3Throat swap culture First step : Breath deeply. Second step: open mouth widely& push the tongue out& phonate “AAHHH”
4Third step: insert the cotton swap through the mouth and rotate on the area of tonsil or both tonsil.
55th step: transport the specimen to the lab as soon (avoid dry) 4th step: remove the cotton swap from the mouth, avoid touch the tongue, teeth…5th step: transport the specimen to the lab as soon (avoid dry)
66th steptake the swap under sterile condition, rotate it on the first quadrant of blood agar plate
77th step# then do the streaking method by loop and stab it few times, then incubate at 37 c / 24 h.# Search for hemolyticß hemolytic: Clear zone.Streptolysin SStreptolysin O (v. imp)
8Streptococcus pyogenes Colonies of Streptococcus pyogenes on sheep blood agar.Notice: * Presence of b hemolysis around colonies* Enhanced hemolysis around stabbing sites* Sensitivity to bacitracin (Disk A)
9Streptococcus pyogenes Pin point colony: (white or gray)Gram stain: G+ve, cocci, single chain.Catalase enzyme: differentiate betweenStreptococcus –veStaphylococcus +ve
10Streptococcus pyogenes Antibiotic susceptibility of S. pyogenes.Bacitracin SensitiveOptochin Resistance
11Haemophilus influenzae G-ve, blood lover, fastidious M.O. need:X factor heme extra & intracellular.V factor NAD intracellular.Best media Choclate
12Haemophilus influenzae G-negative coccobacilli, typical of H. influenzaeGrayish mucoid colonies of H. influenzae on chocolate agar
13Haemophilus influenzae Shows phenomena Satellitism: growth on blood agar near a line of Staphylococcus aureus.
15Lower Respiratory Tract Infections Sputum Examination:Sputum: Trachiobroncial secretions, visco-elastic (95% water and only 5% solids) as it comes out, it is contaminated by nasal and salivary secretions and normal bacterial flora of the oral cavity.
16Specimen collection In case of Adult: 1- mouth should be pre-rinsedremove contaminants.2- first morning specimen, Good specimen <10 epith and >25 WBCs.
17In case of children Nasopharyngeal swab. Cough Swab method. 1- the child mouth is held open by using tongue depressor.2- Epiglottis is visualized and is touched with swab to induce cough.
183- Material expelled deposited on the swab and cultured in three different media. * Blood media.* Chocolate.* MacConcy.
19Macroscopic Examination Consistency and Appearance.normal sputum is clear and watery.Color of Sputum:Normal color is clear and colorless.in case of infections
20Color of Sputumyellow (indicates pus and epithelial cells)=pneumonic+Staphylococcus aureus. Green (pseudomonas)== Otitis. Red (blood) TB.
21Microscopic Examination Mycobacterium tuberculosisAcid fast bacilli
22Mycobacterium tuberculosis Culture on Lowenestein-Jensen media.Yellowish colony on green background
23Streptococcus pneumoniae Lancet-shaped,G-positive diplococci,typical of S. pneumoniae
24a hemolysis on 5% sheep blood agar, S. pneumoniaea hemolysis on 5% sheep blood agar,typical of S. pneumoniae. Sensitivity to optochin is also demonstrated
25Klebsiella pneumoniae Colonies of Klebsiella pneumoniae on MacConkey agar,showing lactose fermentation and mucoid appearance