Microscopy, sterilisation,... Flashcards
Different types of microscopes
- Light
- Compound (bright field, dark ground, phase contrast)
- Fluorescence (UV)
- Electron microscope
Maximum theoretical resolving power of oil immersion and electron microscope
Oil immersion: 0.2 micrometer
1000X
Electron microscope: 0.005 nm
Stains used for fluorescence microscopy
Acridine orange
Auramine O
Fluorescein
Uses of fluorescence microscopy
- Auramine phenol staining
- Direct fluorescent antibody staining
- Indirect “”
First electron microscope was designed by
Ernst Ruska in 1931
Dark field microscope or dark ground microscope
Used for living, unstained or thin bacteria like spirochaetes in a dark background
It has a special condenser
Applications of phase contrast microscope
- Studying microbial motility
- Determining shape of living cell
- Detecting bacterial components such as endospores and inclusions bodies which become clearly visible because they have refractive index markedly different from water
Applications of fluorescence microscope
- Epifluorescence microscope (simple)
A) autofluorescence (cyclospora)
B) microbes coated with a fluorescent dye
Acridine orange dye for malaria parasite (quantitative buffy coat examination)
Auramine phenol for tubercle bacteria
C) immunofluorescence (direct or indirect) - Confocal microscope
Steps for preparation of a thin specimen of bacteria for transmission electron microscope
- Fixation: via glutaraldehyde or OsO4 for stabilisation
- Dehydration: acetone or ethanol
- Embedding: in a plastic polymer then hardened
- Slicing: by a ultramicrotome knife
Mounted on a copper slide
Measures to increase the contrast of electron microscope
- Staining: via lead citrate and uranyl acetate
- Negative staining: specimen is spread out on a thin film with heavy metals like phosphotungstinic acid or uranyl acetate
Structure of viruses, bacterial gas vacuoles,… - Shadowing: specimen is coated with a thin film of platinum or other heavy metal at 45•
For virus morphology, bacterial flagella and plasmids,…
Sterilisation, disinfection, antisepsis
Sterilisation: destruction of all forms of life including spores
Disinfection: destruction of only pathogenic organisms
Antisepsis: disinfection of living tissues
Order of susceptibility of organisms
Prions ➡️ bacterial spores ➡️ cysts of protozoa ➡️ mycobacteria ➡️ non enveloped viruses ➡️ fungi ➡️ gram +ve bacteria ➡️ gram -ve bacteria ➡️ enveloped viruses From difficulty to easy
Heat sterilisation
Most effective Mechanism: 1. Oxidative damage 2. Denaturation of proteins 3. Increased electrolytes to toxic levels
Examples of dry heat sterilisation
- Flaming:
Disinfection of mouth of test tubes, cover slips, slides - Red heat:
Sterilisation of inoculating loops, straight wires, tips of forceps - Incineration
- Hot air oven
Incineration (dry heat)
Sterilisation and reduction in volume of infectious hospital water
Reduction volume decreases by 80-85%
1° chamber: 650-750°C
2° chamber: 1050-800°C
Hot air oven is used for
Sterilisation of:
- Metallic instruments
- Glass ware
- Oils, jellies, powder, waxes
- Cotton swabs
Hot air oven
Temperature and precautions
160°C for 2 hours (M/C) 170°C for 1 hour 180°C for 30 min Precautions: 1. No rubber objects 2. No over loading 3. Cool for 2 hours before opening
Efficacy of hot air oven
Physical: temperature chart recorder
Chemical: Browne’s tube No 3
Biological: spores of C. tetani out B. subtilis
Moist heat
Mechanism:
Denaturation and coagulation of proteins
Superior to dry heat
Examples of moist heat less than 100°C
- Pasteurisation
- Serum bath: MH at 56°C for 1 hour for 3 consecutive days
- Vaccine bath:
MH at 60°C for 1 hour for 3 consecutive days - Inspissation:
MH at 80-85°C for 30 min for 3 consecutive days
