This document discusses the laboratory diagnosis of Staphylococcus, including sample collection, direct smear microscopy, culture techniques, biochemical reactions, antibiotic sensitivity testing, and typing of Staphylococcus aureus. Appropriate samples are collected based on the site of infection and transported to the laboratory for analysis. Direct smear microscopy can identify Gram-positive cocci clusters. Culture techniques help isolate and identify Staphylococcus colonies based on morphology and biochemical reactions provide further characterization. Antibiotic sensitivity testing determines effective treatment options and typing methods like bacteriophage typing are used for epidemiological purposes.
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.
Microbiology of E coli giving basic of Escherichia coli, its morphology, cultural and biochemical characteristics, Antigenic character, pathogenesis, laboratory diagnosis, prevention and control
To study Prevalence, Pre-disposing factors and Prevention of the following MDRO’s – Klebsiella pneumoniae Carbapenemase Producer, Methicillin Resistant Staphylococcus aureus, Multi Drug Resistant Acinetobacter baumannii, Pseudomonas aeruginosa and Escherichia coli.
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.
Microbiology of E coli giving basic of Escherichia coli, its morphology, cultural and biochemical characteristics, Antigenic character, pathogenesis, laboratory diagnosis, prevention and control
To study Prevalence, Pre-disposing factors and Prevention of the following MDRO’s – Klebsiella pneumoniae Carbapenemase Producer, Methicillin Resistant Staphylococcus aureus, Multi Drug Resistant Acinetobacter baumannii, Pseudomonas aeruginosa and Escherichia coli.
A culture test is performed to find germs (such as bacteria or a fungus) that can cause an infection. It is done by using a culture media for their growth
it contains how the sample is processed and how it is subjected to staiing, biochemical reactions, what are the culture medias used, and thier methods. it also includes the antimicrobial susceptibility testing
People in a big city as Antananarivo, capital of Madagascar, have leads to take street foods for their daily nutritional needs. This food habits may be a risk for consumers due to contaminations from street environment and bad practices related to hygiene. This study aimed to examine the quality and safety of street vended foods in Antananarivo, on January 2016 to December 2017.Six hundred and sixty two samples including 126samples of melting salads, 70 beef skewers, 54 chicken skewers, and typical Malagasy foods as : mofoanana (67 samples), mofogasy (64 samples), ramanonaka (64), makasaoka (66), mofoakondro (62) and kobandravina(89);were randomly collected from the streetvendors in Antananarivo marketsto evaluate their bacteriological quality.International Methods (ISO) was adopted for to find the load of Total Aerobic Bacteria andEnterobateriaceae,Escherichia coli and to search pathogen bacteria as Salmonella, Campylobacter jejuni, Escherichia coli O157H7 and Bacillus cereus in these foods.The results revealed that the mean values ofthe Total Aerobic Bacteria count was 0.1x106- 4.8x106cfu/g. Enterobacteriaceaecount range from 0.4x102 to 1.9x102cfu/g. Escherichia coli count range from 0.04x102cfu/g. to 0.19 x102cfu/g.Salmonellawas only present in melting salads, beef skewers and chicken skewers samples. Bacillus cereus count range from 0,1x102 to 1,5x102cfu/g. Campylobacter jejuniwas only present in samples of ramanonaka and kobandravina. Two strains of presumptive Eschercichia coli O157 H7 (βglucuronidase -) were isolated. PCR method was used to confirm the identity of these two isolates. A high contamination above 106 cfu/g food and the presence of potential pathogens bacteria could be hazardous. Systematic inspections and training of food vendors on food hygiene and application of hazard analysis critical control point (HACCP) has been recognised as measures to guarantee improvement of the quality of street foods.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
2. LABORATORY DIAGNOSIS
Sample collection and Transportation
Direct smear Microscopy
Culture
Biochemicals
Typing of Staphylococcus aureus
Antibiotic Sensitivity Testing (AST)
Saturday, February 18, 2017 2
3. SAMPLE COLLECTION
Type of sample depends on the site of
infection.
Saturday, February 18, 2017 3
Infection Specimen
Suppurative lesion Pus, wound swab
Respiratory infection Sputum
UTI Mid stream urine
PUO, Bacteremia Blood
Food poisoning Feces, Vomitus, food
Carriers Nasal and perianal swab
4. DIRECT SMEAR MICROSCOPY
Staphylococcus appear as GPC
measuring 0.5-1.5 microns
Occur singly, in pairs, short chains or
clusters
Present within and outside PMNs
Reporting of direct smears:
◦ quantitation of cell types and
microorganisms
◦ Eg. Many pus cells along with moderate
number of GPC seen
Saturday, February 18, 2017 4
6. CULTURE
• Specimens are inoculated onto the suitable media.
