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Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54
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Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Dec 18, 2015

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Page 1: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc.

Assisting in Microbiology and Immunology

Chapter 54

Page 2: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 2

Microbiology

The medical assistant needs to understand the role of microorganisms.

The main objective of microbiology procedures is to identify the organisms responsible for illness so that the physician can properly treat the patient.

Microbiology procedures may be performed in the POL or in the microbiology department of a medical referral laboratory.

Page 3: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 3

Specimen Collection and Transport

“In what ways can I prevent extraneous microorganisms from contaminating this sample?”

“What can I do to prevent myself from becoming infected while I collect this sample?”

Page 4: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 4

Specimen Collection and Transport

Transport media– Stuart medium or Amies medium

The medical assistant must strictly follow the directions.

Transport specimen directly after collection or by courier.

Page 5: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 5

Containers for Transport

Page 6: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 6

Collection Devices

Page 7: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 7

Classification of Microorganisms

Bacteria, fungi, protozoa

Parasitic worms

Viruses

Page 8: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 8

Naming of Microorganisms

Binomial system of nomenclature– Assigns two names: the first is the genus, and the

second is the species

– Neisseria gonorrhoeae

Page 9: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 9

Typical Pathogenic Bacteria

Bacteria are single-celled prokaryote organisms that reproduce by binary fission.

Often classified by their shape, staining characteristics, and the environmental conditions.

Three types of cell wall structures: gram positive, gram negative, acid fast.

Page 10: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 10

Bacterial Shapes

Page 11: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 11

Bacterial Oxygen Requirements

Aerobes

Anaerobes

Facultative anaerobes

Page 12: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 12

Bacterial Physical Structures

Flagella

Capsules

Endospores

Page 13: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 13

Unusual Pathogenic Bacteria

Chlamydia

Mycoplasmic

Rickettsiae

Page 14: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 14

Fungi

Mycology

Fungi are eukaryotes, larger than bacteria

Present in soil, air, and water

Few cause disease

Transmission

Page 15: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 15

Parasites

Parasitology

Transmitted by ingestion during the infective stage, direct penetration of the skin, inoculation by a vector

Identified in urine, sputum, or tissue fluid or through tissue biopsy

Helminths

Protozoa

Page 16: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 16

Parasites

Page 17: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 17

The Microbiology Laboratory

Most laboratories have:

– Refrigerator, autoclave, safety cabinet, microscope, and incubator

Page 18: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 18

Inoculating Equipment

Inoculating loops and needles

Page 19: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 19

Incineration Equipment

Fastest way to sterilize reusable equipment

Used to heat-fix smears

Bunsen burner

Page 20: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 20

Incineration Equipment (cont’d)

Page 21: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 21

Culture Media

Solid, liquid, or semisolid

Page 22: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 22

Inoculation of Media

Quadrant streak

Lawn or spread streak

After inoculation, plate is inverted

Page 23: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 23

Identification of Pathogens in the Microbiology Laboratory

Assessing a culture– Throat culture

– Urine culture

Staining– Gram’s stain

– Acid-fast stain

Page 24: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 24

Identification of Pathogens in the Microbiology Laboratory (cont’d)

Page 25: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 25

Identification of Pathogens in the Microbiology Laboratory

Gram stain

Page 26: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 26

Identification of Pathogens in the Microbiology Laboratory

Biochemical testing– Performed to identify the

genus and species

Rapid identification methods– Designed to give the physician a positive indication of

the problem

– Rapid strep testing

– Influenza A and B testing

– RSV testing

Page 27: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 27

Identification of Pathogens in the Microbiology Laboratory (cont’d)

Page 28: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 28

Antimicrobial Susceptibility Testing

“Culture and sensitivity” test.

The physician’s decision for antimicrobial agents is based on numerous factors.– Test results, physical examination, and the knowledge

of the patient

Kirby-Bauer Antimicrobial Susceptibility Test.

Page 29: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 29

Antimicrobial Susceptibility Testing (cont’d)

Page 30: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 30

Miscellaneous Microbiology Testing

Testing for pinworms– Specimens best collected at night or early before bowel

movement, urination, or bathing.

– Petroleum jelly paraffin swabs used to collect eggs.

– Parent may also be instructed to bring child to office.

Page 31: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 31

Immunology Testing

Provides information about past or present infections with bacteria or viruses and certain cancers

Demonstrates the reaction between antigen and antibody– Agglutination, precipitation, immunochromatographic

assay

Page 32: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 32

Immunology Testing

The medical assistant may perform CLIA-waived tests for infectious mononucleosis, H. pylori, HIV, and Lyme disease.

Page 33: Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Assisting in Microbiology and Immunology Chapter 54.

Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 33

Patient Education

List of teaching topics to help educate patients– An explanation of patient’s type of infection

– How infection spreads

– Normal barriers to infection

– Risk factor

– Patient preparations, collection

– Hand washing, proper storage and cleaning