Infectious Episode of Streptococcus Pyogenes and Treatment

Infectious Episode of Streptococcus Pyogenes and Treatment A B C D Morphology appearance on AGAR Cocci. Cocci in clusters, short chains, diplococci and single cocci. Thin swabbed orange pigment from plate. Surrounded by zones of clear beta-hemolysis. Cocci. Large round pale opaque grey colonies surrounded by zones of clear beta-hemolysis. Shiny. Bacilli. Small rod pale opaque grey colonies. Translucent. Shiny. Bacilli. Medium size colonies. Dark grey green. Gram Reaction Purple. Positive. Purple. Positive. Pink. Negative. Pink. Negative. Oxidase Negative. Positive. Catalase Negative. Positive. Coagulase Positive. Strep Grouping Latex Positive for group A. Presumptive Identification ? Streptococcus pyogenes. Staphylococcus aureus. Enterobacteria. Pseudomonas species. A = Streptococcus pyogenes. To further confirm that sample A is Streptococcus pyogenes you can undergo a PYR test. The PYR test is a rapid colorimetric method which tests for the presence of the enzyme pyrrolidonyl aminopeptidase present in the microorganism. The enzyme hydrolyses L-pyrrolidonyl-ÃŽÂ ²-naphthylamide (PYR) to ÃŽÂ ²-naphthylamide, which produces a red colour when a cinnamaldehyde reagent is added. Paper strips are used to perform the test. A positive result for this test shows the typical morphology of S. pyogenes (Ferretti et al, 2016). Streptococcus pyogenes can also be tested by bacitracin test due to their sensitivity towards it. The test is used because other streptococci is resistant to bacitracin. A bacitracin test is undergone by making a subculture of the S. pyogenes on sheep blood agar. The bacterial strain S. pyogenes being tested is streaked with individual colonies of a culture which is pure from an SBA agar plate and a disk containing 0.04 units of bacitracin is put onto the SBA plate. Incubation overnight at a temperature of 35Â °C in CO2 (5%) then occurs. A zone of inhibition surrounding the disc indicates the susceptibility of the strain (Ferretti et al, 2016). B = Staphylococcus aureus. To further confirm that sample B is Staphylococcus aureus the thermostable DNase test can be used. The thermostable DNAse test is performed using the agar diffusion method. 2ml aliquot of broth of the blood culture is boiled for a duration of 15 minutes and then allowed to cool to room temperature. Holes of six-millimetres are cut in toluidine blue DNase agar plates. 100Â µl of the boiled culture broth is placed into the well and then incubated at 37oC. Tests are read during 2 and 4 hours. The PPVs and NPVs for the culture is calculated as well as sensitivities and specificities. A result of 100% sensitivity means S. aureus is present (Lagace-Wiens et al, 2007). To distinguish whether the strain is MSSA or MRSA a cefoxitin test is carried out. Susceptibility to cefoxitin is determined by the diffusion disc method on Mueller-Hinton agar plates. A suspension of the organisms is adjusted to 0.5x MacFarland standard, diluted to 1:100 and inoculated onto the Mueller-Hinton agar by streaking the agar surface all over. 30-Â µg cefoxitin disks are applied and the plates are incubated at 37oC for 24 hours. An isolate is an MRSA strain if the cefoxitin inhibition zone diameter is less than or equal to 21 mm (Boutiba-Ben Boubaker et al, 2004). C= Enterobacteria. To further confirm what enterobacteria sample c is, further tests need to be undertaken. To see if sample c is a type of Escherichia bacteria use the lipase test. The test sees if the bacteria uses corn oil as a source of carbon and energy for growth. The result will be negative (if Escherichia) because the colour will be unchanged as no lipase is present (Vumicro.com, n.d.-b). To see if the sample is a Yersinia bacteria the lysine decarboxylase test can be used. The test sees if the bacteria can use lysine as a source of carbon and energy for growth. The result will be negative (if Yersinia) because of lack of colour change to yellow at 24 hours and back to purple at 48 hours (Vumicro.com, n.d.-c). To see if the sample is a Salmonella bacteria use the maltose test. The result will be negative (if Salmonella) due to magenta or hot pink in colour (Vumicro.com, n.d.