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MICRB 202: Introductory Microbiology Lab

Unit VIII: Natural Microbiota and Non-Specific Host Defense

Unit VIII: Natural Microbiota and Non-Specific Host Defense

Activities:

17.2 Effectiveness of Hand Scrubbing (Ex 23) p 1

19.1 Lytic Effect of Tears and Saliva (Ex 24) p 5

19.2 Antimicrobial Sensitivity Testing: Kirby Bauer Method (Ex 25) p 7

18.1 Effectiveness of Hand Scrubbing: (Ex 23)

The importance of hand disinfection in preventing the spread of disease is accredited to the observations of Semmelweis at the Lying-In Hospital in Vienna in 1846 and 1847. He noted that the number of cases of puerperal fever was closely related to the practice of sanitary methods. Until he took over his assignment in this hospital, it was customary for medical students to go directly from the autopsy room to a patient's bedside and assist in deliveries without scrubbing and disinfecting their hands. When the medical students were on vacation, only the nurses, who were not permitted in the

autopsy room, attended the patients. Semmelweis noted that during this time, deaths due to puerperal fever fell off markedly.

As a result of his observations, he established a policy that no medical students would be allowed

to examine obstetric patients or assist in deliveries until they had cleansed their hands with a solution

of chloride of lime. This ruling caused the death rate from puerperal infections to drop from 12% to 1.3% in one year.

Today it is routine practice to wash hands prior to the examination of any patient and to do a complete surgical scrub prior to surgery. Scrubbing the hands involves the removal of transient (contaminant) and resident microorganisms. Depending on the condition of the skin and the numbers of bacteria present, it takes from seven to eight minutes of washing with soap and water to remove all transients; and they can be killed with relative ease using suitable antiseptics. Residents, on the other hand, are firmly entrenched and are removed slowly by washing. These organisms, which consist primarily of staphylococci of low pathogenicity, are less susceptible than the transients to the action of antiseptics.

In this exercise, an attempt will be made to evaluate the effectiveness of the length of time in removal of organisms from the hands using a surgical scrub technique. One member of the class will be selected to perform the scrub. Another student will assist by supplying the soap, brushes, and basins, as needed. During the scrub, at two-minute intervals, the hands will be scrubbed into a basin of sterile water. Bacterial counts will be made of these basins to determine the effectiveness of the previous two-minute scrub in reducing the bacterial flora of the hands. Members of the class not involved in the scrub procedure will make the inoculations from the basins for the plate counts.


Exercise 23:

Part A: Hand Scrubbing:

Materials:

5 sterile surgical scrub brushes, individually wrapped

5 sterile basins, covered to prevent contamination.

7 liters sterile water.
1000 mL sterile graduate cylinder, covered to prevent contamination.

dispenser of disinfecting soap

Procedure:

The two members of the class who are chosen to perform the surgical scrub will set up their materials near a sink for convenience. As one student performs the scrub, the other will assist in reading the

instructions and providing materials as needed. Before beginning the scrub, both students should read all the steps carefully.

Figure 1. Major steps in the hand scrubbing routine. Note steps 2 & 3 get repeated three more times to generate basins C, D, and E.

1. To get some idea of the number of transient organisms on the hands, the scrubber will scrub all surfaces of each hand with a sterile surgical scrub brush for 30 seconds into Basin A. No disinfecting soap will be used for this step. The successful performance of this step will depend on spending the same amount of time on each hand (30 seconds), maintaining the same amount of activity on each hand, and.scrubbing under the fingernails, as well as, working over their surfaces. After completion of this 60-second scrub, notify Group A that their basin is ready for use in inoculations of plates.


2. Using the same brush as above, begin scrubbing with disinfecting soap for two minutes, using

cool tap water to moisten and rinse the hands. One minute is devoted to each hand. The assistant will make one application of disinfecting soap to each hand as it is being scrubbed. Rinse both hands for five seconds under tap water at the completion of the scrub. Discard the brush.

