Laboratory diagnosis of infectious diseases Flashcards
Detection of pathogenic agents:
- Microscopic visualisation of pathogens in clinical material
- Detection of the growth of microorganisms in the laboratory
Identification is based on phenotypic characteristics such as:
- fermentation profiles of bacteria
- cytopathic effects in tissue culture for viral agents
- microscopic morphology for fungi or parasites
What is the first tool in diagnosing microbial disease?
Microbial cultures
What is the sample that is obtained from the patient tested for?
The sample is obtained from the infected individual and tested for the presence of INFECTIOUS AGENT OR MICROBE that is capable of growing in specific media.
- It is critical to isolate the infectious agent in a pure culture containing only the infectious bacteria
What is the most common method to isolate individual cells and produce a pure culture?
The most common method to isolate individual cells and produce a pure culture IS TO PREPARE A STREAK PLATE
How is the streak plate method done?
- The streak plate method is a way to physically separate the microbial population, and it is done by spreading the inoculate back and forth with an inoculating loop over the solid agar plate.
- Upon incubation, colonies will arise and single cells will have been isolated from the biomass
Limitation of the conventional methods:
- lenghty, time consuming
- associated with risk
- culturing of certain organisms like viruses, fungi, or parasites may not be possible
- culture may be negative due to prior antimicrobial therapy
- requires sophisticated labs (impossible in all laboratories e.g. Mycobacteria)
The laboratory diagnosis of infection - others:
- Serological identification/immunological identification of Ags or Abs
- Nucleic acid based/Molecular biology techniques
The laboratory diagnosis of infection - others - ADVANTAGES:
(- Serological identification/immunological identification of Ags or Abs
- Nucleic acid based/Molecular biology techniques)
- provide early diagnosis
- important for uncultivable organisms in the laboratory
- useful in differential diagnosis of certain disease
- useful to measure the antibody level
Biological signal:
signal generated by detection of a material that can be reproducibly differentiated from substances present in the sample
Key issue:
are distinguishing it from background noise and translating it into meaningful information
Useful materials for detection of biologic signals applicable to clinical microbiology include:
- structural components of bacteria, fungi, and viruses
- specific antigen
- metabolic end products
- unique DNA or RNA base sequences
- enzymes
- toxins or other proteins
- surface polysaccharides
What is a detector?
A detector is used to sense a signal and discriminate between that signal and background noise
see screenshot
on iPAD
Direct detection:
Direct detection refers to detection of pathogens without the use of culture
Direct detection examples:
- microscopy and staining
- macroscopy antigen detection
- detection of pathogenic agents by serologic methods
Wet mount:
the simplest method of microscopic evaluation
What is the simplest method of microscopic evaluation?
wet mount
Example 1 of Wet Mount:
CSF examination for the presence of Cryptocosccus neoformans- with India ink
Example 2 of Wet Mount:
Wet Mount with dark-field illumination - used to detect spirochetes in genital lesions or Borrelia and Leptospira in blood
Stains that are used to see bacteria:
- gram´s stain
- acid-fast stain
- fluorochrome stain
- immunofluorescent stain
Gram´s stain:
differentiates between organisms with thick peptidoglycan cell walls (gram-positive), and outer membranes that can be dissolved with alcohol or acetone (gram-negative)
Morphology and Gram´s stain characteristics often can be used to categorise stained organisms into groups such as…….
- streptococci
- staphylococci
- clostridia
Acid-fast stain:
The acid-fast stain identifies acid-fast bacteria (eg. Mycobacteria) by their retention of carbol fuschin dye after acid/organic solvent disruption
Where can we apply acid-fast stain?
The acid-fast stain is applied to sputum, other fluids, and tissue samples when Mycobacterium species are suspected.
What is the alternative method for detection of acid-fast bacteria?
auramine-rhodamine fluorescent dye stain
Fluorochrome stains example:
Acridine orange
Fluorochrome stains:
Fluorochrome stains are used to identify white blood cells, yeast, and bacteria in body fluids.
- Capsular, flagellar or spore stains are used for identification or demonstration of characteristic structures
Immunofluorescent stains division:
- direct
- indirect
Direct Immunofluorescent stain:
The direct immunofluorescent antibody technique uses antibody coupled to fluorescent compound (eg. Fluorescein) and directed at a specific antigen target to visualise organisms
Indirect Immunofluorescent stain:
- The indirect immunofluorescent antibody technique, an unlabeled (target) antibody binds a specific antigen.
- The specimen is then stained with a fluorochrome labeled antibody directed at the target antibody.
- Because each unlabeled target antibody attached to the appropriate antigen has multiple sites for attachment of the second antibody, the visual signal is amplified.
Macroscopic antigen detection examples:
- Latex agglutination assays
- EIAs