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MCB 4203C-Pathogenic Microbiology
Schedule of Activities

Date

Session Topics

Readings & Lab Exercises

August 23

Course Overview

Introduction to Clinical Microbiology

Normal Flora, Pathogens and Opportunistic Infections
Routes of Infection
Host Defense Mechanisms
Exotoxins and Endotoxins
Signs of Infection

Readings: Delost, Chapter 1, pp. 1-9.

This session will address the following learning objectives:
1. Define the following
    a. Infection
    b. Infectious disease
    c. True pathogen
    d. Opportunistic pathogen
    e. Nosocomial infection
    f. Endogenous infection
    g. Exogenous infection
    h. Asymptomatic carriers
    i. Colonization
2. Define normal flora and discuss its role in each of the following sites:
    a. Mouth and oral cavity
    b. Nasopharynx
    c. Stomach and small intestine
    d. Colon
3. List and describe routes of infection.
4. Describe the following host defense mechanisms:
    a. Innate (natural) immunity
    b. Inflammatory response
    c. Acquired immunity
    d. Humoral immunity
    e. Cell-mediated immunity
5. Describe the function of B and T cells in the immune response.
    a. List and summarize the characteristics of the human immunoglobulin classes
    b. List and state the function of four populations T cells.
6. Define and describe endotoxins and exotoxins.
7. List the signs of microbial infection.
8. List the laboratory procedures that might be requested to identify infectious disease.
9. List the major types of nosocomial infection and describe how such infections are acquired.

Date	Session Topics	Readings & Lab Exercises
August 28	Safety in the Clinical Microbiology Laboratory Biological, Chemical and Fire Safety	Readings: Chapter 2, pp. 10-19 Lab Exercises: Lab Safety Update

This session will address the following learning objectives:
1.   Describe the elements of a laboratory safety program
2.   List and describe the possible routes of laboratory-acquired infections.
3.   Name the agencies that recommend policy for laboratory safety.
4.   Discuss the concept of universal precautions.
5.   Describe and practice the general guidelines for safety in the clinical laboratory
      a. Discuss personal protective equipment and its purpose in the clinical laboratory
      b. Describe safety precautions with specific applications to the microbiology laboratory.
6.   Summarize the criteria for and differentiate Biosafety Levels 1, 2, 3, and 4.
7.   Describe and differentiate the various types of biological safety cabinets.
8.   Define and give examples of sterilizers, disinfectants, and antiseptics.
9.   State the principle of the autoclave.
10. List and define the five types of hazardous chemicals.

Date	Session Topics	Readings & Lab Exercises
August 30	Specimen Collection, Transport and Processing Guidelines Clinical Specimens	Chapter 3, pp. 20-35 and Chapter 22, pp. 468-517. Lab Exercises: Review of basic Techniques: pp. 32-33.

This session will address the following learning objectives:
1.   List and discuss the basic concepts for proper specimen collection in diagnostic
      microbiology. Recognize samples that are not suitable and suggest appropriate action.
2.   For each of the following specific sites, describe specific collection requirements:
      a. Throat
      b. Nasopharyngeal
      c. Sputum
      d. Urine (clean catch, catheterized, suprapubic)
      e. Wound
      f. Stool
      g. Cerebrospinal fluid
      h. Genital (male urethral, female vaginal and cervical)
      l. Blood
3.   Discuss proper specimen transport and processing methods. Name the typically used
      transport media.
4.   Describe the gross examination of specimens for microbiology.
5.   List and discuss important quality control measures used in the microbiology laboratory.
6.   For each of the following media, state the purpose and describe the important components:
      a. Sheep blood agar
      b. Colistin-nalidixic acid
      c. Chocolate agar
      d. Modified Thayer-Martin, Martin-Lewis, New York City
      e. MacConkey
      f. Eosin-methylene blue
      g. Gram-negative broth, selenite broth, tetrathionate broth
      h. Thioglycollate
      i. Hektoen enteric, Salmonella-Shigella, xylose-lysine-deoxycholate
8.   List and describe the types of hemolysis observed on sheep blood agar.
9.   Streak an agar plate correctly to obtain isolated colonies.
10. Define and differentiate the following terms:
      a. Aerobe and anaerobe
      b. Facultative anaerobe and obligate anaerobe
      c. Mesophile and thermophile