-a). The citrate test needs to be undertaken to see if the sample is a Shigella bacteria. The test is a test used to assess the ability of the bacteria to utilize sodium citrate and ammonium dihydrogen phosphate. If the sample is a Shigella bacteria then the result for this test will be negative as there will be no colour change as the colour will stay deep forest green (Acharya, 2013). D = Pseudomonas species. To further confirm that sample D is Pseudomonas species a methyl red test can be used. The methyl red test is a test which detects the production of sufficient acid when glucose is fermented and the conditions are maintained such that the pH of the previous culture is kept below the value of 4.5, which is shown by the colour change of the methyl red indicator which is added when the period of incubation finishes. The result of this test for Pseudomonas species is negative because there is no change in colour when methyl red is added. The colour stays yellow (Online Microbiology Notes, 2014a). Another test that can be used is the voges-proskauer (VP) test. The test is a test used to see whether the pathogen produces acetylmethyl carbinol from glucose fermentation. If acteylmethyl carbinol is present it is converted to diacetyl in the presence of ÃŽÂ ±-naphthol, strong alkali and oxygen. Diacetyl found in the peptones in the broth is then condensed to form a pinkish red polymer. The result of this test for Pseudomonas species is negative because acetylmethyl carbinol is not present in Pseudomonas species (Online Microbiology Notes, 2014b). Infectious episode of Streptococcus pyogenes and treatment Streptococcus pyogenes is one of the most important pathogens that cause skin and soft-tissue infections and is also associated with septicaemia and other severe complications (Segal et al, 2005). An example of a disease caused by Streptococcus pyogenes is scarlet fever. Scarlet fever is a contagious bacterial infection which affects children between 5 and 18 years old. It is spread by contact of droplets from the cough and sneezes of an infected person. Fever and sore throat is the first stage of illness. There also may be chills, vomiting and abdominal pain. The tongue is swollen and has a whitish coating. Throat and tonsils become very red and sore, and swallowing becomes incredibly painful. After one or two days of the illness, a rash appears which is red in colour. Strep bacteria of the strain produce a toxin (poison) that causes people to break out in the rash. The rash appears first on the neck, underarm, and groin, which then spreads throughout the body. The rashes are small, flat red blotches that gradually change into fine bumps and feel like sandpaper. The cheeks have a flushed appearance, but there may also be a pale area around the mouth. Around the underarm, elbow, and groin the skin creases are brighter than the rest of the rash. These rashes are termed pastias lines. Complications of kidney damage, hepatitis, vasculitis, septicaemia, congestive heart failure and death may occur (Davis, n.d.). Scarlet fever can be treated with antibiotics. A strep test is needed. The test involves swabbing the throat to confirm whether group A streptococcus is creating the illness. If it is positive, prescription of antibiotics is needed. Antibiotics allows scarlet fever patients recover sooner and protect people from catching the disease (Centers for Disease Control and Prevention, 2017). Infectious episode of Staphylococcus aureus and treatment Staphylococcus aureus can cause endocarditis. Endocarditis occurs when the bacteria adheres to the cardiac valve. Bacteria can colonize the vegetation composed of fibrin and platelets (Keynan and Rubinstein, 2013). S. aureus enters the bloodstream due to healthcare procedures because of the dentogen pathway or drug use. Bacteria adhere extremely fast usually within minutes to an injured valve surface via deposition on platelet fibrin. It also adheres to inflamed valve surface. S. aureus enters via an intracellular route to the valve endothelium which contributes to inflammation and aggressive tissue destruction by the bacteria. The increase of bacteria on and in the endothelium leads to maturation of vegetation on the valve. Spreading of pathogens occurs from embolization of vegetation particles. This leads to complications such as stroke, haemorrhage, meningitis or reaction to the meningeal, brain abscess, and mycotic aneurysm (Werdan et al, 2013). There are many impacts of endocard itis which are physical and emotional. In the acute phase, unpleasant symptoms can be experienced which include high temperature, chills, loss of appetite, headache, muscle and joint pain, night sweats, shortness of breath and persistent coughs. People who suffer from endocarditis experience complications of blood supply to the brain