BIO580 MEDICAL MICROBIOLOGY

Syllabus Fall 2003

A. General information

Infection is a conflict between a host and a microorganism with two possible outcomes, resistance or disease, dependent on interactions between the infectious agent and the host’s immune response. Medical microbiology, therefore, is a discipline that includes the study of the microorganisms, the host immune system, and interactions between the two. Although bacteria and viruses are the most numerous and most important pathogens and are emphasized in this course in lecture and clinical case studies, fungi and protozoa are also included. The goal of this course is to provide a foundation of concepts in host-microbe interactions that will allow students to understand the diseases facing humans today and be prepared to understand the diseases coming tomorrow.

Medical Microbiology is an advanced course and will be taught at a rigorous level. Most of the students who take this course are interested in pursuing a career in health related fields or are graduate students in microbiology and are ready for a course that requires synthesis, integration, and application rather than rote memorization.

 

B. Course logistics.

Lectures meet Mon. and Wed from 2:00-2:50 pm in BR 201. Laboratories meet Mon. and Wed from 3:00-4:50 and 5:00-6:50 pm in BR 129. There will be some Tues., especially during the clinical case portion of the course, when the student or their lab/group partner(s) will need to check laboratory test results.

 

Course instructor: Dr. Elizabeth Alm

 

Office hours: Office hours will be posted. I will have a sign-up sheet outside my door and if you sign up for a time 1) I will be there, and 2) you will not be waiting too long on other students.

 

e-mail: alm1ew@cmich.edu (Note: this is the easiest way to reach me). Important: If you have a BIO580 question, put "BIO580" as the beginning of the subject line of your e-mail message. I group these for reading at one time a day. If you fail to include this header I may miss your question.

Example:

To: Elizabeth.W.Alm <alm1ew@cmich.edu>

From: Susan B. Student <stude1sb@cmich.edu> Subject: BIO580: questions on today’s lecture

 

Prerequisites: Bio208 (General Microbiology) and Bio392 (Mammalian Physiology). Bio324 (Cell Biology) is also recommended.

 

C. Required materials

Textbook: Mims, Playfair, Roitt, Wakelin, and Williams. (1998) Medical Microbiology 2nd Ed., Mosby Europe Limited, Chicago. Lab Manual: Alm (2003) Laboratory Manual of Diagnostic Microbiology. Course Pak.

Access to the World Wide Web and an e-mail account. I will be posting many class materials on the Web, and expect every student to check the Web site for announcements a couple times a week. I can be reached more easily by e-mail than by any other method, and will reply to any concern or question you raise if you have an e-mail account. Go to the computer center help desk to find out how to obtain and use e-mail (available free to all students).

 

D. Laboratory

All organisms handled in the laboratory have the potential to cause illness, especially in compromised individuals (about half of the organisms are classified as Biological Safety Level 2). Compromising conditions include cancer, chemotherapy, diabetes, HIV positivity, open wounds, pregnancy, steroid use, etc. See me if you have concerns about your safety in laboratory. All inquiries will be confidential.


E. Clinical Cases

Three important skills in medical microbiology are problem-solving, interacting with other professionals, and oral and written communication skills. Development of these skills is also an objective in this course. Written communication skills will be developed throughout the semester in essay exam questions. The other skills will be emphasized in the second half of the semester. For the first half of the semester, both the lecture and laboratory will emphasize basic concepts and skills and will operate fairly independent of one another. After the Midterm exam, the labs and lectures will be integrated by way of clinical cases. Case study groups will consist of 4-5 students. Clinical cases will be handed out to each group in lecture at the beginning of the week. Some cases will be accompanied by a clinical sample that you will receive and work with in the laboratory. At least some members of the group will need to come in at times other than scheduled lab times to continue identification of the unknown. Case reports will be collected and graded. One report for the group will be turned in and all members of the group will receive the same grade.

