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© 2009 The McGraw-Hill Companies, Inc. All rights reserved Introduction to Microbiology PowerPoint® presentation to accompany: Medical Assisting Third.

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Presentation on theme: "© 2009 The McGraw-Hill Companies, Inc. All rights reserved Introduction to Microbiology PowerPoint® presentation to accompany: Medical Assisting Third."— Presentation transcript:

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2 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Introduction to Microbiology PowerPoint® presentation to accompany: Medical Assisting Third Edition Booth, Whicker, Wyman, Pugh, Thompson

3 46-2 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Learning Outcomes 46.1 Define microbiology Describe how microorganisms cause disease Describe how microorganisms are classified and named Explain how viruses, bacteria, protozoans, fungi, and parasites differ and give examples of each.

4 46-3 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Learning Outcomes (cont.) 46.5 Describe the process involved in diagnosing an infection List general guidelines for obtaining specimens Describe how throat culture, urine, sputum, wound, and stool specimens are obtained Explain how to transport specimens to outside laboratories.

5 46-4 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Learning Outcomes (cont.) 46.9 Describe two techniques used in the direct examination of culture specimens Explain how to prepare and examine stained specimens Describe how to culture specimens in the medical office.

6 46-5 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Learning Outcomes (cont.) Explain how cultures are interpreted Describe how to perform an antimicrobial sensitivity determination Explain how to implement quality control measures in the microbiology laboratory.

7 46-6 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Introduction Microorganisms cause disease or infection Pathogenic in nature Displaced from their natural environment Medical assistant Identification of microorganisms Proper collection techniques Testing procedures Quality control

8 46-7 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Microbiology and the Role of the Medical Assistant Microbiology – study of microorganisms (simple forms of life visible only with a microscope) Microorganisms Normal flora Pathogenic

9 46-8 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Medical assistant Assists physician Obtains specimens Prepares specimens for direct examination Prepares specimens for transportation to reference laboratory If office has a POL, performs microbiologic procedures Microbiology and the Role of the Medical Assistant (cont.)

10 46-9 © 2009 The McGraw-Hill Companies, Inc. All rights reserved How Microorganisms Cause Disease Cause disease in variety of ways Use nutrients needed by cells and tissues Damage cells directly Produce toxins May remain localized or become systemic Transmission Direct contact Indirect contact

11 46-10 © 2009 The McGraw-Hill Companies, Inc. All rights reserved How Microorganisms Cause Disease (cont.) Localized symptoms Swelling Pain Warmth Redness Generalized symptoms Fever Tiredness Aches Weakness Normal flora Provides a barrier Can cause an infection

12 46-11 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge 1. What role does the medical assistant play in relation to microbiology? ANSWER: The medical assistant may assist the physician in obtaining specimens, obtain specimens herself, prepare specimens for direct examination or transport to a reference laboratory, and possibly perform microbiologic procedures. 2. How do microorganisms cause disease? ANSWER: Organisms cause disease by using nutrients needed by cells and tissues, damaging cells directly, or producing toxins.

13 46-12 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Classification and Naming of Microorganisms Classification by structure Subcellular – DNA or RNA surrounded by a protein coat – viruses Prokaryotic – simple cell structure with no nucleus or organelles – bacteria Eukaryotic – complex cell structure with nucleus and specialized organelles – protozoans, fungi, parasites

14 46-13 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Standardized naming Genus Category of biologic classification Example – Staphylococcus Species of organism Represents a distinct type of microorganisms Examples – Staphylococcus aureus and Staphylococcus epidermidis Classification and Naming of Microorganisms (cont.)

15 46-14 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge Describe the classifications of microorganisms and give an example of each. ANSWER: Microorganisms are classified as: Subcellular organisms that have DNA or RNA surrounded by a protein coat – viruses Prokaryotic organisms have a simple cell structure with no nucleus or organelles – bacteria Eukaryotic have a complex cell structure with nucleus and specialized organelles – protozoans, fungi, parasites

16 46-15 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Viruses Smallest known infectious agents Subcellular microorganism Have only nucleic acid surrounded by a protein coat Must live and grow in living cells of other organisms Hepatitis virus

17 46-16 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Viruses (cont.) Illnesses caused by viruses Colds Influenza Croup Hepatitis Warts Vaccines are available for many viruses AIDS Mumps Rubella Measles Herpes

18 46-17 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Bacteria Single-celled prokaryotic organisms Reproduce rapidly Classification Shape Ability to retain dyes Ability to grow with / without air Biochemical reactions Bacillus bacterial classification

19 46-18 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Bacteria: Classification and Identification Shape Coccus – spherical, round, or ovoid Bacillus – rod-shaped Spirillum – spiral-shaped Virbrio – comma-shaped Spirillum bacterial classification

20 46-19 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Ability to retain certain dyes Grams stain Acid-fast stain Ability to grow in presence or absence of air Aerobes – grow best in the presence of oxygen Anaerobes – grow best in the absence of oxygen Biochemical reactions Bacteria: Classification and Identification (cont.)

