MLT 251 - Clinical Microbiology

1. Assess laboratory safety and quality control.
   1. Identify safety and precaution labels and signs.
   2. Disinfect work area.
   3. Wear appropriate personal protective equipment (PPE).
   4. Practice correct hand-washing technique.
   5. Dispose of biohazardous waste.
   6. Protect self, student-patient, and clinical patients from transmission of infectious disease.
   7. Perform appropriate error correction and documentation.
   8. Identify government agencies regulating laboratory results.
   9. Explain the use of quality control in the lab.
   10. Determine factors that affect procedures and results.
2. Practice sterile technique.
   1. Explain the difference between sterilization and disinfection; and, provide examples of physical and chemical methods of both.
   2. Differentiate among the biohazard safety levels.
   3. State the principle of an autoclave and state the standards (temperature, psi, time) for decontamination of most microbiological materials.
   4. Operate the biological safety cabinet (hood).
3. Evaluate specimen collection and processing.
   1. List types of transport containers and media, and their rationales.
   2. Identify criteria for specimen collection based on body site.
   3. Determine acceptability of a specimen for culturing; and, select corrective action if specimen is unacceptable.
   4. Calculate a colony count for a urine specimen.
   5. Define the Bartlett classification for sputum specimens.
   6. Differentiate among the following types of media: non-selective, differential, broths, selective, antibiotic; and provide examples of each.
   7. State the purpose for commonly-used plating media.
   8. Select appropriate media for plating when given a specimen from a specific body site.
   9. Demonstrate proper plate-streaking techniques for a given specimen.
   10. Accurately identify the types of hemolysis shown on 5% sheep blood agar.
   11. Describe how specimen alterations, inoculation; and incubation temperature, atmosphere and length affect growth on media.
   12. Differentiate obligate aerobe, facultative aerobe, microaerobe, obligate anaerobe, and capnophile.
4. Perform microscopic examination of infected materials.
   1. State the purpose of direct methods of examination: saline mount, iodine mount, potassium hydroxide, and India ink.
   2. Prepare smears from the following sources: swab, clear liquid, non-viscous fluids, granular material (e.g., tissue or bone).
   3. State the purpose of centrifuging non-viscous fluid prior to preparing a smear.
   4. Name the stains used to stain Mycobacterium.
   5. Differentiate among staining methods: Gram stain, Fluorescent, Kinyoun, Calcafluor white, Lactophenyl blue, antibody-conjugated.
   6. Perform Gram staining procedure.
   7. List examples of Gram positive and Gram negative cocci and bacilli.
   8. Identify Gram positive and Gram negative organisms, bacterial morphology, cells, and artifacts.
5. Examine colony morphology.
   1. Explain the reason growth of an organism on several plates is compared to one another, as well as to an initial Gram stain.
   2. List the colony characteristics that are used for differentiation of microorganisms.
   3. Correlate growth on plates with Gram stain results.
   4. Describe growth on plates with regard to size, color, amount, and special selective or differentiating characteristics (lactose/non-lactose fermenter, Gram positive on CNA, Gram negative on MAC, etc.).
   5. Relate colony morphology to organism identification
   6. Identify normal and pathogenic growth based on specimen site.
   7. Discuss how a Clinical Microbiologist determines the final identification of an organism.
6. Perform organism identification of Gram positive cocci, Gram negative cocci, Gram negative bacilli (fermenters and non-fermenters), Gram positive bacilli, and anaerobic organisms.
   1. State Gram stain morphology of organism.
   2. List media used to isolate organism.
   3. Correlate growth on media with organism.
   4. Select appropriate follow-up testing.
   5. Perform and interpret biochemical tests, including kits and multi-test systems.
   6. Discuss automated identification methods.
   7. Differentiate among species of an organism.
   8. Identify unknown organisms.
7. Correlate microorganism with related diseases or infections.
   1. Differentiate true pathogens from opportunistic pathogens.
   2. List examples of direct and indirect routes of infection.
   3. Define nosocomial infection; and, state examples of each type: community-acquired, endogenous, exogenous.
   4. Discuss signs of microbial infections, as well as laboratory procedures that are used to identify infectious disease.
   5. List the clinically significant species of organisms; and, state epidemiology of each.
   6. List and describe both common and severe infections caused by specific organisms.
8. Relate organism identification to body site.
   1. Define normal flora and discuss its role in the: mouth/oral cavity, nasopharynx, stomach and small intestines, and colon.
   2. Distinguish between sterile and non-sterile sites; and, list normal flora found in non-sterile sites.
   3. Describe how the presence or absence of normal flora impacts interpretation of lab results.
   4. List pathogens associated with body sites.
   5. List diseases that are acquired by adults, children, and neonates; and, discuss modes of transmission diagnosis and treatment.
