MBBS Regulations

Microbiology

2) SYLLABUS OF MICROBIOLOGY:

S.No.   Name of the Unit                                                                  No. of  hours

1.            General Bacteriology                                                             8

2.            Immunology                                                                                       20

3.            Parasitology                                                                                       20

4.            Systemic Bacteriology                                                               25

5.            General virology AND Systemic Virology                                 15

6.            Mycology                                                                                          6

            Total No. of Hours 94

TEACHING HOURS CAN BE DIVIDED AS FOLLOWS :

1. Lecturers                                        94

2. Practicals                                        50

3. Demonstration                                  50

4. Symposia & Seminars                     40

5. Internal assessment                  16

Grand Total: 250

NOTE : THE DETALED SYLLABUS IS VIDE ANNEXURE (A)

2) Syllabus of Microbiology :

a)      BROAD AREA OF  STUDY

1.                  General bacterilogy. Those aspects of general bacteriology which help the students to understand the bacterial pathogenesis, diagnosis, treatment, prevention and control must know category.

1.1              Introduction to microbes and methods of studyig them.

1.2              Source and spread of microbes and infection control and containment including principles and uses of antimicrobial agents.

1.3              The pathogenic mechanisms of microbes and pathogenesis of infectious diseases.

1.4              Principles and methods of diagnosis of infections and infectious diseases.

2.                  Immunology : The basic principles of immunity and immunological phenomenon which help to understand the pathogenesis, laboratory diagnosis and control of infectious diseases and not-infectious desieases should be must know category.

1.1              The immune system and host’s reponse to infection.

2.      Systematic microbilogy

3.      Prevention of infectious diseases

4.      Infections and of various systems of the body.

DETAILED SYLLABUS

Chapter 1 ; Inroduction to Microbes and methods of studying them:

Theory :

Objectives : At the end of the chapter, the student should be able to

1.1.1.      describe the unique properties of unicellular organisms, prokaryotes, and viruses in contrast with those of eukanyaoes.

1.1.2.      State the rationale of classifying microbes inbto bacteria,fungiparasites and viruses.

1.1.3.      Recall the growth requirements of microbes

1.1.4.      Use microscopes, media, wire loops, staining procedures and similar equipemnt and processes

1.2.1        The nature of bacteria : morphology

1.2.2        Growth requirements of bacteria (includes the studdy of media); metabolism and genetics

1.2.3        Nomenclature and classification of micro organisms

1.2.4        Microscopy-types and their principles

1.2.5        The hilogy of Protozoa

1.2.6        The nature and properties of viruses

1.2.7        The laborratory jethods of cultivating viruyses

1.2.8        The nature of fungi: basic structure and classification

1.2.9        Growth requirements of fungi

Practical :

Objectives : At the end of the chapter, the student shall be able to

1.3.1.      identify  various morphological forms of bacteria, fungi, viruses and parasites that cause human infections.

1.3.2.      Perform simple, differential staining and other techniques to demonstrate micro-organisms and also to interpret their results.

1.3.3.      To identify common laboratory methods used for cultivation and identification of microbes.

Practical exercises :

1.4.1.      Introduction of media; sear making; simple and differential stains; other basic techniques to demonstrate microorganism and microscopy.

1.4.2.      The microscope; the bacterial colony; fungal growth; culture of parasites; the morphology of micro-organisms. Bacteria:

1.4.3.      Cell cultures, cytopathic effect; haemagglutination by viruses; inclusion bodies; animal inoculation.

Chapter2: The source and spread of Microbes

Theory:

Objectives : At the end of the chapter, the student will be able to

2.1.1.                  define the term : reservoir, souce, exposure, colonization, infection, disease, vector, fomite, e;idemilogy, endemicity, epidemic, pandemic, epizootic, incidence, prevalence, zoonosis, attact rate, asepsis, antisepsis, sterlization, disinfection.

2.1.2.                  List various routes of exposure to microbes

2.2.1        Routes of spread of infections: endogenous vs. exogenous; source and reservoir of infections

2.2.2        Sterilization, antisepsis, disaffection and asepsis

2.2.3        Hospital acquired infections

Practical objective: At the end of the chapter, the student shall be able to studyuing settle plates

2.3.1.                  Observe the presence of microbes in our environments by studying settle plates

2.3.2.                  Observe the presence of normal flora inn nose, throat, etc.

2.3.3.                  Interpret sterility tests done on various  materials

2.3.4.                  Sample appropriate clinical materials for tracing the source and spread of both community and hospital acquired infections. 