which is affected. Worry and anxiety can occur which creates symptoms such as a racing heart, increased breathing rate, a dry mouth, sweating, tingling and feeling dizzy. Low mood and depression also occurs because of endocarditis. When patients feel unwell and are being stuck in a hospital they can become sad. Feeling of hopelessness about the future and lacking in energy and drive can also occur. Struggling to enjoy the things you used to enjoy and feeling bad about yourself or criticised by others along with not being able to sleep or eat well occurs as well (Coping after Endocarditis, n.d.). Endocarditis is treated with a course of antibiotics or su rgery (Nhs.uk, 2016). Infectious episode of Enterobacteria and treatment Enterobacteria such as E. coli can cause gastroenteritis. E. coli enters the gastrointestinal tract and attaches to the lining of the intestinal mucosa where it secretes enterotoxins. Invasion of the intestinal mucosa does not occur. Toxins produced by the bacteria affect absorptions of nutrients and causes the cells of the intestinal mucosa to secrete electrolytes and water. Evidence of this will be in the form of profuse watery diarrhoea including vomiting which starts in 12 to 48 hours after ingestion. Other E. coli strains invade the cells of the mucosa and cause stress ulcers and bleeding. This creates inflammatory diarrhoea commonly associated with diarrhoea which sometimes can be bloody and there is a huge amount of abdominal pain. Toxins which E. coli produce present in foods causes secretory diarrhoea which is profuse and watery with nausea and vomiting that is very prominent. It is fast acting and symptoms may be evident in less than 12 hours after ingesting contaminated fo od. In some cases, the symptoms may be present in 1 to 6 hours. Patients with gastroenteritis have an increased risk for aortic aneurysm and ulcerative colitis (Ternhag et al, 2008). Treatments for gastroenteritis include antibiotics. Not every case of the disease needs antibiotics. Majority of cases of gastroenteritis are self-limiting and resolve in days. If the E. coli strain is associated with stool culture and persisting symptoms, then antibiotic treatment is needed. Patients which are immunocompromised also need antibiotics. Antidiarrheal agents can also be used to treat gastroenteritis. Antidiarrheal agents are used when symptoms are persisting even when antibiotics have been taken. The use of the agent is dependent on a case by case and needs to be consulted with a medical doctor before using an antidiarrheal agent. If a persistent diarrhoea is present then probiotics may also be needed (Chris, n.d.). Infectious episode of Pseudomonas species Pseudomonas aeruginosa is the type specie for Pseudomonas which can cause bronchopneumonia. It is an inflammation of the lungs characterized by foci of consolidation surrounded by normal parenchyma. Bronchopneumonia affects one or more lobes, being frequently bilateral and basal (Pathologyatlas.ro, 2014). When a person suffers from bronchopneumonia the lung parenchyma is attacked by the bacteria. An immune inflammatory response is triggered in response to this. Because of this, the alveolar sacs fill with exudate. Consolidation then occurs when the air space is replaced by the exudate (fluid). Also there are multiple areas which is isolated of consolidation, affecting various pulmonary lobes (Hellomrdoctor.com, 2016). Lobular bronchopneumonia can lead to lobar pneumonia. Exudate starts to build up in the basal lobes. The affectation from this disease is bilateral. The lesions diameter vary between 2 and 4 cm and the lesions turn yellow or grey in colour, is dry and centred on a bronc hiole. As well as this, their delimitation is not clear and the lesions become united. Suppurative exudate gathers due to inflammation in the bronchioles. As more bronchioles suffer inflammation, the congestion experienced by the patient becomes more extensive. Between the areas of consolidation, the parenchyma remains normal and aerated (Hellomrdoctor.com, 2016). The effect of bronchopneumonia includes coughing and fever which makes breathing become difficult. If it is not treated mortality can be as high as 40%. If bronchopneumonia becomes severe the outer lining of the lungs and the inner lining of the chest becomes inflamed making breathing even more painful (Quinn, n.d.). If a person has bacterial bronchopneumonia antibiotics are prescribed. Antibiotics will destroy the bacteria causing the infection. Most people feel