Microbiology

Marks distribution of Assessment of Microbiology:

Total marks – 300

Written= 100 (MCQ 20+SAQ & SEQ 70+formative Assessment Marks 10)
MCQ=20 (Multiple T-F 10 + SBA 10)
SAQ + SEQ = 70
Structured oral examination (SOE) =100
Practical =100 (OSPE-50 +Traditional- 40+ Practical note book-05+ Integrated teaching-05)

[Students will prepare a short case report after each integrated teaching and will submit to all the departments of the respective phase. If a total of 5 classes of integrated teaching occur, students will submit 5 such reports.]

Learning Objectives and Course Contents in Microbiology

General Bacteriology

CORE:

Introduction of Microbiology:

Brief historical background
Branches of Microbiology
Legends in the field of Microbiology
Koch’s postulate, molecular Koch’s postulate, the limitations, and new adjustments
Concept of medical biotechnology in relation to Microbiology
Importance and scope of microbiology in medical science

Bacterial cell:

Prokaryotic and Eukaryotic cells with examples
Different structures of the bacterial cell and their functions
Brief description of the cell wall of Gram-positive and Gram-negative bacteria
Spores structure and clinical importance
L-forms, protoplast, spheroplast, Clinical importance of L-form

Bacterial classification and staining:

Nomenclature of Bacteria
Classification by staining, morphology, Oxygen requirement, and temperature requirement
Staining- Theoretical basis and clinical significance of Gram and Z-N stain, Albert stain, Auramin-Rodamin stain

Practical staining: Gram, Z-N staining, and Albert stain

Nutrition and Cultivation of Bacteria:

Nutritional requirements for the growth of bacteria
Growth curve: phases with clinical significance
Common bacteriological media: classification and uses

Sterilization and Disinfection:

Definition, classification, and applications of sterilization, disinfection, and antisepsis
Methods of sterilizations: details of autoclaving, hot air oven, and chemical methods
Sterilization of medical equipment and culture media
Disinfection of body fluid spillage and equipment
Preparation of disinfectants and their use

Antimicrobial agents:

Definition of antibiotics, antimicrobial agents, chemotherapeutics, bacteriostatic, bacteriocidal, synergism, antagonism, selective toxicity, etc

Classification of anti-microbial agents
Mechanism of action on bacteria with examples
Drug resistance: origin, mechanism, transmission and prevention
Indication of a combination of antibiotics in bacterial infection
Hazards of indiscriminate use of antibiotics
Defining MDR, XDR, and PDR bacteria
Definition and importance of ESBL, MBL, MRSA, VRSA, VRE
Definition and importance of Biofilm

Host-Parasite relationship:

Terms and Definitions.
Parasite and Host attributes
Normal flora, opportunistic pathogens, and their clinical importance

Pathogenesis of bacterial diseases:

Transmission of bacterial agents
Virulence factors: e.g. antigens, toxins, enzymes, invasiveness, and their role in the pathogenesis of

diseases with examples.

Bacterial Genetics:

Bacterial genome, DNA, chromosome, plasmid, transposon, etc
Gene transfer in bacteria
Bacterial DNA replication
DNA recombination, principles of Cloning, and genetic engineering

Septic Shock

Systemic Bacteriology

Staphylococci: S. aureus, S. epidermidis, S. saprophyticus, Enterococcus(VRE), MRSA, VRSA
Streptococci: Group A Streptococcus, Streptococcus agalactiae and Streptococcus pneumoniae
Neissreia: N. gonorrhoea, N. meningitides
Corynebacterium diphtheriae
Enterobacteriaceae: Classification: Salmonella, Shigella, Esch. Coli and other Enterobacteriaceae
Definition and clinical significance of ESBL, MBL, and NDM-producing bacteria.
Vibrio cholera
Helicobacter pylori
Mycobacterium: M. tuberculosis, Atypical mycobacteria, and M. lepra. MDR, XDR TB
Anaerobic bacteria: Clostridium: Cl. tetani, Cl. botulinum, Cl. perfringens and other anaerobic bacteria
Bacillus: B. Anthracis, B. Cereus, B. Subtilis
Spirochaetes: Treponemma pallidum
Important characteristics and diseases produced by: Rickettsia Haemophilus influenzae, Haemophilus
Ducey, Mycoplasma, Chlamydia, Nocardia, Actinomycetes species

Additional:

Streptococcus Group D
Klebsiella, Proteus , Pseudomonas: Ps. aeruginosa , Aeromonas, Plesiomonas,
Campylobacter jejune
Bacteroides species
Clostridium domicile
Listeria
Burkholderia
G. vaginalis
Probiotics

Immunology

CORE:

1. Introduction:

Brief historical background
Basic concepts of immunity: Definition, classification, types, and components with examples

2. Immune system:

Organs, cells, and soluble components

3. Antigens and Immunogens:

Terms and definitions: antigen, immunogen, hapten, epitope, paratope. Criteria of immunogenicity

