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Ministry of higher education & scientific researches Foundation of technical education technical institute of AL-Dewaniyah. Educational bag (Microbiology) This unit is directed For the student of first class in Nursing department By Fatima .A. chaloob MSD. Of medical laboratory sciences Head of the nursing department Lecturer 2009-2010 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :The student will know the shape of the bacteria . Know the components of bacterial cell. know the function of capsule, mesosomes, cell wall. understanding the branches of microbiology. How to compare between eucaryote and prokaryote cells. 1 / C –Central Idea :- - Know the History and scop of microbiology. - The structure of bacterial cell. - The function of each part of bacterial cell. - The shape of bacteria. - The science parasitology , virology , mycology ,bacteriology. 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :- • get 4 or more you do not need to proceed . • get less than 4 you have to study this modular unit well . • After studying the text of this modular unit ,do the post test , and if you :- • get 4 or more , so go on studying modular unit 3 . • get less than 4, go back and study the first and second modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the first modular unit , the student will be able to:- 1- To know the classification of medical microbiology. 2- know what is the function of capsule and cell wall. 3- Know the function of mesosomes. 4- Define protozoa , Algae ,fungi ,Ricketssia ect. 3/ Pre test :Fill in the blanks 1-Microbiology is -------------- 2-Bacteria is ------ microorganism. 3-Germs mean ----------- . 4-Algae has -------- like plants. 5-Ricketssia is obligate unicellular organism and has------ shape. duction/ Microbiology fication of microorganism al microbiology : Is the study of causative s of infectious disease of human beings heir reaction to such infections. robiology : In short this is the science ng with the study of microorganisms. Branches of microbiology : 1 – Medical microbiology . 2 – Industrial microbiology . 3 – food microbiology . 4 – soil microbiology . Medical microbiology studied under following headings : A - parasitology : Deals with the study of parasites causing diseases in man . B - mycology : Deals with the study of fungus causing diseases in man . C - Immunology : Deals with the study of body resistance to infectious diseases . D - Bacteriology : Deals with the study of bacteria . E - Genetics : Is the study of heredity and variations . F - Virology : Is the study of viruses . Scope of microbiology A - Diagnostic of causative organisms . B - Prognosis of disease . C - Guidance in treatment . D - Source of infection . Comparison between prokaryotic and Eukaryotic cells Character Prokaryotic Nucleus Absent Nuclear membrane Absent Eukaryotic cell Present present Nucleolus Absent present Chromosome one more Mitotic division Absent cytoplasmic streaming pinocytosis Absent Absent present Present present mitochodria Absent present Lysosomes Absent present Golgi-apparatus Absent present Endoplasmic – reticulum Absent present Chemical – composition Sterol Absent present Muramic-acid Absent present Sizes ofBacteria Most of bacteria are so small that the size is measured in terms of micron . A-1 micron (m) or micrometer( Mm) one thousand of millimeter . B-1- millimicron ( Mm ) or nanometer (nm) =one thousandth of micron . C- Angstrom units ( A )= one tenth of (nm) Generally cocci are a bout 1m in diameter and bacilli are 2 to 10 m in length and 0.2 to 0.5 m in width. Shape of bacteria On the basis of shape , bacteria are classified as under:- A ) Cocci And on the basis of arrangement, they are described as : 1- staphylococci ( arranged in clusters ) . 2 – streptococci ( arranged in chains ) . 3 – Diplo cocci group of (2) . 4 – Tetrads group of (4) . 5 – Sarcina group of (8) . B – Bacilli : They are cylindrical or rod shaped organisms they are of following types :. 1- coccobacilli e,g brucella . 2-Chinese letter e,g corynebacteria 3-Vibrio : They are comma – shaped e.g Vibrio cholera . Spirochaetes : they are coiled e.g treponema. 5-Actinomycetes : It resembles the radiate of sun rays e.g Actinomyces 6-Mycoplasma : are organisms which lack cell-wall and so do not posses a stable morphology , they are round or oval bodies with filaments . e.g Mycoplasma pnenmonia General structure of bacteria • Bacterial structure * Flagella :. Organ of locomotion . Pili or fimbriae :Organ of adhesion. * Capsule:It is gelatinous secretion of bacteria,a thick coat a round cell-wall present in some spp of bacterioa as: 1- Anthrax . 2- Klebisella . 3- pneumococci . 4 – Bacillus 5 – streptococcus pyogenes * Functions of Capsule :1 - Protection against deleterious agent e.g Lytic enzymes. 2 – Contribute to the virulence of pathogenic bacteria by inhibiting phagocytosis. Cell-wall It is the outer-layer which protects the internal structure . *Functions of cell-wall * 1-protection of internal structure . 2-Gives shape and rigidity to the cell. 3-It has an important role in division of bacteria . 4-offers resistance to harmful effect of environment . Cytoplasmic-membrane It is thin semi permeable membrane which lies just beneath the cell-wall. * Functions of cytoplasmic – membrane * 1- It controls inflow and outflow of metabolites to and from protoplast . 2- Have specific enzyme ( permease ). 3-Have enzymes help to manufacture the cell-wall . 4-It provides little mechanical strength to bacterial – cell. * Cytoplasm It is suspension of organic and inorganic solutes in viscous watery solution, it contains ribosome, inclusion, and vacuoles . * Ribosome s : They are the sites of protein synthesis. * Mesosomes : They are invaginations of plasma- membrane , usually in Gm +Ve bacteria . *Function of mesosomes : They are the sites of respiratory enzymes in bacteria. 2– coordinate nuclear and cytoplasmic division during binary fission . 3 – Responsible for DNA during sporulation * Nucleus It is long filament of DNA tightly coiled inside the cytoplasm.and it is surrounded by nuclear membrane generally one per cell. * Flagella These are long contractile filaments they are organ of locomotion e.g vibrio , E coli , salmonella , flagella may be arranged on bacterial body in following manner Monotrichous e.g vibrio spp. 2-Lophotrichous . 3- Peritrichous e.g E coli. 4- Amphitrichous e.g fecales. Pilli (fimbriae ) They are short thin straight hair like appendages , they are organs of adhering to the surface of other cells. Definitions:1 – Germs : or called ( pathogens ) means disease causing microorganisms . 2 – Infectious disease : Diseases caused by microorganisms 3 – Pathogenicity :. It is referred to the ability of microbial species to produce disease . 4 - Virulence : It is referred to the ability of microbial strains to produce disease e.g. for virulent facters : A- Toxigenecity ability to produce toxins . B – Invasiveness ability to spread in host tissue. Other microorganisms Algae : Eukaryotic photosynthetic organism, its range from small of large algae . they are important source of food, iodine, other minerals. * Protozoa Eukaryotic , usually single animal like microorganisms most are free living microorganisms, found in soil and water they have no chlorophyll . * Fungi * Eukaryotic,. found almost every where on earth living on organic matter in water and soil and living upon and within animal and plants .some are harmful others are beneficial in production of cheeses, beer, and wine,drugs, antibiotics. * Rickettsia Are coccoid rod shaped or irregular Gm-ve bacteria with bacterial type cell-wall they contain both DNA and RNA most of them obligate intracellular pathogens that cause disease in man and other animals , Disease is transmitted by arthropod such as lice , fleas , ticks e.g. Typhus , bacteremia. 3/ Post test :Fill in the blanks 1-Microbiology is -------------- . 2-Bacteria is ------ microorganism. 3-Germs mean ----------- . 4-Algae has -------- like plants. 5-Ricketssia is obligate unicellular organism and has-----shape. . 6/ key answer:1- Pre test :- 1- post test :- 1_ Is science dealing with study of 1_ Is science dealing with study of microorganisms. which cannot be seen microorganisms. which cannot be seen by naked eye by naked eye 2_Procaryotic microorganisms. 2_Procaryotic microorganisms. 3-Pathogens 3-Pathogens 4_Chlorophyll 4_Chlorophyll 5_Irregular. 5_Irregular. References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :- The student will know the spore of bacteria. Know the site of spores within the bacterial cell. 1 / C –Central Idea :- -Identification of bacterial spore. structure of it . the spore sites ,how spore survives in unsuitable conditions. 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :- • get 4or more you do not need to proceed . • get less than 4you have to study this modular unit well . • After studying the text of this modular unit ,do the post test , and if you :- • get 4 or more , so go on studying modular unit 4 . • get less than 4, go back and study the third modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the first modular unit , the student will be able to:1- To know the morphology of bacterial spore . . 2- Define central spore 3- Know the position of spores 4- K now the method of killing spores. 3/ Pre test :Write t or f 1-bacteral spores are destroid by ordinary method of sterilization. 2-spore site is central 3-spore of bacteria has acore in the middle of it. 4- Spore shapes are spherical and oval . 5- bacterial spores withstand against un suitable conditions. * Bacterial spores * Spores : Are highly resistant dormant state of bacteria found in certain genera e.g. bacillus clostridium Gm +ve coccus they are destroyed by ordinary methods of boiling for several hours . they make survival of organism possible under unfavorable Conditions like dry state , spores are resistant to heat, drying, freezing, and, toxic – chemicals . e.g. for not bulging 1 – central not bulging . 2 – terminal not bulging . 3 - sub terminal not bulging . * spore shape may by : 1 – spherical . 2 – oval . * Spore site may be : A- central . B- terminal . C- sub-terminal . Some are bulging and others are not e.g. 1 – central bulging . 2 – terminal bulging . 3 - sub terminal bulging . 3/ Post test :Write t or f 1-bacteral spores are destroid by ordinary method of sterilization. 2-spore site is central . 3-spore of bacteria has acore in the middle of it. 4- Spore shapes are spherical and oval . 5- bacterial spores withstand against un suitable conditions. 6/ key answer:1- Pre test :- 1- post test :- 1-t . 1-t . 2-t . 2-t . 3-t . 3-t . 4-t . 4-t . 5-t . 5-t . References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :* The student will know the nutritional requirements of bacteria. * can differentiate between the aerobic and non aerobic organisms. *Know the types of bacteria as regards to temperature. 1 / C –Central Idea :- 1-The type of bacteria depend on its requirements to essential metabolites. 2-The minerals that bacteria require as ca,mg ,cl,Na etc. 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :• get 4 or more you do not need to proceed . • get less than 4you have to study this modular unit well • After studying the text of this modular unit ,do the post test , and if you :• get 4 or more , so go on studying modular unit 5 . • get less than 4, go back and study the forth modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the first modular unit , the student will be able to:- 1.To know the nutritional requirements of bacteria. 2-Know the aerobic and non aerobic bacteria. 3-Know how to prevent bacteria by not supplying it by the essential metabolites. 5/ Pre test :. Fill in the blanks: Q 1\ The growth curve of bacteria consist of -----. Q2\Bacteria requires minerals as -------. Q3\Aerobics is ---------------- . Q4\Darkness is ------- for bacterial growth . Q5\Psychrophilic prefer temp between--------- . ( Nutritional Requirements of Bacteria ) & ( Factors influencing growth of Bacteria ) Bacteria may require adequate nutrition , optimum PH , temperature, and oxygen for multiplication and growth . Bacteria can be classified into the following types on the basis of nutritional requirement:- 1 – on the basis of energy sources : A – phototrophic: which gets energy from photochemical reaction . B – chemotropic: get energy from chemical reaction . 2 – on the basis of their ability to synthesize essential metabolites :- A – Autotrophic : they use CO2 as the main source of carbon & simple inorganic salts e.g. nitrates , ammonium sulphate etc . to form new protoplasm of the cell . B – Heterotrophic : Here some of the essential metabolites are not synthesized .organic compounds e.g. protein , peptones , amino acid. * The other nutritional requirement are as under : 1- Minerals :. These are sodium ,potassium , Mg , Ca ,Fe , Cl2 , zinc , copper , iodine .These are essential for physiological activities of bacteria 2- Gas requirements . A - oxygen :The capacity of bacteria to grow in the presence of O2 & to utilize it depends on possession of a cytochrome oxides system . 2- Aerobes : The aerobe organisms grow only in the presence of O2 e.g. bacillus , nitrobacteria , pseudomonas etc . * Facultative anaerobes :. They are the organisms that can live with or without O2 e.g. vibrio . E.coli , salmonella, microaerophilic . They grow well with relatively small quantities of O2 e.g. hemophilus . * Obligate anaerobes : They multiply only in the absence of O2 e.g. clostridium , bacteroids , they require a substance other than O2 as hydrogen acceptor. B – Carbon dioxide Some organisms like Neisseria gonorrhoea , brucella , are enhanced by the presence of extra amount of Co2. 3 – Moisture : Bacteria require water for their growth, desiccation may kill most of bacteria . 4 – Temperature A – which an organic grows best is called optimum temp . In human parasitic organisms optimum temp range between 30c◦ & 37c◦ There are three groups of bacteria as regards the temp of growth :A – Psychrorpilic :. These are the organisms growing between 0c◦ to 25c◦ . They are mostly soil & water bacteria . B – Mesophilic :. They grow between ( 20c◦ & 44c◦ ) this group includes bacteria producing disease . C – Thermophilic :. Some organisms grow at (5060c◦) e.g. bacillus & algae * Hydrogen concentration (PH) Most of pathogenic bacteria grow best at pH (7.27.6) ,vibrio which caused cholera grow at alkaline pH . * Osmotic pressure :. Bacteria are usually resitant to changes of osmotic pressure . However 0.5% Nacl is added to almost all culture media to make environment isotonic . * Light :. Darkness is usually favorable for the growth & viability of all the organisms . Direct light exposure shortens the survival of bacteria . Organisms are sensitive to ultraviolet and other radiations . * Accessory nutritional requirement Most often the accessory growth factors are vitamins . The requirement of growth factors differ widely in various bacteria e.g. for S. aureus the growth factor is thiamine and for H. influenza is hematin . they are not synthesized by bacteria and so supplied in media Growth curve When organisms are cultured in appropriate fluid media there would be increase in the size of bacteria without any multiplication for some time ( lag phase ) This is followed by multiplication & increase in number of bacteria to the extent that media look turbid to the naked ( log phase ) after some time growth rate becomes stationary and later on Decline , counting of bacteria at different period after inoculation & then events of sequences are represented on a graph which is called growth curve . 