21 46-20 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Special groups Mycobacteria – bacilli with a cell wall that differs from most bacteria Rickettsiae Very small Live and grow within other living organisms such as mites and ticks Chlamydiae Cell wall structure differs from other bacteria Live and grow within other living cells Mycoplasmas – completely lack the rigid cell wall Bacteria: Classification and Identification (cont.)

22 46-21 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Protozoans Single-celled eukaryotic organisms, larger than bacteria Found in soil and water Illnesses Malaria Amebic dysentery Trichomoniasis vaginitis Leading cause of death in developing countries Protozoan Trichomonas vaginalis

23 46-22 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Fungi Eukaryotic organisms with rigid cell wall Yeasts Single-celled Reproduce by budding Molds Large, fuzzy, multicelled organisms Produce spores Superficial infections Athletes foot Ringworm Thrush Can cause systemic infections Yeast: a single- celled fungi

24 46-23 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Multicellular Parasites Organisms that live on or in another organism and use it for nourishment Parasitic worms Usually due to poor sanitation Roundworms Flatworms Tapeworms Parasitic insects Bite or burrow under the skin Mosquitoes Ticks Lice mites

25 46-24 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge Matching: ___ Yeast or moldA. Virus ___ Tapeworm / liceB. Bacteria ___ Classified by shapeC. Protozoan ___ Subcellular organismD. Fungus ___ May be aerobic or anaerobicE. Multicellular parasite ___ Smallest known organism ___ Found in soil and water E ANSWER: D A B B C A Very Good!

26 46-25 © 2009 The McGraw-Hill Companies, Inc. All rights reserved How Infections Are Diagnosed Steps to diagnosis and treatment 1. Examine the patient Presumptive diagnosis May or may not need additional tests 2. Obtain specimen(s) Label properly Include presumptive diagnosis

27 46-26 © 2009 The McGraw-Hill Companies, Inc. All rights reserved How Infections Are Diagnosed (cont.) 3. Examine specimen directly Wet mount Smear 4. Culture specimen Culture medium – contains nutrients Examine culture visually and microscopically

28 46-27 © 2009 The McGraw-Hill Companies, Inc. All rights reserved How Infections Are Diagnosed (cont.) 5. Determine sensitivity to antibiotics 6. Treat the patient as ordered Antimicrobial – to kill pathogen or suppress its growth

29 46-28 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge What is the process for diagnosing an infection? ANSWER: There are six steps for diagnosis and treatment of an infection: 1.Examine the patient4. Culture the specimen 2.Obtain specimen(s)5. Determine sensitivity 3.Examine specimen directly6. Treat patient / appropriate antimicrobial Super!

30 46-29 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Specimen Collection Must be collected correctly If not, may not grow in culture Contaminants may be mistakenly identified Patient may receive incorrect or harmful therapy

31 46-30 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Specimen Collection (cont.) Devices Use appropriate collection device or specimen container Sterile swabs – absorbent material on the tip Collection and transporting systems Sterile, self-contained Transport medium Aerobic or anaerobic

32 46-31 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Specimen Collection: Guidelines Avoid causing harm, discomfort, or undue embarrassment Collect from appropriate site Obtain specimen at correct time Use appropriate devices Obtain sufficient quantity of specimen Obtain specimen prior to the start of antimicrobial therapy Label correctly

33 46-32 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Specimen Collection (cont.) Throat culture specimens Swab back of throat in the area of the tonsils Avoid touching any structures in the mouth Prepare culture plate or prepare correctly for transport to laboratory

34 46-33 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Specimen Collection (cont.) Urine specimen Clean-catch midstream to minimize contaminants Process within 60 minutes or refrigerate Sputum specimen Specimen from lungs Avoid contaminating specimen with saliva

35 46-34 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Specimen Collection (cont.) Wound specimen Swab wound or lesion Do not touch outside of wound Stool Specimens Technique varies Bacterial infection Protozoal or parasitic infection Instruct patient in correct collection procedure

36 46-35 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge What are the general guidelines for specimen collection? ANSWER: They are to avoid causing harm, discomfort, or undue embarrassment; collect from appropriate site; obtain specimen at correct time; use appropriate collection devices; obtain sufficient quantity of specimen; obtain specimen prior to the start of antimicrobial therapy; and label specimen correctly.

