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8 pages/≈2200 words
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Harvard
Subject:
Biological & Biomedical Sciences
Type:
Lab Report
Language:
English (U.K.)
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Topic:

BHS002-2 Task: ID Of Microorganisms From Patient Samples

Lab Report Instructions:

BHS002-2 MEDICAL MICROBIOLOGY ASSESSMENT

 Patient 1, stool sample 24-year-old female nursery assistant, was advised by the NHS 111 phone service to seek medical attention following an acute episode of abdominal pain, vomiting and diarrhoea with blood and mucus. The patient exhibited symptoms of dehydration and an elevated temperature. Identification: Shigella sonnei

Patient 2, throat swab 4-year-old female, presented in Accident and Emergency with breathing difficulties. The patient has had a sore throat, low-grade fever and cough for several days. Pharyngoscopy revealed the presence of a grey membrane over the pharynx. Identification: Corynebacterium

Patient 3, CSF sample 39-year-old male, admitted as an emergency case with fever, headache, hallucinations, confusion and sensitivity to light. The patient was found to exhibit tachycardia and neck stiffness. A lumbar puncture was performed as blood tests revealed that the patient is HIV positive. Identification: Cryptococcus neoformans

 Patient 4, serous wound exudate 29-year-old male, presented to a walk-in clinic with pain, swelling and redness at a puncture wound in the upper arm. The patient was admitted to hospital immediately as his mental status deteriorated and the pathology appeared to be spreading along the limb. This individual has a recent history of intramuscular injection of narcotics. Identification: Clostridium perfringens

 Patient 5, cervical swab 34-year-old female, presented to her GP with fertility concerns. The patient has been unsuccessfully trying to conceive for 2 years. The patient underwent gynaecological examination and an inflamed cervix was noted. Identification: Chlamydia trachomatis.

 

Brief Description of Assessment Task

 · You will act as if you are a member of a hospital medical microbiology team working to diagnose the cause of an infection

 · For your submission, you are expected to prepare a portfolio (one document) containing five short, independent clinical microbiology reports that each describe the source of five patient samples and relevant clinical details (given to you), lists the results of the tests you believe would have been performed to obtain the identification given. You must also interpret/discuss the potential consequences of the results for the ‘patients’. Your report MUST include references from the scientific literature

  • · Your assignment should be structured in the format specified below and in the associated briefing material. References should be cited using Journal of Cell Science format, and should be submitted via BREO.

 · You must ensure that your assignment is written in your own words AND that all information is cited/referenced appropriately. Do not copy from group members, friends, lecturers, the protocol, websites, books, journal articles etc. Plagiarism of any kind will not be tolerated Skills taught / practiced / assessed Core technical skills Subject specific skills Transferable skills -Collaborative working and discussion -Contextualisation: relation to diagnosis -Report writing -Information research -Word processing -Referencing -Appreciation of importance of controls Maths / Statistics -Data handling -Appreciation of uncertainty -Accuracy, precision Academic Year 15-16 2 Relation to the Unit Learning Outcomes

 · This assessment will allow you to demonstrate your understanding of relevant microbiological tests used to culture and identify microorganisms

 · Your submission should demonstrate your capability to appropriately present and analyse scientific data, by using scientific language and IT resources to effectively communicate your findings · Your discussion should provide evidence of your ability to evaluate the role of pathogens and their pathogenicity in disease and illness Outline Of Report Structure This assignment brief explains the basic structure and requirements of your submission. Your assignment should be formatted as a portfolio (a single document) of six clinical microbiology reports. This means you write one short report for each sample, 1-5. EACH SHORT REPORT SHOULD NOT EXCEED 400 WORDS, so your whole portfolio will not exceed 2000 words excluding references. See BREO for an example of the layout. Each section should be clearly labelled. Clarity of English and presentation is essential throughout. Each report must contain in-text scientific references. 1)

Sample and clinical information

 · Present the sample information given to you (see BREO, assessments folder), including the sample type, patient details and symptoms

  • · Highlight a key detail for each patient that you think is likely to be an important factor in the case and suggest a formal disease diagnosis 2) Test Results

 · Briefly state the test EXPECTED test results for each sample based on the species ID you have been given (e.g. Gram stain, culture characteristics, biochemical features, metabolic needs and so on). As this is a short report used to convey information, you may not need to write full paragraphs of text here. 3) Interpretation (minimum 300 words in each individual report – note this is 65% of the marks) You should discuss the meaning of your findings here in full paragraphs of text. Ensure that you relate the identity of each organism to the symptoms displayed by the patients. You MUST:

  • · suggest what disease each patient could be suffering from based on the ID of the organism isolated from the patient. For each microorganism, suggest a suitable, specific treatment and give any other relevant advice
  • · for each microorganism, give at least one example of a relevant virulence factor and explain how this enhances pathogenicity

 · highlight any risk factors or possible underlying issues in the patient profile, explaining WHY these could contribute to disease caused by the particular organism.

