The document discusses laboratory diagnosis of infectious diseases. It covers proper selection, collection and transport of clinical specimens; laboratory tests including microscopy, culture techniques, and biochemical reactions; and specimens from different parts of the body. Key points are the importance of collecting specimens properly before antimicrobial treatment and transporting them quickly to preserve microorganisms. A quality laboratory uses quality assurance and quality control to accurately diagnose infectious agents.
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
2021 laboratory diagnosis of infectious diseases dr.ihsan alsaimarydr.Ihsan alsaimary
2021 laboratory diagnosis of infectious diseases
dr. ihsan alsaimary
university of basrah - college of medicine- DEPARTMENT OF MICROBIOLOGY
POBOX 696 ASHAR
BASRAH 42001
IRAQ
Use of Sputum sample for diagnosis of disease, interpretation, treatment & cl...narmeenarshad
Sputum Sample
Sputum is mucus that is coughed up from the lower airways.In medicine, sputum samples are usually used for microbiological investigations of respiratory infections and cytological investigation of respiratory systems.
This is prepared for my project and im sharing this for useful to others.This slides contain the processing of urine specimens in microbiology.im prepared on basis of our medical college method.sometimes the methods will vary with other hospitals
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
2021 laboratory diagnosis of infectious diseases dr.ihsan alsaimarydr.Ihsan alsaimary
2021 laboratory diagnosis of infectious diseases
dr. ihsan alsaimary
university of basrah - college of medicine- DEPARTMENT OF MICROBIOLOGY
POBOX 696 ASHAR
BASRAH 42001
IRAQ
Use of Sputum sample for diagnosis of disease, interpretation, treatment & cl...narmeenarshad
Sputum Sample
Sputum is mucus that is coughed up from the lower airways.In medicine, sputum samples are usually used for microbiological investigations of respiratory infections and cytological investigation of respiratory systems.
This is prepared for my project and im sharing this for useful to others.This slides contain the processing of urine specimens in microbiology.im prepared on basis of our medical college method.sometimes the methods will vary with other hospitals
Urinary tract infection or UTI is an infection that affect your urinary system including the urethra,bladder,ureters and the kidneys.Most commonly occur in females compared to men due to the anatomical variation. At least one episode of urinary tract infection can experienced by each individual during their entire lifetime and the risk of developing reinfection is higher in these people compared to those who do not experience initial infection before.After menopause, patient with indwelling catheters are also have high risk of getting UTI. Variety of pathogenic organisms mainly E.coli plays a vital role in UTI. Proper management helps to eliminate infection and protect your urinary system from the development of complications such as kidney failure. Prophylactic antibiotic therapy also helps to prevent from the recurrence of infection.
Urinary tract infection or UTI is an infection that affect your urinary system including the urethra,bladder,ureters and the kidneys.Most commonly occur in females compared to men due to the anatomical variation. At least one episode of urinary tract infection can experienced by each individual during their entire lifetime and the risk of developing reinfection is higher in these people compared to those who do not experience initial infection before.After menopause, patient with indwelling catheters are also have high risk of getting UTI. Variety of pathogenic organisms mainly E.coli plays a vital role in UTI. Proper management helps to eliminate infection and protect your urinary system from the development of complications such as kidney failure. Prophylactic antibiotic therapy also helps to prevent from the recurrence of infection.
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
The presentation summarises important methods and protocols of Clinical Microbiology. It may be useful to learners of Clinical microbiology at the undergraduate label. The presentation describes the procedures for collecting clinical samples, transport, and testing. It also describes the different methods of antimicrobial susceptibility testing and standards.
Src jbbr-21-125 Dr. ihsan edan abdulkareem alsaimary PROFESSOR IN MEDICAL M...dr.Ihsan alsaimary
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Src jbbr-20-120 Dr. ihsan edan abdulkareem alsaimary PROFESSOR IN MEDICAL M...dr.Ihsan alsaimary
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Doi10.18535ijmsciv7i11.06 Dr. ihsan edan abdulkareem alsaimary PROFESSOR I...dr.Ihsan alsaimary
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Assessment of immunomolecular_expression_and_prognostic_role_of_tlr7_among_pa...dr.Ihsan alsaimary
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Estimation of Dr. ihsan edan abdulkareem alsaimary PROFESSOR IN MEDICAL MICR...dr.Ihsan alsaimary
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Tolerance & autoimmunity and organ specific autoimmune diseasesdr.Ihsan alsaimary
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Pathogenesis of microbial infections dr. ihsan alsaimarydr.Ihsan alsaimary
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
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
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
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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.