Date	Session Topics	Reading & Assignments
Sept. 4	Labor Day Holiday

Date	Session Topics	Readings & Assignments
Sept. 6	Methods of Identification Overview of Conventional Methods for Bacterial Identification Molecular Methods for Microbial Identification and Characterization Immunochemical Methods Used for Organism Identification Serologic Diagnosis of Infectious Diseases	Chapter 4, pp. 36-45 and Chapter 5, pp. 46-61 Lab Exercises: Microscopic Techniques, pp. 42-44.

This session will address the following learning objectives:
1.   Recognize and state the function of the following parts of the compound microscope:
      a. Ocular
      b. Objectives
      c. Condenser
      d. Iris diaphragm
2.   Describe the use of darkfield microscopy in clinical microbiology.
3.   Discuss the principle of fluorescent microscopy.
4.   State the purpose of each of the following direct methods of examination:
      a. Saline mount
      b. Hanging drop
      c. Iodine mount
      d. Potassium hydroxide preparation
      e. Nigrosin
      f. Neufeld (Quellung) reaction
5.   Prepare smears from stock cultures or clinical specimens without error.
6.   State the reagents used in the Gram stain and the function of each.
      a. Perform Gram stains on stock cultures or clinical specimens without error.
      b. Interpret Gram stains to include the shape, morphology, and Gram stain reaction.
7.   Name the stains used to stain Mycobacterium and explain why these bacteria are termed
      acid-fast bacilli.
8.   Name two fluorescent stains and state the purpose of each.
9.   Describe the use of antibody-conjugated stains in clinical microbiology.
10. Discuss the use of miniaturized, multitest systems in the microbiology laboratory.
11. State the principle of colorimetry, and explain how it is used in semi-automated and
      automated identification systems.
12. State the principle of nephelometry, and explain how it is used in semi-automated and
      automated identification systems.
13. List at least two semi-automated identification systems.
14. For each of the following automated identification systems, state the principle(s) of
      operation and capabilities:
      a. Vitek
      b. AutoSCAN W/A
15. Describe and compare the Bactec and BacT/Alert with respect to principle and capabilities.
16. List two automated urine screening methods.
17. Discuss the significance of collecting both an acute phase and a convalescent phase
      specimen for serological testing.
      a. Define titer.
      b. Indicate the rise in titer that is necessary to diagnose a current infection.
18. For each of the following immunoserologicall methods, state the principle and discuss the
      application of the test to clinical microbiology:
      a. Agglutination
      b. Coagglutination
      c. Enzyme-linked immunosorbent assay
      d. Immunofluorescence: direct and indirect
19. Briefly describe molecular methods that are available in clinical microbiology.

Date

Session Topics

Readings & Assignments

Sept. 11

Sept. 13

Principles of Antimicrobial Action and Resistance

Laboratory Methods for Detection of Antibacterial Resistance

Laboratory Strategies for Antimicrobial Susceptibility Testing

Exam 1; Chapters 1-6, 22.

Chapter 6, pp. 62-93;

Lab Exercises: Antibiotics, pp. 79-90.

This session will address the following learning objectives:
1.   Describe the mode of action of each class of antimicrobial agents.
2.   List the bacterial types targeted by each class of antimicrobial agent.
3.   Identify common pathways of antimicrobial resistance.
4.   Identify factors contributing to the emergence and dissemination of antimicrobial
      resistance.
5.   Describe the methodologies used to measure antimicrobial susceptibility.
6.   List the advantages and disadvantages of each method.
7.   Define the terms, MIC, MBC, SBT.
8.   Discuss the criteria involved in the decision to perform a susceptibility test.
9.   Identify the QA and QC criteria for performing antimicrobial susceptibility testing.
10. Identify and discuss key components that contribute to susceptibililty testing accuracy.