Plates incubated for 18-24 hour at 37°C.
On nutrient agar
Colonies are golden yellow and opaque with smooth
glistening surface, 2-4 mm in diameter, circular, convex,
shiny & easily emusifiable.
(Most strains produce non diffusible Golden yellow
pigment)
Nutrient Agar slope
◦ Confluent growth, Oil paint appearance.
Saturday, February 18, 2017 6
7. Blood agar
◦ Colonies similar to those on Nutrient Agar
◦ Colonies are beta-hemolytic
Liquid medium
◦ Uniform turbidity
MacConkey Agar
◦ Small pink colonies due to Lactose
fermentation
Saturday, February 18, 2017 7
11. BIOCHEMICAL REACTIONS
•Catalase : positive
•Coagulase test : positive
•Oxidase : negative
(Except S.sciuri group i.e., S.sciuri, S.lentus,
S.vitulinus)
•Ferment glucose, lactose, maltose, sucrose and
mannitol, with production of acid but no gas
•Indole : negative
•MR test : positive
•VP test : positive
•Gelatin liquefaction : positive
•Phosphatase : positiveSaturday, February 18, 2017 11
12. Catalase test
•Done to distinguish staphylococci from
streptococci (catalase negative)
Saturday, February 18, 2017 12
13. Coagulase test
•Done to distinguish pathogenic strain (S.aureus)
from non-pathogenic strains.
•2 Methods of coagulase detection are:
(1) Slide coagulase test : detects bound
coagulase
(2) Tube cogulase test : detects free coagulase
(other coagulase +ive staphylococci are
S.intermedius, S.hyicus)
Saturday, February 18, 2017 13
15. Gelatin liquefaction
Principle: this test is used to determine the ability
of an organism to produce proteolytic enzyme
(gelatinase) that liquefies the gelatin.
Saturday, February 18, 2017 15
16. Methyl Red test
Principle: this test detects the production of
sufficient acid during fermentation of glucose by
bacteria and sustained maintenance of ph below
4.5
Saturday, February 18, 2017 16
17. Voges-Proskauer (VP) test
Principle: the test depends upon the production
of acetoin from pyruvic acid in the media. In the
presence of alkali & atmospheric oxygen, acetoin
is oxidised to diacetyl which reacts with alpha
naphthol to give red color.
Saturday, February 18, 2017 17
18. DNA Hydrolysis
•Principle : this test is used to determine the ability of
an organism to hydrolyze DNA. Green color of the
medium is due to DNA-methyl green complex. If the
organism growing on the medium hydrolyzes DNA,
the green color fades & the colony is surrounded by
a colorless zone.
Saturday, February 18, 2017 18
19. Phosphatase test
Principle: Staphylococci are grown on nutrient agar
containing sodium phenolphthalein diphosphate and
incubated overnight at 37°C. The plate is exposed to
ammonia vapours. The pink color of the colonies
indicate a positive result.
Saturday, February 18, 2017 19
22. Epidemiological purpose to trace
source of infection.
Useful in outbreaks like food poisoning
in a community.
Typing methods:
◦ Phenotypic-bacteriophage typing:
staphylococci are typed based on their to
bacteriophages.
◦ Molecular typing: DNA finger-printing,
ribotyping, PFGE etc.
Saturday, February 18, 2017 22
23. Bacteriophage typing
Method
◦ Test strain inoculated as lawn culture on NA.
◦ Drops of routine test dose of known set of
different phages are spot inoculated &
incubated.
◦ Zone of lysis will be produced in those areas
where test strain is susceptible to phages
applied.
◦ If strain lysed by phages 29, 52A, 79, but not
other phages; it is designated as phage type
29/52A/79
◦ National Reference Centre: MAMC, NewSaturday, February 18, 2017 23
26. Why AST has become a
necessity ??
Bacteria have the ability to develop resistance
following repeated or subclinical doses, so more
advanced antibiotics are required to overcome
them.
Antibiotic sensitivity test: A laboratory test
which determines how effective antibiotic
therapy is against a bacterial infections.
Testing will assist the clinicians in the choice of
drugs for the treatment of infections.
Helps in the local pattern of antibiotic
prescribing. Saturday, February 18, 2017 26
27. Methods of AST
•Performed on MHA by Kirby-Bauer Disc diffusion
method.