Sterilisation of heat sensitive medium
Examples of pasteurisation
1. Holder method: MH at 63°C for 30 min 2. Flash method: MH at 72°C for 15-20 sec followed by rapid cooling to <13°C 3. Very High Temperature method: MH at 149°C for 0.5 sec
Pathogenic bacteria surviving Holder method
Coxiella burnetti
Efficacy testing of pasteurisation
- Coliform test: superior
Pasteurised milk overnight on McConkey agar, no gas and acid - Phosphatase test: M/C
Pasteurised milk and substrate (disodium phenyl PO4) for 2 hours
Moist heat at 100°C
- Tydallisation/fractional sterilisation
2. Autoclave
Tydallisation (fractional sterilisation)
Moist heat sterilisation done in Koch and Arnold Steam steriliser for 20 min for 3 consecutive days
Sterilisation of media:
TCBS, XLD, DLA, selenite F broth, sugar solutions, gelatin media
Autoclave
Principle:
Use of saturated steam under pressure
•M/C used is moist heat at 121°C for 15-20 min at 15 psi
•Moist heat at 134°C for 3 min at 30 psi
Uses of autoclave
Sterilising:
- Dressing, linen
- Non sharp metallic instruments
- Aqueous solutions
- Microbiological media
- Plastic pipettes, tubes
Efficacy testing of autoclave
Physical: temperature chart recorder
Chemical: Browne’s tube No 1, Bowie Dick tapes
Biological: spores of B. stearothermophilus
UV rays wrt sterilisation
Non ionising with λ of 220-280 nm
Acts via DNA damage
Poor penetrating power and non-sporicidal
Disinfection of biosafety cabinets, hospital corridors
Ionising radiation wrt sterilisation
γ rays for cold sterilisation
Mechanism: DNA damage
High penetration and sporicidal
Efficacy testing using spores of B. pumilis
Uses of cold sterilisation
γ rays Disposable gloves, petriplate, syringes IV sets, foley’s catheters Sutures, implants, prosthesis Glassware Fabrics, contraceptive devices, cotton swabs
Filtration
For heat sensitive liquids Pre side: 0.45 μ Efficacy testing: Serratia marcescens Brevundimonas diminuta
Filtration is used for
Heat sensitive liquids lie Sera Antibiotic solutions Vaccines Sugar/urea solution Gelatin media
Types of filtration
- Earthen wave filters
- Asbestos filters
- Sintered glass filters
- Membrane filters/ Millipores
Earthen wave filters
Made of diatomaceous or porcelain earth Shaped in form of candles Eg., Pasteur chamberland filters Berkefeld filters Mandler filters
Asbestos filters
Made up of magnesium trisilicate
Shape in form of discs. Eg., Seitz filters
Has carcinogenic potential
Sintered glass filters
Shaped in the form of discs
Disadvantage: expensive
Millipores/Membrane filters
Made up of cellulose ester, polyesters
Available in form of discs
Single use discs
M/C used filters
FDA classification of chemical disinfectants
1. High level: Kills everything 2. Intermediate level: Does not kill all spores 3. Low level: Does not kill spores and not all viruses and mycobacterium
Examples of each level of FDA classification of chemical disinfectants
1. High level: ETO, plasma aldehydes 2. Intermediate level: Phenol, halogens 3. Low level: Alcohols, surface acting agents
Alcohols as disinfectants
Mechanism:
Coagulation of proteins, dehydration of cells
60-80% concentration
Ethyl alcohol- spirit
Isopropyl alcohol- hand disinfectant
Methyl alcohol- fungal spores in biosafety cabinets
Aldehydes as disinfectants
Mechanism: alkylation of hydroxyl, amino and carbonyl residue of proteins Examples: 1. Formalin 2. Glutaraldehyde 3. Ortho-phthaldehyde
Uses of formaldehyde 40%
- Fumigation of OTs, wards
- Duckering- B. anthracis spores in animal wool
- Preservation of anatomical specimens
Glutaraldehyde/cidex 2% uses
Sterilisation and disinfection of: 1. Anaesthetic equipment 2. Cysto/broncho/endoscopes, corrugated rubber tubings, endotracheal tubes Sterilisation in 6-8 hours Disinfection in 25-30 min Dilution reused for (10-14 days)
