2Introduction to Microbiology Objectives:46-1 Define microbiology.46-2 Describe how microorganisms cause diseases.46-3 Describe how microorganisms are classified and named.46-4 Explain how viruses, bacteria, protozoans, fungi, and parasites differ and give examples of each.46-5 Describe the process involved in diagnosing an infection.
3Introduction to Microbiology Objectives (cont.)List general guidelines for obtaining specimens.Describe how throat cultures, urine, sputum, wound, and stool specimens are obtained.Explain how to transport specimens to outside laboratories.46-9 Describe two techniques used in the direct examination of cultures specimens.46-10 Explain how to prepare and examine stained specimens.
4Introduction to Microbiology Objectives (cont.)46-11 Describe how to culture specimen in the medical office.46-12 Explain how cultures are interpreted.46-13 Describe how to perform an antimicrobial sensitivity determination.46-14 Explain how to implement quality control measures in the microbiology laboratory.
5Introduction You will learn: Processes in identifying microorganismsCulture medias usedAntimicrobial testingQuality controlWhen microorganisms are pathogenic in nature or displaced from their natural environment, they cause infections and disease.You must understand different life forms of microorganisms, how they may be identified, and how to teach proper collection techniques for common specimens.
6Microbiology and the Role of the Medical Assistant Microbiology – study of microorganisms (simple forms of life visible only through a microscope usually single celled)Found everywhereCause infectionsMildSevere
7How Microorganisms Cause Disease By using up nutrients or other materials needed by cells and tissues they invadeBy damaging body cells by reproducing inside the cellsBy making body cells targets of body’s own defensesResulting in:FeverTirednessAchesWeaknessSkin reactionsGastrointestinal upsetTransmitted from one person to anotherby direct touching or by vectors,droplets, or contaminated food or drink.
8Classifications of Microorganisms Subcellular – DNA or RNA surrounded by a protein coatProkaryotic – simple cell structure no nucleus or organellesEukaryotic – complex cell structure with nucleus and specialized organelles
9Naming of Microorganisms Types of microorganisms:VirusesBacteriaProtozoansFungiMulticellular parasitesNamed by first word refers to genus (biologic classification between family and species) and second word refers to particular speciesStaphylococcus aureus
10Viruses Smallest known infectious agents Cannot be seen by regular microscopeConsist of only nucleic acid surrounded by a protein coatCauses:ColdsInfluenzaCroupHepatitisHepatitis Virus
11Bacillus bacterial classification Single-celled prokaryotic organismsReproduce quicklyMajor cause of diseasesMany different types and ways to identify themRapid reproduction is why untreated infections can be dangerousBacillus bacterial classification
12Bacteria Classification Shape – coccus, bacillus, spirillum, virbrioAbility to retain certain dyesAbility to grow in presence or absence of airBiochemical reactionsSpirillum bacterial classification
13Protozoan Trichomonus vaginalis ProtozoansSingle celled eukaryotic organisms – larger than bacteriaFound in soil and waterCause:MalariaAmebic dysenteryTrichomonus vaginalisProtozoan Trichomonus vaginalis
14Yeast a single-celled fungi An eukaryotic organism – rigid cell wallGrow mainly as single-celledReduce by buddingYeastsMoldsCause superficial infectionsAthlete’s footRingwormThrushYeast a single-celled fungi
15ParasitesOrganism that lives on or in another and uses that organism to provide nourishmentInfections caused by parasites are called infestationsWormsInsects -ticks
16Apply Your Knowledge -Answer How is bacteria classified? Shape – coccus, bacillus, spirillum, virbrioAbility to retain certain dyesAbility to grow in presence or absence of airBiochemical reactions-AnswerHow is bacteria classified?
17Diagnosing Infections Step 1 – Examine the patients signs and symptomsStep 2 – Obtain SpecimensStep 3 – Examine the Specimens DirectlyStep 4 – Culture the SpecimenStep 5 – Determine the Culture’s Antibiotic SensitivityStep 6 – Treat the Patient as Ordered
18Specimen CollectionIf specimen is collected incorrectly, the organism will not grow in culture and then cannot be identified.If a specimen contains contaminants that are identified as causing the infection, the patient may be treated incorrectly.
