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LAB 7: RESPIRATORY SYSTEM RESPIRATORY SYSTEM: UPPER AND LOWER THE RESPIRATORY SYSTEM Host Defense Mechanisms Anatomical characteristics/mechanisms to prevent/fight infection: – nasal hairs – antibacterial enzymes (lysozyme) – convoluted passages – cilia and mucous lining of the trachea – mucous linings of the nasal turbinates – reflexes --coughing, sneezing, swallowing – Normal flora of nasopharynx and presence of normal flora NORMAL MICROBIOTA OF THE RESPIRATORY SYSTEM • UPPER respiratory tract : – Coagulase – negative staphylococci – Neisseria (Gram – negative cocci) – Corynebacterium spp. (Diphtheroids) (Gram – positive rods) – Anaerobic bacteria – Pathogens in low numbers (colonization vs. pathogenic) (S. aureus, Gram-negative rods (Enteric/Pseudomonas spp.) • LOWER respiratory tract (trachea, bronchi, and bronchioles) is virtually free of microorganisms, mainly because of the efficient cleansing action of the ciliated epithelium RESPIRATORY TRACT INFECTIONS Bronchitis Pharyngitis Pneumonia Epiglottitis Sinusitis PATHOGENS OF THE UPPER RESPIRATORY TRACT THROAT: •Streptococcus pyrogenes (Group A strep) •Viruses SINUS: •Moraxella catarrhalis (Gram – negative cocci) •Gram – negative rods •Staphylococcus aureus •Viruses PATHOGENS OF THE LOWER RESPIRATORY TRACT • Streptococcus pneumoniae • Hemophilus influenzae • Staphylococcus aureus • Moraxella catarrhalis (Gram – negative cocci) • Gram – negative rods (Klebsiella sp., Enterobacter sp., Serratia sp., E. coli, Pseudomonas sp.) • Fungi (Cryptococcus neoformans) • Viruses The Respiratory System: Collecting Specimens & Diagnosis • Upper respiratory tract: Mucus membrane (throat, sinus) is wiped with a special collection swab. – Culture for isolation, identification and susceptibility testing of pathogens • Lower respiratory tract: Sputum and or bronchial specimens are collected into a sterile container. – Gram stain for white blood cells and microorganism and to check for the quality of the specimen – Culture for isolation, identification and susceptibility testing of pathogens. MEDIA Sheep Blood agar: •Enriched (contains 5% sheep blood with tryptic soy agar base) •Differential (used to detect hemolysis of microorganisms) •Microorganisms produce toxins called hemolysins that can break down red blood cells causing a visual change in the media IDENTIFICATION • DIFFERENTIATION OF STAPHYLOCOCCI AND STREPTOCOCCI – GRAM STAIN – CATALASE – HEMOLYSIS ON SHEEP BLOOD AGAR GRAM STAIN • STAPHYLOCOCCUS GRAM POSITIVE COCCI IN PAIRS AND CLUSTERS • STREPTOCOCCUS GRAM POSITIVE COCCI IN PAIRS AND CHAINS CATALASE TEST Streptococci are Gram-positive, catalase negative (no bubbles) Staphylococci are Gram-positive, catalase positive (bubbles) Blood Agar - Hemolysins • Alpha-hemolysis – causes partial lysis of RBCs and breakdown of hemoglobin which leads to a green color change in the agar. • Beta-hemolysis – causes complete lysis of RBCs and breakdown of hemoglobin which leads to a colorless clearing in the agar. • Gamma-hemolysis – an organism that does not cause hemolysis. SHEEP BLOOD AGAR BLOOD AGAR LAB PROCEDURE BLOOD AGAR LAB PROCEDURE Blood Agar Lab Procedure: RESULTS GROUP A STREP (S. pyrogenes) – (causative agent of ‘Strep throat’) Bacitracin (A) disk test Group A beta strep is sensitive to bacitracin (zone of inhibition) Other beta streps are resistant to bacitracin (no zone of inhibition) Streptococcus pneumoniae • S. pneumoniae is an alpha streptococci that is susceptible to the optochin disk (zone of inhibition) • Most common cause of CAP • Other alpha streptococci are resistant to optochin (no zone of inhibition) Streptococcus pneumoniae • S. pneumoniae • Catalase negative • Gram – positive cocci in LANCET PAIRS • Frequently encapsulated DICHOTOMOUS KEY FOR IDENTIFICATION OF STAPHYLOCOCCI AND STREPTOCOCCI GRAM POSITIVECOCCI IN PAIRS, CHAINS OR CLUSTERS CATALASE NEGATIVE = STREPTOCOCCI CATALASE TEST CATALASE POSITIVE= STAPHYLOCOCCI HEMOLYSIS ALPHA HEMOLYSIS – Optochin disk sensitive = S. pneumoniae BETA HEMOLYSIS – Bacitracin disk sensitive = S. pyrogenes (Beta hemolytic strep Group A) GAMMA HEMOLYSIS STAPHYLOCOCCI VS. STREPTOCOCCI PAIRS AND CHAINS GRAM POSITIVE COCCI PAIRS AND CLUSTERS NEGATIVE CATALASE POSITIVE HEMOLYSIS ALPHA BETA GAMMA POSITIVE S. aureus MSA PLATE NEGATIVE Coagulase negative Staphylococci