CLINICAL MICROBIOLOGY AND VIROLOGY

Degree course: 
Corso di Second cycle degree in BIOMEDICAL SCIENCES
Academic year when starting the degree: 
2021/2022
Year: 
1
Academic year in which the course will be held: 
2021/2022
Course type: 
Supplementary compulsory subjects
Language: 
English
Credits: 
6
Period: 
Second semester
Standard lectures hours: 
48
Detail of lecture’s hours: 
Lesson (48 hours)
Requirements: 

Students are expected to be familiar with general microbiology skills and principles .

Final Examination: 
Orale

Oral exams, the minimum to pass the exam is 18/30. During the exam the student will be evaluated considering his knowledge and understanding ( 25 % ), the ability to apply knowledge and understanding ( 25 % ) , his independent judgment ( 15 % ), the communication skills ( 15 % ) and the ability to learn ( 20 % ) in relation to curse program.

Assessment: 
Voto Finale

The course aims at providing a complete overview of the major infections agents of medical interest, to understand the alterations that may cause infectious diseases.
Critically review the laboratory investigations and methods available in routine laboratories and new approaches, such as molecular biology techniques and MALDI-TOF, to diagnose infectious diesease through the recognition of pathogenic agent.
On successful completion of this module, the learner will be able to: Identify the laboratory approach for the evaluation of infectiuos disease. Identify the critical step in the laboratory investigations such as specimen sampling and transport. Identify the principles and evaluate the biochemical methodologies used for the isolation of specific microorganisms. Identify and appraise the hierarchical methods to be used in complex pipelines for microroganism identification. To evaluate the importance of the clinical presentation of the infectious disease leading to the use of the most appropriate laboratory method to diagnose the disease. Demonstrate the use of various laboratory instruments and equipment.
Applying knowledge and understanding (Skills and know how).
Be able to apply the methods to analyze the specimen used in microbiological laboratory as blood, urine, SCF in order to identify specific agents of pathology. Be able to employ the acquired notions to select specific list of exams to use for a complete diagnostic procedure and to select the appropriate technologies.

1.BACTERIOLOGY

I.INTRODUCTION
II. OVERVIEW OF THE LABORATORY’S ROLE IN THE DIAGNOSIS OF BACTERIAL INFECTIONS
III. ROAD TO BACTERIAL IDENTIFICATION
IV. SEQUENCING
V. MATRIX-ASSISTED LASER DESORPTION IONIZATION TIME-OF-FLIGHT MASS SPECTROMETRY (MALDI-TOF MS) FOR BACTERIAL IDENTIFICATION
VI. BASICS OF BACTERIAL IDENTIFICATION BY MALDI-TOF MS
VII. CLINICAL SYNDROMES

2.ANTIMICROBIAL SUSCEPTIBILITY TESTING

I. INTRODUCTION
II. KEY ANTIBACTERIAL AGENTS USED IN CLINICAL PRACTICE
III. PERFORMANCE OF ANITIMICROBIAL SUSCEPTIBILITY TEST
IV. ANTIMICROBIAL RESISTANCE AND TESTING CONSIDERATIONS FOR KEY BACTERIAL PATHOGENS
V. ANTIMICROBIAL RESISTANCE AND TESTING CONSIDERATIONS FOR MYCOBACTERIA AND AEROBIC ACTINOMYCETES
VI. SUSCEPTIBILITY TESTING OF CANDIDA SPECIES

3.MYCOBACTERIOLOGY

i. INTRODUCTION AND OVERVIEW OF MYCOBACTERIA
ii. CLASSIFICATION OF MYCOBACTERIA AND CLINICAL SIGNIFICANCE
iii. LABORATORY METHODS
iv. CONCLUSIONS AND FUTURE DIAGNOSTIC DEVELOPMENTS

4.MYCOLOGY

INTRODUCTION
MANUALS AND GUIDELINES
GLOSSARY OF MYCOLOGIC TERMS
ABBREVIATIONS
FUNGAL TAXONOMY AND NOMENCLATURE
EPIDEMIOLOGY OF FUNGAL INFECTIONS
LABORATORY DIAGNOSIS OF FUNGAL INFECTIONS: AN INTRODUCTION
LABORATORY DIAGNOSIS: PREANALYTICAL PHASE
LABORATORY DIAGNOSIS: ANALYTICAL PHASE
LABORATORY DIAGNOSIS: POSTANALYTICAL PHASE
ANTIFUNGAL AGENTS
INTRODUCTION TO FUNGAL INFECTIONS
BLOODSTREAM INFECTIONS AND ENDOCARDITIS
RESPIRATORY TRACT INFECTIONS
CENTRAL NERVOUS SYSTEM INFECTIONS
BONE AND JOINT INFECTIONS
INTRAABDOMINAL INFECTIONS
GASTROINTESTINAL INFECTIONS
URINARY TRACT INFECTIONS
GENITAL INFECTIONS
EYE INFECTIONS
EAR INFECTIONS
SKIN, HAIR, AND NAIL INFECTIONS
SUBCUTANEOUS INFECTIONS
MICROSPORIDIOSIS AND RARE INFECTIONS