5/ Post test :. Fill in the blanks: 1\ The growth curve of bacteria consist of ------ . Q2\Bacteria requires minerals as -------. Q3\Aerobics is ---------------- . Q4\Darkness is ------- for bacterial growth . Q5\Psychrophilic prefer temp between--------- . 6/ key answer:1- Pre test :Pre test 1- post test :- ,log = 1 _lag phase,log phase.stationary phase ,decline phase , , stationary = 2-Ca,mg,cl ,Na . 1 _lag phase ,decline phase. 2-Ca,mg,cl ,Na . 3-grow only in the presence of o2 4-suitable. 5-(0- 20 )c 3-grow only in the presence of o2 4-suitable. 5-(0- 20 )c References:1- Jawetz, etal. Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :* The student will know the method of sterilization. * can differentiate between sterilization, disinfection, bactericidal ,and bacteristatic. * Know the physical and chemical method of sterilization. * Know the tyndalization and filtration. * Know how to sterile objects and instruments ect. 1 / C –Central Idea :- -The physical and chemical methods of sterilization. -The chemical agents . -How to stop growth of bacteria, and how to kill all type of life. -The dry and moist heat. 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :• get 4 or more you do not need to proceed . • get less than 4you have to study this modular unit well • After studying the text of this modular unit ,do the post test , and if you :• get 4 or more , so go on studying modular unit 7 . • get less than 4, go back and study the 5and6 modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the first modular unit , the student will be able to:- 1.To know the difinition of sterilization and how to sterile elements and surface of things . 2-Know the physical and chemical method of sterilization. 3-Understand the meaning of pausteurization , tandalization. 3/ Pre test :WRITE TRUE OR FAULSE 1-Sterilization is stop growth of bacteria 2- Bacteriostatic agents kills bacteria. 3-Pausterization is boiling milk at 60 c . 4-One of the chemical agents of dinfection is soap. 5-Sun light is one of physical method of sterilization. sterilization : It is a process by which the articles become free form all microorganisms ( pathogenic ) and non pathogenic , either in vegetative or spore form . Disinfection It is a process of destruction of pathogenic organism capable of giving rise to infection . Bactericidal agent : bacteria Agents are able to kill e.g. penicillin , Fuci din Bacteriostatic - agents Agents which are only prevent multiplication of bacteria and they may remain alive e.g. Tetracycline Various agents used in sterilization A - physical agents : 1 - sunlight . 2 - drying . 3 - Heat ( dry heat , moist heat ) . 4 - Radiation . 5 - filtration . B – chemical agents . 1- Acid . 2- Alkaline . 3- salts . 4- Halogens . 5- oxidizing agents . 6- formaldehyde . 7- Reducing . 8- phenol . 9- soap . 10- Dyes . 11- Alcohol . Sun light : have bacterial activity due to ultra violet ray , this is one of the natural method of sterilization in cases of water in tank river ,lakes . Drying : Drying in air has harmful effect on many bacteria e.g. Treponema , Neisseria , are vary sensitive to drying , the spores are not affected by drying . Heat A - Dry heat : 1 - Red heat e.g. flaming of wire loop till they are become red ( needle , scalpels forceps & any metallic objects . 2 - Flaming : passing of the object over flame without allowing it to become red e.g. mouth of culture tubes , cover , slides . 3 - Incineration : for destruction of infected material e.g. bed , pathological materials . 4 - Hot air over : sterilization by hot air over require ( 140 - 160 ) c◦ for one hour e.g. sterile all glass material , syringes Petri dish test tubes . B - Moist – heat 1 – Temperature below 100c◦ A - pasteurization of milk : by using 63c◦ for 30 minute , organism like brucella , salmonella , mycobactenum are killed by this method 2 – temp at 100 c◦ : A- tyndalization : process by which medium is placed at 100c◦ in flowing steam for 30 min each 3 successive days the vegetative bacteria are killed at 100 c◦ & remaining spore which germinate during storage interval are killed on subsequent heating e.g. sterilization of egg or serum containing media . B - Boiling of needles syringes of for (10-30) min kill the vegetative form & bacteria spores & hepatitis virus are not killed or destroyed by this pro ccdure C – Steam at atmospheric pressure (100c◦) 3 – Temp more than 100 c◦ : ( Autoclave ) Is the best method of sterilization in which the vegetative & spore from of bacteria are killed , by using (121 c◦) for ( 15 – 20 ) min at 15/b ( pressure per square inch is used for culture media ) syringes Sterilization by filtration : This method is useful for antibiotics , sera , solution , carbohydrate , solution , filtration is useful for antibiotic as best on dies & filter e.g. seitz filter Radiation : Ultra viold radiation like using of ultra violet tamps in laboratories & x-rdy are useful for the sterilization of disposable material like catgut , disposable syringe * Chemical – agents : 1 - Acids : causes rate of death e.g. carbonic acid , citric acid , boric acid 2 - Alkaline : e.g. NaoH 0.5 % 3 - Salts : salts of heavy metals e.g. silve. , nitrate copper salts . 4 - Halogens : e.g. chlorine , Iodine , fluorine 5 – oxidizing – agents : e.g. 1/500 potassium permananganate 6 - formal dchyde : e.g. Formalin 7 - Reducing agents : e.g. Hydrogen peroxide ( H2O2 ) 8 - phenols 9 - soap :.mechanical or physical of bacteria 10 - Dyes : e.g. crystal violet , Acriflavin . 11 - Alcohol : e.g. chlorine , Iodine , fluorine 3/ Post test :WRITE TRUE OR FAULSE 1-Sterilization is stop growth of bacteria 2- Bacteriostatic agents kills bacteria. 3-Pausterization is boiling milk at 60 c . 4-One of the chemical agents of disinfection is soap. 5-Sun light is one of physical method of sterilization. 6/ key answer:1- Pre test :1_false 1- post test :- 2_false 1_false 3_ true 2_false 4_ true 3_ true 5_ true 4_ true 5_ true References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :* The student will know the general character of Staphylococcus. * can differentiate between the three spp of bacteria Staphylococcus. . * Know how to prevent and control this organism. * Know the diagnosis and treatment . 1 / C –Central Idea :- - Know the morphology of Staphylococcus aureus . -The bacteria that infect the respiratory system for e.g streptococcus ect. - Know the color of the 3 spp of Staph. -The toxins which produced by Staph spp. 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :• get 4 or more you do not need to proceed . • get less than 4you have to study this modular unit well • After studying the text of this modular unit ,do the post test , and if you :• get 4 or more , so go on studying modular unit 8 . • get less than 4, go back and study the 7 modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the eighth modular unit , the student will be able to:- 1.To know characters. the morphology of Staphylococcus ,general 2-Know the 3 spp of this bacteria and the color of the culture media 3-Understand the method of controling and treatment.. 3/ Pre test :WRITE TRUE OR FAULSE 1-Staphylococcus produce many types toxins e,g hemolysin. of 2- Staphylococcus pyogens produce golden yellow colonies on blood agar. 3-It ferments sugars and produce acid. . 4-One of the drugs used in treating of Staph aureus is penicillin. 5-Staph citrus is pathogenic bacteria. Brucella Brucellosis is an infectious disease caused by the bacteria of the genus Brucella. These bacteria are primarily passed among animals, and they cause disease in many different vertebrates. Various Brucella species affect sheep, goats, cattle, deer, elk, pigs, dogs, and several other animals. Humans become infected by coming in contact with animals or animal products that are contaminated with these bacteria. In humans brucellosis can cause a range of symptoms that are similar to the flu and may include fever, sweats, headaches, back pains, and physical weakness. Severe infections of the central nervous systems or lining of the heart may occur. Brucellosis can also cause long-lasting or chronic symptoms that include recurrent fevers, joint pain, and fatigue. Can brucellosis be spread from person to person? Direct person-to-person spread of brucellosis is extremely rare . Mothers who are breast-feeding may transmit the infection to their infants. Sexual transmission has also been reported. Forboth sexual and breast-feeding transmission, if the infant or person at risk is treated for brucellosis, their risk of becoming infected will probably be eliminated within 3 days. Although uncommon, transmission may also occur via contaminated tissue transplantation . Diagnoses Brucellosis is diagnosed in a laboratory by finding Brucella organisms in samples of blood or bone marrow. Also, blood tests can be done to detect antibodies against the bacteria. If this method is used, two blood samples should be collected 2 weeks apart Treatment Is there a treatment for brucellosis? Yes, but treatment can be difficult. Doctors can prescribe effective antibiotics. Usually, doxycycline and rifampin are used in combination for 6 weeks to prevent reoccurring infection Depending on the timing of treatment and severity of illness, recovery may take a few weeks to several months. Mortality is low (<2%), and is usually associated with endocarditis. Bacterial infection of respiratory system &can be isolated from the infected throat :1 – Streptococcus pyogenes ( B- hemolytic strep) 2 – staphylococcus aureus 3 – corynebacterium diphtheria 4 – Haemophilus influenza . Staphylococcus They are aerobic & facultative anaerobic, arranged in groups,non motile, ovoid or spherical in shape ( grape – like – clusters they form (white – yellow ) ,( golden yellow colonies on solid – )medium , pathogenic strains produce coagulase sugar fermentar ( glucose / lactose, manitol ) with acid production , Liquifiy gelatin , produce pus in lesion , catalase positive . species are present on basis of pigment production 1– staph aureus ( pyogens ) pathogenic ( golden –yellow ) . 2– staph albus (white ) non pathogenic . 3– staph citrus ( lemon ) non pathogenic . Pathogenicity Staph –aureus : Normally it is present on skin mucus membrane in 60% or in the nose, aerobic, produce uniform turbidity on fluid haemolysis on the blood media B- make wide zone of gar .it produces haemolysin , enterotoxin & fibrinolysin cause the majority of acute pyogenic lesion in man., tonsillitis , pharyngitis , sinusitis , pneumonia , endocarditis and food poisoning due to production of enterotoxins Characteristic of pathogenic strains of staph aureus 1 - coagulase positive . 2 - manitol - fermenter . 3 - B – haemolysis . 4 – Golden - yellow pigment . 5 – Liquify gelatin . 6- phosphate is produced * Selective & differential media used in isolation of staphylococcus 1 – ( MSA) ( manitol salt agar ), manitol fermenter which change the color from red to yellow 2 – phenol phathaline diphosphate media . Treatment : Vancomycin , cloxacillin , penicillin 3/ Post test :WRITE TRUE OR FAULSE 1-Staphylococcus produce many types of toxins e,g hemolysin. 2- Staphylococcus pyogens produce golden yellow colonies on blood agar. 3-It ferments sugars and produce acid. 4-One of the drugs used in treating of Staph aureus is penicillin. 5-Staph citrus is pathogenic bacteria. 6/ key answer:1- Pre test :- 1- post test :- 1- true . 1- true . 2- true . 2- true . 3- true . 3- true . 4- true . 4- true . 5- false . 5- false . References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :* The student will know the morphology of S. pyogens ,S. viridans , S.faecalis . * can differentiate between the three spp of Streptococcus . * understanding the source of infection. * Know the morphology of S.pnemoniae,S.viridans ,S. faecalis prevention and control. * Know how to prevent these diseases. (3) 1 / D –Instructions:• Study over view thoroughly. •. Identify the goal of this modular unit . • Do the pre test and if you :- • get 4 or more you do not need to proceed . • get less than 4you have to study this modular unit well . • After studying the text of this modular unit ,do the post test , and if you :- • get 4 or more , so go on studying modular unit 9 . • get less than 4, go back and study the first modular unit ; or any part of it ; again and then do the post test again . (5) 1 / C –Central Idea :-Morphology of the genus Streptococcus. -The dangerous of these diseases to man . -How are the diseases transmits from person to person. -The methods of controlling these diseases. (4) 2/ Performance Objectives :After studying the first modular unit , the student will be able to:1.To talk about Pneumoniae and pyogenic disease caused by S pyogenes. . 2-Know the four spp of Streptococcus.. 3-Know how to prevent these diseases . 4-Understand the source of infection. (6) 3/ Pre test :WRITE TRUE OR FAULSE 1-E.faecalis is an apportunistic pathogen. . 2-Streptolysin is atoxin produced by Streptococcus pyogens. 3-S.pneumonae is the common cause of meningitis. . 4-Treatment of S. pyogenes is by Ampicilin vial 500mg. 5-Alphae haemolytic streptococci produce greenish coloration. (7) Enterococcus faecaliS Is a Gram-positive cocci shaped bacterium that occurs in chain. Microscopically the organism is very similar to the Genus Streptococcus. At one time organisms of the genus Enterococcus was considered to be a group of Streptococcus, faecalis is a non motile, spherical bacterium. It can be observed singly, in pairs, or in short chains, The organism is commonly found in the distal end of the urethra and sometimes in the small intestine of humans and other animals. Enterococcus faecalis is an opportunistic pathogen that can cause urinary tract infections and endocarditis (an infection of the heart It is a facultative anaerobe with a fermentative metabolism.S .faecalis can often be confused with S.pneumonia . identification features that can be verified with testing. faecalis is listed as the first to the third leading cause of nosocomial infections Diagnosis by a PYR test and then the sample is plated on an Arabinose plate. The PYR test is an enzymatic test. Treatment 1- consists of a synergistic combination of aminoglycoside and cell wall-active antibiotics. In trying to prevent further antibiotic resistant strains, drug susceptibility testing is strongly recommended. 