37 46-36 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Transporting Specimens to an Outside Laboratory Many offices send cultures to an outside lab Three main objectives Follow proper collection procedures and proper collection device Prevent deterioration of specimen Protect anyone handling specimen

38 46-37 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Transporting Specimens to an Outside Laboratory (cont.) Regularly scheduled daily pickups by the lab Most reliable As-needed pickup by the lab Through the mail Follow U.S. Public Health Service regulations Etiologic Agent label

39 46-38 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge What are the objectives for transporting a specimen to an outside laboratory? ANSWER: They are to follow proper collection procedures and use proper collection device, prevent deterioration of the specimen during transport, and protect anyone that will handle specimen from exposure. Impressive!

40 46-39 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Direct Examination of Specimens Enables physician to initiate treatment immediately Wet mounts NaCl mixed with specimen of glass slide Presence of pathogen and movement of microorganism Potassium hydroxide (KOH) mounts Used if a fungal infection of the skin, nails, or hair is suspected KOH dissolves keratin that can mask presence of a fungus

41 46-40 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Preparation and Examination of Stained Specimens Quick, tentative diagnosis Differentiation between types of infections Grams stain Moderate- complexity test Bacteria either retain or lose purple color Gram-positive bacteria Gram-negative bacteria

42 46-41 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Culturing Specimens in the Medical Office More common to send specimens for culture to outside labs Culturing involves placing a sample of specimen on a culture medium Medium – nutrients Place in incubator for growth – colony develops as microorganism multiplies

43 46-42 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge 1. What are the methods for preparing a slide for direct examination by the physician? ANSWER: They are wet mount and KOH mount. 2. How does the examination of stained specimens facilitate patient care? ANSWER: Stained specimens enable the physician to provide a quick, tentative diagnosis and differentiate between types of infections.

44 46-43 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge 3. What is the process for culturing a specimen? ANSWER: The culture medium is inoculated with the specimen and placed in an incubator to promote growth of the organism on the culture medium.

45 46-44 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Culturing Specimens (cont.) Culture media Liquid, semisolid, or solid forms Contains agar Selective or nonselective Special culture units Rapid urine culture – Uricult Also available for throat, vaginal, and blood specimens

46 46-45 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Culturing Specimens (cont.) Inoculating a culture plate Transfer some of the specimen onto a culture plate Label the plate correctly Qualitative analysis – determination of type of pathogen Quantitative analysis – number of bacteria present in sample

47 46-46 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Culturing Specimens (cont.) Incubating culture plates 35 to 37 º C for 24 to 78 hours Agar side up Interpreting cultures Requires skill and practice Characteristics of colonies Relative number Changes to media around colonies

48 46-47 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Determining Antimicrobial Sensitivity An outside lab reports Sensitive – no growth Intermediate – little growth Resistant – overgrown Procedure Filter paper containing antimicrobial agents placed on inoculated agar plate Incubated for 24 hours Evaluate effectiveness of agent

49 46-48 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge 1. What is the difference between selective and nonselective culture media? ANSWER: Selective culture media allows the growth of only certain kinds of bacteria. Unselective culture media support the growth of most organisms. 2. The office received a culture sensitivity report on a bacteria that said it was resistant to an antimicrobial. What does this mean? ANSWER: It means that the bacteria was not killed by the antimicrobial and that there was an overgrowth of the bacteria.

50 46-49 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Quality Control in the Medical Office Ongoing evaluation of the quality of medical care being provided Objective means to define, monitor, and correct potential problems Routine evaluation All media, staining solutions, and reagents Equipment

51 46-50 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Quality Control: Impact of CLIA 88 Appropriate policies and procedures Proper documentation Lab policies and procedures Materials Personnel qualifications and training Participation in proficiency testing program

52 46-51 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge What is the purpose of a quality control program in the medical office? ANSWER: To provide an ongoing evaluation of the quality of medical care provided and to provide an objective means to define, monitor, and correct potential problems. Very Good!

53 46-52 © 2009 The McGraw-Hill Companies, Inc. All rights reserved In Summary Microorganisms are a major cause of disease Medical assistant Collects specimens Processes or transports specimens Quality control – ensures quality medical care

54 46-53 © 2009 The McGraw-Hill Companies, Inc. All rights reserved End of Chapter Each organism's environment, for the most part, consists of other organisms. ~ Kevin Kelly


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