Ortho-phthaldehyde OPA 0.55%
Same uses as cidex
Active at wide pH (cidex-alkaline pH)
Less irritant
Better mycobacteriocidal activity
Chlorine compounds disinfectants
Mechanism:
oxidation of sulf-hydryl residues of proteins
1. Cl2 tablets: disinfection of water supplies
2. Sodium hypochlorite:
•Disinfection of infectious hospital spills
•Hospital floor
Iodine compounds as disinfectants
Skin antiseptics
Mechanism: oxidation of sulf-hydryl residues of proteins
1. Tincture of iodine:
2% iodine in 70% alcohol
2. Betadine:
Iodine coated onto a neutral carrier poly vinyl pyrrolidone
Phenolics - coal tar derivatives as disinfectants
Mechanism: Precipitation of proteins and DNA damage Active in organic matter Examples: 1. 5% phenol 2. 1-4% cresol 3. 2-5% lysol Uses: 1. Surface disinfection of hospital floors 2. Discard jars
Modified phenolics
Chlorinated biphenolics Lost corrosiveness ➡️ antisepsis Examples: 1. Chlorhexidine- hand disinfectant 2. Hexachlorophene 3. Chlorxylenol 4. Triclosan Savlon - chlorhexidine+cetrimide Dettol - 10% chlorxylenol
Surface acting disinfecting agents
Mechanism: damaging membranes
Cationic:
Cetrimonium bromide (Savlon), Benzalkonium chloride
Anionic: soap
Ethylene oxide as disinfectants
9% of it + 91% of CO2 or HCFC
Used for sterilising heat labile and moisture sensitive objects like:
1. Bedding, blankets, rubber and plastic objects
2. Disposables, heart lung machines, respirators, dental equipment
Cycles of ETO or ethylene oxide and efficacy
1 cycle time: 18-24 hours (aeration required)
2 types of sterilisers:
1. Cold cycle- 37-44°C
2. Hot cycle- 55°C
Efficacy: spores of Bacillus atropheus (pigmented variant of B. subtilis)
Disadvantages of ETO as disinfectant
1. Toxic: exposure monitoring required because of cataracts and neural disturbances 2. Carcinogenic 3. Irritant 4. Inflammable
Plasma (VHP) sterilisation
VHP vaporised H2O2 (59%) Steps: 1. Creation of vacuum 2. Introduce gas 3. Electromagnetic radiation (radiowaves or microwave) ➡️ releases toxic O2 radicals
Plasma steriliser (STERRAD)
Temperature: 30-60°C
Cycle time: 60-75 min
Efficacy: spores of B. stearothermophillus
Use: sterilisation of heat sensitive metal or non-metal hospital devices
Plasma sterile should be dry
Spaulding classification
Classification of medical devices into categories based on the risk of infection involved with their use:
Critical, semicritical and non-critical
Critical category of Spaulding classification
Enter sterile tissues and vasculature of body
Sterilised before use
Eg., surgical instruments, implants, prosthesis, catheters, laproscopes, Foley’s catheter
Semicritical category of Spaulding classification
Contact with mucus membranes and breaks in skin
Eg., GI endoscopes
Bronchoscope
Cystoscope
Anaesthetic equipment
(Above eg. should have high level of disinfection or sterilisation)
Oral and ractal thermometers (intermediate level)
Non critical category of Spaulding classification
Contact with intact skin
Eg., stethoscope, ECG electrode, bed pans
Low level of disinfection is enough
Phenol coefficient
Efficacy of disinfectant
More than 1 ➡️ efficacious than phenol and vice versa
Phenol coefficient statins
- Serial dilution of new disinfectants along with phenol
- Each of these solutions as standard inoculum of S. typhi or S. aureus
- After every 5 min subculture into solid medium
- We will find out highest dilution of new disinfectant and phenol which kills organism in 10 min but not in 5.
- Solutions will be calculated respectively
- Determine ratio
Test for efficacy of disinfectants (phenol coefficient)
- Rideal Walker test
- Chick Martin test:
Better, superior test since more realistic
Along with S. aureus, S. typhi, we also add 3% sterile faeces in this test