2- E. faecalis is easily treated with penicillin Streptococcus pneumoniae Both H. influenzae and S. pneumoniae can be found in the human upper respiratory system. "lancet shaped" diplococci. It has a polysaccharide capsule that acts as a virulence factor for the organism; S. pneumoniae is part of the normal upper respiratory tract flora but as with many natural flora, it can become pathogenic under the right conditions (e.g., if the immune system of the host is suppressed). Invasins such as Pneumolysin, an anti-phagocytic capsule, various adhesins and immunogenic cell wall components are all major virulence factors. S. pneumoniae is the most common cause of bacterial meningitis in adults and children, and is one of the top two isolates found in ear infection, otitis media. Pneumococcal pneumonia is more common in the very young and the very old. espite the name, the organism causes many types pneumococcal infection other than of otitis ,acute sinusitis pneumonia, including ,sepsis ,bacteremia ,meningitis ,media ,endocarditis ,septic arthritis ,osteomyelitis brain cellulitis, and ,pericarditis ,peritonitis abscess S. pneumoniae can be differentiated from Streptococcus Viridans, some of which are also S. optochin test, as alpha hemolytic, using an S. .pneumoniae is optochin sensitive pneumoniae can also be distinguished based on its sensitivity to lysis by bile. The encapsulated, coccoid gram-positive pneumococcus, is Streptococcus pneumoniae, or alpha-hemolytic, bile soluble ,gram-positive aerotolerant anaerobe and a member of the A significant human Streptococcus genus S. pneumoniae was ,pathogenic bacterium pneumonia Identification Viridans streptococci can be differentiated from Streptococcus pneumoniae using an optochin test, as Viridans streptococci are optochin resistant; they also lack either the polysaccharide-based capsule typical of S. pneumoniae or the Lancefield antigens of the pyogenic members of the genus.[3] Diagnosis of S.pneumoniae Optochin S. pneumoniae is sensitive Most of these infections occur after surgery of the abdomen or a puncturing trauma, but can also be linked to the increased use of IV’s and catheters, which are considered compromising devises. It is also responsible for urinary tract infections bacterimia, endocarditis, meningitis, and can be found in wound infections along with .many other bacteria Streptococcus viridans Viridans Streptococcus is a pseudo-taxonomic non-Linnaenan term for a large group of commensal streptococcal bacteria that are either α-hemolytic, producing a green coloration on blood agar plates (hence the name "viridans", from Latin "vĭrĭdis", green), or non-hemolytic. They possess no Lancefield antigens.[1] If they are introduced into the bloodstream they have the potential of causing endocarditis, particularly in individuals with damaged heart valves. They are the most common causes of subacute bacterial endocarditis. They can also cause necrotizing fasciitis. Pathology The organisms are most abundant in the mouth and one member of the group, S. mutans, is the etiologic agent of dental caries. Others may be involved in other mouth or gingival infections Streptococcus pyogens Genoral characters :. They are gram positive cocci arranged in chains , non motile and non sporing They require media enriched with blood serum for their growth . They are important human infection they are pathogens causing pyogenic responsible for acute rheumatic fever glomerulo – nephritis . They are aerobic or facultative anaerobes are classified on the base of hemolytic properties on blood agar plate . ( A ) Alpha hemolytic streptococci : produce ,a zone of greenish discoloration around the colony , This zone of partial lysis is 1.2 m wide with irregular margin (B) Bata hemolytic streptococci: produce sharply defined clear , colorless zone of hemolysis 2 to 4 mm wide . Streptococcus pyogenes : It is 0.5 to 1Mm & arranged in chain it is usually encapsulated Toxins : 1 – Hemolysin of two types : A – streptolysin O. B – streptolysin S. 2 – Erythrogenic toxin 3 – streptokinase 4 – deoxyribonucleases Resistance in presence of 6.5%. sodium chloride :. It grew at PH – It survives at 60c° temp for . 30min. Pathogenicity It invades tissue &may produce pyogenic lesions e.g. cystitis , vaginitis , cervicitis and subacute bacterial endocarditis . Treatment : procaine penicillin or Ampicillin deal 500mg or 250 3/ Post test :WRITE TRUE OR FAULSE 1-E.faecalis is an apportunistic pathogen. . 2-Streptolysin is atoxin produced by Streptococcus pyogens. 3-S.pneumonae is the common cause of meningitis. . 4-Treatment of S. pyogenes is by Ampicilin vial 500mg. 5-Alphae haemolytic streptococci produce greenish coloration. (7) 6/ key answer:- 1- Pre test :1_T 2- T 3-T 4-T 5-F 1- post test :- 1_ T 2- T 3-T 4-T 5-F References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/ Over view 1/A –Target population :For the student of first class in Nursing department In technical institute of ALDewaniyah (2) 1/B-Rationale :* The student will know the symptoms of tuberculosis ,Leprosy ,and gonnerhoea. * can differentiate between the three spp of Mycobacterium . * understanding the source of infection. * Know the morphology of Neisseria, prevention and control. * Know how to prevent these diseases. (3) 1 / C –Central Idea :-Morphology of the genus Mycobacterium, Nesseria spp. -The dangerous of these diseases to man . -How are the diseases transmits from person to person. -The methods of controlling these diseases. - (4) 1 / D –Instructions:• Study over view thoroughly. •. Identify the goal of this modular unit . • Do the pre test and if you :- • get 4 or more you do not need to proceed . • get less than 4you have to study this modular unit well . • After studying the text of this modular unit ,do the post test , and if you :- • get 4 or more , so go on studying modular unit 10 . • get less than 4, go back and study the first modular unit ; or any part of it ; again and then do the post test again . (5) 2/ Performance Objectives :After studying the first modular unit , the student will be able to:1.To talk about tuberculosis , leprosy , Gonnerhoea which are dangerous infectious disease. 2-Know the three spp of Mycobacterium .,Nesseria. 3-Know how to prevent these diseases . 4-Understand the source of infection. (6) 3/ Pre test :WRITE TRUE OR FAULSE 1-Mycobacterium avium infect man. 2-Tuberculosis transmits via oral droplets. 3-Mycobacterium leprae cause leprosis . 4-One of the symptoms of tuberculosis is bloody sputum. 5-Mycobacterium have branches like fungus. (7) Mycobacteria Includes bacteria which are characterized by the ability to branch ( like – fungus ) , the genus mycobacterium includes organisms responsible for tuberculosis & leprosy * Mycobacterium tuberculosis M.tuberculosis : is a slender , straight or slightly curved rod , Gm +ve , non motile , non sporing & non capsulated . * Classification It has been shown that tuberculosis in man is caused by several types of mycobacteria , the human type is M .tuberculosis , the bovine type is M. bovis and the avian type is M . avium ,which infect birds . infection with tuberculosis take place through the respiratory tract by the droplets and dust , contaminated food stuffs , skin & mucous – membranes . * Laboratory diagnosis * Microscopy of smear from sputum , pus , urine , faeces , etc. stained by ziehl – nelson method . * Diagnosis : By tuberculin ( allergen ) test used for detecting infection of children with M. tuberculosis * treatment : 1-Isoniazid . 2-Rifadin. 3-Streptomycin. Neisseria gonorrhoeae Bacterial Genitourinary Tract infections Neisseria gonorrhoeae also known as gonococcus or Gc Gram – negative diplococci , some strains called *(penicillinase –produang ) gonorrhoae or (PPNG) transmission : direct mucous membrane to mucous – membrane contact usually sexual contact , a dull to child (may indicate sexual abuse ) mother to neonate during birth Incubation period : Usually 2 -7 days but some times longer Prevention & control 1 – Avoid intercourse with infected people 2 -Vaginal &cervical cultures for pregnant women Treatment 1 – cefixime 2 – ceftriaxone 3 – ofloxacin Mycobactenum Leprae Morphology : It have many properties in common with the tubercle bacilli they are straight or slightly curved bacilli & clup-shaped swellings & granular forms. they usually occur in groups resembling packets of cigars , non motile produce neither spores non capsules & Gm +ve , the pramary infection is occur in skin & nerves for ( M. Leprae ) . * Resistance : M.Leprae are extremely resistance & survive in human corpses for several years . * Pathogenesis :. The source of infection is a sick . person , the causative agent is transmitted by the air dropld route the nasopharynx & injured skin , then it will pentrate into the nerveendings . * Pathogenesis :. The source of infection is a sick , person , the causative agent is transmitted by the air droplet route through the nasopharynx & injured skin , then it will pentrate into the nerve- endings . * Lab-diagnosis :. Specimens for exam are obtained from nasal – mucosa , scarping ( on both sides ) , sputum blood is examined during the fever period smears of blood are stained with ziehl-Nelson stain Treatment : Sulphon drugs . Nesseria meningitdis * other neisseria meningitis or meningococci , anaerobic , Gm ‾ve diplococcus , found as micr oflora of the upper respiratory tract of some people (carriers ) . . 5/ Post test :Q1\ Q2\ Q3\ Q4\ Q5\ What is the shape of the bacteria M.Leprae ? How is Nesseria transmmit from person to person ? Nesseria m eningitidis cause adisease called ? What organism does Mycobacterium avium infect ? What is the treatment lf M.Leprae ? 6/ key answer:1- Pre test :- 1- post test :- 1_ true 1_ group like a packet of cigars . 2_ by mucous to a) Mucous membrane contact . b) Sexual contact . 3_ cause mennagitis . 4_ infect birds . 5_ sulphon drugs . 2_ true 3_ true 4_ true 5_ true References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :- The student will know the morphology of the bacteria Clostridium tetani, resistance pathogenesis , lab diagnosis, toxin and treatment . 1 / C –Central Idea :- -Identification of the bacteria Clostridium tetani , spore shape ,toxin production , how is the disease transmits from person to person , prevention , treatment and control. 1 / D –Instructions:1.Study over view thoroughly. 2.Identify the goal of this modular unit . 3.Do the pre test and if you :•get 2 or more you do not need to proceed . •get less than 3 you have to study this modular unit well . 4.After studying the text of this modular unit ,do the post test , and if you :- •get 3 or more , so go on studying modular unit 11 . •get less than 3 , go back and study the 10th modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the first modular unit , the student will be able to:1.To .know the shape of the bacteria Clostridium tetani . 2-Know the shape of the spore. 3-Know how the infection occur and how is the disease transmit from one to other . 4-Understand how to prevent and control the disease . 3/ Pre test :Circle the correct answer : - 1-clostridium tetani is : a-spore former bacteria. B-non spore former. 2-Clostridium tetani have:a-circular shape. b-Drum stick shape. Introduction : 4/ The Text Clostridium tetani morphology : it is a thin motile rod , it has • peritrichous flagellation & contains granular inclusions which occur centrally and at the ends of the cell . it produce round terminal spores , Gm+ ve drum – stick shape . . . (10) Resistance : vegetative cells of the tetanus organism withstand a temperature of 60-70c° for 30 min & are destroyed quite rapidly by all disinfectants ,the spores are very resistance . direct sunlight destroys them in 3 – 5 days . * Pathogenesis : the sources of the infection are the healthy people whose discharge the organism in their feaces into the soil , the spores may be spread in dust , carried into houses & fall on clothes , underwear , footwear & other objects. * Lab-diagnosis Is usually not carried out because clinical symptoms of the disease are self – evident , soil & dust dressing . * Toxin : produce neurotoxin → tetanospasmin which cause tetanus . * Treatment penicillin in high dose , & antitoxiod serum . 5/ Post test :. Circle the correct answer:1- Clostridium tetani caused: a-Tetanus . b-gas gangrene. . 2-The infective stage of clostridium tetani is a-cyst b-spore. 6/ key answer:1- Pre test :- 1-a 2- b 1- post test :- 1-a 2-b References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :* The student will know the symptoms of gas gangrene . * can differentiate between the three clinical forms of the bacteria Anthrax bacilli . * understanding the source of infection. * Know the morphology of Anthrax bacilli prevention and control. * Know the morphology of Clostridium perfringes * Know how to prevent these diseases. 1 / C –Central Idea :- -Morphology of the bacteria Anthrax bacilli ,Clostridium perfringes. -The dangerous of these diseases to man . -How are the diseases transmits from person to person. -The methods of controlling these diseases. 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :• get 4 or more you do not need to proceed . • get less than 4you have to study this modular unit well • After studying the text of this modular unit ,do the post test , and if you :• get 4 or more , so go on studying modular unit 10 . • get less than 4, go back and study the first modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the first modular unit , the student will be able to:- 1.To talk about Gas gangrene and Anthrax bacilli. 2-Know the three clinical forms of Anthrax bacilli . 3-Know how to prevent these diseases . 4-Understand the source of infection. 5-Know the shape of Clostridium perfringes spores. 3/ Pre test :WRITE TRUE OR FAULSE 1- Treatment of Anthrax occur by anti anthrax globulin . 2- Gas gangrene is caused by Clostridium tetani. 3- Anthrax is atypicaly zoonosis disease. 4- Anthrax occur s in three clinical forms . 5- Clostridium perfringes is spore former . Gas gangrene Gas gangrene is a bacterial infection that produces gas within tissues . it is a deadly from of gangrene usually caused by Clostridium perfringens bacteria . Infection spreads rapidly as the gases produced by bacteria expand and infiltrate healthy tissue in the vicinity . because of its ability to quickly spread to surrounding tissues gas gangrene should be treated as a medical emergency . Gas gangrene is caused by a bacterial exotoxinproducing clostridial species which are mostly found in soil and other anaerobes ( e.g. Bacteroides and anaerobic streptococci ) . These environmental bacteria may enter the muscle through a wound and subsequently proliferate in necrotic tissue and to toxemia and shock is often very rapid . secrete powerful gas at the same time . a gas composition of 5.9 % hydrogen 3.4% carbon dioxide , 74.5% nitrogen and16.1% oxygen was reported in one clinical case . Gas gangrene can cause necrosis gas production and sepsis . progression Treatment As early as 1028 , when antibiotics had not yet been discovered fly maggots were commonly ( citation needed ) used to treat chronic wound or ulcers to prevent or arrest necrotic spread as some species of maggots consume only dead flesh leaving nearby living tissue unaffected . This practice largely died out after the introduction of antibiotics acetonitrite ( citation needed ) and enzyme to the range of treatments for wounds . Recently however maggot therapy has regained some credulity and is sometimes employed with great efficacy in cases of chronic tissue necrosis . In modern times treatment is usually surgical debridement and excision with amputation is necessary in many cases . antibiotics alone not effective because they do not penetrate ischemic muscles sufficiently Anthrax bacilli * Morphology : They are large organisms measuring ( 3 – 5 ) mcm in length and 1-1.2 cmc in breadth they occur in pairs or in short chains , non motile out side the host ′s body , they produce oval – shaped central spores , no spores are produced in the 43°c & below 15°c . * Pathogenesis : Anthrax is atypical zoonosis human acquired the disease from sick animals or articles & clothes manufactured from contaminated raw sheep skin ( coats , hate , in summer infection transmitted by blood – sucking insects . * Anthrax occurs in three main clinical forms : 1- cutaneus . 