Date	Session Topics	Readings & Assignments
Sept. 18-20	Staphylococci and Micrococci	Readings: Chapter 7, pp 94-117 Lab Exercises: pp. 103-115

This session will address the following learning objectives:
1.   Name the four genera composing the family Micrococcaceae. Differentiate Staphylococcus
      from Micrococcus.
2.   List media on which Staphylococcus can be isolated.
3.   List and describe methods to differentiate Staphylococcus from Streptococ-cus to include:
      a. Gram stain
      b. Colonial morphology
      c. Catalase reaction
4.   Differentiate Staphylococcus from Streptococcus when given an unknown culture.
5.   State the principle and purpose of the catalase reaction.
6.   State the principle and purpose of the coagulase test.
7.   Give the principle and purpose of the following media.
      a. Mannitol salt agar
      b. DNase medium
8.   Differentiate Staphylococcus aureus from coagulase-negative Staphylococci.
9.   Describe each of the following compounds and the role played by each in infections caused
      by Staphylococcus aureus.
      a. Hemolysins
      b. Coagulase
      c. Enterotoxins
      d. Leukocidin
      e. Nucleases
      f. Exfoliatin
      g. Hyaluroniclase
      h. Staphylokinase
      i. Protein A
      j. Beta-lactamase (penicillinase)
10. List and describe the more common infections caused by Staphylococcus aureus
11. List and describe the more serious infections caused by Staphylococcus aureus.
12. Describe the carrier state and its relationship to transmission of Staphylococcal infection.
13. Describe beta-lactamase, and its role in infection and antibiotic treatment of
      Staphylococcus aureus infections.
14. State the principle and purpose of the following techniques to identify S. aureus:
      a. Latex agglutination
      b. HemaggIutination
15. List medically significant species classified as coagulase-negative Staphylococci (CoNS)
      and describe infections attributed to these organisms.
16. Describe the identification of Staphylococcus epidermidis
17. Name infections attributed to Staphylococcus epidermidis and describe the patient
      population typically infected.
18. State the purpose and principle of the novobiocin test.
19. Discuss the clinical significance of isolating Staphylococcus saprophyticus.

Date	Session Topics	Readings & Assignments
Sept. 25-27	Streptococci and Enterococci	Readings: Chapter 8, pp. 118-141 Lab Exercises: pp. 130-138 Unknown Set I, Throat and Skin Cultures

This session will address the following learning objectives:
1.   Describe characteristics of the genus Streptococcus.
2.   List the media typically used to isolate Streptococci.
3.   List, recognize, and describe the types of hemolysis.
4.   Differentiate between streptolysin S and streptolysin 0.
5.   Give the Lancefield group and preliminary tests used to identify each of the following
      streptococcal species:
      a. S. pyogenes
      b. S. agalactiae
      c. Enterococcus. E. faecalis, E. faecium, E. durans, E. avium
      d. Non-Enterococcus: S. bovis, S. equinus
6.   Differentiate between the Enterococcus and the non-Enterococcus.
7.   State the principle and the purpose of the following tests.
      a. Bacitracin ("A" Disk)
      b. SXT
      c. CAMP reaction
      d. Bile-esculin
      e. 6.5% salt broth
      f. PYRase
8.   Describe the principle of rapid tests for group A streptococci.
9.   Discuss the clinical significance of infection caused by:
      a. Group A streptococci, including primary infection and sequelae
      b. Group B streptococci
      c. Enterococcus
      d. Non-Enterococcus
10. List antibiotics effective in the treatment of streptococcal infections.
11. List those species known as, "viridans" streptococci, and discuss the clinical significance of
      their isolation.
12. Describe and recognize the appearance of Streptococcus pneumoniae on:
      a. Gram-stained smear
      b. Blood agar
13. Differentiate between viridans Streptococcus,and Streptococcus pneumoniae.
14. State the principle of and perform and interpret the optochin test without error.
15. Describe the principle and use of the following in the identification of Streptococcus
      pneumoniae:
      a. Neufeld (quellung) reaction.
16. List infections associated with Streptococcus pneumoniae.
17. List antibiotics effective in treatment of pneumococcal infections.
18. Briefly discuss the significance of the following streptococci:
      a. Lancefield group C
      b. Lancefield group F
      c. Lancefield group G
      d. Nutritionally variant

Date	Session Topics	Readings & Assignments
Oct. 2-4	Neisseria and Moraxella	Readings: Chapter 9, pp.142-161, Lab Exercises: pp. 151-158.