3. With a fresh sterile brush, scrub the hands into Basin B in a manner that is identical to #1, above. Don't use soap. Notify Group B when this basin is ready.

4. Same as #2; scrub each hand for one minute using soap.

5. Same as #3; use a fresh brush and scrub each hand for 30 seconds in Basin C.

6. Same as #2; scrub each hand for one minute using soap.

7. Same as #3; use a fresh brush and scrub each hand for 30 seconds in Basin D.

8. Same as #2; scrub each hand for one minute using soap.

9. Same as #3; use a fresh brush and scrub each hand for 30 seconds in Basin E.

10. Dry hands and apply lotion if available.

Part B: Inoculating Pour Plates:

Materials:

30 veal infusion agar pours-6 per group (25 mL in each)

1 ml pipettes

30 sterile Petri plates-6 per group

70% alcohol

L-shaped glass stirring rod (optional)

Procedure:

While the scrub is being performed, the rest of the class will work collaboratively to determine make five sets of pour plates for determining the bacterial count per milliliter in each scrub basin. In this way we hope to determine, in a relative way, the effectiveness of scrubbing in bringing down the total bacterial count of the skin. Perform the following for each of the five basins (A, B, C, D, and E)

Figure 2. Mixing of basin sample (A) prior to use in inoculating pour plates (B).

1. Liquefy six pours of veal infusion agar and cool to 50° C. While the medium is being liquefied, label two plates each: 0.1 ml, 0.2 ml, and 0.4 ml. Also, indicate the Basin designation on the plate.

2. As soon as the scrubber has prepared the basin, take it to your bench and make inoculations as follows:

a. Stir the water in the basin with a pipette or an L-shaped stirring rod for 15 seconds. For consistency of results, you should all use the same method of stirring.

b. Deliver the proper amounts of water from the basin to the six Petri plates. The pipette used for stirring may be used for the deliveries.

c. Pour a tube of veal infusion agar, cooled to 50° C, into each plate, rotate to get good

distribution of organisms, and allow to cool.

d. Incubate the plates at 37° C for 24 hours, after the agar has solidified.

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3. After the plates have been incubated, select the pair that has the best colony distribution with no fewer than 30 and no more than 300 colonies. Count the colonies on the two plates using the Quebec Counter and record your counts on the chart on the chalkboard.

4. After all data is on the chalkboard, record the table into your notebook.

5. Make a “XY scatter” graph with symbols and lines for these results (CFU/mL to wash number) and include a proper figure legend.

6. What was your expected result (“a steady decline in numbers with each successive wash”)? Offer an explanation as to why you did or did not get your expected result.

7. After all that scrubbing, why should a surgeon still where sterile gloves for the patients sake?


19.1 Lytic Effect of Tears and Saliva: (Ex 24)

Our defenses against microbial infection are collectively termed resistance. Resistance can either be non-specific (act on all microbes) or specific (target a particular microbe).

Specific resistance, or immunity, involves the production by our immune system of specific proteins called antibodies, which bind to distinct microorganisms. Binding of antibodies is a means of hindering and identifying invading cells needing to be destroyed by other immune system functions. A set of unique antibodies will be produced in response to every new strain of microorganism that has breeched the non-specific defenses and causes an infection. For example, microbe A causes an infection and the host responds by producing antibodies against microbe A; microbe B infects the body and response is to produce antibodies against microbe B; antibodies against microbe A are ineffective against microbe B, and visa versa. More specifically, antibodies target their binding to unique biomolecules (proteins, polysaccharides, etc) often on the microbe cell surface, which are called antigens. It is the presence of a new antigen in the body that induces antibody production against it, and thereby against the microbe with that antigen.

Non-specific resistance includes defenses to protect against invasion by any microbe. These defenses include physical barriers, such as epithelial (non-vascularized) tissues, i.e. skin and mucus membranes. Inflammation and phagocytosis by white blood cells (WBC; leukocytes) also play a role in non-specific resistance, as do certain groups of proteins called bactericidins. One such bactericidin is the enzyme lysozyme, which catalyzes the breakdown of the peptidoglycan in the cell wall of gram-positive and some gram-negative bacteria. Lysozyme is present in our saliva and tears, as well as in the whites of bird eggs. In fact, lysozyme from eggs is commercially produced for its use in biotechnology application requiring the destruction of bacterial cell walls (e.g., DNA extraction protocols).