2- respiratory . 3- Intestinal . * Lab- diagnosis : Examined of sputum , urine , faeces , blood in case of septicaemia & deep layer of oedema tous area . * Treatment : I.M . injection of antianthrax globulin & uses of antibiotics & using of penicillin Tetrayclinc & streptomycin . 5/ Post test :. WRITE TRUE OR FAULSE 1- Treatment of Anthrax occur by anti anthrax globulin . 2- Gas gangrene is caused by Clostridium tetani. 3- Anthrax is atypicaly zoonosis disease. 4- Anthrax occur s in three clinical forms . 5- Clostridium perfringes is spore former . 6/ key answer:1- Pre test :- 1- post test :- 1- true 1- true 2- false 2- false 3- true 3- true 4- true 5- true 4- true 5- true References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :* The student will know the Enterobacteriacea * Know the bacteria salmonella typhi and paratyphi . *Know how to diagnose each one. * Know how to prevent and control these diseases. 1 / C –Central Idea :- - KNOW the intestinal bacteria types. -The morphology of pathogenic intestinal bacteria. -Know salmonella group ,s. typhi ,s.paratyphi ,s.typhimurium.What is the infective stage. -How to control and prevent these diseases. 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :• get 4 or more you do not need to proceed . • get less than 4you have to study this modular unit well • After studying the text of this modular unit ,do the post test , and if you :• get 4 or more , so go on studying modular unit 14 . • get less than 4, go back and study the 13 modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the first modular unit , the student will be able to:1. To know the pathogenesis of the intestinal entrobacteriacea. 2-Know the diagnosis of each one. 3-Know how to prevent these diseases 4-Understand the method of controlling these diseases. . 3/ Pre test :WRITE TRUE OR FAULSE 1-Shigellosis is caused by Shigella dysentriae 2-The infection occur by oral fecal route . 3- E.coli is normal flora in the intestine of man 4-Shigella is lactose fermenter bacteria. 5-Flagellar antigen is one of E.coli antigen called F antigen . Bacillary dysentery Bacillary dysentery is a type of dysentery, and is a severe form of shigellosis. Bacillary dysentery is associated with species of bacteria from the Enterobacteriaceae family The term is usually restricted to Shigella infections Shigellosis is caused by one of several types of Shigella bacteria Three species are associated with bacillary dysentery : Shigella sonnei, Shigella flexneri and Shigella dysenteriae One study in China indicated that Shigella flexneri 2a was the most common serotype Salmonellosis caused by Salmonella enterica (serovar ) Typhimurium has also been described as a cause of bacillary dysentery,though this definition is less common. It is sometimes listed as an explicit . Differential diagnosis of bacillary dysentery, as opposed to a cause Bacillary dysentery should not be confused with diarrhea caused by a bacterial infection. One characteristic of bacillary dysentery is blood in stool which is the result of invasion of the mucosa by the pathogen. By contrast, conditions such as Campylobacteriosis causes diarrhea, but usually not bloody diarrhea. Pathogenesis Humans may get the infection by ingesting food or drink contaminated by feces from carriers of the bacteria. The organism infects the epithelial cells of the terminal ileum and colon and multiply inside them. The distal part is severely infected. The inflammatory reaction is cause by the rushing of T-cells to the infected site. Treatment Dysentery is initially managed by maintaining fluid intake using oral dehydration therapy. If this treatment cannot be adequately maintained due to vomiting or the profuseness of diarrhea, hospital admission may be required for intravenous Treatment fluid replacement. Ideally, no antimicrobial therapy should be administered until microbiological microscopy and culture studies have established the specific infection involved. When laboratory services are not available, it may be necessary to administer a combination of drugs, including an amoebicida drug to kill the parasite and an antibiotic to treat any associated bacterial infection. Anyone with bloody diarrhea needs immediate medical help. Treatment often starts with an oral dehydrating solution -- water mixed with salt and carbohydrates - to prevent dehydration. No vaccine is available. There are several Shigella vaccine candidates in various stages of development that could reduce the incidence of dysentery in endemic countries, as well as in travelers suffering from traveler's diarrhea Enteric bacteria There are normal flora present in the intestine of man , there are two types : 1- Lactose fermenter e.g Escherichia coli Klebsiella Spp 2- Non- latose fermenter e.g PseudomonaSPP , shigella SPP , salmonella SPP ,both are pathogenic to intestine . Esherichia coli * Morphology : Gm –ve bacilli rod shaped , motile , lactose – fermenter , live normally in intestine , culture aerobically in blood & macconkey agar & produce endotoxin , not used citrate as source of energy , urease -ve * Antigenic – structure 1234- somatic antigen O . surface antigen K . flagellar antigen H . fimbriae antigen F . toxin production : 1- produce end toxin inside bacteria & exotoxin ( out – side – bacteria ) & entorotoxinogenic E . coli . 2-haomolysin ( B.hemelysis ). pathogenicity : 1- gastro enteritis : certain type cause of diarrhea infant a company with vomiting & fever . 2- U.T.I : ( urinary – tract – infection ) Cystitis , urinary obstruction , 3- pyogenic infection , wound infection , abscess , septicaemia , meningitis , cholecystitis . * Lab – diagnosis specimen of urine , stool , pus , blood , C.S.F swab , is inoculated on blood or macconkey agar, colonies are pink on MaCc due to lactose ferment . Treatment * sulfonamide , trimetheprim useful in U.T.I & Garamycin . * E . coli is useful as an indicator of water contamination with bacteria * two general type of E . coli * enterohemorrhagic E.coli ( EHEC ) diarrhea Characteristics : hemorrhagic , watery diarrhea , abdominal pain , no fever , about 5% of the infected people is children under 5 ages & the elderly 4-develop hemolytic – uremic syndrome ( HUS ) with anemia , low platelet count , & kidney failure . * Pathogen : E.coli O 157 : H7 ( cell wall antigen ) If is Gm-ve bacilli that produce cytotoxins called shigella like toxins which resembles shigella dysentery toxins . * Reservoirs : cattle , also infected humans . * Transmission : fecal-oral rout , inadequately cooked , fecally contaminated beef unpasteurized , milk , person to person , fecally contaminated Wales . * Incubation period : 3 to 8 days , usually 3 to 4 days. * prevention & control 1- minimize contamination of meat by animal intestinal contents during slaughtering process 2- pasteurization of milk . 3- adequate cooking of food . * Diagnosis : E . coli O 157 = H7 infection should be suspected to any patient with bloody diarrhea , stool specimens cultivated an macc agar * treatment : fluid & electrolyte replacement don’t use antimicrobial agents in treatment of E . coli 157 = H7 . B : Enterotoxigenic E . coli ETEC diarrhea * characteristic : watery diarrhea with or with out mucus or blood , vomiting , abdominal cramping , dehydration & low grade , fever may occur , * pathogens : many different serotype of enterotoxigenic E. coli that produce either a heat labile toxin , a heat stable – toxin , or both toxin . * Reservoir : infected human * transmission : fecal oral route , ingestion of fecally contaminated food or water . * Incubation period : 10 to 72 hrs . Prevention & control 1- avoid salads & uncooked vegetables . 2- eat only cooked foods . 3- don’t eat food from or by street vendors . 4- proper sewage disposal & water treatment . 5- hand washing * diagnosis Isolation of organism from stool specimen followed by demonstration of 5 – enter toxin production , DNA probe techniques Treatment fluid & electrolyte replacement therapy , bland diet , drugs 1- sulfamethoxazole or tetracycline may be a value & trimetheprim . and Shigella sonnei is mannitol and ornithine positive, and is also late lactose fermentor (ONPG positive). Some Shigella species are capable of producing indole. slant and acidic butt with no gas or H2S production. Following incubation on SIM, the culture appears non-motile with no H2S production.Addition of Kovac's reagent to the SIM tube following growth typically indicates no indole formation (serotypes 2 , 7 and 8 produce indole ]). It's noteworthy that Shigella flexneri will produce acid and gas from glucose, Diagnosis A stool specimen is Gram-stained to show Gramnegative rods, with no particular arrangement. Enrichment is performed by growing the organisms on Selenite-F broth. Then, since the specimen is not sterile, the use of selective plates is mandatory. XLD agar, DCA agar, or HE agar are inoculated and colonies are colorless on all of them as the organism is non-lactose a fermentor. Inoculation of a TSI slant shows an alkaline Shigella dysenteriae is a species of the rod-shaped bacterial genus Shigella , Shigella can cause shigellosis (bacillary dysentery). Shigellae are Gramnegative, non-spore-forming, facultatively anaerobic, non-motile bacteria S. dysenteriae, spread by contaminated water and food, causes the most severe dysentery because of its potent and deadly Shiga toxin, but other species may also be dysentery agents . Contamination is often caused by bacteria on unwashed hands during food preparation, or soiled hands reaching the mouth . Shigella dysenteriae Scientific classification Kingdom: Bacteria Phylum: Proteobacteria Class: Gamma Proteobacteria Order: Enterobacteriales Family: Enterobacteriaceae Genus: Shigella Species: S. dysenteriae Binomial name Shigella dysenteriae (Shiga 1897) Castellani & Chalmers 1919 and Shigella sonnei is mannitol and ornithine positive, and is also late lactose fermentor (ONPG positive). Some Shigella species are capable of pro ducing indole. slant and acidic butt with no gas or H2S production. Following incubation on SIM, the culture appears non-motile with no H2S production. Addition of Kovac's reagent to the SIM tube following growth typically indicates no indole formation (serotypes 2, 7 and 8 produce indole It's noteworthy that Shigella flexneri will produce acid and gas from glucose, Diagnosis A stool specimen is Gram-stained to show Gramnegative rods,with no particular arrangement. Enrichment is performed by growing the organisms on Selenite-F broth. Then, since the specimen is not sterile, the use of selective plates is mandatory. XLD agar, DCA agar, or HE agar are inoculated and colonies are colorless on all of them as the organismis non-lactose a fermentor. Inoculation of a TSI slant shows an alkaline Shigella dysenteriae is a species of the rodshaped bacterial genus Shigella Shigella can cause shigellosis (bacillary dysentery). Shigellae are Gram-negative, non-spore-forming, facultatively anaerobic, non-motile bacteria S. dysenteriae, spread by contaminated water and food, causes the most severe dysentery because of its potent and deadly Shiga toxin, but other species may also be dysentery agents . often caused by bacteria on unwashed hands during food preparation, or soiled hands reaching the mouth . 3/ Post test :WRITE TRUE OR FAULSE 1-Shigellosis is caused by Shigella dysentriae 2-The infection occur by oral fecal route . 3-E.coli is normal flora in the intestine of man. 4-Shigella is lactose fermenter bacteria. 5-Flagellar antigen is one of E.coli called F antigen . 6/ key answer:1- Pre test :1_ true 1- post test :1_ true 2_ true 2_ true 3_ true 3_ true 4_ false 4_ false 5_ false 5_ false References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :- The student will know the intestinal flagellates, the shape, diagnosis prevention& treatment. Know the symptoms of the disease that caused by the parasite and howto prevent & control it.the pathogenicity and clinical presentations 1 / C –Central Idea :-Studying the disease pertussis . -Taking vaccine for this disease in suitable time. -Know how to prevent and control it . 1 / D –Instructions:1.Study over view thoroughly. 2.Identify the goal of this modular unit . 3.Do the pre test and if you :4.get 4 or more you do not need to proceed . 5.get less than 4 you have to study this modular unit well . 6.After studying the text of this modular unit ,do the post test , and if you :- 7.get 4 or more , so go on studying modular unit two . 8.get less than 4 , go back and study the first modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the first modular unit , the student will be able to:1.To know the source of infection. 2-Define pertussis ,and know how anthrax bacilli transmitted in summer, 3-Know how to prevent and control these diseases . 4-Understand the benefit of vaccine 5-Avoid direct contact with animals. . 3/ Pre test :- write yes or no 1-Bordetela infect children more than adults. 2-pertussis is adisease caused by borellia 3-whooping cough is skin Disease. 4-The is no vaccine for whooping cough 5-Bordetella is gram negative bacteria .. Brucella Brucellosis is an infectious disease caused by the bacteria of the genus Brucella. These bacteria are primarily passed among animals, and they cause disease in many different vertebrates. Various Brucella species affect sheep, goats, cattle, deer, elk, pigs, dogs, and several other animals. Humans become infected by coming in contact with animals or animal products that are contaminated with these bacteria. In humans brucellosis can cause a range of symptoms that are similar to the flu and may include fever, sweats, headaches, back pains, and physical weakness. Severe infections of the central nervous systems or lining of the heart may occur. Brucellosis can also cause long-lasting or chronic symptoms that include recurrent fevers, joint pain, and fatigue. Can brucellosis be spread from person to person? Direct person-to-person spread of brucellosis is extremely rare . Mothers who are breast-feeding may transmit the infection to their infants. Sexual transmission has also been reported. Forboth sexual and breast-feeding transmission, if the infant or person at risk is treated for brucellosis, their risk of becoming infected will probably be eliminated within 3 days. Although uncommon, transmission may also occur via contaminated tissue transplantation . Diagnoses Brucellosis is diagnosed in a laboratory by finding Brucella organisms in samples of blood or bone marrow. Also, blood tests can be done to detect antibodies against the bacteria. If this method is used, two blood samples should be collected 2 weeks apart Treatment Is there a treatment for brucellosis? Yes, but treatment can be difficult. Doctors can prescribe effective antibiotics. Usually, doxycycline and rifampin are used in combination for 6 weeks to prevent reoccurring infection Depending on the timing of treatment and severity of illness, recovery may take a few weeks to several months. Mortality is low (<2%), and is usually associated with endocarditis. * whooping , cough , pertusis Characterispus : A highly contagious , acute bacterial chilled hood (usually ) infection , the first stage of the prodromal stage , the second stage the paroxysmal stage produce severe , uncontrollable coughing the coughing often ends in a prolonged , high pitched , deeply indrawn breath , the third with 4 weeks of onset * pathogens : pertussis is caused by Bordetella pertussis , a small , encapsulated , non- motile , Gramˉ negative coccobacillus that produces endotoxin & exotoxins . * Reservoir : Humans * Transmission : Airborne via droplets produced by coughing . * Incubation period : 6- 20 days * Epidemiology : Worldwide occurrence . * Prevention & control : 1- Vaccination of all young children with ‹ DTP › ( diphtheria , tetanus , pertussis ) . 