19Specimen Collection Devices Sterile swabsAbsorbent material on the tipCollection and transporting systemsContains a polyester swab and a small thin-walled vial of medium in a plastic sleeve
20Throat Culture Specimens Avoid touching any structures in the mouthGet the specimen from the throat area onlyClinical medical assistants must know how to obtain a throat culture specimen correctly
21Other SpecimensUrineObtain clean-catch midstream specimen to prevent contaminantsSputumInstruct patient to cough up mucus from the lungsWoundUse a swabStoolUse clean paper plate or waxed paper
22Transporting Specimens Many offices do not perform microbiologic testing.You may send culture specimens to outside labs.There are three main objectives.
23Transporting Specimens (cont.) Three main objectives:Follow proper collection procedures and use correct device.Maintain the samples in a state close to their original as possible.Protect anyone who handles the specimen container from exposure to potentially infectious material.
24Methods of Transportation Regularly scheduled daily pickups by the labAs needed pickup by the labThrough the mail
25Direct Examination of Specimens Physician may examine specimens under the microscope to detect microorganisms.Two types of procedures:Wet mounts- permits quick identificationPotassium Hydroxide (KOH) mounts – suspects a fungal infection of the skin, nails, or hair.
26Stained SpecimensEnables the doctor to differentiate between types of infections.The medical assistant should be able to prepare a specimen slide and perform a Gram’s stain.
27Culturing SpecimensYou will need on-the-job training or additional courses to culture certain specimens.More common to send these specimens to outside labs.Culturing involves placing a sample of specimen on a culture medium.
28Culturing Specimens (cont.) Culture media – liquid, semisolid, or solid formsMedium called – agarSpecial culture units – used to perform rapid urine cultures (Unicult)
29Culturing Specimens (cont.) Inoculating a culture plateTransferring some of the specimen onto the plateLabel the plate:Patient’s nameDoctor’s nameSource of sampleDate and time of inoculationYour initials
30Culturing Specimens (cont.) Streak the plate with the specimen swab for:Qualitative analysis – type of pathogenQuantitative analysis – number of pathogen present in the specimenIncubating Culture plates – to allow bacteria to grow (incubator set at 35 to 370 C)Allow to grow for 24 to 48 hours.
31Interpreting Cultures This step is performed by physicians, microbiologists, or technicians who have been properly trained.They will look for:Characteristics of colony growthRelative number of colony growthChanges in the media surrounding the colonies
32Determining Antimicrobial Sensitivity Taking a sample of the isolated pathogen and suspending it in a liquid medium and streaking it on a culture plate.Small disks of filter paper with antimicrobial agents are placed on top.Plate is incubated at 370 C for 24 hours.The antimicrobial that inhibited microbial growth will be effective in treating the infection.
33Quality Control in the Office Ongoing system to evaluate the quality of medical care being provided.Provides an objective means to define, monitor, and correct potential problems.All media, staining solutions, and reagents should be evaluated frequently.Equipment must also be in proper running order.
34Impact of CLIA’ 88All labs must incorporate the appropriate policies and procedures to comply with CLIA’ 88Proper documentation of lab policies and procedures, materials, and lab personnel qualification and training.Proficiency testing program monitors quality of laboratory’s test results
35Apply Your Knowledge -Answer Small disks of filter paper with antimicrobial agents are placed on top of the inoculated culture plate, and if the antimicrobial agents stop the growth of the pathogens, it will be effective in treatment of the infection.-AnswerHow are pathogens tested to see if they can be treated effectively by antimicrobial agents?
36Medical Assistant Summary Developing your clinical skills will be an asset to the office and will allow you to advance your career.Quality control in the microbiology laboratory is an important factor in ensuring high-qualitymedical care.