2. Outline
Rejection of specimens
04
CLINICAL SPECIMENS
05
Laboratory Investigation of Microbial
infections
06
COMMUNICATION BETWEEN PHYSICIAN AND
LABORATORY
01
specimens 02
QUALITY ASSURANCE AND
QUALITY CONTROL
03
3. COMMUNICATION BETWEEN PHYSICIAN AND
LABORATORY
• The techniques used to characterize infectious depending on the clinical syndrome and
the type of infectious agent.
• Because no single test will permit isolation or characterization of all potential
pathogens, clinical information is much more important for diagnostic microbiology
than it is for clinical chemistry or hematology.
4. Diagnosis of infectious diseases
• The proper diagnosis of an infectious disease requires :
• (1) patient history.
• (2) physical examination of the patient.
• (3) carefully evaluating the patient’s signs and symptoms.
• (4) conducting appropriate laboratory tests and other methods.
• (5) proper selection, collection, and transport of appropriate clinical specimens.
5. Guidelines for the collection and transportation of specimens
must emphasize two important aspects
• I-Collection of the specimen before the administration of
antimicrobial agents.
• II-Prevention of contamination of the specimen with externally
present organisms or normal flora of the body.
6. The Three Components of Specimen Quality
Component Explanation
Proper selection of the
specimen
The specimen must be the appropriate type to diagnose the
infectious disease suspected by the clinician.
Proper collection of the
specimen
Proper collection eliminates or minimizes contamination of the
specimen with microflora. Sometimes special collection devices
are required.
Proper transport of the
specimen
The specimen Transport let viable and/or preserves agent
morphology (e.g., rapid transport, sometimes by packing the
container in ice or by using a preservative)
7. PROPER SELECTION, COLLECTION AND TRANSPORT OF CLINICAL
SPECIMENS
1-The specimen must be
properly selected.
Collect the appropriate type of specimen for diagnosis of the infectious
disease.
2-The specimen must be
properly and carefully
collected.
1-From a site of pathogen is most likely to be found.
2-Before antimicrobial therapy has begun
3-The acute stage is the best
4-Avoid harming the patient and causing discomfort.
5-Sufficient quantity.
6-All specimens should be placed or collected into a sterile container
3-Specimens must be
properly transported to
the lab
Specimens should be protected from heat and cold to ensure represent
the number and types of organisms present at the time of collection.
8. QUALITY ASSURANCE AND QUALITY CONTROL IN THE
CLINICAL MICROBIOLOGY LABORATORY
•A-Quality Assurance (QA)
•B-Quality Control (QC)
9. Quality Assurance (QA)
• It is continuously identify, monitor,
evaluate, and improve the reliability
10. Quality Control (QC)
• Is designed to monitor the accuracy, reliability, and reproducibility of all tests
performed within the laboratory and to identify and correct any problems
that exist.
• Components of a CML’s QC program include the following:
• 1-Standard operating 2-Test verification.
procedures manual.
3-Test methods and procedures.
The procedures written for every
aspect of CML work.
use methods for most accurate
The QC program must monitor, document, and
evaluate all aspects of every test procedure that is
performed in the CML.
11. • 4-Media, reagents, staining solutions, antisera.
• 5-Equipment and instruments.
• 6-Records and reports. 7-Proficiency testing.
Avoid expiration dates
maintained and monitored of
equipment for performance.
QC measures and
documented
positive and negative controls
used for every test procedure
12. Criteria for rejection of specimens
• i-Missing or inadequate identification.
• ii-Insufficient quantity.
• iii-collected in an inappropriate container.
• iv-Contamination suspected.
• v-Inappropriate transport or storage.
• vi-Unknown time delay.