2- Droplet precaution for hospitalized patients . * diagnosis : Nasopharyngel aspiratos or swabs should be sent to the microbiology laboratory special media , such as ( apotato –based medium ) Anthrax bacilli * Morphology : They are large organisms measuring ( 3 – 5 ) mcm in length and 1-1.2 cmc in breadth they occur in pairs or in short chains , non motile out side the host ′s body , they produce oval – shaped central spores , no spores are produced in the 43°c & below 15°c . * Pathogenesis : Anthrax is atypical zoonosis human acquired the disease from sick animals or articles & clothes manufactured from contaminated raw sheep skin ( coats , hate , in summer infection transmitted by blood – sucking insects . * Anthrax occurs in three main clinical forms : 1- cutaneus . 2- respiratory . 3- Intestinal . * Lab- diagnosis : Examined of sputum , urine , faeces , blood in case of septicaemia & deep layer of oedema tous area . * Treatment : I.M . injection of antianthrax globulin & uses of antibiotics & using of penicillin Tetrayclinc & streptomycin . Post test write yes or no :1-the incubation period of pertussis is between (620). 2 There is no vaccine against this disease. Note - Check your answers in key answer page at the end. 6/ key answer:1- Post test :- 1-yes 2-no . 1- pre test :- 1- yes 2- yes 3- no 4- no 5- yes. References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :* The student will know the morphology of the bacteria Vibrio cholera. * can isolate and identify this bacteria. * Know the morphology of Vibrio cholerae and the position of the spore. * Know how to treat and control this disease. 1 / C –Central Idea :- - The general character of the bacteria Vibrio cholerae . - The pathogenesis and diseases caused by it. - The morphology of it and the position of the flagella . 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :• get 4 or more you do not need to proceed . • get less than 4you have to study this modular unit well • After studying the text of this modular unit ,do the post test , and if you :• get 4 or more , so go on studying modular unit 16 . • get less than 4, go back and study the 15 modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying this modular unit , the student will be able to:- 1.To know the morphology of the bacteria vibrio cholera. 2-Understand the method of controlling and treatment. 3-Know the general characters of this bacteria. 3/ Pre test :WRITE TRUE OR FAULSE 1-Vibrio cholera has comma shape. 2-The symptoms of cholera is watery diarrhea. 3-Vibrio can treated by dehydration oral salts. 4-Flagella is the organ of locomotion in vibrio. 5-Vibrio has peritrichous flagella is the organ of locomotion. Vibrio cholerae (also Kommabacillus) is a gram negative comma shaped bacterium with a polar flagellum that causes cholera in humans , V. cholerae and other species of the genus Vibrio belong to the gamma subdivision of the Proteobacteria. There are two major biotypes of V. cholerae, classical and El Tor, and numerous other serogroups. Cholera is a diarrhoeal disease caused by Vibrio cholera. Children as well as adults can get infected. Among those infected, about 20% develop acute watery diarrhea, of which 10-20% develop severe watery diarrhea with vomiting. The mainstay of treatment is dehydration and up to 80% of cholera cases can be treated successfully using only oral dehydration salts. V. cholerae was first isolated as the cause of cholera by Italian anatomist Filippo Pacini in 1854, but his discovery was not widely known until Robert Koch, working independently thirty years later, publicized the knowledge and the means of fighting the disease prevention and control The current response to cholera outbreaks tends to be reactive, in the form of an emergency response. While this approach prevents many deaths, it fails to prevent cases of cholera. The importance of medium- and long-term prevention activities in cholera control should therefore be emphasized. the need to obtain better data and ensure greater information sharing; the adoption of a coordinated multi sectoral approach; efforts to improve sanitation and sewage disposal; the need to ensure political commitment and community involvement. The importance of medium- and long-term prevention activities in cholera control should therefore be emphasized. The capacity for disease prevention, epidemic preparedness, and emergency response varies greatly among countries. Regional strategies are needed to ensure that all countries have the capacity to deal with these issues. Among the priorities are: Treatment of cholera Surveillance systems Sensitive surveillance and prompt reporting contribute to the rapid containment of cholera epidemics. In many endemic countries, cholera is a seasonal disease, occurring every year usually during the rainy season. Surveillance systems can provide an early alert to outbreaks, which should lead to a coordinated response, and assist in the preparation of preparedness plans. As part of an integrated surveillance system, an efficient cholera surveillance system can also improve the risk assessment for potential cholera outbreaks. Understanding the seasonality and location of outbreaks will provide guidance for improving cholera control activities for the most vulnerable. This will also contribute to developing indicators for appropriate use of oral cholera vaccines. significantly decrease mortality; when applied properly, case-fatality rate should be below 1%. In untreated cases the case fatality ratemay reach 30-50%. These levels are often observed in crisis situations with overcrowding, limited access to health care, and precarious environmental management. 3/ Post test :WRITE TRUE OR FAULSE 1- Vibrio cholera has comma shape. 2- The symptoms of cholera is watery diarrhea. 3- Vibrio can treated by dehydration oral salts. 4- Flagella is the organ of locomotion in vibrio. 5- Vibrio has peritrichous flagella is the organ of locomotion. 6/ key answer:1- Pre test :- 1- post test :- 1- true . 1- true . 2- true . 2- true . 3- true . 3- true . 4- true . 4- true . 5- true . 5- true . 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :- The student will know the morphology , pathogenesis , diagnosis and treatment. Know the symptoms of the disease that caused by the bacteria Treponema pallidum and howto prevent & control it.and the clinical presentations 1 / C –Central Idea :- -Identification of the bacteria Treponema pallidum and Leptospira ,epidemiology,pathogenicity&treatment &how is the disease transmit from person to person . 1 / D –Instructions:1. Study over view thoroughly. 2. Identify the goal of this modular unit . 3. Do the pre test and if you :- 4. get 4 or more you do not need to proceed . 5. get less than 4 you have to study this modular unit well . 6. After studying the text of this modular unit ,do the post test , and if you :- 7. get 4 or more , so go on studying modular unit two . 8. get less than 4 , go back and study the first modular unit ; or any part of it ; again and then do the post test again . (5) 2/ Performance Objectives :After studying the first modular unit , the student will be able to:1.To know the morphology of these bacteria . 2-Know the three stages of syphilis . 3-Know the pathogenesis of Leptospira . 4-Know how to prevent and control these diseases. (6) 3/ Pre test :Answer the following questions :Q1: What is the morphology of the bacteria Treponema pallidum ? Q2: Nunmerate the stages of syphilis ? Q3: How is syphilis transmits from person to person ? Q4: What is the disease caused by Leptospira ? Q5: Which organism did Leptospira interrogans infect ? (7) Causative agent of syphilis Treponame pallidum * Morphology : They are spiral threads with 8- 14 small & uniform convolutions , it have a cytoplasm membrane consisting of three layers , motile , and stain poorly with dyes , they are stained light-pink . * Cultivation : It doesn’t grow on ordinary – media but grows at 35°c under anaerobe condition . * Pathoyenesis & disease in man : Person affected with the disease are sources of infection , the disease is transmitted via the genital organs & by contaminated dishes & other objects . The causative agent localizes at first in the mucous membranes of the genital – organs & mouth and the skin , syphilis may also be transmitted through the placenta . ( congenital syphilis ) , three periods of syphilis are distinguished . 1- Primary syphilis : Develops after a variable incubation period 2 wk to 3 months ( average 21-24 days ) it is charactenzed by the formation of a primary syphiloma , a hard infiltrate with an erosion or ulceration on its surface at the point where the treponema enters the body . then enlarged & hard lymph nodes this stage lasts for 6 weeks . 2- secondary syphilis : characterized by eruptions on the skin & mucous membranes & the development of specific lesions in the internal organs , bones , & peripheral & central nervous system , this period may vary form 2-3 to several years . 3- Tertiary syphilis : It is characterized by the production of papules , tubercles , gummas or gummatous infiltrates in the skin , the lesions have a tendency to produce necrosis , this period persists for several years . In some cases , progressive paralysis or tabes dorsalis develops after 9 -10 years . a large number of treponemas are present in the brain tissue during time period & cause deep organic changes in the central nervous system . * Laboratory diagnosis : Microscopic examination of ulcer , erosion or papule discharge or material obtained by puncture of the regional lymph nodes is perfumed during the primary & secondary stages . * Pathogenic leptospirae It is responsible for a disease leptospirosis or ( lepto spiral , jundice ) , the causative agent of leptospirosis are several serological groups & types of leptospira e,g L . canicola , L .pomona . * Morphology : they are small closely coiled spirals from ( 12- 18 ) per organism & resemble a tightly wound spring with thick hooked ends . they stain poorly with aniline dyes , light pink , they able to form C & S forms . * Pathogenesis & disease in man : rats are the source of infection , which discharge leptospira into the environment , water , soil , objects & food stuff with the urine . * Pathogencity from animals : L. interrogans is pathogenic for rats , rodent and cattle . 3/ Post test :Answer the following questions :Q1: What is the morphology of the bacteria Treponema pallidum ? Q2: Nunmerate the stages of syphilis ? Q3: How is syphilis transmits from person to person ? Q4: What is the disease caused by Leptospira ? Q5: Which organism did Leptospira interrogans infect ? (7) 6/ key answer:1- pre test :- 1- spiral threads. 2-three stages . 3-Via the gemnital organs and contaminated objects . 4-Leptospirosis. 5-Infect rats ,rodents ,and cattles . 1- post test :- 1- spiral threads. 2-three stages . 3-Via the gemnital organs and contaminated objects . 4-Leptospirosis. 5-Infect rats ,rodents ,and cattles . References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :* The student will know the fungal infection. * can differentiate between the three species of dermatomycosis. * understanding the meaning of mycelium. * Know the morphology of candida albicans. * Know how to prevent these diseases. 1 / C –Central Idea :- -Morphology of the fungi. -The dangerous of these diseases to man . -How are the diseases transmits from person to person. -The methods of controlling these diseases. 2/ Performance Objectives :After studying the first modular unit , the student will be able to:- 1.To know the morphology of fungi. 2-Know the spp of dermatomycosis. 3-Know the pathogenesis of Candida albicans. 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :• get 4 or more you do not need to proceed . • get less than 4you have to study this modular unit well • After studying the text of this modular unit ,do the post test , and if you :• get 4 or more , so go on studying modular unit 18 . • get less than 4, go back and study the 17th modular unit ; or any part of it ; again and then do the post test again . 3/ Pre test :Fill in the blanks with suaitable words 1- Mycology is science study------------. 2-Candida albicans is ---------------- fungi . 3- Group of hyphae called ------------. 4-Trichophyton infect -------- and ----------and ------- . 5-Candida albicans cause variety of disorders like ----------. Mycology : science dealing with the study of fungi Mycosis : the disease which caused by fungal infection. * Fungi : are eucaryotic microorganism does not have chlorophyll composed of filament called ( hyphae ), septate or non septate , cell wall composed of cellulose , group of hyphae called Epidermophyton ( mycelium ), the fungi can be classified depending on morphology into : 1- mould 2- yeast 3- yeast like fungi 4- Dimorphic fungi. e.g Candida albicans cause candidiasis Candida albicans It is oval , budding , yeast like fungi 2-5 Mm in diameter characterized by presence of pseudohyphae ( non septate projection from the yeast like cells ) it is normally found in the upper respiratory tract , mouth, intestine , female genital tract & on the skin of healthy people ( as normal flora ,and become pathogenic when there is malnutrition , diabetes , and after using broad spectrum antibiotics. and use of oral contraceptives . * pathogenesis *It cause a wide variety of disorder such as 1- Thrush 2- Vulvo – vaginitis . 3- monilial enteritis 4- Dermatitis . 5- Bronchial infection 6- Candida endocarditis * Lab – diagnosis * ( in urine , stool ) Direct exam of urine sediment or direct smear of stool or swabs & scraping from the surface of the lesions The cell of yeast are oval 2-5 Mm in diameter have pseudohyphae, take Gm+ve stain strongly it is easily recognized in stained film . Or sabarouds agar gives moist creamy colonies . Dermatomycosis : Are superficial infection of skin,hair, nail by three general fungi :1- Trichophyton → invade skin , hair , nail 2- Epidermophyton → not infect hair ( invade skin & nail ) 3- microsporum → not infect nail ( invade skin & hair ) * The different between the 3 genera does by the feature of macroconidia which is either : Microsporum 1- cylindrical – shape . 