This session will address the following learning objectives:
1.   Describe the general morphological and biochemical characteristics of Neisseria.
2.   List special growth requirements for the pathogenic Neisseria.
3.   State the principle and purpose of the cytochrome oxidase reaction. Perform and interpret
      the reaction without error.
4.   Describe the infections associated with Neisseria gonorrhoeae.
5.   Describe the correct methods for specimen collection and processing for N. gonorrhoeae.
6.   List and compare the media selective for isolation of N. gonorrhoeae.
7.   Describe the use of the Gram stain in the workup of clinical specimens for N. gonorrhoeae.
9.   Describe how specimens for Neisseria meningitidis are cultured and processed.
10. Discuss the infectious process of N. meningitidis.
11. Describe how N. meningitidis is isolated and identified.
12. Describe the isolation, identification, and clinical relevance of Moraxella ca-tarrhalis.
13. Based on growth characteristics and biochemical reactions, differentiate among the
      following Neisseria and Moraxella species:
      a. N. gonorrhoeae
      b. N. meningitidis
      c. M. catarrhalis
      d. N. lactamica
      e. N. cinerea
      f. N. sicca
      g. N. subf1ava
      h. N. flavescens

Date	Session Topics	Readings & Assignments
Oct. 9-16 Oct. 20	Enterobacteriacea Exam 2: Chapters 7-10,	Readings: Chapter 10, pp. 162-205. Lab Exercises: pp. 180-202 Unknown Set II, Stool Cultures.

This session will address the following learning objectives:
1 . List and describe the serological characteristics of the members of Enterobacteriaceae.
2.   Describe the biochemical reactions that are characteristic for the Enterobacteriaceae.
3.   State the principle of each of the following biochemical techniques.
      a. Carbohydrate fermentation
      b. Triple sugar iron (TSI)
      c. Indole
      d. Methyl red
      e. Voges-Proskauer
      f. Citrate
      g. Urease
      h. Deaminase (phenylalanine)
      i. Decarboxylase,
      j. ONPG
      k. Hydrogen sulfide (H,S)
      l.. motility
4.   Describe the isolation, identification, and infections of Escherichia coli.
5.   Discuss the significance of ETEC, EIEC, EPEC, and VTEC.
6.   Discuss the identification of the subgroups and species, of Shigella and the infections
      associated with Shigella.
7.   Describe the identification and infections of the Klebsiella-Enterobacter--Serratia-Hafnia
      group.
8.   Describe a currently accepted method for classification of Salmonella.
9.   Describe the types of Salmonella infections and indicate how each is acquired.
10. List members of the tribe Proteae (Proteus group).
      a. State the important biochemical reactions of this group.
      b. Identify clinically significant members and state the clinical significance of each.
11. Describe how Citrobacter can be differentiated from Salmonella. Describe the identification
      and clinical significance of clinically important mem-bers of the genus Citrobacter.
12. Describe the identification and clinical significance of the isolation of Edwardsiella tarda.
13. List the three species of Yersinia and discuss the identification and clinical significance of
      each.

Date	Session Topics	Readings & Assignments
Oct. 25-27	Nonfermentative Gram-Negative Baccili and Haemophilus	Readings: Chapter 11, pp 206-223; Chapter 12, pp. 224-237 Lab Exercises: pp. 218-221; pp. 231-235.