• vii-Haemolysed blood sample.
13. CLINICAL SPECIMENS FROM VARIOUS ANATOMICAL SITES AND
ORGAN SYSTEMS
• Circulatory System
• Skin, Abscess, and Wound Specimens
• Eyes and Ears
• Respiratory System
• Central Nervous System
• Urinary Tract
• Genital Tract
• Oral Cavity
• Gastrointestinal Tract
• Body Fluids
14. Circulatory System
•Blood
• Blood is usually sterile.
• Bacteremia:presence of bacteria in the bloodstream.
• Septicemia condition: bacteria product or any toxic substance in blood.
• The severe types of septicemia are caused by Gram-negative bacilli that
release endotoxin from their cell walls, it can induce fever and septic shock,
which can be fatal.
18. Lymphatic System
• The lymphatic system consists of lymphatic vessels, lymphoid tissue (including lymph
nodes, tonsils, thymus, and spleen), and lymph (the liquid that circulates through the
lymphatic system),contains many lymphocytes.
• specimens :culturing lymphnode and/or by blood culture,
(if the pathogens have entered the bloodstream).
• Lymphadenopathy: Diseased lymph nodes.
19. Skin, Abscess, and Wound Specimens
• skin is a type of host defense mechanism, serving as a physical barrier.
•
Sebaceous glands: Glands in the dermis that usually open into hair follicles and secrete an oily
substance known as sebum.
Folliculitis: Inflammation of a hair follicle
Sty (or stye): Inflammation of a sebaceous gland that opens into a follicle of an eyelash.
Furuncle: A localized pyogenic (pus-producing) infection of the skin, usually resulting from
folliculitis; also known as a boil.
20. Obtaining specimens from the skin:
• 1-For pustules :
• The covering removed using a sterile needle, then fluid and basal cells collected.
• 2-For petechiae :
• specimen is collected by vigorously scraping the outer margin of the lesion.
• 3-Collecting abscess specimens:
• the abscess contents are aspirated using a needle and syringe.
• 4-Collecting wound specimens:
• specimen should be an aspirate, or a sample taken from the advancing margin of the lesion.
21. Eyes and Ears
•Eyes
• infectious diseases of the eye include the following:
• Conjunctivitis: An infection or inflammation of the conjunctiva.
• Keratitis: An infection or inflammation
of the cornea.
22. • Keratoconjunctivitis: An infection that involves both the cornea and
conjunctiva.
• specimen as conjunctival swab, corneal scraping, or aspirate.
• Using separate sterile swabs, sample the conjunctiva of both eyes, even if
only one eye is infected.
23. •Ears
• There are three pathways for pathogens to enter the ear:
• (1) Eustachian tube, from the throat and nasopharynx.
• (2) from the external ear.
• (3) via blood or lymph.
• otitis media Infection of the middle ear
• otitis externa infection of the outer ear canal.
• specimen collected by swab of external ear canal, fluid aspirated from the middle ear,
24. Respiratory System
Specimen:
• A. Nasal swabs
• B. Nasopharyngeal / Pernasal swabs
• C. Nasopharyngeal aspirates
• D. Nasal washings
• E. Throat swabs
• F. Lung aspirations
• G. Open lung biopsy
25. Central Nervous System
• The nervous system is composed of the central nervous system (CNS) and the peripheral nervous
system.
• It is sterilized but agent enter through trauma, blood and lymph or along the peripheral nerves.
• Glucose level indicator for infection.
• Encephalitis: Inflammation of the brain.
• Encephalomyelitis: Inflammation of the brain and spinal cord.
• Myelitis: Inflammation of the spinal cord.
• Meningitis: Inflammation of the membranes (meninges) that surround the brain and spinal cord.
• Meningoencephalitis: Inflammation of the brain and meninges.
27. • Microscopic Examination :
• Smears are made from the sediment of centrifuged CSF.
• Gram stain :
intracellular gram-negative diplococci (meningococci)
small gram-negative rods (H influenzae or enteric gram-negative rods).
lancet-shaped gram-positive diplococci (pneumo-cocci)
• Follow-Up Examination of Cerebrospinal Fluid:
• glucose level and cell count toward normal is good evidence of adequate therapy.