2.3.5.                  Interpret the findings of various surveillance procedures

Practical demonstrations :

2.4.1.                  Demonstration of equipment’s and agents used in sterlization and disinfection.

2.4.2.                  Study of microbes in our enviroment by settle plates; effect of hand washing method

2.4.3.                  Study of normal flora of man by examining throat and nasal swabs and also by coughj plate method

2.4.4.                  Visit to the Microbiology Laboratory and central sterilization and supplies department (CSSD)

Chapter 3 : The pathogenic  mechnaisms of microbes  and  pathogenesis of  infectious diseases

Theory :

Objectives : At  the  end  of  the chapter, the  student  shall be able  to

1.1.1.      enumnerate  the variety  of interactions between  microbes and humans, ranging  from commensalism  to  pahogenesis

1.1.2.      define wofds:  saprophyt, commensal carier state,  latency chronic  infection,  virulence,  oppotunism,  toxin  invasion, viraemia, bacteriaemia  and  septicaemia

1.1.3.      cite  examples  of  different  patheogenic  mechanisms  of  baceterial, fungal, parasitic  and  viral  illness.

1.1.4.      State the principles  of quantation  of microbial  dose  in  animal  inoculation, such  as median  infectious  dose,  lethal dose and of neutralization.

1.1.5.      Host   parasite  interactions – mechanisms of microbial  pathogenesis;  infection; host  response; virulence ;  toxigenicity

3.2.2            Pathogenesis  of bacterial  infections

3.2.3            Pathogenesis  of  parasitic  infestation

3.2.4            Pathogenesis  of  viral  infections

3.2.5            Pathogenesis of  fungal  infections 

Practical   :

Objective :  At  the  end  of the chapter,  the  student  shall  be able  to demonstrate  the virulence  factors  of  microorganisms , using  simple  techniques

Practical  demonstrations :

3.3.1            demonstration  of  capsule; coagulase  test

3.3.2            demonstration  of  Elek’s  test; experimental tetanus

3.3.3.   case  study;  bacterial  diseases ;  viral  diseases

Chapter 4 :  The  immune system  and   host’s  response  to  infection

Theory :

Objectives:  At  the end  of  the  chapter  the  student  shall be  able to

4.1.1.  describe  the anatomy  and   physiology  of  primary and  secondary  lymphoid  organs,   tissues  and cells of  immune  system

1.1.2        describe the  terms: natural resistance, immunity, antigen,  epitope, hapten, antibody, immunoglobulin, ocal immunitym systemic  immunity cell medaited immu ity, hypersensitiveity,  autoimmunity, memory and  also  correlate  them  with  normal  physiology  and  pathology.

1.1.3        Describe  with  examples various  types of  antigen  - antibody  reactions  in  vitro  and in vivo

1.1.4        Enumerate  thje  immune  deficiency  states  and  their  causes

1.1.5        Describes  the  tests used  to  measure the  immune   fuctions

4.1.6.`State  the  principles  of histocompatibility

4.2.1.`Anatomy  of  immune  apparatus

4.2.2`Antigens;  antigen presentation and cell cooperation in immunity

1.2.3        Immunoglobulins  and  their  role in  immunity

1.2.4        Antigen  - Antibody  reactions  - 1

1.2.5        Antigen  - Antibody  reactions  - 2

1.2.6        Cell  mediated immunioty and their  role  in  immunity

1.2.7        Complement  and  its  tole  in  immunity

1.2.8        Hypersensitivity

1.2.9        Measuring  immue  functions

1.2.10    Autoimmunity

1.2.11    Immunodeficiency  and  tolerance

1.2.12    Transplanation   immunology

1.2.13    Turnover  immunology

1.2.14    Immunization  schedules  and  proggrams

Practical :

Objectives  :  At  the end  of  the   session,  the  studwent  shall  be  able  to  identify  and   interpret  the  results   of    the  following  tests :

4.3.1    Slide and  tube  agglutination,  latex  agglutination  and   coagglunation; indirect  and  reverse  passive  haemaggluatination   tests