5.PARASITOLOGY

I. INTRODUCTION
II. PARASITE CLASSIFICATION AND TAXONOMY
III. LABORATORY METHODS
IV. BLOOD AND TISSUE PROTOZOA
V. INTESTINAL AND UROGENITAL PROTOZOA AND MICROSPORIDIA
VI. INTESTINAL HELMINTHS
VII. BLOOD AND TISSUE HELMINTHS
VIII. MEDICALLY IMPORTANT ARTHROPODS
IX. DELUSIONAL PARASITOSIS

6.VIROLOGY

I. INTRODUCTION AND HISTORICAL PERSPECTIVE
II. VIRAL INFECTIONS OF THE RESPIRATORY TRACT
III. VIRAL INFECTIONS IN IMMUNOCOMPROMISED POPULATIONS
IV. SEXUALLY TRANSMITTED INFECTIONS
V. VIRAL INFECTIONS OF THE CENTRAL NERVOUS SYSTEM
VI. VIRAL GASTROENTERITIS
VII. VIRAL HEPATITIS
VIII. REEMERGING VACCINE-PREVENTABLE VIRAL ILLNESS
IX. SUMMARY AND CONCLUSION

1.Bacteriology
Introduction process of specimen submission to the clinical microbiology laboratory.
Identification of bacteria  key principles in biochemical identification.
Organism categorization  modern diagnostic methods such as MALDI-TOF MS and sequence-based identification.
Comprehensive discus¬sion of bacterial infections with a focus on the laboratory methods required to diagnose them.

2. Antimicrobial Susceptibility Testing
Key aspects of antimicrobial suscep¬tibility testing of bacteria, mycobacteria, and yeast.
Antimicrobial susceptibility testing (AST) effect of antimicrobial agents on the growth of an organism, in culture.
Standardization of AST  consis¬tent inoculum concentrations, test media, and incubation conditions.
Surrogate agent testing, detection of resistance mechanisms, use of commercial systems, and molecular methods for susceptibility testing
Additional testing  to detect impor¬tant resistance, including methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus, β-lactam resis¬tance in the Enterobacteriaceae, key concepts for testing Streptococcus pneumoniae, β-hemolytic Streptococcus spp., Neisseria gonorrhoeae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia.
Common antimicrobials used in clinical practice.

3. Mycobacteriology
Laboratory methods used for the detection and identification of Mycobacterium species.
Traditional microbiologic methods vs. molecular methods of detection and identification acid-fast staining and culture for mycobacteria, molecular technologies (nucleic acid hybridization probes, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), and DNA sequencing)
Nucleic acid amplification methods  detection of the M. tuberculosis complex and MAC within respiratory specimens, prediction of susceptibility to anti-infective therapy.

4. Mycology
Prevalent and emerging fungal infections
Review of nomenclature changes
Preanalytical, analytical, and postanalytical procedures for the laboratory diagnosis of fungal infections  fungal morphology
Common histopathologic and cytologic features related to anatomic pathology
Review of nonphenotypic methods  mass spectrometry, immunological assays, and molecular tests.
Principal fea¬tures of fungal infections  patient populations affected, clinical manifestations, relevant diag¬nostic approaches and tests, and therapeutic issues related to antifungal resistance.

5. Parasitology
Overview of human parasitology and the general laboratory approaches for identifying impor¬tant parasites in various specimens.
Conventional and state-of-the-art diagnostic methods  light microscopy, serology, antigen detection, and nucleic acid amplification.
Testing in blood and stool.
The most important human parasites  fundamental clinical and biologic informa¬tion needed for accurate diagnosis and management of infec¬tion.
Categories of parasites  blood and tissue protozoa, intestinal protozoa, intestinal helminths, tissue helminths, and medically important arthropods.

6. Virology
Use of qualitative and quantitative nucleic acid amplification and detection methods to diagnose and monitor viral infections.
Alternative diagnostic methods
Specific topics  viral infections of the respiratory tract, viral illness in immunocompromised populations, infections of the central nervous system, sexually transmitted viral illness, viral hepatitis, viral hemorrhagic fever, and diagnosis of vaccine-preventable viral infections.
Epidemiology of the key organisms responsible for each of the clinical syndromes
Factors impacting laboratory diagnosis and interpretation of results  optimal specimen type, availability of standardized assays, utility of qualitative versus quantitative results, multiplexed detection strategies, and potential shortcomings of current diagnostic approaches.

Tietz textbook of clinical chemistry and molecular biology, 6th edition
Jawetz, Melinick and Adelberg’s medical microbiology, 28th edition
Koneman’s Color Atlas and Textbook of Diagnostic Microbiology, 7th edition

Convenzionale

Lectures based on the use of power points presentations and video projections.

For student reception, make an appointment via email with the teachers.
Student Reception: appointment by e-mail (francesco.pallotti@uninsubria.it).