4. Major histocompatibility complex (MHC/ HLA):

Terms and definitions, types and distribution, clinical and biological significance

5. Immunoglobulins and Antibodies:

Terms and definitions, classification, structure, biological properties, and functions.
Monoclonal antibodies

6. Complements:

Terms and definitions, activation, biological functions and clinical significance, deficiency disorders

7. Mechanisms of immune response:

Antibody and cell-mediated immune response
Primary and secondary immune response

8. Hypersensitivity:

Terms and definitions, classifications, mechanisms, and clinical significance with examples
Atopy, desensitization
Tests for Type-I reaction: Patch test, RAST, serum IgE assay

9. Transplantation and Tumor immunity:

Terms and definitions, types and outline of prevention of graft rejection
Tumor antigens, role in diagnosis and clinical significance
Immunosurveillance

10. Tolerance and Autoimmunity:

Definition and classification of tolerance
Terms and definitions, basic concepts, and mechanism of development of autoimmunity

11. Immunodeficiency disorders and immunotherapy:

Classification with examples

12. Agents of immunotherapy and biologics

13. Immunodiagnostic tests

Terms and definitions, types and applications in diagnostic medicine
Agglutination, precipitation, ELISA, Western blot test, PCR and RT-PCR

Parasitology

CORE:

Introduction:

Introduction to parasitology, common parasitic diseases of Bangladesh, Terms and definitions, classifications of parasites according to habitat

Host: definition, classification with examples

Intestinal, luminal, and free-living protozoa:

Entamoeba:

Classification
Geographical distribution, morphology, disease, clinical features, pathogenesis, laboratory diagnosis and treatment

Extraintestinal amoebiasis

Giardia intestinalis and Trichomonas vaginalis:

Morphology, transmission, disease, clinical features, pathogenesis, laboratory diagnosis and treatment
Acanthamoeba, Naegleria, Balamuthia and Sappinia

Blood and Tissue Protozoa:

Leishmania species: Classification, morphology, disease production.

Leishmania donovani and PKDL:

Geographical distribution morphology, lifecycle, disease, clinical features, pathogenesis laboratory diagnosis and treatment

Cutaneous leishmaniasis: Causative agents, pathogenesis, lab diagnosis and management
Mucocutaneous leishmaniasis (MCL)

Plasmodium species:

Epidemiology, morphology, lifecycle, disease, clinical features, pathogenesis, complications, laboratory diagnosis, treatment and prevention

Acanthamoeba, Naegleria, Balamuthia, and Sappinia

Toxoplasma gondii, Cryptosporidium, Balantidium coli

Cestodes and Trematodes:

Classify according to habitat with examples
Common characteristics of Cestodes, Trematodes, and Nematodes
Morphology, lifecycle, diseases, clinical features, pathogenesis, laboratory diagnosis of Taenia saginata and Taenia solium, T. asiatica

Echinococcus: Different species

Morphology, lifecycle, disease, clinical features, pathogenesis, and laboratory diagnosis and treatment

Intestinal Nematodes:

Geographical distribution, morphology, lifecycle, disease, clinical features, pathogenesis, laboratory diagnosis of Ascaris lumbricoides, Hookworm, Trichuris trichiura, Enterobious vermicularis, Strongyloides stercoralis

Larva migrans and larva currens
Hyperinfection syndrome

Tissue nematodes: Classification, morphology, and mode of transmission, diseases produced. Wuchareria bancrofti, Brugia malayi, B. timori

Morphology, lifecycle, disease (classical and occult filariasis, tropical pulmonary eosinophilia), clinical features, pathogenesis, complications, laboratory diagnosis and treatment of filariasis. Periodicity of microfilaria. Provocative test

Parasites associated with cancer

Additional:

1. Important characteristics and diseases produced by:

Hymenolepes nana, Diphylobothrium latum, Dipylidium
Schistosoma
Trypanosoma
Loa loa, Onchosercous volvulus
D. medians
Fasiolopsis buski, Fasciola hepatica: habitat, disease, clinical features, laboratory diagnosis and treatment
Anisakis
Cyclospora, Cystoisospora, Sarcocystis
Trichinella

Virology

CORE:

1. General virology:

Introduction to virology, common viral diseases in Bangladesh
The basic structure of the virus
Outline of viral replication
Classification
Lab diagnosis of viral diseases
Antiviral agents

2. Herpes viruses:

Classification, important characteristics, diseases, important clinical features, transmission, pathogenesis, complications, laboratory diagnosis, treatment and prevention

Latency and reactivation of Herpes viruses

3. Orthomyxo and para myxo viruses

Important characteristics, diseases, important clinical features, transmission, pathogenesis, complications, laboratory diagnosis, prevention, and management

4. Hepatitis viruses:

Classification, important characteristics, diseases, transmission, pathogenesis, complications, laboratory diagnosis, prevention, and management

5. Poliovirus

Important characteristics, diseases, transmission, pathogenesis, laboratory diagnosis and prevention
Merits and demerits of oral and injectable polio vaccine