In this lab exercise, we will run some experiments to test for lysozyme presence in our tears and saliva. We will also compare the effectiveness of lysozyme on three different bacteria. We will test gram-positive (Micrococcus luteus) and gram-negative bacteria (Escherichia coli). In both experiments we will use a commercial stock of egg lysozyme as a positive control and sterile water as a negative control.

Exercise 24:

Lysozyme Activity Assay:

Materials:

2x Nutrient agar plates

Culture of either: M. luteus and E. coli

2x Sterile cotton swab

Sterile blotting paper pieces

Wax pencil

Bunsen burner

Forceps

Sterile water

Egg Lysozyme

Onion

Procedure:

1. Divide both your plates into quadrates using a wax pencil, and label as illustrated below:

2. Each plate will be inoculated with one of the two bacteria, so label plates accordingly.

3. Swab-inoculate each plate with culture of the appropriate bacterium for lawn growth.

a)  Dip a sterile swab into the culture, and then gently squeeze excess culture drops from the swab by rolling the swab on the inside wall of the culture container.

b)  Use the swab to inoculate the entire surface area of the plate. Work the swab back and forth once and then again at 90 degree from the first swabbing.

4. Expectorate saliva (i.e. spit) into the bottom half of a sterile Petri plate.

5. Generate tears, via the sliced onion technique, and collect in the lid of a sterile Petri plate.

6. Wick the test solution and controls into respective pieces of sterile paper, and place in the center of the appropriately labeled quadrate of the inoculated plates. In doing this step, it is important not to overload the paper piece – listen to your instructor’s suggestions in this regard.

7. Incubate at 37 ºC for 24 h to 48 hours.

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8. Measure the distance for any zone of growth inhibition (like in the disinfectant lab), and record results on the chalk board for class average calculations. Record the table in your notebook.

9. Calculate class averages for each bacterium and treatment.

10. Did you get the results you expected for negative and positive controls?

11. Was there lysozyme in your tears and saliva? Which had a greater effect, tears or saliva? Assuming you loaded equal volumes of body fluid to the paper wicks, why might there be a difference in the level of activity between tears and saliva?

12. What are at other factors that contribute to the non-specific resistance of your eyes? Of your mouth?

13. Look up another group of proteins involved in our non-specific resistance to microbes (textbook/literature search assignment). Describe its function and where it is located in the body.

19.2 Antimicrobial Sensitivity Testing: Kirby Bauer Method: (Ex 25)

The principal drugs used in the treatment of infectious disease fall into three categories: antibiotics, sulfonamides, and chemotherapeutics. Collectively, they may be referred to as antimicrobics. Once the causative organism of a specific disease has been isolated, the physician needs to know, as soon as possible, which antimicrobic will be most effective. The use of sensitivity disks can readily provide this information.

Antimicrobic impregnated disks were first introduced in the late 1940s as penicillin came into widespread use. As the decades rolled by and a multitude of new drugs were discovered, a great deal of experimentation took place with the hope of developing a test method that would accommodate the large variety of antimicrobics with a high degree of reliability. Many problems were encountered.

The effectiveness of an antimicrobic in sensitivity testing is based on the size of the zone of inhibition. The zone of inhibition, however, varies with the diffusibility of the agent, the size of the inoculum, the type of medium, and many other factors. Only by taking all these variables into consideration could a reliable method be worked out. The Kirby-Bauer method, which is described here, is such a method and is the accepted procedure in use today. It is sanctioned by the U.S. FDA and the Subcommittee on Antimicrobial Susceptibility Testing of the National Committee for Clinical Laboratory Standards. Although time is insufficient here to consider all facets of the test, the basic procedure will be followed.