4.3.2            Capillary  and  gel  precipitation  tests,  counter  immunoelectro – phoresis  and  radial  immuodiffusion 

1.3.3        Complement  fixation  test

1.3.4        ELISA  test

1.3.5        Various  skin  tests

            Practical  :

4.4.1.      Phagocytosis; opsoniation

4.4.2.      Immunoprecipitation  tests

4.4.3.      Agglutination  tests

4.4.4.      Delayed hypersensitivity;  and  tests  for  CMI

4.4.5.      Rheumatoid  facto,  antinuclear  antibody

Chapter 5 :  The  Principles and  methods  of  diagnosis  of  infections  and  infections  diseases and  their  treatment

Theory :

Objectives :  At  the end  of  the Chapter, the  student  shall  be  able  to

5.1.1.            list  the diagnostic   tests used for common and important  infections and identify the specimens  necessary for  each

1.1.2        state  the  principles  of  isolating/culturing bacteria, virses  and fungi

1.1.3        describe  the  principles  of  antigen  detection   methods

1.1.4        list  various serological  tests and state their  principles,  applications  in  diagnosis

1.1.5        demonstrate  various microbes/parasites/ova/cysts by direct  microscopy

5.2.1            Collection  and  transport  of  clinical  samples;  culture  of  microbes

5.2.2.            Serological  meth\ods  of  diagnosis  of   bacterial   infections

5.2.3            Serodiagnosis  of  fungal  infections

5.2.4            Serodiagnosis of viral  infections

5.2.5            Serodiagnosis   of  parastic  infections

5.2.6            Rapid  diagnostic  methods  especially  with reference   to  viruses

Practical :

Objective: At  the  end  of the  session,  the  student shall be able  to  perform and interpret  the  following   techniques

5.3.1.            Simple  stains,  Gram  stain, Acid  fast staining  techniques;  saline and iodine  preparations  for  ova  & cysts and  also concentration  methods; peripheral  blood  smear  for parasites; lactophenol  cotton  blue  & KOH preparations  for fungi, rapid diagnostic  methods

5.3.2            Be  able  to  collect  appropriate  clinical material;  for  laboratory diagnosis

5.3.3.            Be  able  to  do  preliminary   processing  of  clinical  materials

Practical  demonstrations :

5.4.1            Demonstation  of  specimen  container,  collection   of  specimens,  transport  and  media; prelimiary  processing  in  the  laboratory

1.4.2        Demonstration  of  common  methods  used  for  demonstation of pathogenic  micriirgnisms

            5.4.3            Culture  of bacteria,  fungi,  protozoa,  virsues

            5.4.4            Serological  tests  for  diagnosis  of  microbial  infections

            5.4.5            Rapid  diagnostic  tests  for  various  microorganisms

            Practical  demonstrations :

            5.4.1.            Demonstration  of  specimen container, collection  of  specimens, tansport   and  media;  preliminary processing  in  the  laboratory

            5.4.2            Demonstration of  common  methods  used  for  demonstration of  pathogenic  microorgisms

            5.4.3.            Culture  of  bacteria,  fungi,  protozoa,  viruses

            5.4.4            Serological   tests  for  diagnosis  of  microbial infections

            5.4.5            Rapid  diagnostic  tests  for  various  microorganisms

            Chapter 6 : Principles  and  uses  of  antimicrobial   agents

            Theory :

            Objectives:  At  the  end  of  the  chapter,  the  student  shall  be  able  to

1.1.1        list  antimicrobial  agents  and  classify  them  as  antibiotics  and  chemotherapeutic  agents.

1.1.2        Define  the  terms  : susceptibility,  resistance and describe  the  mechanisms  of  transferrable  and  nontansferable  drug  resistance

1.1.3        Describe the  testts  necessary  to  determine drug  susceptibility, antibiotic conentration and  serum  bactericidal  level

1.2.1        Antibiotics  and  chemontherapeutic  agents  and  their  modes  of action

1.2.2        Antimicrobial   resistance

1.2.3        Laboratory  monitoring  of  antimicrobal  therapy

Practical :

Objectives :  At  the end  of  the course,  the student  should  be able  to interpret the  results  of

