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For this performance assessment, you will choose an agar plate with an unknown bacteria growing on it. Each plate will be labeled with a number that corresponds to one of eight possible bacteria: Klebsiella pneumonaie, Mycobacterium smegmatis, Listeria  monoctyogenes, Pseudomonas aeruginosa, Staphylococcus aureus, Proteus vulgaris,  Bacillus cereus, or Streptococcus pyogenes. Your task will be to identify the bacteria on your plate using a series of laboratory techniques we have utilized this semester (see the separation scheme below). You may use the resources provided in lab (stains, microscopes, agar plates and broths ect.), your lab manual and, of course, your instructor.

However, this is an individual project, you will not be working with your lab partner or  the other students at your lab table. Once you have identified your unknown bacteria’ genus and species name, you are to write a two-part paper that

1.) Summarizes the process you used in lab to identify an unknown bacterial sample and

2.) describe a disease related to your identified bacterial genus (For example, if your unknown is Mycobacterium smegmatis, you could write about anthrax, caused by Mycobacterium  anthracis). 

Identification of Unknown Bacteria Sample

For my unknown ID performance assessment task, I picked agar plate number 17. In the process of identifying which bacteria I had, the first technique I performed was to make a streak plate using the bacteria from my agar plate. Next, I heated and fixed the bacteria to a slide in order to perform other identification tests on it. One of the first differential tests run on a bacterial specimen in any laboratory to determine identification and drug therapy is the gram stain; therefore, this was the next test I performed on my bacteria.

The results of the gram stain revealed the bacteria were gram-positive since it retained the deep purple colour (if the bacteria on the slide were pinkish red, then it would have been gram negative) and the morphology was cocci because of the round shape of the bacteria. Since the bacteria were gram-positive and not gram-negative, this allowed me to exclude the following bacteria: Pseudomonas aeruginosa, Klebesiella pneumonaie, and Proteus vulgaris because they are all gram-negative.

In addition, I was able to exclude the following bacteria: Bacillus cereas, Mycobacterium smegmatis and Listeria monocytogenes based on the fact that they are gram-positive rods and my bacteria was a gram-positive coccus. This brought me to the next identification test which was the catalase test. My bacterium was catalase positive because the catalase test produced bubbles if there would have been no bubbles present, then the results would have been catalase negative.

The results of the catalase test allowed me to exclude the bacteria Streptococcus pyogenesis which is gram-positive cocci and catalase negative. In conclusion, based on the results of my tests which were gram-positive, cocci, and catalase positive; I determined that my agar plate number 17 bacteria was Staphylococcus aureus a causal bacterium responsible for MRSA (Methicillin-resistant Staphylococcus aureus) disease.

MRSA is a contagious infection caused by Staphylococcus bacteria. The disease is highly resistant to antibiotics making its treatment challenging. By nature, the bacteria do exist in the nose and on the skin, but little do they cause harm (Shrestha, Fraser & Gordon, 2017). However, when the bacteria start to multiply uncontrollably, they lead to an MRSA infection.

The disease can be transferred by agents that include sharing of items with someone who has MRSA such as clothes, sheets and towels. In addition, touching someone who has it or surfaces that have MRSA in them also lead to disease transmission (Shrestha, Fraser & Gordon, 2017). Also, the disease can be transferred easily to people with open wounds, those who use feeding tubes in hospitals and those with burns.

Process

Since an MRSA is a staph disease, there should be some already existing bacteria and mucous membranes within the individuals’ body. Therefore, it is difficult to determine the exact and correct period of incubation for the disease. But, if the infections are inherited from another person through open wounds or damaged mucous membranes, the period of incubation ranges from the first day to the tenth day (Lee, Pettitt & Dancer, 2018).

The disease does not dispose any serious symptoms to anyone having it unless a screening test is conducted for the disease. However, if the MRSA disease prolongs and gets deeper into the body, reddening of the skin, swelling, pus formation and pain are among the characteristics that the patients start to experience (Shrestha, Fraser & Gordon, 2017). Again, if the condition persists in the body, dizziness, aching, confusion and chills are experienced by the patient.

Structural defences against phagocytosis.

The DNA of the bacteria is integrated from the dead genome hence the bacteria can undergo mutations all the time for survival. The gene can be altered by a single nucleotide granting resistance to the microorganism (Kon & Rai, n.d.). Consequently, they exist naturally in numerous numbers to increase the chances of survival from being digested by the white blood cells. Lastly, the outside layer of their cells is bilayer that reduces the rate at which phagocytosis takes place.

