during
convalescent phase
• Used for serological assays
22. Widal test
• Aim: Measurement of H and O agglutinins for
typhoid and paratyphoid
• Principle : Tube Agglutination
• Requirements:
• Serum, Tubes, Antigen, Incubator, Waterbath
• Tubes : Dreyer`s tube and Felix tube
23. Antigens
• O antigen of S.Typhi
• H antigen of S.Typhi
• H antigen of S.Paratyphi A and B
• Strain used to prepare : S.Typhi 901, O and H
24. • Procedure:
1. Serial dilutions of equal volumes of serum
and antigen mixed.
2. Put controls
3. Incubated overnight at 37degC
4. Read the results
5. No agglutination in controls
6. For O antigen – disc like pattern
7. For H antigen – loose, cotton wooly clumps
25. • Highest dilution – TITRE
• Moderate sensitivity and specificity
• 30% of culture proven cases found to be Widal
negative ( WHO – TFguide)
• Slide Widal test – undiluted patient serum and
antigens
27. Interpretation
• Always rising titre by testing paired sera –
fourfold rise in the titre needed
• Single report with caution
• Baseline titre in endemic areas
O - > 1:100
H - > 1:200
28. IDL Tubex ® test
• Simple, Rapid
• Slide latex agglutination test
• O 9 antigen – Highly specific for S.Typhi, used
here , immunodominant epitope
• Only for Typhoid fever, does not give positivity
for S.Paratyphi
• Detects IgM antibodies
29. • Test Pack:
1. Sets of V shaped tubes – six samples per set –
tested simultaneously
2. Reagent A, magnetic particles coated with
S.Typhi LPS
3. Reagent B, Blue coloured latex particles
coated with a monoclonal antibody specific
for the O9 antigen
30. • Test serum ( one drop ) + Reagent A (one
drop) – 1 minute – mix
• Then add two drops of Reagent B
• Keep the tubes in magent embedded stand,
and slid it several times
• Read the results immediately
• Based on the colour of the reaction –
compared with the chart – Titre value noted
• Stored sera has a better result in tubex than
widal
32. Typhidot ® test
• Simple, speed, economical
• Sensitivity is 85.9%, Specificity 96.7%
• To detect specific IgM and IgG antibodies to
S.Typhi
• Typhidot - M ® - To detect IgM alone
• Replaces the widal when used in conjunction
with the culture (Gold Standard)
• High negative predictive value – useful in high
endemic areas
34. IgM dipstick test
• Detects IgM antibodies in serum and whole
blood
• Materials:
1. Dipstick
2. Lyophilised non enzymatic detection reagent
3. Liquid to reconsitute the detection reagent
4. Liquid to wet the test strip of dipstick
35. • Wet the test strip in a mixture of serum and
detection reagent ( 1:50)
• Incubate for 3 hours at RT
• Rinse the test strip with water
• Allow it to dry
• Compare the color with reference strip
• Grade it as 1+, 2+, 3+ and 4+
• Sensitivity – 65% to 77%
• Specificity – 95% to 100%
36. Enterocheck - WB
• Immunochromatographic test in cassette from
• 30 minutes test
• Sensitivity – 79.3%
• Specificity – 90.2%
37. Coagglutination test
• Demonstration of circulating antigen
• Done in the blood and in urine
• Done in early phase of the disease
• S.aureus (Cowan I Strain) which contains
protein A is stabilised with formaldehyde and
coated with S.Typhi antibody
• 1% above suspension + patient serum – in a
slide – visible agglutination (2 min) – positive
38. Urine
• Irregular and infrequent shedding of bacilli
• Positive only in second and third weeks
• 25% cases +
• Clean voided urine samples are inoculated
into enrichment and selective media
39. Feces
• Collected in a container
• Spoonful amount
• Transport immediately
• 6ml of buffered glycerol saline transport
medium
Alternate specimen:
• Rectal swabs
• Fecel swabs
40. • Shed throughout the course of the disease
and also in convalescence
• Valuable in patients on antibiotics ( drug does
not eliminate the bacilli from the gut)
• Fecal samples plated directly on
MacConkey
DCA / XLD
Wilson Blair Media
• Enrichment also done in selenite or
tetrathionate broth , incubated for 6 to 8
hours and subcultured.
