Lab Week 3

This week's lab was very interesting. I don't know about everyone else, but i found it extremely helpful to look at throat and sputum cultures the way we did; this was probably the first time I had to look and differentiate between 2 different, yet very similar colonies on the same culture.
The main problem that I faced while differentiating the 2 colonies is that they looked very much alike, they both grew on sheep blood agar only, and did not grow on MAC (which means they were both gram positives). The main difference I had is that one of them was beta-hemolytic; however, that was not of much help in the beginning, because the other organism that was not beta hemolytic only grew in limited spaces on the agar, and were very close to the first colony and I rarely had independent colonies that were not intertwined with the first ones. I really hope to have more specimens like these, because I know that it is going to be even more complicated when we graduate and have to figure all this out by ourselves.
My plate looked a lot like the picture attached 

http://medinfo.ufl.edu/year2/mmid/labimage/case3_bc.jpg

The first colonies were beta-hemolytic, PYR negative, PathoDx grouping showed clumping for group c antigen. 

The second colonies showed a gram positive cocci in clusters and staphaurex was negative. 

I am actually not going to list what these organisms are, and I will post it later on this week, hoping that someone might guess what it could be.

Studying tips

http://www.cse.buffalo.edu/~rapaport/howtostudy.html#examstudy

Does this sound familiar? Since we had a test this past week, and did not really cover a lot of material, i wanted to do something a little different and give some studying tips that might be helpful.  I know that most of us have too many homework and studying to do, but organization is the main key to success and doing better.

http://www.cse.buffalo.edu/~rapaport/howtostudy.html#examstudy

I have looked over many references, and basically studying for a test can be summed in those few points:

1. Manage your time: Begin studying about 1 week before the exam. Spend at least an hour each night (or day) studying for the exam . Try to spend the entire night (and/or day) before the exam studying for it.
2. How not to study: re-reading your textbook has "little or no benefit" when you are studying for a test. One method of studying that is better than passive re-reading is the "read-recite-review" ("3R") method: "Read the text, set the text aside and recite out loud all that [you can] remember, and then read the text a second time" (McDaniel et al. 2009).
3. Make a study outline
4. Write sample essays & do sample problems
5. Make "flash cards"
6. Stop studying when you feel confident: when you get to the point that you feel confident and ready for whatever will be on the exam and actually eager to see the exam to find out if you guessed its contents correctly, then you know that you are ready and you should be able to get some rest and sleep in order to be ready. 

Other tips have proven to be extremely powerful guides for organizing, thinking, studying, and learning in college.

Study Space

Your study space should be as quiet and comfortable as possible. Avoid studying in noisy places such as cafeterias, recreation rooms, or lounges.

Tip: When studying, keep a waste basket handy.

Tip: Have everything needed for studying handy beforehand. Don't waste valuable time looking for books, notes, of other information. After you have assembled the items you need, put them where you can reach them easily.

Study Habits

Tip: Begin studying no less than 30-90 minutes after a meal.

Tip: Never study within 30 minutes of going to sleep.

Tip: Prioritize! Make a list of what you intend to study, prioritize the list, and stick to it!

Tip: If possible, study no more than 30-40 minutes at a stretch.

Tip: Take study breaks away from your desk or wherever you are studying. 


references:
http://www.cse.buffalo.edu/~rapaport/howtostudy.html#examstudy
http://www.teachervision.fen.com/study-skills/teaching-methods/6390.html?detoured=1
http://www.adprima.com/studyout.htm

