1. LAB 7: RESPIRATORY SYSTEM

2. RESPIRATORY SYSTEM: UPPER AND LOWER

3. THE RESPIRATORY SYSTEM Host Defense Mechanisms Anatomical characteristics/mechanisms to prevent/fight infection: –nasal hairs –antibacterial enzymes (lysozyme) –convoluted passages –cilia and mucous lining of the trachea –mucous linings of the nasal turbinates –reflexes --coughing, sneezing, swallowing –Normal flora of nasopharynx and presence of normal flora

4. NORMAL MICROBIOTA OF THE RESPIRATORY SYSTEM UPPER respiratory tract : –Coagulase – negative staphylococci –Neisseria (Gram – negative cocci) –Corynebacterium spp. (Diphtheroids) (Gram – positive rods) –Anaerobic bacteria –Pathogens in low numbers (colonization vs. pathogenic) (S. aureus, Gram-negative rods (Enteric/Pseudomonas spp.) LOWER respiratory tract (trachea, bronchi, and bronchioles ) is virtually free of microorganisms, mainly because of the efficient cleansing action of the ciliated epithelium

5. RESPIRATORY TRACT INFECTIONS Bronchitis Pharyngitis Epiglottitis Sinusitis Pneumonia

6. PATHOGENS OF THE UPPER RESPIRATORY TRACT THROAT: Streptococcus pyrogenes (Group A strep) Viruses SINUS: Moraxella catarrhalis (Gram – negative cocci) Gram – negative rods Staphylococcus aureus Viruses

7. PATHOGENS OF THE LOWER RESPIRATORY TRACT Streptococcus pneumoniae Hemophilus influenzae Staphylococcus aureus Moraxella catarrhalis (Gram – negative cocci) Gram – negative rods (Klebsiella sp., Enterobacter sp., Serratia sp., E. coli, Pseudomonas sp.) Fungi (Cryptococcus neoformans) Viruses

8. The Respiratory System: Collecting Specimens & Diagnosis Upper respiratory tract: Mucus membrane (throat, sinus) is wiped with a special collection swab. –Culture for isolation, identification and susceptibility testing of pathogens Lower respiratory tract: Sputum and or bronchial specimens are collected into a sterile container. –Gram stain for white blood cells and microorganism and to check for the quality of the specimen –Culture for isolation, identification and susceptibility testing of pathogens.

9. MEDIA Sheep Blood agar: Enriched (contains 5% sheep blood with tryptic soy agar base) Differential (used to detect hemolysis of microorganisms) Microorganisms produce toxins called hemolysins that can break down red blood cells causing a visual change in the media

10. IDENTIFICATION DIFFERENTIATION OF STAPHYLOCOCCI AND STREPTOCOCCI –GRAM STAIN –CATALASE –HEMOLYSIS ON SHEEP BLOOD AGAR

11. GRAM STAIN STAPHYLOCOCCUS STREPTOCOCCUS GRAM POSITIVE COCCI IN PAIRS AND CLUSTERS GRAM POSITIVE COCCI IN PAIRS AND CHAINS

12. CATALASE TEST Streptococci are Gram-positive, catalase negative (no bubbles) Staphylococci are Gram-positive, catalase positive (bubbles)

13. Blood Agar - Hemolysins Alpha-hemolysis – causes partial lysis of RBCs and breakdown of hemoglobin which leads to a green color change in the agar. Beta-hemolysis – causes complete lysis of RBCs and breakdown of hemoglobin which leads to a colorless clearing in the agar. Gamma-hemolysis – an organism that does not cause hemolysis.

14. SHEEP BLOOD AGAR

15. BLOOD AGAR LAB PROCEDURE

18. Blood Agar Lab Procedure: RESULTS

19. GROUP A STREP (S. pyrogenes) – (causative agent of ‘Strep throat’) Bacitracin (A) disk test Group A beta strep is sensitive to bacitracin (zone of inhibition) Other beta streps are resistant to bacitracin (no zone of inhibition)

20. Streptococcus pneumoniae S. pneumoniae is an alpha streptococci that is susceptible to the optochin disk (zone of inhibition) Most common cause of CAP Other alpha streptococci are resistant to optochin (no zone of inhibition)

21. Streptococcus pneumoniae S. pneumoniae Catalase negative Gram – positive cocci in LANCET PAIRS Frequently encapsulated

22. DICHOTOMOUS KEY FOR IDENTIFICATION OF STAPHYLOCOCCI AND STREPTOCOCCI GRAM POSITIVECOCCI IN PAIRS, CHAINS OR CLUSTERS CATALASE TEST CATALASE NEGATIVE = STREPTOCOCCI CATALASE POSITIVE= STAPHYLOCOCCI GAMMA HEMOLYSIS BETA HEMOLYSIS – Bacitracin disk sensitive = S. pyrogenes (Beta hemolytic strep Group A) ALPHA HEMOLYSIS – Optochin disk sensitive = S. pneumoniae

23. STAPHYLOCOCCI VS. STREPTOCOCCI GRAM POSITIVE COCCI PAIRS AND CHAINS PAIRS AND CLUSTERS CATALASE NEGATIVE POSITIVE HEMOLYSIS ALPHA BETA GAMMA HEMOLYSIS ALPHA BETA GAMMA MSA PLATE POSITIVE NEGATIVE Coagulase negative Staphylococci S. aureus