1.3.1        Disc  diffusion  tests

1.3.2        MIC/MBC  Value, break-points, MIC-50, MIC 90, etc.

1.3.3        Assays  for  antimicrobial  levels  in body fluids

Practical  demonstrations :

6.4.1            Demonstation   of  antimicrobial  susceptibility  tests both  diffusion  and dilution tests

6.4.2        Demonstration of  antimicrobial  assay

Chapter  7  :  Systematic  Micro biology

Theory  :

Objective :  At  the  end  of  chapter,  the student  shall be  able to

1.1.1        state  the  basic  taxonomy of  common  and  important  microorganisms

1.1.2        recall  the  basic  principles  of  identifying   microbes

1.1.3        list  the  basic biological  properties  of commion and important  microbes

1.1.4        describe  the  role of  physician  in  intiating  microbilogical investigations

Bacteriology

7.2.1     Staphylococci

7.2.2.Streptococci

7.2.3   Neisseria

7.2.4   Corynebacteria

7.2.5    Mycobacteria

7.2.6     Baillus

7.2.7     Clostridium

7.2.8     Actinomycetes

            7.2.9    Haemophilus  and  Bordetella

1.2.10    Enterobacteriaceae

1.2.11    Vibros and campylobacter

1.2.12    Brucella,  Frasncisella  and Legionella

1.2.13    Pseudomonas  and  other non-fermenters

1.2.14    Spirochaetes -  Treponema, Borrelia,  Leptospira

1.2.15    Rickettsia

1.2.16    Chlamydia

1.2.17    Nonsporing  anaerobic bacteria

1.2.18    Mycoplasma and I  forms

Mycology

1.2.19    Agents  of  very  superficial  mycoses

1.2.20    Agents  of  superficial  mycoses; dermatophytoses

1.2.21    Agents  of  subcutaneous  mycoses

1.2.22    Agents  of  systemic  mycoses

1.2.23    Opportunistic  fungi

Virology

1.2.24    Picorna Viruses

1.2.25    Hepatitis  viruses

1.2.26    Herpes viruses

1.2.27    Herpes  Viruses

1.2.28    Orthomyxo  and  Paramyxoviruses

1.2.29    Toga  Viruses

1.2.30    Oncogenic / retro viruses

7.2.30              Viruses  causing   gastroenteritis

1.2.31    Adeno  viruses

1.2.32    Rhabdo  viruses

1.2.33    Teratogenic  viruses

1.2.34    Stow  viruses  Parasitology

1.2.35    Entamoeba  histolytica and  free  living  amoeba

1.2.36    Giardia,  Trichomonas,  Sarcocysists,  and  Toxoplasma

1.2.37    Leishmania

1.2.38    Plasmodia  and  Babesia

1.2.39    Medically  important  helminths  belonging  to  Cestoda,   Trematoda  and Nematoda

Practical  :

Obejctives:

1.3.1        Bacteriology ; The student shall be able to  identify  pathogenic bacteria  by  Gram stain, morphology, colony characters  and  key  biochemical  reactions

1.3.2        Mycology :  The  student  shall  be able  to identify  pathogenic  fungi   by  their  appearance  in  Lactophenol  cotton  blue preparation, KOH, india ink preparations,  Gram  and  other  staining   as  well  as  pertinent  colony morphology

1.3.3        Parasitology :  The student  shall  be able  to  identify  ova  and cysts  of  common  intestinal  parasites,  identify   blood  and  tissue  parasites

Chapter  8 :  Prevention  of   infectious  Diseases

Theory  :

Obejcetives :  At  the  end of the  chapter the student  shall  be  able  to   define  temrs; passive  and active  immunity, live and killed  vaccine, efficacy  of  a  caccine;  disease  control  and  eradication

1.1.1.      Epidemiology  of  infectius  diseases

1.1.2.      Hygience  and protection  of food and  water

1.1.3.      Immunization  schedules  in  Indai;  vaccine efficacy; universal  immunization

Practical  :

Objectives : At  the  end of  the session,  the student  shall  be able  to 

1.2.1        discuss  a  case  study on an outbreak  situation

1.2.2        apply  principles  of asepsis,  antisepsis and  disinfection inn day-to-day  clinical  practice.

