Clinical Microbiology

  1. Antimicrobial Susceptibility Testing
    1. Principles of Antimicrobial Action
      1. Mechanisms of Action
        1. Inhibition of Cell Wall Synthesis
          1. Beta-Lactam Antibiotics
            1. Glycopeptides
              1. Bacitracin
              2. Inhibition of Protein Synthesis
                1. Aminoglycosides
                  1. Chloramphenicol
                    1. Macrolides
                      1. Lincosamides
                        1. Tetracyclines
                        2. Inhibition of Nucleic Acid Synthesis
                          1. Fluoroquinolones
                            1. Rifamycins
                              1. Metronidazole
                              2. Disruption of Cell Membrane
                                1. Polymyxins
                                  1. Daptomycin
                                  2. Antimetabolite Activity
                                    1. Sulfonamides
                                      1. Trimethoprim
                                    2. Pharmacokinetics and Pharmacodynamics
                                      1. Absorption and Distribution
                                        1. Metabolism and Excretion
                                          1. Concentration-Dependent vs Time-Dependent Killing
                                        2. Susceptibility Testing Methods
                                          1. Disk Diffusion Method
                                            1. Kirby-Bauer Technique
                                              1. Principle and Procedure
                                                1. Zone Diameter Interpretation
                                                  1. Quality Control
                                                    1. Limitations
                                                    2. Dilution Methods
                                                      1. Broth Microdilution
                                                        1. Principle and Procedure
                                                          1. MIC Determination
                                                            1. Automated Systems
                                                            2. Broth Macrodilution
                                                              1. Agar Dilution
                                                              2. Gradient Diffusion
                                                                1. E-test Principle
                                                                  1. MIC Determination
                                                                  2. Automated Susceptibility Testing
                                                                    1. Instrument Platforms
                                                                      1. Advantages and Limitations
                                                                        1. Quality Control
                                                                      2. Interpretation of Results
                                                                        1. Clinical Breakpoints
                                                                          1. Susceptible Category
                                                                            1. Intermediate Category
                                                                              1. Resistant Category
                                                                                1. Breakpoint Development
                                                                                2. Minimum Inhibitory Concentration
                                                                                  1. Definition and Significance
                                                                                    1. MIC50 and MIC90
                                                                                    2. Minimum Bactericidal Concentration
                                                                                      1. Definition and Applications
                                                                                      2. The Antibiogram
                                                                                        1. Construction and Format
                                                                                          1. Clinical Applications
                                                                                            1. Infection Control Uses
                                                                                          2. Antimicrobial Resistance Mechanisms
                                                                                            1. Intrinsic Resistance
                                                                                              1. Natural Resistance
                                                                                                1. Species-Specific Patterns
                                                                                                2. Acquired Resistance
                                                                                                  1. Genetic Basis
                                                                                                    1. Chromosomal Mutations
                                                                                                      1. Plasmid-Mediated Resistance
                                                                                                        1. Transposon-Mediated Resistance
                                                                                                      2. Biochemical Mechanisms
                                                                                                        1. Enzymatic Inactivation
                                                                                                          1. Beta-Lactamases
                                                                                                            1. Aminoglycoside-Modifying Enzymes
                                                                                                              1. Chloramphenicol Acetyltransferase
                                                                                                              2. Target Site Modification
                                                                                                                1. Altered PBPs
                                                                                                                  1. Ribosomal Modifications
                                                                                                                    1. DNA Gyrase Mutations
                                                                                                                    2. Efflux Pumps
                                                                                                                      1. Single-Drug Efflux
                                                                                                                        1. Multidrug Efflux
                                                                                                                        2. Reduced Permeability
                                                                                                                          1. Porin Loss
                                                                                                                            1. Membrane Changes
                                                                                                                        3. Detection of Resistance Mechanisms
                                                                                                                          1. Beta-Lactamase Detection
                                                                                                                            1. Phenotypic Methods
                                                                                                                              1. Nitrocefin Test
                                                                                                                                1. Acidometric Methods
                                                                                                                                2. Molecular Methods
                                                                                                                                  1. PCR Detection
                                                                                                                                    1. Gene Sequencing
                                                                                                                                  2. Extended-Spectrum Beta-Lactamases
                                                                                                                                    1. Phenotypic Detection
                                                                                                                                      1. Confirmatory Tests
                                                                                                                                        1. Molecular Detection
                                                                                                                                        2. Carbapenemase Detection
                                                                                                                                          1. Phenotypic Screening
                                                                                                                                            1. Confirmatory Tests
                                                                                                                                              1. Molecular Methods
                                                                                                                                              2. Methicillin Resistance in Staphylococci
                                                                                                                                                1. mecA Gene Detection
                                                                                                                                                  1. PBP2a Detection
                                                                                                                                                    1. Phenotypic Methods
                                                                                                                                                    2. Vancomycin Resistance
                                                                                                                                                      1. van Gene Detection
                                                                                                                                                        1. Phenotypic Methods
                                                                                                                                                        2. High-Level Aminoglycoside Resistance
                                                                                                                                                          1. Screening Methods
                                                                                                                                                            1. Clinical Significance
                                                                                                                                                          2. Specific Organism Testing
                                                                                                                                                            1. Staphylococcus Species
                                                                                                                                                              1. Standard Methods
                                                                                                                                                                1. Special Considerations
                                                                                                                                                                2. Streptococcus Species
                                                                                                                                                                  1. Beta-Hemolytic Streptococci
                                                                                                                                                                    1. Streptococcus pneumoniae
                                                                                                                                                                      1. Viridans Group Streptococci
                                                                                                                                                                      2. Enterococcus Species
                                                                                                                                                                        1. Standard Methods
                                                                                                                                                                          1. Resistance Detection
                                                                                                                                                                          2. Enterobacteriaceae
                                                                                                                                                                            1. Standard Methods
                                                                                                                                                                              1. ESBL Detection
                                                                                                                                                                                1. Carbapenemase Detection
                                                                                                                                                                                2. Non-Fermenting Gram-Negative Bacilli
                                                                                                                                                                                  1. Pseudomonas aeruginosa
                                                                                                                                                                                    1. Acinetobacter Species
                                                                                                                                                                                    2. Fastidious Organisms
                                                                                                                                                                                      1. Haemophilus Species
                                                                                                                                                                                        1. Streptococcus pneumoniae
                                                                                                                                                                                        2. Anaerobic Bacteria
                                                                                                                                                                                          1. Special Methods
                                                                                                                                                                                            1. Clinical Significance

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                                                                                                                                                                                        6. Clinical Mycology