References / Bibliography

You MUST include a list of references, in the correct format: as used in Journal of Cell Science. Ensure that all of your references are also cited in your text at the appropriate point. Aim to include at least five references, using no more than two textbooks. You MUST NOT copy any text from any sources, even if you cite the source – you must write about what you have read in your own words – this is very important.

Submission

The report will be marked according to the attached mark scheme, which explains our expectations in relation to the assessment criteria (quality of scientific understanding and analysis, data handling and presentation, critical evaluation and discussion, written expression and structure, and use of literature and referencing). It will be marked on a percentage scale according to the University of Bedfordshire regulations. Additional Information You must access BREO assessments folder) to obtain the patient case notes, sample information and identifications made for the five samples. You MUST base your portfolio on this information. DO NOT BASE YOUR PORTFOLIO ON ANY DATA YOU OBTAINED YOURSELF,

What disease does the patient have? What specific treatment should be prescribed? Are there any important risk factors to consider? Give a relevant virulence factor for the organism Further tests? How has this contributed to disease? You will write five individual sample reports

 

Lab Report Sample Content Preview:
Report To: Doctor XReport From: Laboratory XXX
[Clinic], [Street], [City][Address], [Contact No.]
Patient Name: Patient 1-Nursery Assistant Date of Report: 12-Jul 2017
Date of Birth: unknown, 24 years old Sample Type: stool
Gender: Female Date Collected: 7-Jul 2017
Microbiological Assessment
Reason for Referral:
The patient had an acute episode of abdominal pain, vomiting and diarrhea with blood and mucus. She also had symptoms of dehydration and hyperthermia which suggest severity of the condition. Bloody stool could be caused by Campylobacter jejuni, Escherichia coli, Salmonella, Shigella, Schistosoma, and Entamoeba histolytica (WHO, 2005). Microbial analysis is needed for a more appropriate treatment due to severity and urgency of the condition.
Results:
Test

Results

XLD agar, aerobic, at 35-37°C
for 18 - 24hr culture

1-2 mm pink red colonies without black centre

DCA agar, aerobic, at 35-37°C
for 18 - 24hr culture

Pale pink colonies

Gram Staining:

Gram negative rods

Urease Test:

Negative

Oxidase Test:

Negative

Carbohydrates Fermentation:

Positive

Agglutination Test:


API:


Identification: Shigella sonnei Confidence Level: 90%
Assessment: Shigellosis.
Discussion and Recommendation:
Shigella sonnei virulence is caused by release of enterotoxins that inhibit sodium chloride absorption which leads to infectious diarrhea. The bacteria colonize the gastrointestinal tract and continuously release toxins until the immune system takes control or when antibiotics take effect. Its virulence is enhanced by the Gram negative endotoxin lipid A which makes the bacterium resistant to opsonization, phagocytosis and intracellular killing. (Lindberg et al., 1991)
The patient is advised to consult with doctor for appropriate medications because taking dehydration solution might be insufficient to treat a severe condition. The patient is advised to avoid going to her workplace or participating in group activities where she might have contacted the disease. Working in nursing homes is a risk factor.
References:
Lindberg, A., Karnell, A., Weintraub, A. (1991). The Lipopolysaccharide of Shigella Bacteria as a Virulence Factor. Rev. Infect. Dis. 13, S279-S284.
Standards Unit, Microbiology Services, Public Health, England. (2015). UK Standards for Microbiology Investigations for Identification of Shigella Species. Bacteriology-Identification 3(20), 1-22
World Health Organization. (2005). Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae.
 
Prepared by: [Name of Student]
Report To: Doctor XReport From: Laboratory XXX
[Clinic], [Street], [City][Address], [Contact No.]
Patient Name: Patient -2Date of Report: 12-Jul 2017
Date of Birth: unknown, 4 years old Sample Type: throat swab
Gender: Female Date Collected: 7-Jul 2017
Microbiological Assessment
Reason for Referral:
The patient complained of breathing difficulties and was brought to emergency. She had a sore throat, low-grade fever and cough for several days. A grey membrane over the pharynx w...
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