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J637
Preparation of Medium
°
Test Procedure
°
Tellurite Agar
selective medium Corynebacterium diphtheriae.
diphtheriae
Preparation
°
°
Thayer-Martin Medium
selective medium N. gonorrhoeae
N. meningitidis
A. Gonococcus (GC) Agar Base
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Medical Laborato Technology: Volume 2
Preparation
°
°
Procedure:
°
°
C.
Note
Proteus
Thioglycollate Medium
anaerobic organisms
strictly anaerobic
Clostridium) microaerophilic Lactobacillus).
J639
Preparation of Medium
°
Do not refrigerate.
Triple Sugar Iron Agar (TSI) Slant
Enterobacteriaceae.
type of sugar fermented
2
Preparation of Medium
°
Biochemical Reactions on TSI Slant
°
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Medical Laborato Technology: Volume 2
=
= =
+
+ +
- -
+ +
+
(
?
)
-
2
+
=
=
False results:
Thiosulphate Citrate Bile Salt Sucrose Agar (TCBS)
selective isolation
enrichment
J641
Preparation
°
Trypticase Soy Broth (TSB) and Trypticase Soy Agar (TSA)
Preparation
°
°
Urease Test
urease enzyme. ammonia
carbon dioxide.
alkaline Proteus
Klebsiella E. coli
Cpto
coccus Brucella, Citrobacter, Enterobacter cloacae Y. enterocolitica.
Christensen Urea Agar
A. Agar Base
s42 I
Medical Laborato Technology: Volume 2
Urea Solution
Preparation
Note
°
°
Preparation
Test Procedure
°
Proteus
Klebsiella Citrobacter)
Salmonella Shigella),
enteric pathogens,
Shigella
Salmonella Edwardsiella Shigella, Proteus, Providencia
S. paratyphi A
J643
Preparation
°
Chapter
Laboratory Diagnosis
of Mycotic Infections
Monisha Bhatia and nai L Mukherjee
21
eukaryotic,
prokaryotic,
binary ssion
conidia,
Laboto Diagnosis of Mycoc Infections
J645
conidiophore).
saprophytic
immunocompromised
mycoses
diversity of fungal infections
Trichophyton, Microsporum Epidermophyton.
(Tinea capitis)
646 I
Medical Laborato Technology: Volume 2
Cuent Situation
Invasive fungal infections have become a major cause of morbidity and mortality over the past
3 decades. Organ transplantation, the use of aggressive chemotherapy, and the availability
and widespread use of immunosuppressive treatments for many medical ailments have
resulted in large populations of patients who are at risk for fungal disease. Early diagnosis
and prompt therapy are instrumental to successful treatment of these infections, but con
ventional methods for diagnosis of fungal disease are slow and lack sensitivity. Important
advances in diagnosing invasive mycoses, particularly in laboratory-based testing, have been
realized over the years. Antigen-based assays, new laboratory methods for identication of
fungi, and reference guidelines for susceptibility testing have been developed and validated
for use in clinical laboratories.
Most of the mycotic agents belong to the class Deuteromycota or Fungi Imperfecti. These
fungi do not possess any known form of sexual reproduction. They might produce various
types of conidia but do not produce sexual spores. Deuteromycetes also always have septate
hyphae. Some fungi that cause disease in humans do have sexual forms. Spores that these
organisms produce are classied based upon their structure. For example, Zygomycetes
(Rhizopus, Mucor) produce both asexual spores called sporangiospores and sexual spores
called zygospores. The taxonomy of some mould species can be very consing, with some
organisms having two dierent names depending on whether they produce sexual spores or
not. For example, one mould that is a common cause of eumycotic mycetoma (Madura foot)
has an asexual form known as Scedosporium apiospermum. However, it also has a sexual form
that produces spores called asci. When it is producing asci, it is known as Pseudallescheria
bo
dii.
y
From the morphological point of view, the mycotic agents can be divided into four main
categories (Table 21.1 and Figure 21.1).
TABLE 21.1
Monomorphic
Mould
Classication of mycoc agents
Yeast
Dimorphic
Phenotypic dimorpbs
Thermal dimorphs
-
-
Monomohic Moulds
These are lamentous, mycelial fungi that are always found in a mould form. In a patient
specimen, they appear as hyphal fragments (septate except in the case of Zygomycetes). On an
agar surface, they produce an aerial mycelium bearing conidiophores and conidia necessary
for microscopic identication. Dermatophytes (causes of ringworm) belong to this group, as
do many species of saprophytic moulds that cause opportunistic infection in compromised
patients.