2- pear – shape . 3- boat – shape . 3/ Post test :Fill in the blanks with suaitable words 1- Mycology is science study------------. 2-Candida albicans is ---------------- fungi . 3- Group of hyphae called ------------. 4-Trichophyton infect -------- and ----------and ------- . 5-Candida albicans cause variety of disorders like --------- 6/ key answer:1- Pre test : 1- Post test : 1- fungi . 1- fungi . 2-yeast like fungi. 2-yeast like fungi. 3- mycelium. 3- mycelium. 4- hair and skin and nails. 4- hair and skin and nails. 5- thrush, Volvo vaginitis. 5- thrush, Volvo vaginitis. References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :* The student will know the antigen and antibody . * can differentiate between the different type of immunoglobulin. * understanding the meaning of serology and immunity . 1 / C –Central Idea :- -The student know the component of immune system. -The relation between the Ag & Ab. -Know the innate and acquired immunity. -The types of immunoglobulin. 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :• get 4 or more you do not need to proceed . • get less than 4you have to study this modular unit well • After studying the text of this modular unit ,do the post test , and if you :• get 4 or more , so go on studying modular unit 19 . • get less than 4, go back and study the 17th modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the first modular unit , the student will be able to:- 1.To know the innate and acquired immunity. 2-Know the types of immunoglobulin . 3-Know the component of central immune system and peripheral immune system. 3/ Pre test :Fill in the blanks with suaitable words 1-Antigen is ----------- 2-Serology is ---------- . 3-Active acquired immunity is----------- . 4-The central immune system include-----------. 5-Antigen antibody reaction called-------------- . Immunity & Resistance Serology :. Science deals with the study of serum & other constituents . Serum :. Defibrinated plasma Immunology :. Science dealing with the study of body resistance to infection Immunity :. Specific resistance of host (man) against antigenic factors ( infection ) * Immunity generally can be classified in to : * Innate immunity :. Natural resistance to infection which has been found in the body and doesn’t depend on direct antigen contact . Active acquired immunity :. Resistance which has been develops after direct contact with the antigen (Ag) . * Passive acquired immunity :. Resistance which has been developed in the body after giving anti body ( A b ) . Immune system : . consisting from organs which are responsible for production of lymphocytes : A – Microphage . B – Macrophage . ( Immune system ) Central immune system 1 – bone-marrow node 2 – Thymus 3 –bursa pitches peripheral immune system 1 – Lymph 2 – Tonsils 3 – payers In fetal ( liver & spleen ) * Antibody (Ab) :. they are glycoprotein substance which produced as response to the antigenic stimulation & have the ability to bind with antigen . * Antigen (Ag) :. They are foreign substance ( protein ) when enter to the body have the ability to induce an immune response such as production of antibodies . Immunity ↓ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ↓ ↓ ) Innate ( Natural Acquired ↓ ↓ ـــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــ ↓ ↓ ↓ ↓ Non specific specific passive Active ↓ ↓ ـــــــــــــــــــــ ــــــــــــــــــــ ↓ ↓ ↓ ↓ Natural Artificial Natural Artificial * Properties and antigen characters 1 – foreign. . 2 – high molecular weight more the 10,000 dalton on the size . depend 3 – large molecular surface . * Antigen & Antibody reaction :. Antigen -Ab reaction in vitro are called serological reaction . 3/ Post test :Fill in the blanks with suaitable words 1-There are many types of immunoglobulin is -------------. 2-Serology ---------------- . 3-Active acquired immunity-------------- . 4-The central immune system include---------- . 5-Antigen antibody reaction called ----------- . 6/ key answer:1- Pre test :1_ IgA - IgG - IgE 1- Pre test :- IgM - IgY 2-science deals with the study of serum and other constituents. 3-Resastance which has been developed after direct contact with the Ag . 1_ IgA - IgG - IgE IgM - IgY 2-science deals with the study of serum and other constituents. 3-Resastance which has been developed after direct contact with the Ag . 4-bone marrow ,bursa, thymus. 4-bone marrow ,bursa, thymus. 5- serological reaction. 5- serological reaction. References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :* The student will know the symptoms of Amoebic dysentry. * can differentiate between E.hitolytica and Entaemoeba coli . * understanding the differences between bacteria and parasite. * Know the protozoa, parasitisim . * Know how to prevent and control these diseases. 1 / C –Central Idea :-Morphology of the parasite Entameba histolytica and E.coli . -The dangerous of the parasitic diseases to man. -How are the diseases transmits from person to person. -The methods of controlling these diseases. 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :• get 4 or more you do not need to proceed . • get less than 4you have to study this modular unit well • After studying the text of this modular unit ,do the post test , and if you :• get 4 or more , so go on studying modular unit 21 . • get less than 4, go back and study the 19 &20 modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the first modular unit , the student will be able to:- 1.To talk about Dysentery ,especially amoebic dysentery , 2-Know the two parasite E.histolytica and E.coli. 3-Know how to prevent parasitic diseases . 4-Understand the source of infection. 5-Know the classification of parasites. . 3/ Pre test :Choose the correct answer for Q1,2.3 Q1\ Parasitology is : A- study bacteria B-study parasite. ? Q2\The infective stage of Enta coli is the: A-cyst B-Mature cyst. Q3-the trophozoit of Enta histolytica contain A- vacuoles with R.B.C B- not have . Q4\Draw the life cycle of Enta. histolytica . Q5\How can you diagnose Amoeba ? Parasitology Branch of biology deals with the study of parasite & parasitism . * Parasite :.organisms which have adapted them selves to live in or on another organism the later is the host . Parasitism Any relation between two organism in which one of them is completely depended on the other permanently or temporarily Infection : .Is the entrance of any microorganism to the host establishment & multiplication . * primary infection :.it is the initial any microorganism . infection of * final host :. Is the host in which found adult parasite and the sexual the occur in it . reproduction * Intermediate host :.is the host in which apart of life cycle of the parasite is completed e.g. larval stage . Ecto parasite: are those parasite which live out side the body of the host Endo parasite :. Are those parasite which live inside the body of the host, parasites are either called organism e.g. protozoa or helminthes such as long worm e.g. Ascaris or arthropodes or permanent , pathogenic Classification :. The medical parasite are belong to three phyla of the animal kingdom 1-protozoa . 2- platyhelminthes . 3- Nemathelminthes . each phylum divided first into classes , these into orders families , genera & species. the generic name start with capital, the specific name small letter e.g E.hitolytica. Parasitic epidemiology Is the knowledge of the parasite, source, reservoir, animal vector and route of infection by knowledge of those infection, the control ,and prevention of the epidemic parasitic diseases become easy . The wide distribution of parasitic disease is due to simple life cycle . Transmission of parasitic disease require source of infection . Mode of infection Suitable host . Epidemic disease :. When the disease spread in anew area . Endemic disease :. Contiuous presence of the disease in an local area. protozoa They are unicellular microorganism consist from cytoplasm & nucleus and have ability to do all the metabolic activites each cell have mitochondria , Golgi apparatus and plasmic- reticulum& nucleus , the cytoplasm consist from layers 1 – ectoplasm 2 – endoplasim . the movement occurs by pseudopodia, flagella cilia, reproduction is ( sexual or asexual ), binary fission budding schizogony . Amoeba Entamoeba histolytiea Distribution :. Cosmopolitan mainly tropics & sub tropic area. Habitat :. Mucosa & sub mucosa of large intestine of .man Morphology : the parasite have two form and Trohozoit ( en cyst form ) Trophozoit : Consist of small mass of cytoplasm capable of amoeboid movement ( moved by pseudopodia ) its size ( 10 – 60 ) m ,the cytoplasm have two layers 1 – clear outer layer called ectoplasm . 2 – dense Inner layer called endoplasim nucleus contain regular arranged small granules of chromatin with large central granule called ( karyosome ) the endoplasm also contain vacuoles which contain mainly ( RBCS ) . Introduction : Intestinal protozoa Amoebic dysentry Entamoeba histolytica The cyst are round or oval in shape about ( 12 m) in diameter , the cyst are refractile & some was pearly in shape with define cyst wall ,the cyst containing one or two or four nuclei may be present in the same sample of faces. it is also contains glycogen mass & usually characterstic refractile rod like structure,with rounded ends called chromatoid bodies which they are two mostly, the mature cyst contain ( 4 nuclei)&the chromatoid bodies are disappear . * Epidemiology : The infective stage is the mature cyst which have ( 4 nuclei ), the infection occur after taking the contaminated vegetable, food & water by the infective stage of amoeba . * pathogenicity 1- Amoebic dysentery. 2- Amoebic liver abscess . * symptom :. Mucoid diarrhea . * Diagnosis :. By identification of parasite in the stool &tissue prevention & control : 1- not use un purified water . 2- Avoid house fly . 3- not eaten un cooked vegetables . 4- proper sewage of discharge. Entamoeba coli ( not pathogenic parasite ) Distribution : cosmopolitan. Habitat :Large intestine, its present in the fecal sample indicate that patient taken contaminated food or drink. Morphology:It have Trophozoit form & encyst from. Trophozoit :Large,have large nucleus, with a eccentric Karyosome,the nuclear membrane doted by rough irregular chromatin granules, the vacuoles doesn’t contain R.B.C.S. Encyst : large cyst ( 17m ) contain 8 nucleus which is the infective stage, it doesn’t contain chramatoid body or glycogen granules , the immature cyst which have less than 8 nuclei contain chromatoid bodies which taken the needle shape & have glycogen granules . * Diagnosis : depending on identification of parasite in the fecal sample & should be diffrentiatial from the Ent. Histolytica . 5/ Post test :- Choose the correct answer for Q1,2.3 . Q1\ Parasitology is : A- study bacteria B-study parasite. ? Q2\The infective stage of Enta coli is the: A-cyst B-Mature cyst. Q3-the trophozoit of Enta histolytica contain A- vacuOles with R.B.C B-NOT HAVE. Q4\Draw the life cycle of Enta.histolytica . Q5 \How can you diagnose Amoeba? 6/ key answer:1- Pre test :- 1- post test :- 1- B . 1- B . 2- B . 2- B . 3- A . 3- A . 4- Answer in page 28 . 4- Answer in page 28 . 5- Presence of the parasite in fecal sample . 5- Presence of the parasite in fecal sample . References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :- The student will know the intestinal flagellates, the shape, diagnosis prevention& treatment. Know the symptoms of the disease that caused by the parasite and howto prevent & control it.the pathogenicity and clinical presentations 1 / C –Central Idea :- -Identification of the parasite Giardialamblia,trophozoit ,cyst ,life cycle. ,epidemiology,pathogenicity&treatment &how is the disease transmit from person to person,and took care during vegetable washing. 1 / D –Instructions:1.Study over view thoroughly. 2.Identify the goal of this modular unit . 3.Do the pre test and if you :•get4 or more you do not need to proceed . •get less than4 you have to study this modular unit well . 4.After studying the text of this modular unit ,do the post test , and if you :•get 4 or more , so go on studying modular unit two . •get less than4 , go back and study the first modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the first modular unit , the student will be able to:1.To .know the shape of the parasite Giardia lamblia. 2-Know the two stages of the parasite . 3-Know the infective stage, 4-Understand how to prevent and control the disease . 3/ Pre test :Circle the correct answer : - 1- Giardia lamblia is a-bacteria b-parasite c-virus d- fungus 2- The infective stage is:a-Trophozoit b-cyst c-larvae d-cyst &trophozoit. 3- The parasite have:a-4pair of flagella. b-2pair . c-8pair . d-4 only. 4-Mature cyst have a -4 nuclei b-2 nuclei . c-6 nuclei. d-5 nuclei. 5-The trophozoit have a-Traingle shape. b-Teardrop shape. c-Circular shape. d-Oval shape. Introduction: The trophozoit has almost perfect bilateral symmetry ,it is teardrop shaped with twonuclei at the anterior end.The nuclei look like aset of eyes, the trophozoit have leaf like motility with the aid of four pair of flagella ditributed on both sides .Trophozoit also have axostyle which look like long slender , the troph attachsto intestinal epithelial cellswith a unique sucking disc The cyst form of Giardia lamblia : Is10-13 micron long slightly smaller than the trophozoit and egg shaped.An immature cyst has two nuclei and a mature cyst has four nuclei. The cyst contains remnants of the axostyle and the parabasal body,.The cyst is the infectious form of G.lamblia. Epidemiology: People are infected through ingestion of cysts in contaminated water or food or contact with feces. Life cycle : Once ingested ,the cyst travel to the distal end of the duodenum and the stomach , and the pancreatic enzymes in the duodenum stimulate excystation.Two trophozoites are released from the posterior end of each cyst. The motile trophozoites attach to the microvilli of the brush border of the small intestine with their sucking disc.In this environment the trophozoites will multiply every9-12hrs Diagnosis Testing stool sample can be done ,for detection of Giardia lamblia ,the cyst are not excreteduntil after symptoms have been present for asmall period of time. Trophozoits are present in jejunal aspirate of an infected patient. Treatment : Three drugs are comme only used to treat Giardiasis,quainacrine ,furazolidone , and metronidazole. Metronidazole is the most effective.Quinacrine is just as effective and is the least expensive but it causes vomiting in children under 5.Furazolidone is comm only used for infants because it is the only one of the three that comes in a liquid from. 5/ Post test :. Circle the correct answer:1- Giardia lamblia is a-parasite b-fungus c-virus d-bacteria. 2-The infective stage of Giardiasis is : a-cyst c-trophozoit and cyst b-trophozoit d-mature cyst. 3-Giardia have :a-square shape b-traingle shape . c-circular shape. D-teardrop shape. 