better within one to three days after starting antibiotics. Fever reducer or cough medication for bronchopneumonia may also be prescribed. These medications can h elp relieve symptoms, but does not cure the patient (Martel, 2015). Bibliography Acharya, T. (2013). Citrate utilization test: Principle, Procedure, expected results and positive organisms microbeonline. [Online] microbeonline. Available at: http://microbeonline.com/citrate-utilization-test-principle-procedure-expected-results-and-positive-organisms/ [Accessed 28 Mar. 2017]. Boutiba-Ben Boubaker, I., Ben Abbes, R., Ben Abdallah, H., Mamlouk, K., Mahjoubi, F., Kammoun, A., Hammami, A. and Ben Redjeb, S. (2004). Evaluation of a cefoxitin disk diffusion test for the routine detection of methicillin-resistant Staphylococcus aureus. Clinical Microbiology and Infection, 10(8), pp.762-765. Centers for Disease Control and Prevention. (2017). Scarlet Fever. [Online] Available at: https://www.cdc.gov/Features/ScarletFever/ [Accessed 12 Mar. 2017]. Chris, D. (n.d.). What is Bacterial Gastroenteritis? Pathophysiology and Treatment | Healthhype.com. [Online] Healthhype.com. Available at: http://www.healthhype.com/what-is-bacterial-gastroenteritis-pathophysiology-and-treatment.html [Accessed 13 Mar. 2017]. Coping after Endocarditis. (n.d.). 1st ed. [PDF] London: Imparts, pp.1-13. Available at: https://www.kcl.ac.uk/ioppn/depts/pm/research/imparts/Quick-links/Self-Help-Materials/Coping-After-Endocarditis-(long).pdf [Accessed 15 Mar. 2017]. Davis, C. (n.d.). Scarlet Fever (Scarlatina) Symptoms, Treatment, Causes What is the prognosis of scarlet fever? What are the long-term effects of scarlet fever? MedicineNet. [Online] MedicineNet. Available at: http://www.medicinenet.com/scarlet_fever_scarlatina/page4.htm [Accessed 17 Mar. 2017]. Ferretti, J., Stevens, D. and Fischetti, V. (2016). Streptococcus pyogenes : Basic Biology to Clinical Manifestations. 1st ed. [ebook] Oklahoma City: University of Oklahoma Health Sciences Center, pp.875-891. Available at: https://www.ncbi.nlm.nih.gov/books/NBK343617/ [Accessed 10 Mar. 2017]. Hellomrdoctor.com. (2016). Bronchopneumonia Symptoms, Pathophysiology, Diagnosis, Treatment. [Online] Available at: http://hellomrdoctor.com/bronchopneumonia/ [Accessed 13 Mar. 2017]. Keynan, Y. and Rubinstein, E. (2013). Pathophysiology of Infective Endocarditis. Current Infectious Disease Reports, 15(4), pp.342-346. Lagace-Wiens, P., Alfa, M., Manickam, K. and Karlowsky, J. (2007). Thermostable DNase Is Superior to Tube Coagulase for Direct Detection of Staphylococcus aureus in Positive Blood Cultures. Journal of Clinical Microbiology, 45(10), pp.3478-3479. Martel, J. (2015). Bronchopneumonia. [Online] Healthline. Available at: http://www.healthline.com/health/bronchopneumonia#Overview1 [Accessed 13 Mar. 2017]. Nhs.uk. (2016). Endocarditis Treatment NHS Choices. [Online] Available at: http://www.nhs.uk/Conditions/Endocarditis/Pages/Treatment.aspx [Accessed 15 Mar. 2017]. Online Microbiology Notes. (2014a). Methyl Red (MR) Test- Principle, Procedure and Result Interpretation. [online] Available at: http://www.microbiologyinfo.com/methyl-red-mr-test-principle-procedure-and-result-interpretation/ [Accessed 17 Mar. 2017]. Online Microbiology Notes. (2014b). Voges-Proskauer (VP) Test- Principle, Reagents, Procedure and Result. [online] Available at: http://www.microbiologyinfo.com/voges-proskauer-vp-test-principle-reagents-procedure-and-result/ [Accessed 17 Mar. 2017]. Quinn, B. (n.d.). The effects of pneumonia. [Online] Telegraph.co.uk. Available at: http://www.telegraph.co.uk/news/uknews/1553760/The-effects-of-pneumonia.html [Accessed 22 Mar. 2017]. Segal, N., Givon-Lavi, N., Leibovitz, E., Yagupsky, P., Leiberman, A. and Dagan, R. (2005). Acute Otitis Media Caused by Streptococcus pyogenes in Children. Clinical Infectious Diseases, 41(1), pp.35-41. Tong, S., Davis, J., Eichenberger, E., Holland, T. and Fowler, V. (2015). Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management. Clinical Microbiology Reviews, 28(3), pp.603-661. Ternhag, A., TÃ ¶rner, A., Svensson, Ã…., Ekdahl, K. and Giesecke, J. (2008). Short- and Long-term Effects of Bacterial Gastrointestinal Infections. Emerging Infectious Diseases, 14(1), pp.143-148. Vumicro.com. (n.d.-a). Maltose Fermentation Test. [Online] Available at: http://www.vumicro.com/vumie/help/VUMICRO/Maltose_Fermentation_Test.htm [Accessed 28 Mar. 2017]. Vumicro.com. (n.d.-b). Lipase (Corn Oil) Test. [Online] Available at: http://www.vumicro.com/vumie/help/VUMICRO/Lipase_Corn_Oil_Test.htm [Accessed 28 Mar. 2017]. Vumicro.com. (n.d.-c). Lysine Decarboxylase Test. [Online] Available at: http://www.vumicro.com/vumie/help/VUMICRO/Lysine_decarboxylase_Test.htm [Accessed 28 Mar. 2017]. Werdan, K., Dietz, S., LÃ ¶ffler, B., Niemann, S., Bushnaq, H., Silber, R., Peters, G. and MÃ ¼ller-Werdan, U. (2013). Mechanisms of infective endocarditis: pathogen-host interaction and risk states. Nature Reviews Cardiology, 11(1), pp.35-50.