This session will address the following learning objectives:
1.   Describe the natural environment and types of infections attributed to the nonfermentative
      gram-negative bacilli.
3.   State the principle of, use, and interpret oxidative-fermentative medium. Differentiate
      nonfermenters, fermenters, and nonsaccharolytic organisms.
4.   List those pseudomonads that are pyocyanin positive.
5.   List two unique characteristics used in the identification of Pseudomonas aeruginosa.
      a. Explain how this organism is identified.
      b. Describe the types and sources of infections for this organism.
      c. List and describe at least three compounds produced by P. aeruginosa that are associated
          with its pathogenicity.
      d. Identify P aeruginosa as an unknown without error.
6.   Briefly discuss the identification and clinical significance of Pseudomonas species other
      than P. aeruginosa, including P. cepacia.
7.   Describe the clinical significance of Xanthomonas maltophilia, and explain how it is
      identified.
8.   State the characteristics of Acinetobacter, and differentiate A. baumanii from
      A. calcoaceticus.
      a. Differentiate Acinetobacter from Neisseria.
      b. Relate the clinical significance of Acinetobacter.
9.   Describe the clinically significant Alcaligenes, and state the important morphological and
      biochemical characteristics.
10. Describe the clinically significant Moraxella and Oligella, and explain how each is
      identified in the laboratory.
11. State a unique trait of the genus Flavobacterium. Describe infections associ-ated with F.
      meningosepticum, and explain how this organism is identified.
12. Identify an unknown gram-negative nonfermenter through biochemical reactions and
      morphological characteristics.
13. Describe the general morphological and biochemical characteristics of Haemophilus
14. Describe X and V factors and indicate a source for each. Perform and interpret the test for
      X and V factors.
15. List the media used to isolate Haemophilus.
16. Describe the principle of satellitism.
17. State the principle of the delta-aminolevulinic acid (ALA) test.
18. Describe how H. influenzae is identified from a clinical specimen.
      a. State the correct results for the following reactions: hemolysis, requirement for
          X and V factors, ALA, and fermentation of glucose, sucrose, lactose, and fructose.
19. List the serotypes of H. influenzae, and indicate which is found most frequently in human
      infection.
20. Describe how the capsular antigen is used to identify H. influenzae.
21. List the infections associated with H. influenzae, and indicate which population is most
      affected.
22. Briefly describe the identification and clinical relevance of:
      a. H. ducreyi
      b. H. aegyptius
      c. H. parainfluenzae
      d. H. aphrophilus
      e. H. paraphrophilus
      f. H. haemolyticus

Date	Session Topics	Readings & Assignments
Nov. 2-4	Miscellaneous Gram-Negative Bacilli	Readings: Chapter 13, pp. 238-251. Lab Exercises: pp. 249, Handouts and Computer Simulations

This session will address the following learning objectives:
1. Discuss why the number of miscellaneous gram-negative bacilli associated with human
    infections has increased.
2. Name the agent of cholera, and explain how this organism is identified.
    a. Name the two biovars of cholera.
    b. Explain how cholera is transmitted.
3. Describe the unique characteristics of the genus Campylobacter
    a. Explain how Campylobacter infections are transmitted.
    b. Differentiate C. jejuni subspecies jejuni from C. coli.
4. Discuss the clinical significance of Helicobacter pylori,
5. Describe the clinical significance and differentiate Aeromonas from Plesiomonas.
6. Name the etiologic agent of legionnaires' disease.
    a. Describe and compare the types of legionellosis.
    b. List two other species of Legionella, associated with human infection.
    c. Name the media used to isolate Legionella.
    d. Explain how Legionella is identified.
7. For each of the following bacteria:
    a. Name the media required for isolation.
    b. Name or describe the infectious process.
    c. Explain how each organism is identified.
        (1) Bordetella pertussis
        (2) Brucella
        (3) Pasteurella
        (4) Francisella
8. Describe the characteristics of bacterial vaginosis, and name the agent associated with this
    condition.
9. Identify and describe the gram-negative bacillus associated with rat-bite fever.

Date	Session Topics	Readings & Assignments
Nov. 8 Nov. 10	Spirochetes Borellia Treponema Leptospira Exam 3: Chapters 11-14.	Readings: Chapter 14, pp. 252-259 Lab Exercises: Unknown Set III, Urine Specimens.