•Following antibiotics are employed for
staphylococcus:
•Amoxyclav
•Clindamycin
•Cefoxitin
•Ciprofloxacin
•Erythromycin
•Gentamicin
•Linezolid
•Levofloxacin
•Penicilin-G
•Vancomycin
•Teicoplanin Saturday, February 18, 2017 27
28. Kirby-Bauer method
1. Dry the agar plates (MHA) & label them.
2. Dip a sterile swab into the broth and express
any excess moisture by pressing the swab
against the side of the tube.
3. Swab is streaked as a lawn (lawn culture)
onto a Mueller-Hinton agar (in 3 directions
to ensure confluence).
4. The anitibiotic(s) disk will be placed onto the
MHA plate.
5. The plate is incubated and is examined for
resistance and sensitivity pattern the
following day.
Saturday, February 18, 2017 28
29. MRSA
•Methicillin-resistant S. aureus.
•First reported in 1960s.
•May colonize mucosal or epithelial surfaces,
(common : anterior nares)
•Nosocomial pathogen.
•Shows Resistant to penicillins,
cephalosporins, carbapenems,
monobactams.
•Vancomycin resistance is rare – so far
•Hospital-acquired (HA MRSA)
•Community-acquired cases now (CA MRSA)
Saturday, February 18, 2017 29
30. Predisposing factors for
MRSA
•Prolonged & repeated hospitalization
•Indiscriminate use of antibiotics
•Intravenous drug abuse
•Presence of indwelling medical devices
Saturday, February 18, 2017 30
31. MECHANISM
•MRSA contains the mecA gene which is responsible
for the production of an altered plasma (cell)
membrane-bound enzyme, penicillin-binding protein
2a (PBP- 2a.)
•The altered PBP 2a while able to perform its cell-wall
synthesis function, has a lower affinity and does not
bind to beta-lactam antibiotics
•Thus, the presence of the mecA gene confers
resistance to all beta-lactam antibiotics such as
methicillin.
Saturday, February 18, 2017 31
32. • Vancomycin remains the drug of choice for
treatment of infections caused by MRSA,
although it is intrinsically less active than the
antistaphylococcal penicillins.
•Combinations of vancomycin with ss-lactam
antibiotics may be synergistic in vivo against
MRSA strains, including those with intermediate
susceptibility to vancomycin.
•Given the increasing prevalence of MRSA in
hospitals and in community settings, alternative
approaches are needed for treatment of
infections caused by MRSA.Saturday, February 18, 2017 32
33. Preventive measures
•Isolation & treatment of MRSA patients.
•Detection of carriers among hospital staff, their
isolation & treatment.
•Avoid indiscriminate usage of antibiotics.
•Following strict aseptic technique
Saturday, February 18, 2017 33
34. •HAND WASHING STILL CONTINUES TO REDUCE
SEVERAL INCIDENCES OF MRSA SPREAD IN
HEALTH CARE
Saturday, February 18, 2017 34
35. Detection of MRSA
•MRSA is determined by disc diffusion test using
cefoxitin (30µg) disc on MHA with 2% NaCl & 104
cfu/ml inoculum and incubated at 33-35°C for 24
hour.
•As per CLSI guidelines inhibition zone of </= 21
mm was taken to be MRSA.
Saturday, February 18, 2017 35
36. Coagulase Negative
Staphylococci
Two species of coagulase negative
Staphylococci can cause human infections:
1. Staphylococcus epidermidis
2. Staphylococcus saprophyticus
Saturday, February 18, 2017 36
37. S. epidermidis:
•It is a common cause of stitch abscesses.
•It has predilection for growth on implanted
foreign bodies such as artificial valves, shunts,
intravascular catheters and prosthetic appliances
leading to bacteremia.
•In persons with structural abnormalities of
urinary tract, it can cause cystitis.
•Endocarditis may be caused, particularly in drug
addicts.
Saturday, February 18, 2017 37
38. S.saprophyticus:
•It causes urinary tract infections, mostly in
sexually active young women.
•The infection is symptomatic and may involve
the upper urinary tract also.
•Men are infected much less often.
•It is one of the few frequently isolated CoNS that
is resistant to Novobiocin
Saturday, February 18, 2017 38
39. Other coagulase negative staphylococci:
•S.haemolyticus
•S.saprophyticus
•S.warneri,
•S.hominis,
•S.epidermidis
•S.caprae
•S.lugdunensis
Saturday, February 18, 2017 39