Mid Term 1 Solution

COT5405 Analysis of Algorithms Midterm 1 Solution Summer 2012 June 11 In all cases explain clearly and as succinctly as possible. Problem 1 10 Pts Answer: n T (n) = 2T ( n ) + log n 2 2 n = 4T ( n ) + logn n + log n 4 2 2 2 n = 4T ( n ) + log nn? 1 + log n 4 2 2 = †¦ ?log2 n 1 = nT (1) + n i=1 i ? n Since i=1 1 > ln n, T (n) ? ?(n log log n) i Problem 2 20 Pts Answer: The general idea is to use the technique similar to quick sort, by doing partition on both lids and cups.First we pick a cup randomly, and use it to partition the lids into two subsets: those lids smaller than the size of that cup, and those larger than the size of the cup. We can also ? nd the correspondent lid for that chosen cup. Second we use that lid to partition the cups and divide them into two sets. We keep on repeating this procedure on each subset of cups/lids until all the cups/lids are paired. The overall time complexity is O(n log n) (Worst case: O(n2 )). Problem 3 20 Pts Answer: In this problem we are more interested in ? ding the median instead of the minimum/maximum element. The ? n ? th element in a min/max heap is not the median. 2 In this case, we should develop a new type of heap to adapt this problem. Problem 3 2 The solution is to use two heaps: a min heap and a max heap. Suppose the total number of elements is n, we set the restriction that the max heap should contain ? n ? 2 elements. Correspondingly, the min heap contains n ? ? n ? elements. 2 When we insert an element, we always insert it into the max heap.If the number of elements in the max heap exceeds ? n ? , we remove the maximum element in the 2 max heap (the root), and insert it into the minimum heap. During this procedure, we need to do heapify to maintain the heap structure for both heaps. Under this setting, it is easy to see that all the elements in the max heap are less than those in the min heap, and the two elements at the root of both heaps represent the ? n ? th 2 and (? n ? + 1)th element. 2 Suppose the median is de? ned to be the ? n ? th element over all n elements.When 2 we delete the median, we just delete the root of the max heap, and the following two cases might occur: (1) If the max heap contains ? n? 1 ? elements, then we do delete-max to the max 2 heap. (2) If the max heap contains ? n? 1 ? ? 1 elements, we take out the root of the min 2 heap and set it to be the root in the max heap (because it is larger than all the elements in the max heap), then we do delete-min to the min heap. It is straightforward to see that the time complexity for both insert and delete-median is O(log n). COT5405 Analysis of Algorithms HW 2

The Capgemini Essay Writing Samples Diaries

The Capgemini Essay Writing Samples Diaries The conclusion should include a synthesis or a succinct summary. The author starts with a rather in depth story of an event or description of an individual or place. A lyrical introduction is among the universal means, and connects the topic of the work by means of your life experience. The introduction and conclusion shouldn't be more than 25% of the full work, the principal part being 75% of the job. The War Against Capgemini Essay Writing Samples Otherwise, you're most likely to fail the undertaking. The Capgemini recruitment and placement procedure contains off-campus along with on-campus recruitment. The process happened in three rounds. The selection procedure for the business contains 3 rounds. They cannot find an addmission in a superior colleage or university. Students may go through these samples before availing help from us so they can secure a notion about the characteristic of the solutions we provide. They can g et free access to these. They can understand their topics by using the samples available on our website. Be sure you hold on to graded copies so that you've got a broad range of samples to select from once the time is appropriate. The journey to come up with a perfect and error-free dissertation isn't an easy one. In addition, we understand there are strict lecturers