41. Pale non lactose non sucrose fermenting
colonies – DCLS
Red, black centred colonies – XLD
• Rule out proteus by urease test
• Check for purity by subculturing in nutrient
agar
• Do biochemical reactions and sugars
• Do serotyping by slide agglutination test
42. Interpretation
Provisional report – given on third or fourth day and
inform the clinician
Secondary confirmation test panel:
1. Citrate agar slope
2. Lysine decarboxylase medium with control
3. Salicin peptone water
4. ONPG
5. Mac Conkey secondary purity plate
6. Nutrient agar slope
7. Sensitivity agar plate
43. If the secondary tests – confirm – pure culture of
Salmonella seed it on to two Dorset egg
slopes and send one to a Salmonella
Reference Laboratory for final serotyping.
Send a confirmation report to clinician
47. • Most of the strains are sensitive
• Resistant – depends on serotype, phage type
and country of origin
• 1990 – 20% strains resistant to
Chlorampenicol isolated in UK
• 90% of strains are resistant to ampicillin and
trimethoprim
• In Multidrug resistant areas – Ciprofloxacin is
the drug of choice
48. • A multidrug resistant strain of S.Typhimurium
definitive type 104 that is resistant to five
antibiotics emerged around 1990s
• 50% of the S.Typhimurium isolates were
resistant to one or more drugs and 28% had a
five drug resistance pattern
• 1998 – S.Newport – emerged as a major MDR
pathogen
51. Diagnosis of Carriers
• High incidence due to carrier state
• Contamination of food by food handlers
(Carriers)
• Convalescent carriers
• Temporary carriers
• Chronic carriers ( 2 to 5%)
• Bacilli persists in the Gallbladder and kidney
• Intermittent shedding
52. • Repeated sampling – Bile or Faeces, urine for
culture (Confirmatory)
• Demonstration of antibodies to Vi antigens
(Screening test)
• IgG is the primary indicator of carriers
• IgA and secretory IgA are seen. In Vaccinated –
No secretory IgA
• Hence High IgA content indicate typhoid
carrier state
53. Public health ?
• In cities – tracing of carriers – Sewer Swab
technique
• Sewage – Filtration through Millipore
membrane – culture in Wilson and blair media
• Food safety – Carriers in hotels – Eg: Typhoid
mary
54. Salmonella and Eggs
• According to the Centers for Disease Control, 1
in 10,000 eggs contain Salmonella.
• Experts say that chickens carry the bacteria in
their own bodies, and pass Salmonella along
to the yolk and white while the egg is forming
in the ovaries.
• Chickens can also pass bacteria to the
eggshell—and through the shell pores into the
inner egg—when the egg is laid.
55. • The eggs are then submerged in all-natural water
bath, where computer-controlled temperature
zones monitor & heats the eggs in their shells to
the exact temperature needed to destroy all
bacteria, without cooking the egg.
• After pasteurization, the eggs are sealed with an
FDA-approved, food-grade wax coating to prevent
contamination and preserve product freshness.
• After pasteurization, the eggs are dried, cooled,
and then stamped as P , which identifies them as
pasteurized .
57. Typing methods
Bacteriophage typing :
• Depends on Vi antigen
• Used in epidemiological surveillance
• National Salmonella Phage Typing Centre –
Lady Hardinge Medical College
• S.Typhi phage types A and E1 – common in
India
• S.Paratyphi A , types 1 and 2
59. Summary
• Culture – Gold standard – Late results – AST
• Widal – Duration – Endemicity – paired sera
• Slide tests – Discrepancies between labs
Ideal diagnostic test rapid, specific, sensitive
TYPHIDOT EIA
60. In this study ,
• 66% blood culture +
• 66% Widal test +
• 74% Typhidot +
Typhidot is found to have high sensitivity and
good specificity , alternate to blood culture
61. References
• Mackie & McCartney – Practical Medical Microbiology
– 14th Edition
• Konemann – Colour atlas of diagnostic microbiology –
6th edition
• Harrisons – principle of internal medicine – 18th edition
• District laboratory practive in tropical countries – 2nd
edition – Monica cheesbrough
• Wain J et al, Specimens and culture media for the
laboratory diagnosis of typhoid fever
• WHO – Salmonella surveillance report
• Nitte journal of health science
• Malaysian journal of medical sciences
Editor's Notes
Have to type coagglutination, phage typing, biotyping, molecular methods, research