Listeriosis

During our lab this week, i have come across an organism that is a serious concern in public health.  Therefore I did some research on Listeria monocytogenes and listeriosis.
Listeriosis is usually caused by eating food contaminated with Listeria monocytogenes, and is an important public health problem in the United States according to the CDC website. It primarily affects older adults, pregnant women, newborns, and the immunodeficient patients.
Listeria is killed by pasteurization and cooking; however, in some ready-to-eat foods, contamination may occur after factory cooking but before packaging. Unlike most bacteria, Listeria bacteria can grow and multiply in the refrigerator. (Does anyone still want to eat that rare meat at the restaurant?)
Pregnant women have to be particularly careful, because other than the fact that their immune system is compromised, babies can be born with listeriosis if their mothers eat contaminated food during pregnancy. 
I have also found this interesting article from the CDC website titled:
Outbreak of Listeria monocytogenes Infections Associated with Pasteurized Milk from a Local Dairy --- Massachusetts, 2007 and you can find it at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5740a1.htm. This article or incidence, along with the previous article that I posted last week, just points out the seriousness or severity of risk of contamination to the general public.

Respiratory tract infections

We have discussed in class this week upper and lower respiratory tracts, and there is a lot of information involved while studying for those diseases. I have found some tables and pictures that some of us might find useful.

A fun fact about upper respiratory tract infections is that they are the most common infectious causing illness in the general population and they are the leading reasons for people missing work or school, and the leading acute diagnosis in the office setting.

Disease Location	Disease		Group of Pathogen	Comments
Upper respiratory tract
Nasal passages	Common cold		Viruses	Most common cause rhinovirus
Nasal sinuses	Rhinosinusitis		Viruses Bacteria	Viruses are most common cause of rhinosinusitis
Pharynx	Pharyngitis		Viruses  Streptococcus pyogenes and Corynebacterium diphtheriae	Viruses cause 90% of these infections
Respiratory airways
Epiglottis		Epiglottitis	Bacteria	Usually Haemophilus influenzae type b
Trachea and bronchi		Bronchitis, tracheobronchitis, croup, laryngitis	Viruses	Usually caused by viruses
Bronchioles		Bronchiolitis	Viruses	Most common cause is respiratory syncytial virus
Lower respiratory tract
Alveoli and alveolar sacs		Pneumonia	Bacteria	Most common cause in adults is Streptococcus pneumoniae

And this schematic might simplify some of the pathogens that do cause the various diseases.

 

http://www.atsu.edu/faculty/chamberlain/Website/lectures/lecture/introurt.htm

9 Dead After IV Infections at 6 Ala. Hospitals

We spoke in class about the importance of following the correct procedures to avoid contamination of samples, or sterile solutions. This article is a perfect example of what could happen if an unwanted organism is present, and how it could affect our patients, and their lives.

This article is from the following link:

http://www.aolnews.com/2011/03/29/9-dead-after-iv-infections-at-6-ala-hospitals/?icid=maing-grid7|main5|dl1|sec3_lnk3|52887

Also for a video about the same issue, please follow this link from CNN:

http://amfix.blogs.cnn.com/2011/03/30/nine-die-due-to-contaminated-iv-bags/

9 Dead After IV Infections at 6 Ala. Hospitals

Mar 29, 2011 – 9:11 PM

Text Size

Anna McFall

AP

MONTGOMERY, Ala. -- Nine Alabama hospital patients who were treated with intravenous feeding bags contaminated with bacteria have died and the maker has pulled the product off the market, state health officials said Tuesday.

Ten others who got the nutrient treatments that are delivered directly from the plastic bags into the bloodstream through IV tubes also were sickened by the outbreak of serratia marcescens bacteria, health officials said. All the patients were critically ill before receiving the IVs and officials have not definitively tied the deaths to the outbreak at six hospitals, State Health Officer Donald Williamson said.

"There is nothing to suggest the deaths were directly related to the bacterial infection," said Williamson who declined to give details on the patients including their ages and illnesses.

Christopher Furlong, Getty Images

State officials confirmed on Tuesday that nine hospital patients who were treated with contaminated intravenous feeding bags have died, and the maker has pulled the product off the market.

On March 16, two hospitals reported increased cases of serratia marcescens to the Alabama Department of Public Health. Officials linked the infection to TPN, a common nutritional supplement delivered through IVs.