• Culture :
• Sheep blood and chocolate agar together grow almost all bacteria and fungi that cause meningitis.
28. Urinary Tract
• 1-Upper UTIs : kidneys and ureters.
• 2-Lower UTIs : urinary bladder, the urethra, and in males, the prostate.
• Cystitis: Inflammation of the urinary bladder.
• Nephritis: inflammation of the kidneys.
• Pyelonephritis: inflammation of the renal parenchyma.
(the basic cellular tissue of the kidney).
29. • Proper Collection of urine Specimen:
• 1. Have at hand a sterile, screw-cap specimen container and two to three gauze sponges soaked
with nonbacteriostatic saline (antibacterial soaps for cleansing are not recommended).
• 2. Spread the labia with two fingers and keep them spread during the cleansing and collection
process. Wipe the urethra area once from front to back with each of the saline gauzes.
• 3. Start the urine stream and, using the urine cup, collect a midstream specimen. Properly label
the cup.
30. • Microscopic Examination
• leukocytes, epithelial cells, and bacteria if more than 105/mL are present.
• Culture
• “urethral syndrome,” – ve culture with sign mean ureteral obstruction, tuberculosis of the bladder, gonococcal
infection, or other disease must be considered.
31. Genital Tract
• The urethra contain microflora in males and females, special female genital region
supports the growth of many microorganisms.
• Cervicitis: Inflammation of the cervix, that part of the uterus that opens into the vagina.
• Endometritis: Inflammation of the endometrium (the inner layer of the uterine wall).
• Oophoritis: Inflammation of an ovary.
32. Diseases
A.Gonorrhea
• A stained smear of a urethral or a cervical exudate that shows intracellular gram-negative diplococci
strongly suggests gonorrhea. The sensitivity is about 90% for men and 50% for women Thus.
• B. Syphilis
• Dark-field or immunofluorescence examination of fresh tissue fluid expressed from the base of the
chancre may reveal typical T. pallidum.
33. C. Vaginosis/Vaginitis
• A-Bacterial vaginosis associated with Gardnerella vaginalis or Mobiluncus and parasite
Trichomonas vaginalis.
• The discharge :
(1) is grayish and sometimes frothy,
(2) has a pH above 4.6
(3) has an fishy odor
(4) contains “clue cells,” large epithelial cells covered with gram-negative or gram-variable rods
• B-Candida albicans vaginitis is diagnosed by finding yeast or pseudohyphae in a potassium
hydroxide preparation of the vaginal discharge.
34. Oral Cavity
• Dental caries: Tooth decay or cavities, Streptococcus mutans.
• Gingivitis: Inflammation of the gingiva (gums).
• Bacteria are isolated from oral swabs, Carefully collected
scrapings or aspirates should be transported to the CML.
35. Gastrointestinal Tract
• The gastrointestinal (GI) tract consists of a long tube with many expanded areas designed
for digestion of food.
• Most of the microorganisms low pH (1.5),
and are inhibited from growing in the lower
intestines by the resident microflora.
36. • Diarrhea: An abnormally frequent discharge of semi-solid or fluid fecal matter.
• Dysentery: Frequent watery stools accompanied by abdominal pain, fever, and dehydration and may
contain blood and/or mucus.
• Enteritis: Inflammation of the intestines.
• Gastritis: Inflammation of the mucosal lining of the stomach.
• Gastroenteritis: Inflammation of the mucosal linings of the stomach and intestines.
37. Body Fluids
• body fluid specimens include abdominal or peritoneal fluid, pleural or
thoracentesis fluid, synovial (joint) fluid, and amniotic fluid. Carefully collected
aspirates of amniotic and pleural fluids are usually transported to the CML in
an anaerobic transport system.
38. Factors limiting usefulness of microbiology
investigations
Specimen should be obtained from site
of infection
Sample must be taken aseptically
Sample size must be large enough
Metabolic requirements for the organism
must be maintained during sampling,
storage, and transport.