Enzymes within the body are inhibited by the bacteria. This mechanism uses different means of modifying the antibacterial structural compounds (Kon & Rai, n.d.). Hydrolysis is done on the enzymes together with the capability to modify penicillin-binding proteins (PBP) within the host.

The bacteria produce efflux pumps which becomes a complex defense mechanism as it is also supported by the outer membrane. This limits the chances of toxin penetration into the bacteria hence creating room for more replications and dominance (Kon & Rai, n.d.).

The membrane outside the Gram-negative bacteria on the outer part of the cell wall contains lipids that are bilayer. This minimizes passage of hydrophilic compounds from the antibiotics (Kon & Rai, n.d.). Other factors that limit the passage of drug to the bacteria are its size and different shapes in which it exists.

Incidence

According to the analysis done by Shrestha, Fraser and Gordon (2017), the incidence of MRSA ranges from ten to thirty per 100000 person-years. Also, the rate of increase is directly proportional to time such that as the time goes, the patient record is increasing as reported by the Centre for Disease Control ("Methicillin-resistant Staphylococcus aureus (MRSA) Infections | MRSA | CDC", 2018). Also, age is a major determinant of the MRSA infections with high rates in the first year of life, low incidences in adults that are young and a gradual rise for the old individuals together with diabetic people being prone to risks of MRSA infections (Lee, Pettitt & Dancer, 2018).

Lab Techniques Used

Under a study conducted by Shrestha, Fraser and Gordon (2017) in Canada, higher death rates of the disease were those above sixty-five years old with minimal recordings from younger ages. This was followed by 1104 cases of deaths containing diabetic and AIDS in blacks, males and females.

High prevalence of MRSA occurs in diabetic people and people living with AIDS. Moreover, MRSA affects body parts with a high prevalence on buttocks, armpits and even eyes. Lastly, Lee, Pettitt and Dancer (2018) illustrates that high morbidity rates are contributed by people with burns.

Diagnosis, Treatment and Prevention of MRSA

The disease can be diagnosed by a doctor by doing a check on a nasal secretion of the bacteria, or a check can be done on a tissue sample (Lee, Pettitt & Dancer, 2018). The sample to be tested is taken to the laboratory and placed where bacterial growth can be enhanced using an appropriate dish of nutrients for 48 hours.

Moreover, after the test has been conducted and MRSA has been found, one is subjected to decolonization which entails; use of antibacterial cream that is applied on the nose three times a day, five day washing of the infected area by antibacterial shampoo and changing of towels, beddings and clothes with the laundry being washed at high temperatures away from people (Kon & Rai, n.d.).

 When the person is infected, the patient is subjected under antibiotic treatment that works against the MRSA. This may include injections or tablets that may take some days to few weeks’ completion time. In order to avoid the spread of the disease, the person may be required to stay in a personal room or with others who also have MRSA.

MRSA can be prevented in different ways despite the area the patient resides either at the hospital or home. To begin, proper hand washing before and after eating should be observed to avoid the spread (Lee, Pettitt & Dancer, 2018). In addition, instructions given regarding taking care of devices that may lead to infection such as urinary catheters and wound caring should be considered. Lastly, reporting of any unclean facilities in hospitals should be done to people with authority in hospitals without fear.

In conclusion, if all prevention, treatment and control measures are taken care of, there will be low incidence rates and morbidity rates of MRSA in different areas. It should also be clear that prevention is better than cure.

References

Kon, K., & Rai, M. Antibiotic resistance.

Lee, X., Pettitt, A., & Dancer, S. (2018). Quantifying the relative effect of environmental contamination on surgical ward MRSA incidence: An exploratory analysis. Infection, Disease & Health, 23(3), 127-136. doi: 10.1016/j.idh.2018.02.005

Methicillin-resistant Staphylococcus aureus (MRSA) Infections | MRSA | CDC. (2018). Retrieved from https://www.cdc.gov/mrsa/

Shrestha, N., Fraser, T., & Gordon, S. (2017). Patients Colonized with Methicillin-Susceptible Staphylococcus aureus Rarely Get Methicillin-Resistant Staphylococcus aureus Infections. Open Forum Infectious Diseases, 4(suppl_1), S638-S639. doi: 10.1093/ofid/ofx163.1695

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