9. Evaluate susceptibility testing.
   1. List considerations when selecting antimicrobial agents.
   2. Differentiate between bacteriocidal and bacteriostatic antimicrobials, and provide examples of each.
   3. Differentiate between narrow-spectrum and broad-spectrum antimicrobials, and provide examples of each.
   4. Define the minimum bacteriocidal concentration (MBC) and minimum inhibitory concentration (MIC).
   5. Perform titrations of antibiotics to determine the MIC and MBC.
   6. Discuss susceptibility testing using principles of immunology, serology, and automation.
   7. Explain the role of beta-lactamase in the treatment of various bacterial infections.
   8. Describe the mode of action and list examples of common antimicrobials.
   9. Describe autonomous, antagonistic, additive, and synergistic antimicrobial reactions.
   10. Discuss the Kirby-Bauer disk diffusion method.
   11. Explain the serum bacteriocidal test and its use in treatment.
   12. Differentiate between peak and trough levels as they pertain to therapeutic drug monitoring.
10. Discuss clinically-significant spirochetes.
    1. State the etiology of Syphilis, Yaws, Pinta, Lyme Disease, Relapsing Fever, Leptospirosis.
    2. List and describe the stages of syphilis.
    3. Compare and contrast treponemal and non-treponemal tests for syphilis.
    4. Discuss the symptoms and treatment of Lyme Disease.
11. Assess viruses clinically-significant to humans.
    1. Explain the infection process of viruses.
    2. Differentiate viruses based on structure, nucleic acid composition, and special characteristics.
    3. Describe collection, processing and transport of specimens for viral testing.
    4. Describe methods of viral detection.
    5. Discuss the important characteristics, route of infection, and identification of viruses.
    6. State the structure of the Human Immunodeficiency Virus (HIV).
    7. State immunologic markers of Acquired Immunodeficiency Syndrome (AIDS).
    8. List common opportunistic infections seen in patients AIDS.
    9. Perform testing for viruses.
12. Evaluate mycobacteria.
    1. Define acid-fast bacilli (AFB) and state why mycobacteria are considered acid-fast.
    2. List general characteristics of mycobacteria.
    3. List species of Mycobacterium in the Tuberculosis complex.
    4. Define MOTT; and, list common species of Mycobacterium that are included in this group.
    5. Describe specimen collection, decontamination, digestion, and concentration of mycobacteria.
    6. Recall common media and special requirements for isolating mycobacteria.
    7. Describe methods of direct examination and identification of mycobacteria.
    8. Differentiate among the Runyon classification of mycobacteria; and, name common species found in each category.
    9. Describe the etiology, symptoms, infections, laboratory identification, and treatment of Mycobacterium tuberculosis and other clinically-significant Mycobacterium species.
    10. Describe the purified protein derivative (PPD) test.
    11. Observe acid fast smears.
13. Discuss medically-important parasites.
    1. Discuss etiology and clinical significance of parasites.
    2. Identify stages in the malarial life cycle.
    3. Identify collection, transport, and processing of specimens for ova and parasite testing.
    4. Identify clinically-significant parasites.
    5. Describe methods of direct examination of parasites.
    6. Differentiate among Protozoa, Nemotodes, Cestodes, and Trematodes.
    7. Differentiate cysts and trophozoites (trophs).
14. Assess clinical manifestations of human mycoses.
    1. Describe specimen collection and transport.
    2. Discuss the clinical laboratory’s approach to diagnosis of fungal infections.
    3. Describe macroscopic and microscopic characteristics of clinically-significant mycotic organisms.
    4. Identify clinically-significant mycotic organisms.
    5. Correlate mycotic organisms with disease states (mycoses).
    6. Differentiate between yeast and mold phases.
    7. Define dimorphic fungi.
    8. Identify mycelium, conidia, macroconidia, microconidia, and blastoconidia.
15. Demonstrate professional conduct.
    1. Demonstrate interpersonal communication skills with patients, other health care professionals, and the public.
    2. Practice confidentiality.
    3. Follow written and verbal instructions.
    4. Demonstrate ethical time management.
    5. Choose workplace-appropriate clothing and jewelry.
    6. Recognize the responsibilities of other laboratory and health care personnel, interacting with them with respect to their jobs and patient care.
    7. Recognize the need for continuing education as a function of growth and maintenance of professional competence.
    8. Maintain professional growth and competence through involvement in continuing education.
    9. Demonstrate workplace basic skills of listening, writing, leadership, and time management.
    10. Practice written and oral communication skills.
    11. Create a team atmosphere in laboratory functions.
16. Demonstrate judgment and decision making skills.
    1. Analyze laboratory findings to recognize common procedural and technical problems.
    2. Perform corrective action.
    3. Check for sources of error.
    4. Evaluate laboratory findings to recognize and report the need for additional testing.