Wrong sample
e.g. saliva instead of sputum
Delay in transport / inappropriate storage
e.g. CSF
Overgrowth by contaminants
e.g. blood cultures
Insufficient sample / sampling error
e.g. in mycobacterial disease
Patient has received antibiotics
40. 1-Microscopy
• is a relatively simple and inexpensive, but much less sensitive method than culture for
detection of small numbers of bacteria.
• 1-simple microscope: is defined as a microscope containing only one magnifying lens.
41. • 2-compound microscope: is a microscope that contains more than one magnifying lens.
• Because objects are observed against a bright background, or “bright field,” bright field microscope.
• the regularly used condenser is replaced with what is known as a darkfield condenser, illuminated objects are
seen against a dark background, or “dark field,” dark field microscope.
42. 3-Electron Microscopes
• Electron microscopes: use an electron beam as a source of illumination instead of visible light and
magnets instead of lenses to focus the beam.
• Transmission electron microscope: has a very tall column, at the top of which an electron gun fires a
beam of electrons downward.
50. 2-Culture
• The media are referred to as artificial media or synthetic media because they do not occur
naturally but are prepared in the laboratory.
• Inoculation of a liquid medium involves adding a portion of the specimen to the medium.
While Inoculation of a solid or plated medium involves the use of a sterile bacteriological
loop to apply a portion of the specimen to the surface of the medium.
• A CO2 incubator: has a cylinder of CO2 attached. CO2 is periodically introduced into the
incubator to maintain a concentration of about 5% to 10%.
• A non-CO2 incubator: contains room air; thus, it contains about 20% to 21% O2.
• An anaerobic incubator: contains an atmosphere devoid of oxygen.
51. Culture
• Solid media: are prepared by adding agar to liquid media and then pouring the liquid
media into tubes or circular, shallow, plastic containers called petri dishes, where the
media solidifies.
• For Identification – Enumeration – sensitivity and chemical and products.
Liquid media (broth):also known as broths, are usually contained in tubes and are
thus often referred to as tubed media.
• For enrichment or maximum sensitivity or measure amount of bacteria and motility.
52. Culture of Pathogenic Microbes
• Most microbes of clinical importance can be grown, isolated, and identified with specialised growth media
• 1-General Purpose Media
• Support growth of most aerobic and facultatively aerobic organisms .EX: nutrient agar
53. • 2-enriched medium
• medium containing a rich supply of special nutrients that promotes the growth of bacteria. EX: Blood agar
• 3-Selective Media
• contains substances that inhibit growth of certain organisms .EX: MacConkey agar
• 4-Differential Media
• permits the differentiation of organisms that grow on the medium. EX: MacConkey agar.
54. Antimicrobial Susceptibility Testing
• 1-Disk Diffusion Test
• Standard procedure for assessing antimicrobial activity
• 2-E-TEST ( Epsilometer test)
• strip contain more than one antibiotic
• Inhibition Zones
Used to determine an organism’s susceptibility to an antimicrobial agent
55. Minimum Inhibitory Concentration (MIC)
• Antibiotic dilution to detect minimum concentration that prevent bacteria growth and disappear of turbidity.
56. • Catalase Test
• This test is used to identify organisms that produce the enzyme catalase. H2O2 . EX: Staphylococcus spp
• Oxidase Test
• This test is used to identify microorganisms containing the enzyme cytochrome oxidase EX:
Enterobacteriaceae
3-Biochemical reactions
57. • Coagulase test
• Coagulase is an enzyme that clots blood plasma. EX: Staphylococcus aureus
• bacitracin sensitivity testing
• Distinguish between organisms sensitive to the antibiotic bacitracin and those not. EX: Streptococcus
agalactiae (bacitracin resistant) and Streptococcus pyogenes (bacitracin sensitive).
58. • optochin sensitivity testing
• This is a differential test used to distinguish between organisms sensitive to the antibiotic
optochin and those not EX: Streptococcus pneumoniae (optochin sensitive) and other a-
hemolytic streptococci (optochin resistant Streptococcus mitis)
• MacConkey agar
• This medium is both selective and differential. crystal violet which inhibit the growth of
Gram-positive bacteria. The differential ingredient is lactose. Fermentation of this sugar
results in an acidic pH and causes the pH indicator, neutral red, to turn a bright pinky-red
color. Thus organisms capable of lactose fermentation such as Escherichia coli, form bright
pinky-red colonies. MacConkey agar is commonly used to differentiate between
the Enterobacteriaceae.