1.2.3        Interpret results  of steility  tests done on varipous  materials 

Practical  demonstrations :

8.3.1        Case study  of  an epidemic/outbreak  of nosocomial infection

8.3.2        Demonstration  of  vaccines  & toxoids, antisera & infection  specific  immunoglobulins

8.3.3        Bacteriological analysis  of  water,  Pasteurization of milk

Chapter 9 :  Systemic Microbiology (Infection  & Diseases  of  the  various systems  of   the  Body)

Objectives :   At  the  end  of  course ,  the students  shall  be able   to 

9.1.1            list  infectious  diseases  of   each  system  and correlate  them with  probable  aetiological   agents

9.1.2            undetstand  the  aeitilogy, pathogensis and methods of  laboratory diagnosis  and apply  that  knowledge  in the treatment  and  prevention  of   common  communicable  diseases caused  by all  types  of microorganisms

1.2.1        Gastrointestinal  infections caused  by bacteria: Peptic ulcer disease; enteric fever,  gastroenteriti; shigellosis;  food  poisoning

1.2.2        Gastrointes5tinal   infections  caused  by  parasites:

1.2.3        Gastrointestinal  infections  caused  by  viruses

1.2.4        Hepatitis  and other  infections  of  liver  and biliary tract

1.2.5        Upper  respiratory tract  infections – viruses

1.2.6        Acute  infections  of lower  respiratory  tract

9.2.8            Chronic  infections  of  lower  respiratory tract ; national  TB  control   program

9.2.9        Sexually transmitted diseases; national  STD  control  program

9.2.10    Urinary  Tract  infections

9.2.11    Infections  of  Central  Nervous  System  -  bacterial

9.2.12    Infections  of   Central  Nervous System  - non bacterial

9.2.13    Wound  infections

9.2.14    Superficial  fungal  infections:  dermatomycoses; national  leprosy control  program

9.2.15    Deep  mycoses

9.2.16    Eye  infections : national program  for prevention  of blindness

9.2.17    Septicaemic  conditions

9.2.18    Bone, joint and  related  conditions

9.2.19    Exanthematous conditions

9.2.20    Opportunistic  infections

9.2.21    Blood  and  tissue  parasites; national  filariasis  control  program national  malaria control  program

Practical :

Objectives  :  At  the end of  the  session, the students shall be able  to identify  the agents  causing infections  of  various  systems of  the  body  and the  student shall  be  able  to  collect appropriate  specimens  at an  appropriate  time  and send them  to  the  laboratory.

Practical  exercises :

9.3.1        Viable  counts  on  normal  faeces

9.3.2        Case  study  -  dysentery ; stool  with ova  and cysts

9.3.3        Case  study -   cholera  with  demonstrations

9.3.4        Case  study -  typhoid  with  demonstration

9.3.5        Case  study  -  infective  and  serum hepatitis  with demonstations

9.3.6        Case  study  -  diphtheria   with  demonstations

9.3.7        Case  discussion -  diagnosis  of  tuberculosis

9.3.8        Microscopic  morphology  of  agents  causing  STD; Demonstrations of  syphilis  and  IIIV  scrology

9.3.9        Case  study -  UTI  with demonstrations

9.3.10    Microbiology  of CNS  infections  - demonstrations 

9.3.11    Carrier  study  of  staphylococcus  on skin,  throat  and nose

9.3.12    Diagnosis of  dermatomycosis,  mycetoma and  chromomycosis

9.3.13    Laboratory  diagnosis  of  candidiasis  and crytococcosis

9.3.14    Demonstration  of  fungi  causing  deep mycoses

9.3.15    Demonstration  of agents  causing eye infections

9.3.16    Case  study – endocarditis,  Gram  negative  speticaemia, brucellosis, enteric  fever  and parasitaemia

9.3.17    Case  study  -  acute infections  of  bone, etc

Microbiology  books  recommended:

1.      Text  book  of Microbiology by Anantha  Narayana  & Ch. Jayaram Paniker

2.      Medical  Microbiology  Vol  I & II by Mackie  & Mecartney

3.      A  hand books of Practical  and clinical  iramunology  by G.P. Talwar  & SK Gupta

4.      Medical  Laboratory Munal for  toopical countries  Vol I & II by  Moknica Cheesbrough

                        Parasitology  books  recommended :

1.                  Parsitology  in  relation  to  clinical  Medicine by K.d. Chattarjee           

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