4-Mature cyst have :a-4 nuclei. b-2 nuclei. c-3 nucleid- 4 pair of nuclei. 5-Giardia lamblia is one of a-blood parasite. b-intestinal parasite . c-skin parasite d-nervous system parasite. Note :check your answers in key answer page at the end . 6/ key answer:1- Pre test :1- b 2- b 3- a 4-a 5-b Quiz No. 1 Giardia lamblia is aparasite that infect intestine of man. Quiz No. 2 The infective stage is mature Quiz No. 3 The parasite have 4 pair of flagella. 1- post test :1-a 2- d 3-d 4-a 5-b References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :* The student will know the parasite Balantidium coli * Know the organ of locomation. *Know how to differniate between the trophozoit and cyst. * Know how to prevent and control this disease. . 1 / C –Central Idea :- - KNOW the intestinal ciliates. -The morphology of Balantidium coli . -What is the infective stage. -How to control and prevent balantidiasis . 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :• get 4 or more you do not need to proceed . • get less than 4you have to study this modular unit well • After studying the text of this modular unit ,do the post test , and if you :• get 4 or more , so go on studying modular unit 23 . • get less than 4, go back and study the 22 modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the first modular unit , the student will be able to:- 1-To know the two stages of Balantidium coli. 2-Know the infective stage of Balantidium coli. 3-Know how to prevent this disease . 4-Understand the invasive balantidiasis. 3/ Pre test :WRITE TRUE OR FAULSE 1-Balantidium coli is one of intestinal ciliates . 2-The infective stage is the cyst. . 3-Balantidium coli has one nucleus. . 4-One of the symptoms of balantidiasis is diarrhea. 5-Cilia is the organ of locomotion. . . Introduction Balantidium coli is a protozoan parasite responsible for the disease Balantidiasis . Balantidium coli is the largest protozoan and the only ciliate known to parasitiz Humans . Balantidium coli most commonly infects humans , other and pigs which are reservoirs of the parasite . the protozoa are bund worldwide and incidences of infection have been hooted in Bolivia Papua New Guinea , and the Philippines at usually with a prevaience of less then 1% infection is rare but is likely to occur in places where humans live closely with swine and where water sanitation is poor or non-existent Balantidium coli : are released in feces of infected hosts . consequently , Balantidium coli is transmitted by a fecal-oral route : humans are infected by ingestion of water or food contaminated by feces containing the protozoa . Balantidium coli infection is most often asymptomatic but the parasite can invade the large intestine leading to diarrhea dysentery ( bloody diarrhea ) colitis and abdominal pain . This collection of symptoms is Balantidiasis which can be treated effectively with antibiotics and can be prevented with proper hand washing practices water treatment separation of human and swine habitats and proper waste disposal . The parasite : Balantidum coli ( B. coli ) Balantidium coli is the only ciliate known to parasitize humans . Cillates represent a phylum of protozoa characterized in at least one stage of development by simple or compound ciliary organelles on the surface of their membranes that are used for locomotion, ciliates have 2 nuclel ( one macronucleus and micronucleus ), and reproduce by transverse binary finery fission , balantidium coli has 2 contractile vacuoles . Although contractile vacuoles are common to ciliates they are rare in parasitic protozoa. developmental stages : Balantidium coli has 2 a trophozoite stage and cyst stage Life cycle of Balantidium coli Balantidium coli has 2 developmental stages : a trophozoite stage and a cyst stage . The cyst is the infective stage of Balantidium coli life cycle . once the cyst is ingested via feces contaminated food or water it passes through the host digestive system . the tough cyst wall allows the to resist degradation in the acidic environment of the stomach and the basic environment of the small intestine until it reaches the large intestine . There excystation takes place excystation produces a trophozoit from the cyst stage . The motile trophozoite then resides in the lumen of the large intestine , feeding on intestinal flora and intestinal nutrients . Trophozoites multiply by asexual binary fission or sexual conjugation ( with the exchange of nuclear material ) The trophozoite may become invasive and penetrate the mucosa of the large intestine trophozoites are released with the feces and en cyst to from new cysts . Encystation takes place in the rectum of the host as feces are dehydrated or soon after the feces have been excreted . Cysts in the environment are then ready to infect another host . Diagnosis of Balantidiasis Balantidiasis is an uncommon infection . symptoms if present Includ diarrhoe , dysentery and abdominal pain .Balantidiasis should be considered if the patient works closely with pigs or other livestock lives in or has recently traveled to a region with poor water sanitation or has contact with infected persons . 1 – Balantidiasis is diagnosed by microscopic examination of a patients feces . a stool sample is collected and a wet mount is prepared .cysts or trophozoites can be detected in the feces Balantidiun coli is passed periodically there fore stool samples should be collected frequently and examined immediately in order to make a definitive diagnosis 2 – Trophozoites can also be detected in tissues In order to collect . A tissue specimen from the large intestine a sigmoidoscopy procedure is used . A thin hollow instrument called a sigmoidoscope is used to visually inspect the last sections of the large intestine the rectum and the sigmoid colon . A physician can look for blooding ulcers and inflammation in order to diagnose the cause of diarrhea and other Gl complaints and can take a tissue biopsy for inspection Treatment of Balantidisis Balantium coli infection can be treated effectively with antibiotics . Three drugs are commonly used and administered orally . They are listed below in order of recommendation . 1 – Tetracyclines 500 mg four times daily for 10 days ( contraindicated in pregnant women and children younger than 8 years of age ) . 2 – Metronidazole 750 mg three time daily for 5 days . 3 – Lodoquino 640 mg three times daily for days . * Note :. These drugs are approved by the FDA but are considered investigational for the treatment of Balantidiasis . cases of Balantidium coli infection are asymptomatic . if possible asymptomatic individuals should stick be treated in order to halt further transmission of the disease . Many people clear the infection spontaneously without treatment infection individuals usually respond well to treatment using one of the aforementioned regimens . If left untreated Balantidiasis can become chronic .persistent diarrhea can lead to high fluid loss and dehydration . abdominal bleeding can lead to death 3/ Post test :WRITE TRUE OR FAULSE 1-Balantidium coli is one of intestinal ciliates . 2-The infective stage is the cyst. . 3-Balantidium coli has one nucleus. . 4-One of the symptoms of balantidiasis is diarrhea. 5-Cilia is the organ of locomotion. . . 6/ key answer:1- Pre test :1_ true 2_ true 3_ false 4_ true 5_ true 1- post test :1_ true 2_ true 3_ false 4_ true 5_ true References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :- The student will know the morphology of the parasite Ascaris lumbricoides male and female ,life cycle, diseases lab diagnosis , and treatment . 1 / C –Central Idea :- -Identification of the parasite Ascaris lumbricoides , shape of male and female, egg, life cycle ,diagnosis and treatment. 1 / D –Instructions:1.Study over view thoroughly. 2.Identify the goal of this modular unit . 3.Do the pre test and if you :•get4 or more you do not need to proceed . •get less than 4 you have to study this modular unit well . 4.After studying the text of this modular unit ,do the post test , and if you :•get 4 or more , so go on studying modular unit two . •get less than 4 , go back and study the first modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the 24 modular unit , the student will be able to:- 1.To .know the life cycle of the parasite . 2-Know the shape of the female and the male of Ascaris lumbricoides . 3-Know how the diseases controlled. 3/ Pre test :Circle the correct answer : - 1-Female of Ascaris is a-shorter than male. b- longer than male. 2 -the male of Ascaris a-have capulatory spicules . b-not have. 3 -Ascaris is A-round worm . B-pin worm . Q4 –Draw the life cycle of Ascaris lumbricoides. Q5-What is the disease caused by Ascaris lumbricoides. (Ascaris Lumbricoides and Ascaris Suum) Ascaris round worms are parasites commonly hosted in the intestines of various terrestrial animals, chiefly herbivores. They are typically large worms characterized by a mouth surrounded by three lips. The species Ascaris lumbricoides is probably the most familiar parasite in humans. An almost identical worm, often called A. suum, occurs in pigs The intestinal roundworm Ascaris lumbricoides infection in humans follows the ingestion of Ascaris eggs that have contaminated foods or soil. In the small intestine the larvae are liberated pass from the respiratory passages into the digestive tract and mature into egg-producing worms, which grow to some 15 to 40 cm (6 to 16 inches) in length, in the small intestine. Serious, even fatal, complications of ascariasis result from the infiltration of the larvae into sensitive tissues, such as the brain, and from the migration of the adult worms into various body structures where they produce abcesses and toxic manifestations. Ascariasis round worms exists worldwide and is believed to affect some 660 million persons. and migrate through the intestinal wall, reaching the lungs, where they may produce a host sensitization that results in lung inflammation and fluid retention. About 10 days later, the larvae Prevention By treatment Pathogenesis A- Heavy infestations may cause the lungs to be damaged when the juveniles break out of the respiratory system, resulting in Ascaris pneumonitis. B-The main food of Ascaris is liquid contents of the intestine , moderate and heavy infestations result in malnutrition and underdevelopment in small children.Allergic responses are not uncommon,abdominal pain , Life Cycle Diagram (of Ascaris lumbricoides ). 3/ Post test :Circle the correct answer : 1- Female of Ascaris is a- shorter than male. b- longer than male. 2- the male of Ascaris a- have capulatory spicules . b- not have. 3 -Ascaris is a-round worm . b-pin worm . Q4- Draw the life cycle of Ascaris lumbricoides. Q5- What is the disease caused by Ascaris lumbricoides 6/ key answer:1- post test :- 1- Pre test :- 1- b 1- b 2- a 2- a 3- a 3- a 4- answer in page no.17 4- answer in page no.17 5- ascariasis. 5-ascariasis. References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :* The student will know the parasite Taenia saginata and Taenia solium . * can differentiate between shape of Taenia saginata and Taenia solium * understanding the source of infection. * Know how to prevent these diseases. 1 / C –Central Idea :- -Morphology of the genus Taenia . -The dangerous of these diseases to man . -How are the diseases transmits from person to person. -The methods of controlling these diseases. 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :• get 4 or more you do not need to proceed . • get less than 4you have to study this modular unit well • After studying the text of this modular unit ,do the post test , and if you :• get 4 or more , so go on studying modular unit 27. • get less than 4, go back and study the first modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the first modular unit , the student will be able to:- 1-Know the two spp of Taenia . 2-Know how to prevent these diseases . 3-Understand the source of infection. 3/ Pre test :Circle the correct answer : 1- Taenia saginatais: A-round worm B- Tapworm. 2-The lengthof Taenia saginata isabout: A- (2-7)meter. B- (20-25)meter. 3-Taenia saginata infect : A-cattle. B- pigs . 4-The infective stage of Taenia saginata is : A- gravid segments. B- scolex. 5-Draw the life cycle of Taenia saginata. Taenia solium & Taenia saginata Life cycle Taenia saginata and taenia solium pass their life cycles in two hosts . in man the adult lives in the small intestines . humans are the only definitive hosts for taenia saginata, and Taenia solium eggs or gravid segments are passed with faeces, they can survive for days ,months in the environment cattle ( T. saginata ) and pigs ( T. solium ) become infected by ingesting vegetable contaminated with eggs or gravid segments. In the animal s intestine , they hatch invade the intestinal wall , wall and migrate to the muscles , where they develop into cysticercus . a cysticercus can survive for several years in the animal . Humans become infected by ingesting raw or undercooked infected meat in the human intestine the cysticercus develops over 2 months an adult tapeworm , which can survive for years . the adult tapeworms attach to the small intestine by their scolex and reside in the small intestine . length of the adult worms is usually 5 metres or less for T. saginata ( however it may reach up to 25 metres ) and 2 to 7 metres for T. solium . the adults produce proglottids which mature , become gravid detach from the tapeworm and migrate to the anus or are passed in the stool ( approximately 6 per day ) T. saginata adults usually have 1,000 to 2,000 proglottids while T. solium adults have an average of 1,000 proglottids . the eggs contained in the gravid proglottids are released after the proglottids are passed with the faeces . T. saginata may produce up to 100,000 and T. solium may produce 50,000 eggs per proglottid respectively . The adult stages of T. saginata and T. solium may persist for several years in infected humans . Mixed infection of both the parasites can occur . The incubation period for the adult tapeworm is from is 8 to 14 weeks . Symptoms Tapeworm infestation does not usually cause any symptoms infection is generally recognized when the infected person passes segments of proglottids in the stool especially if the segment is moving Taenia saginata , taeniasis produces only mild abdominal symptoms occasionally , appendicitis . Taenia solium taeniasis is less frequently symptomatic than Taenia saginata taeniasis . The main symptom is often the passage ( passive ) of segment. But heavier infections may produce abdominal discomfort , epigastric pain vomiting and diarrhea ( both Taenia spp. ) . The most important feature of Taenia solium taeniasis is the risk of development of cysticercosis . Diagnosis Microscopic identification of eggs and proglottids in faeces (or from the perianal area ) is diagnostic for taeniasis , but is not possible during the first 3 months following infection . Eggs of Taenia sp. Are spherical yellowish brown . the shell is thick and radially striagted .within the shell the onchosphere has 3 pairs of hook lets . microscopic identification of gravid proglottid allows determination . Treatment Tapeworms are treated with oral medications , usually in a single dose . the drug of choice is niclosamide & praziquantel . Although nicolosamide is effective against T. solium but this drug isn’t recommended because it cause disintegrating of proglottides and releasing of eggs into the bowel lumen , possibly increasing the hazard of cysticercosis Complete eradication of the tapeworm occurs following treatment . Complications 1- self-infection with tapeworm eggs – cysticercosis ( T. solium only ) which may cause seizures . 