who will penalize you in case you submit your assignment late. Participating in such a huge study from begin to finish has validated my interest in academic research for a profession. The Battle Over Capgemini Essay Writing Samples and How to Win It One have to keep in mind a particular regularity in the usage of verbal forms. No body is going to assist you to and additionally you also may help no body. Be cautious not to make your very first paragraph uninformative for instance, a single example with no extra information isn't going to be sufficient to convince others of your position. Any example needs to be accompanied by an explanation of how this specific case in point is related to your thesis. Often examples can be interpreted in many of various ways, and it's your job as an author to spell out how exactly your example is linked to the remainder of the job. Don't be worried about quant and reasoning. Whatever They Told You About Capgemini Essay Writing Samples Is Dead Wrong...And Here's Why Essay writing can be rather a challenge. Essay writing may be fundamental part of analyzing each university pupil knows it is crucial to be aware of the gaps between several kinds of writings in order to produce the journey at master how to compose papers that are excellent. Writing the college application essay can be among the most daunting components of applying to college. Essay writing examples in doc format like the ones given may help steer you in writing an excellent composition. If you ask a seasoned essay writer how to write an argumentative essay, he will likely say that one of the most vital things is that each example needs context, even the ones which are well known and seemingly require no explanation. Bridget's essay is extremely strong, but there continue to be a couple little things that could be made better. Our eight steps are able to help you compose a better scholarship essay. Denote for yourself what will be the principal portion of the essay, and what's the auxiliary material. This section comprises two examples of superior college essays. Here is some advice on the significance of sample high school essays. Considering credible sample high school essay, students can be sure they're made for private use when learning. At our cheap essay writing service we're confident that students ought to be concise in their choice and our task is simply to demonstrate our advantages and limitations honestly.

Dehumanization And Isolation Of Louie Zamperini - 1329 Words

War can be loud and visible or quiet and remote. It affects the individual and entire societies, the soldiers, and the civilians. Both U.S. prisoners of war in Japan and Japanese-Americans citizens in the Unites States during WWII undergo efforts to make them â€Å"invisible.† Laura Hillenbrand’s Unbroken hero, Louie Zamperini, like so many other POW’s, is imprisoned, beaten, and denied basic human rights in POW camps throughout Japan. Minà © Okubo, a US citizen by birth, is removed from society and interned in a â€Å"protective custody† camp for Japanese-American citizens. She is one of the many Japanese-Americans who were interned for the duration of the war. Louie Zamperini, as a POW in Japan, and Minà © Okubo, as a Japanese-American internee,†¦show more content†¦Furthermore, communication with the outside world is impossible. To the world, including Louie’s family, he vanished. Initially declared missing at sea and later declared dead by the U.S. military, he becomes invisible to the outside world. However, Louie does what he can to resist these efforts. The Bird forces officers to work, even though it’s against the rules of war. Thus, the officers find their own way to resist by ruining the leather and depriving the Bird of seeing them miserable. The officers who worked in the camp â€Å"deliberately stitched leather improperly† (247). The POWs were later sent out to work outsi de of the camp,, but they resist by sabotaging everything can get their hands on, â€Å"At the worksites, Omori’s POWs were waging guerilla war. At the rail yards and docks, they switched mailing addresses, and changed the labeling on the boxcars, send tons of goods to the wrong destinations. They threw fistfuls of dirt into gas tanks and broke anything mechanical that passed through their hands† (248). This example is evidence of resisting invisibility since the POWs are sent out to do work that would support the Japanese war effort†¦ an act that would be considered that of a traitor. The POWs find a way to