59. • Starch hydrolysis test
• This test is used to identify bacteria that can hydrolyze starch using the enzymes a-amylase
and oligo-1,6-glucosidase. EX: Bacillus subtilis
• Methyl Red / Voges-Proskauer (MR/VP)
• This test is used to determine which fermentation pathway is used to utilize glucose. EX:
Escherichia coli is MR+ and VP-
60. CAMP Test
• CAMP factor is a diffusible, heat-stable protein produced by group B streptococci. This is a
synergistic test between Staphylococcus aureus and Streptococcus agalactiae.
S. aureus produces sphingomyelin C, which binds to red blood cell membranes with CAMP.
61. • Urease test
• This test is used to identify bacteria capable of hydrolyzing urea using the enzyme urease.
EX: Proteus mirabilis is a rapid hydrolyzer of urea
• Motility agar
• is a differential medium used to determine whether an organism is equipped with flagella
and thus capable of swimming away from a stab mark
63. 4-GAS-LIQUID CHROMATOGRAPHY
• Two ways in which GLC can be used in the identification of bacteria and yeasts are :
• (1) analysis of acid end products of metabolism.
• (2) analysis of cellular fatty acids.
64. 5-IMMUNODIAGNOSTIC PROCEDURES
• Immunodiagnostic procedures (IDPs) are laboratory procedures that help to
diagnose infectious diseases by detecting either antigens or antibodies in clinical
specimens.
• presence of antibodies to a particular pathogen:
• 1. Present infection.
• 2. Past infection: the person was infected with the pathogen in the past, and antibodies
directed against that pathogen are still present in the person’s body
• 3. Vaccination; the antibodies are the result of the person having been vaccinated against
that particular pathogen at some time in the past
65.
66. Serologicalmethods:
• There are a variety of serological assays available including
• Several of these tests can measure antibody titer by performing dilutions of
patient serum to determine the lowest titer at which reactivity is seen.
•1-ELISA.
70. Western Blot Immunoassays
• This method is based on the electrophoretic separation of major proteins of
the organism in question in a two-dimensional agarose gel.
71. 6-Molecular Diagnostic Procedures
• A. Nucleic Acid Hybridization Probes
• the hybridization of a characterized nucleic acid probe to a specific nucleic acid
sequence in a test specimen followed by detection of the paired hybrid. For
example, single-stranded probe DNA (or RNA) is used to detect complementary
RNA or denatured DNA in a test specimen.
73. C. Bacterial Identification Using 16S rRNA Probe Hybridization
• The 16S rRNA of each species of bacteria has stable (conserved) portions of the sequence.
Many copies are present in each organism. Labeled probes specific for the 16S rRNA of a
species are added, and the amount of label on the double stranded hybrid is measured.
• EX: Histoplasma capsulatum
74. 7-Bacteriophages
• Bacteriophage (phage) are obligate intracellular parasites that
multiply inside bacteria by making use of some or all of the host
biosynthetic machinery.
•1-generalizedtransduction
•2-specializedtransduction
75. • 1-generalized transduction: A DNA fragment is transferred from one
bacterium to another by a lytic bacteriophage that is now carrying donor bacterial
DNA due to an error in maturation during the lytic life cycle.
76. • 2-specialized transduction: A DNA fragment is transferred from one bacterium to
another by a temperate bacteriophage that is now carrying donor bacterial DNA due to an
error in spontaneous induction during the lysogenic life cycle
77. 8-Animal pathogenicity
• use of non-human animals in experiments that seek to control the
variables that affect the behavior or biological system under study.
• Animals commonly used : guinea pigs, rabbits, mice
• Importance of pathogenicity test: -
• 1-Differentiate pathogenic and non pathogenic
• 2- Isolation organism in pure form
• 3- To test ability of toxin production
• 4- Evaluation of vaccines and antibiotics