2- rarely , worms may cause obstruction of the intestine . 3/ Post test :Circle the correct answer : 1- Taenia saginatais : A-round worm . B- Tapworm. 2-The lengthof Taenia saginata isabout: A- (2-7)meter. B- (20-25)meter. 3-Taenia saginata infect : A-cattle. B- pigs . 4-The infective stage of Taenia saginata is : A- gravid segments. B- scolex. 5-Draw the life cycle of Taenia saginata. 6/ key answer:1- Pre test :- 1- post test :- 1- b. 1- b. 2- a . 2- a . 3- a . 3- a . 4- a . 4- a . 5- the answer in page 11. 5- the answer in page 11. References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :- * The student will know the parasite Schistosoma. * can differentiate between the three species of schistosoma . * Know the morphology of miracidium and cercaria . * Know how to prevent this disease . 1 / C –Central Idea :- -Morphology of the male and female of bilharizia. -The dangerous of this diseases to man . -How are the diseases transmits to human being. -The methods of controlling this diseases. 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :• get 4 or more you do not need to proceed . • get less than 4you have to study this modular unit well • After studying the text of this modular unit ,do the post test , and if you :• get 4 or more , so go on studying modular unit 29 . • get less than 4, go back and study the 28th modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the first modular unit , the student will be able 1.To know the parasite schitosoma . 2-Know the pathogenesis and symptoms of this disease. 3-Know the shape of ova and spice position. 3/ Pre test :Fill in the blanks with suaitable words 1-Schistosomaisis is also called ---------2-Schistosoma haematobium has ------------spice ova. 3-There are three species of schitosoma 1------2-------3-------. 4- ----------Is the infective form of bilharzia. 5-Schistosoma is diagnosed by examining--------or--------sample. Introduction Schistosomiasis, also known as bilharzias (bill-HARzi-a), is a disease caused by parasitic worms. Infection with Schistosoma mansoni S. haematobium, and S. japonicum causes illness in humans. Although schistosomiasis is not found in the United States, More 200 million people are infected worldwide. Life cycle of Bilharzia Within days after becoming infected, you may develop a rash or itchy skin. Fever, chills, cough, and muscle aches can begin within 1-2 months of infection. Most people have no symptoms at this early phase of infection . Eggs travel to the liver or pass into the intestine or bladder, causing inflammation or scarring. Children who are repeatedly infected can develop anemia, malnutrition, and learning difficulties. After years of infection, the parasite can also damage the liver, intestines, A blood test has been developed and is available at CDC. For accurate results, you must wait 6-8 weeks after your last exposure to contaminated water before the blood sample is taken. Diagnose of schistosomiasis Your health care provider may ask you to provide stool or urine samples to see if you have the parasite 3/ Post test :Fill in the blanks with suaitable words 1-Schistosomaisis is also called ---------2-Schistosoma haematobium has ------------spice ova. 3-There are three species of schitosoma 1------2-------3-------. 4- ----------Is the infective form of bilharzia. 5-Schistosoma is diagnosed by examining--------or--------sample. 6/ key answer:1- Pre test :- 1- post test :- 1- Bilharizia. 1- Bilharizia. 2- terminal spice. 2- terminal spice. 3- S.haematobium 3- S.haematobium ,S.japanicum. ,S.japanicum. ,S.mansoni. ,S.mansoni. 4-Cercaria. 4-Cercaria. 5- Urine ,stool sample. 5- Urine ,stool sample. . References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :* The student will know the blood unicellular parasite. * Know the pathogenesis and life cycle. *Know how to diagnose each one. * Know how to prevent and control these diseases. 1 / C –Central Idea :- - KNOW the blood unicellular parasite plasmodium. - The shape of the eggs . - Know the life cycle of plasmodium. - How to control and prevent these diseases. - Know the three spp of plasmodium P.vivax ,P.falciparum , P.malariae . a 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :• get 4 or more you do not need to proceed . • get less than 4you have to study this modular unit well • After studying the text of this modular unit ,do the post test , and if you :• get 4 or more , so go on studying modular unit 29 . • get less than 4, go back and study the 28 modular unit ; or any part of it ; again and then do the post test again . 2/ Performance Objectives :After studying the first modular unit , the student will be able to:1.To know the pathogenesis of the parasite plasmodium . 2-Know the diagnosis of it. 3-Know how to prevent this diseases . 4-Understand the method of controlling this diseases. 3/ Pre test :WRITE TRUE OR FAULSE 1-Malaria is an infectious disease caused by plasmodium. 2-Using of bed net to ovoid the bite of female mosquito anopheles. 3-Malaria could be diagnosed by a smear of thick and thin blood film. 4- Species of malaria are responsible for causing disease to man. 5-The disease transmitted by the bite of male anopheles Symptoms of Malaria Malarial attacks present over 4 to 6 hours with shaking chills, high fever, and sweating, and are often associated with fatigue, headache, dizziness, nausea, vomiting, abdominal cramps, dry cough, muscle or joint pain, and back ache. The attacks may occur every other day or every third day Treatment of Malaria Medical treatment should be sought immediately. The effectiveness of anti malarial drugs differs with different species of the parasite and with different stages of the parasite's life cycle. Your physician will determine the treatment plan most appropriate for your individual condition. Drugs include chloroquine, mefloquine, primaquine, quinine, pyrimethamine-sulfadoxine (Fansidar), and doxycycline. Some plasmodium have developed resistance to certain medications, and therefore, alternative medications will be prescribed for you . Prevention of Malaria No prophylactic regimen gives complete protection. Speak with your physician or local travel clinic to receive up to date information about the best malaria protection for you. Effectiveness of any given medication varies by the region of the world in which you plan to travel. Effectiveness also varies from year to year, so current information is essential. Prevention is based on: evaluating the risk of exposure to infection preventing mosquito bites by using DEET mosquito repellant, bed nets, and clothing that covers most of the body Diagnosis of Malaria Methods of diagnosis are: complete medical history of symptoms and travel physical examination blood tests, including thick and thin blood films, to identify the plasmodium species responsible for infection. A blood test has been developed and is available at CDC. For accurate results, you must wait 6-8 weeks after your last exposure to contaminated water before the blood sample is taken. Cerebral malaria and death can occur, sometimes within 24 hours, if the infection is caused by plasmodium falciparum. Fever or other symptoms can develop in malaria as early as 8 days or as late as 60 days after exposure or stopping prophylaxis. For plasmodium vivax in temperate areas, the delay may be up to one year. Life cycle of Malaria PLASMODIUM Causes and Risk Factors of Malaria Malaria comes from being bitten by a mosquito carrying the malaria organism. Risk factors include traveling in areas in which such mosquitoes are found or, rarely, being bitten by a mosquito that has previously fed on an "imported" case of malaria (such that the case can occur in an area of the world where malaria is not endemic). The first stage of plasmodium development in humans takes place in the liver. When the more mature plasmodium escape from the liver and enter the bloodstream, they infect red blood cells and multiply, causing the red blood cells to burst open after about 2 to 3 days and to release a new crop of parasites (plasmodium) The cycle of invasion, multiplication, and red blood cell rupture may be repeated many times The female Anopheles mosquito becomes infected by ingesting blood containing the sexual forms of the parasite plasmodium. After developing in the mosquito, the plasmodium is inoculated into humans when the mosquito next feeds (bites). Malaria continues to be endemic in many parts of the tropics and subtropics. Today, the number of cases is rising worldwide. Malarial parasites cause clinical illness in an estimated 300 to 500 million people every year and cause 1.5 to 2.7 million deaths per year. Description of Malaria Four species of the parasite plasmodium are responsible for malaria in humans: Plasmodium vivax, Plasmodium malariae, Plasmodium ovale, and Plasmodium falciparum Definition of Malaria Malaria is an infectious disease caused by a parasite (plasmodium) which is transmitted from human to human by the bite of infected female Anopheles mosquitoes. 3/ Post test :WRITE TRUE OR FAULSE 1-Malaria is an infectious disease caused by plasmodium. 2-Using of bed net to ovoid the bite of female mosquito anophils. 3-Malaria could be diagnosed by a smear of thick and thin blood film. 4-Species of malaria are responsible for causing disease to man. 5-The disease transmitted by the bite of male anopheles 6/ key answer:1- Pre test :- 1- Post test :- 1- true . 1- true . 2- true . 2- true . 3- true . 3- true . 4- true . 4- true . 5- false . 5- false . References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010. 1/ Over view 1/A –Target population :- This unit is directed to the first class students in nursing department. 1/B-Rationale :The student will know the life cycle of the parasite . Know how to prevent and control these diseases . know the sand fly which is the vector of this disease. 1 / C –Central Idea :- -Identification of the parasite Leishmania . -Know the stages of Leishmania . -Know the vector ,sand fly . 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :• get 4 or more you do not need to proceed . • get less than 4you have to study this modular unit well • After studying the text of this modular unit ,do the post test , and if you :• get 4 or more , so go on studying modular unit 30 . • get less than 4, go back and study the 29 modular unit ; or any part of it ; again and then do the post test again . 3/ Pre test :Write true or false 1-The spread of Leishmania occur by sand fly. 2-Leishmania have one stage . 3-Leishmania tropica cause oreintal sore or baghdad boil . 4-Leishmania donovani is dangerous than L.tropica . 5-Promastigote has one terminal flagella . 2/ Performance Objectives :After studying the first modular unit , the student will be able to:- 1.To know the life cycle of Leishmania tropica and Leishmania donovani . 2-know how to prevent and control these diseases . 3-Know how to avoid sand fly . 4-Know the stages of Leishmania. promastigote and mastigote. 1 / D –Instructions:• Study over view thoroughly. • Identify the goal of this modular unit . • Do the pre test and if you :- • get 4 or more you do not need to proceed . • get less than 4 you have to study this modular unit well . • After studying the text of this modular unit ,do the post test , and if you :- • get 4 or more , so go on studying new modular unit • get less than 4, go back and study the 29-30 modular unit ; or any part of it ; again and then do the post test again . . through sandflies of the genus Phlebotomus inLeishmania the Old World, and of the genus Lutzomyia in the New World. Their primary hosts are vertebrates; Leishmania commonly infects hyraxes, canids, rodents, and humans. Leishmania currently affects 12 million people in 88 countries. The parasite was named in 1903 after the Scottish pathologist William Boog Leishman. Pathogenicity Pathophysiology Leishmania cells have two morphological forms: promastigote (with an anterior flagellum , in the insect host, and amastigote (without flagella) in the vertebrate host. Infections are regarded as cutaneous, mucocutaneous, or visceral. parasites of the protozoan sandfly, the Transmitted by the Leishmania major may switch the strategy of the first genus immune defense from eating/inflammation/killing to phagocyte' eating/no inflammation/no killing of their host They ]citation needed[.and corrupt it for their own benefit use the willingly phagocytosing polymorphonuclear neutrophil granulocytes (PMN) rigorously as a tricky hideout, proliferate unrecognized from the immune where they macrophages to establish system and enter the long-lived infection ”a “hidden Neutrophil granulocytes - the Trojan horses for Leishmania parasites pathogenicity of The strategy of the "Trojan horse" as a mechanism of immune system and its memory microorganisms is, to avoid the intracellular neutrophils by apoptotic phagocytosis of infected and function cleverly, with macrophages, employing the non-danger surface signals of apoptotic citation needed [.cells Life cycle of Leishmaniamicrobial infection PMN move out from the bloodstream and By a through the vessels’ endothelial layer, to the site of the infected tissue (dermal tissue after fly bite). They immediately start their business there as the first immune response and phagocytize the invader because of the foreign and activating surfaces. In that processes an inflammation emerges. Activated PMN secrete IL-8 particularly, to attract further ,chemokines granulocytes and stimulate them to phagocytosis. Leishmania major increases the secretion of Furthermore obligate IL-8 by PMN. In the parasites case, . intracellular Treatment Main article: Leishmaniasis Antimonial compounds are the traditional treatments for leishmaniasis (sodium stibogluconate, meglumine antimoniate).[ Resistance to the antimonials is prevalent in some parts of the world, and the most common alternative is leishmaniasis for other treatment see( ]amphotericin B Paromomycin is an inexpensive alternative .)options The with fewer side effects than amphotericin that orphan Institute for OneWorld Health has funded for . drug for use in treatment of Leishmaniasis , 3/ Post test :Write true or false 1-The spread of Leishmania occur by sand fly. 2-Leishmania have one stage . 3-Leishmania tropica cause oreintal sore or baghdad boil . 4-Leishmania donovani is dangerous than L.tropica. 5-Promastigote has one terminal flagella. 6/ key answer:1- Pre test :- 1- post test :- 1- true . 1- true . 2- false . 2- false . 3- true . 3- true . 4- true . 4- true . 5- true . 5- true . References:1- Jawetz, etal..Medical microbiology, 2004,twenty third edition 2-Dr NAJAH.M.HASSAN, Medical parasitology for medical technology 3-Jawetz,etal. Medical microbiology ,2002. 4-Internet,2009-2010.