This session will address the following learning objectives:
1. State the etiologic agent for the following diseases:
    a. Syphilis (venereal)
    b. Yaws
    c. Pinta
    d. Endemic syphilis (nonvenereal)
2. List and describe the stages of syphilis. Discuss laboratory methods to identify primary,
    secondary, and tertiary syphilis.
3. Compare and contrast the treponemal and nontreponernal tests for syphilis.
    a. State the principle for each of the following tests:
       (1) RPR
       (2) VDRL
       (3) FTA-absorbed
       (4) TPI
    b. Discuss biological false positives (BFPs) and explain how to differentiate a BFP from a
        true positive.
4. Name the etiologic agent and tick or louse vector for the following borrelioses:
    a. Relapsing fever
    b. Lyme disease
5. Describe how Lyme disease is acquired and diagnosed.
    a. List and describe the laboratory methods used to diagnose Lyme disease.
    b. Discuss the stages of Lyme disease.
6. Discuss how relapsing fever is acquired and diagnosed.
7. Name the etiologic agent of leptospirosis and describe its significant characteristics.

Date	Session Topics	Readings & Lab Exercises
Nov. 15	Gram-Positive Bacilli Spore Formers Non Spore Formers	Readings: Chapter 15, pp. 260-267 Lab Exercises: Handouts and Computer Simulations

This session will address the following learning objectives:
1. Describe and recognize the following:
      a. Diphtheroid
      b. Metachromatic granules
      c. Pleomorphic
2.   State the purpose of the following media:
      a. Tellurite medium
      b. Loeffler serum medium
3.   Discuss the identification and infectious process of Corynebacterium diphtheriae. Describe
      the significance and technique used to identify its exotoxin.
4.   Describe the identification and clinical significance of C. jeikeium (group X).
5.   Explain the relevance of isolating:
      a. Corynebacterium uIcerans
      b. Corynebacterium pseudodiphtheriticum
6.   Describe the identification and clinical significance of Listeria monocytogenes.
      a. List the outstanding characteristics of this organism.
      b. Describe the types of infections and how they are transmitted.
7.   Discuss the homeostatic mechanism of Lactobacillus acidophilus
8.   Describe the infections attributed to Erysipelothrix rhusiopathiae.
9.   Based on colonial morphology and biochemical reactions, differentiate Lactobacillus,
      Erysipelotherix, and Listeria.
10. Describe the significant morphological and microscopic characteristics of the genus
      Bacillus.
11. List and describe the types of anthrax.
12. Compare and contrast Bacillus anthracis and Bacillus cereus, including biochemical
      reactions, morphological characteristics, and diseases.
13. Discuss the clinical significance of the nocardioforms and aerobic
      actinomycetes.
      a. Relate epidemiological, clinical, and pathological aspects of Nocardia.
      b. Differentiate Nocardia from other aerobic actinomycetes.

Date	Session Topics	Readings & Lab Exercises
Nov. 17-22	Anaerobes Specimen Collection Gram-Negatives Gram-Positives	Readings: Chapter 16, pp. 268-295 Lab Exercises: pp. 283-292 and Computer Simulations

This session will address the following learning objectives:
1.   Define and differentiate among obligate anaerobes, facultative anaerobes, and obligate
      aerobes.
2.   List at least 10 types of infections in which anaerobes may be found.
3.   Identify three anaerobes that are normal flora of the body and identify the site(s) of each.
4.   When given types of specimens submitted for anaerobic culture, indicate if each specimen
      is acceptable or not. Discuss why needle aspiration is preferred over collection by swab
      for anaerobes.
5.   State the purpose of each of the following anaerobic media:
      a. Anaerobic blood agar
      b. Phenylethyl alcohol blood agar
      c. Kanamycin-vancomycin blood agar
      d. Paromomycin-vancomycin laked blood
      e. Thioglycollate
      f. Bacteroides bile-esculin agar
6.   Discuss how an anaerobic environment may be achieved through the anaerobic jar,
      evacuation-replacement, glove box, or other methods.
7.   List and briefly explain how anaerobes are identified.
9.   List the important characteristics (Gram stain, colonial morphology, biochemical reactions)
      to identify each of the following Gram-negative bacilli:
      a. Bacteroides fragilis
      b. Prevotella intermedius
      c. Porphyromonas asaccharolyticus
      d. Fusobacterium nucleatum
      e. Fusobacterium necrophorum
      f. Fusobacterium mortiforum
10. Discuss the clinical relevance of isolation of the Gram-negative anaerobic bacilli.
11. For each of the following Clostridium, discuss the disease process and explain how each
      is identified:
      a. C. botulinum
      b. C. tetani
      c. C. perfringens
      d. C. difficile
12. List and describe the five Clostridium groups.
13. Describe the clinical relevance of isolation of the following Gram-positive
      non-spore-forming bacilli:
      a. Actinomyces israelli
      b. Propionibacteriurn acnes
14. List the clinically important Gram-negative anaerobic cocci.
15. Discuss how the following Gram-positive anaerobic cocci are identified, and relate the
      clinical significance of each.
      a. Peptostreptococcus anaerobius
      b. Peptococcus niger