6. Rabies virus:

Important characteristics, diseases, transmission, pathogenesis, laboratory diagnosis and prevention and treatment, merits, and demerits of different types of vaccines

7. Rotavirus:

Diseases, transmission, pathogenesis, laboratory diagnosis, prevention and treatment

8. HIV:

Classification, important characteristics, diseases (AIDS), transmission, pathogenesis, laboratory diagnosis, prevention, and treatment

9. Dengue

Important characteristics, diseases (DHF, DSS), transmission, pathogenesis, laboratory diagnosis, prevention, and treatment

10. Chikungunya: Important characteristics, transmission, epidemiology, pathogenesis, laboratory diagnosis, prevention and treatment

11. Coronavirus: Important characteristics, epidemiology, transmission, pathogenesis, organs involved, clinical features, laboratory diagnosis, prevention and treatment of COVID-19 and other Coronaviruses

12. Other Emerging viral diseases

Avian flu, SARS, MERS, Nipah, Swine flue, Zika, Ebola, etc

Important characteristics of the virus, important clinical features, transmission, pathogenesis, laboratory diagnosis, and prevention

13. Oncogenic viruses

Definitions, list of oncogenic viruses with their associated tumors

14. Latent and chronic viral infections

Mycology

CORE:

1. Introduction:

Introduction to Mycology, beneficial and detrimental effects, morphology, classification
Difference between fungus and bacteria
Antifungal agents and antifungal drug resistance

2. Superficial and cutaneous mycoses:

Aetiological agents and diseases
Transmission and pathogenesis, laboratory diagnosis of Pityriasis versicolor, Dermatophytosis

3. Subcutaneous

Aetiological agents and diseases
Transmission, pathogenesis, and Lab Diagnosis
Rhinosporiodiasis and Madura foot

4. Systemic mycoses:

Aetiological agents and diseases
Transmission, pathogenesis, and lab diagnosis
Histoplasmosis, Cryptococcal meningitis, Candidiasis, Pneumocystis jerovici, fungus ball, mycotoxin

5. Opportunistic fungal diseases

Clinical Microbiology

CORE:

1. Collection of samples, transportation, and storage

2. Microbial diseases of Gastrointestinal and Hepatobiliary diseases and Food poisoning

3. Microbial diseases of the Genito-Urinary system

4. Microbial diseases of upper and lower Respiratory Tract

5. Microbial diseases of CNS

6. Hospital Acquired Infections

7. Microbial diseases of Bone and Soft Tissue

8. Microbial diseases of the Cardiovascular System

9. Microbial diseases of the eye, ear, nose, and throat

10. Pyrexia of unknown origin (Microbial cause with emphasis on blood culture)

11. Infectious disease control and prevention

12. Collection, transport, preservation, and lab tests of samples collected from COVID-19 patients

13. Use of different types of masks, sanitizers, and PPE in the prevention of viral infections

Practical

1. Gram’s staining

2. Z-N staining, Albert stain, Auramin-Rodamin stain

3. Demonstration of culture media namely Nutrient agar, Blood agar, Chocolate agar, MacConkey’s agar, Lowenstein Jensen, Robertson’s cooked meat media, Blood culture media, transport media (Carry-Blair/Stuart/Peptone water) with and without bacterial growth

4. Demonstration of colony morphology of common bacteria: Staphylococci, Streptococcus Lactose fermenters, Lactose nonfermenters, Proteus, Klebsiella, E. coli, Pseudomonas, Mycobacterium

5. Demonstration of inoculation, incubation (aerobic, CO2 and Anaerobic condition), and plate reading

6. Demonstration of catalase, coagulase, oxidase, TSI, MIU, and Simmon’s citrate tests

7. Demonstration of in vitro antibiotic sensitivity test by disk diffusion method

8. Demonstration of sterilization by chemical agents autoclaving and hot air oven

9. Demonstration of donning and doffing, wearing PPE, and hand washing/sanitization

10. Preparation of disinfectants

Demonstration

Microscopic examination of stool for demonstration of cyst/trophozoites of protozoa, ova/larva of intestinal helminths, pus cells, macrophage, and RBC

Microscopic examination of urine for demonstration of epithelial cells, pus cells, RBCs, casts, and parasites

Examination of blood smear for demonstration of malarial parasites
Examination of bone marrow smear for LD body
Microscopic examination of Gram stain smear of throat swab, wound swab, urethral discharge
Examination of throat swab by Albert stain
Microscopic examination of sputum and urine by Z-N stain for AFB
Modified Z-N stain for Cryptosporidium in stool
Immunological tests: Demonstration and interpretation of Widal test, RPR, ICT for HBsAg, Dengue, Chikungunya, HIV, HCV, COVID-19, Plasmodium, LD body and Filaria

Microscopic examination of skin scrapping for demonstration of fungal elements (dermatophytes and candida)

PCR and RT-PCR