A single pharmacy, Birmingham-based Meds IV, made the bags. Williamson said the company has notified its customers of the contamination, has discontinued production and was being very cooperative.

"We wouldn't be nearly as far along as we are without them," said Williamson.

Calls to Meds IV and its owner seeking comment were not returned.

Meds IV is registered to Edward Cingoranelli, who appears to have been involved in at least three other medical supply companies, according to the Alabama Secretary of State's office. Meds IV was incorporated two weeks after one of the other firms.

When Select Specialty Hospital in Birmingham learned one of its suppliers may have distributed bags containing the bacteria, it started investigating and stopped using Meds IV products, said the hospital's chief executive officer. Other hospitals also immediately stopped using the products.

"We are committed to high-quality patient care and are fully cooperating with government officials in their ongoing investigation of the supplier," said Jeffrey Denney.

Hospitals have very strict infection control for TPN. The supplement compound of several different nutrients, including electrolytes, is delivered daily in bags that are pre-mixed, not done in the hospital. The supplement is administered into a central line intravenously, going directly into the patients' blood stream. Patients are monitored carefully for symptoms of septic shock.

Serratia marcescens bacteria grow in moist areas and can settle in hospital patients' respiratory and urinary tracts. The bacteria is common and easily treatable if detected early. Patients with serratia sepsis may have fever, chills, shock, and respiratory distress.

http://www.aolnews.com/2011/03/29/9-dead-after-iv-infections-at-6-ala-hospitals/?icid=maing-grid7|main5|dl1|sec3

S. dysgalactiae subsp. equisimilis

In my lab results, i have encountered a patient diagnosed with endocarditis due to an infection with S. dysgalactiae subsp. equisimilis, an organism that many of us probably don't know a lot about, so i thought i could just elaborate a little bit about it and add some information about it. 
S. dysgalactiae subsp. Equisimilis (SDSE) is a sub-specie of Group G Streptococcus (GGS) species, which were first isolated in patients with puerperal sepsis in 1935.  GGS are known to be commensals and pathogens in domestic animals. In humans, they may colonize the pharynx, skin, gastrointestinal and female genital tract. It has been increasingly reported in human infections such as pharyngitis, cellulitis, meningitis, endocarditis, and sepsis. S. dysgalactiae subsp. equisimilis is the most common species of GGS that is β-hemolytic on sheep blood agar. 
The pathogenicity of S. dysgalactiae subsp. equisimilis has a wide spectrum of disease similar to that caused by Streptococcus pyogenes. Invasive infections with SDSE comprise arthritis, osteomyelitis, pleuropulmonary infections, peritonitis, intra-abdominal and epidural abscesses, meningitis, endocarditis, puerperal septicemia, neonatal infections, necrotizing fascitis, myositis, and streptococcal toxic-like syndrome. The invasive infections caused by SDSE has been found to be due to a rare mutation of the emm gene, which encodes for the M protein, which is a major virulence factor is SDSE (also present in S. pyogenes).
SDSE is susceptible to penicillin and other β-lactam agents, and penicillin is considered the drug of choice. The addition of an aminoglycoside to the cell wall-active agent is granted in serious infections. Also the Quinolone drugs have shown to have very good coverage for the eradication of the organism and treatment of invasive infections.
In conclusion, SDSE has many times been overlooked as a potential for invasive infections, and physicians and microbiologists are learning to look for this organism more, in order to provide the patient with optimized antimicrobial regimen.

Welcome To My Microbiology Blog!

Welcome to Taha's blog.
This Blog was created to post information, questions, comments and pictures related to Mrs. Linda Jeff's microbiology class, CLS 538. This is a learning experience for all of us, and together we will learn about the organisms and the infections they cause according to the different organ systems.
Your feedback will be appreciated, and hope that I will be able to provide some useful information.
See you in class.