Date	Session Topics	Readings & Lab Exercises
Nov. 24 Nov. 29	Mycobacteria Specimen Collection and Processing Runyon Classification	Readings: Chapter 17, pp. 296-325 Lab Exercises: pp. 309-322, Case Studies, Computer Simulations

This session will address the following learning objectives:
1.   Discuss why the mycobacteria are known as "acid-fast bacilli."
2.   Discuss safety measures to be observed when working with the mycobacteria.
3.   Describe the processes of digestion and decontamination for mycobacteria.
4.   Name the three categories of media used to cultivate mycobacteria.
      a. Give examples of each category.
      b. Compare the composition and use of each category of media.
      c. Correctly inoculate and incubate mycobacterial media.
5.   Contrast the Kinyoun and Ziehl-Neelsen stains.
6.   When given the number of acid-fast bacilli (AFB) seen per number of fields,
      state the CDC rating.
7.   State the principle and purpose of the following assays:
      a. Photochromogenicity
      b. Niacin accumulation
      c. Nitrate reduction
      d. Heat-stable catalase
      e. Tween 80 hydrolysis
      f. Arylsulfatase
      g. Pyrazinamidase
      h. Urease
      i. Growth in 5% NaCI
      j. Iron uptake
8.   Describe the usefulness of the following assays for mycobacterial identification.
      a. Photochromogenicity
      b. Niacin accumulation
      c. Nitrate reduction
      d. Tween 80 hydrolysis,
      e. Arylsulfatase
9.   Name the four Runyon groups and describe the characteristics of each. When given a
      species of Mycobacterium, state the correct Runyon group.
10. Describe the infectious process of tuberculosis.
      a. Explain how the infection is transmitted.
      b. Define the following terms:
         (1) Primary tuberculosis
         (2) Reactivation tuberculosis
11. Discuss the identification of M. tuberculosis, citing significant biochemical reactions.
12. For each of the following mycobacteria, state the Runyon group (when applicable),
      briefly describe its clinical significance, and discuss its identification
      a. M. ulcerans
      b. M. bovis
      c. M. leprae
      d. M, kansasii
      e. M. marinum
      f. M. simiae
      g. M. gordonae
      h. M. avium-intracellulare
      i. M. fortuitum-chelonei

Date	Session Topics	Readings & Lab Exercises
Dec. 1	Chlamydia, Mycoplasma and Rickettsia	Readings: Chapter18, pp. 326-333 Lab Exercises: Case Studies, Computer Simulations

This session will address the following learningc objectives:
1. State the important characteristics of the genus Chlamydia.
2. List the pathogenic species of Chlamydia and describe the diseases associated with each.
3. Describe the life cycle of Chlamydia.
4. Discuss how Chlamydia species are identified from clinical specimens.
5. List the important characteristics of the genus Mycoplasma.
6. Discuss the infectious diseases associated with Mycoplasma pneumoniae.
7. Describe how M. pneumoniae infection is diagnosed.
8. List the clinically significant genital mycoplasmas and ureaplasmas and name the
    associated infections.
9. For each of the following rickettsiae, name its group, species, and insect vector:
    a. Rocky Mountain spotted fever
    b. Rickettsialpox
    c. Endemic typhus
    d. Brill-Zinsser disease
    e. Scrub typhus
    f. Q fever
    g. Trench fever

Date	Session Topics	Readings & Assignments
Dec. 6	Exam 4: Chapters 15-18

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