 

Books on 2 h reserve in library:

Bailey and Scott's Diagnostic Microbiology. Betty A. Forbes. 1998. QR67.B37 1998

Cellular microbiology: Bacteria-host interactions in health and disease. Brian Henderson, et al. 1999.

Compact American Medical Dictionary. 1998. R121.C665 1998.

Harrison's Principles of Internal Medicine. 1994. RC46.H333 1994.

Medical Microbiology. Patrick R. Murray. 1998. QR46.M4683 1998.

Microbiology. T. Stuart Walker. 1998. QR46.W245 1998.

Microbiology in Clinical Practice. D.C. Shanson. 1999. QR46.S478 1999.

The American Heritage Stedman's Medical Dictionary. 1995. R121.A53 1995.

Zinsser Microbiology. Wolfgang K. Joklik, ed. 1992. QR46.26 1992

 

F. Reading assignments

Reading assignments in the text are listed on the tentative lecture schedule. Readings and lectures will complement each other — I cannot cover every detail in lecture, and will expect you to obtain certain information from reading the text rather than from lecture. Don't fall behind! Try to read the assignment before each class, but at the very latest read it on the same day as the class.

 

G. Grades

Quizzes and Tests: 10-15 point quizzes may consist of a mixture of material from lectures and laboratories. Tests may include a mixture of different types of questions, such as short-answer, multiple-choice, true-false, and/or short essay. There will be a Midterm laboratory practical; a makeup will not be possible for this test under any circumstances.

 

Final Exam: The final exam is comprehensive. Note University policy on scheduling of final exams: "Students scheduled for more than three examinations on the same day may arrange to have the examination in excess of three [that means the 4th one] rescheduled for another time during the examination week." Therefore, I do not anticipate rescheduling a final for anyone.

 

Grading:

 

Undergraduates

Graduates

Quizzes

10%    

8%

Lecture Test One         

10%                

8%

Lecture Test Two        

15%

13%

Bacterial Unknown

10%

8%

Lab Practical

15%

13%

Case Reports

20%

17%

Final Comprehensive Exam

20%

17%

Additional Required Elements

 

17%


Grading Scale:

94+ = A

80-83.9 = B-

90-93.9 = A-

77-79.9 = C+

87-89.9 = B+  

74-76.5 = C

84-86.9 = B

70-73.9 = C-

 

H. Students requiring accommodations

CMU provides students with disabilities reasonable accommodation to participate in educational programs, activities or services. Students with disabilities requiring accommodation to participate in class activities or meet course requirements should first register with the office of Student Disability Services (250 Foust Hall, telephone #989-774-3018, TDD #2568), and then contact me as soon as possible.

 

I. Makeup policy

Makeup exams are available only to students who have a legitimate excuse for missing an exam, such as personal illness or injury, sanctioned athletic team event out of town, or death in the immediate family. If you know in advance that you must miss an exam, see me in advance and bring documentation to support your anticipated absence. If you miss an exam unexpectedly because of last-minute illness or accident, contact me when you return to campus (or by email or phone if you will be away for some time) with documentation of your situation. Makeups for the final exam will be scheduled for Friday of exam week.

 

J. Extra credit

Students wishing to make up for poorer than expected exams may write essays for a maximum addition of 10 points to the total course points.

Essays - You may write up to five short (2-3 pages, double-spaced) essays on Medical Micro related topics during the semester. Due dates for each essay opportunity will be posted in "Instructor Announcements" on the web page. Each essay submitted will earn up to 2 points added to the total course points, as follows:

·        2 points - good work, appropriate references,

·        1/2 to 1 point - basically acceptable content but marred by mechanical problems such as incorrect spelling or grammar, or lack of clarity in explaining the topic, lack of or inappropriate references,

·        0 point - unacceptable or plagiarized.

**Any evidence of plagiarism will result in zero points for all students involved and denial of any extra credit points otherwise earned in the course. Essays should integrate at least two articles from the primary literature, not textbooks or internet sources.

 

K. How to succeed in this course

As you proceed upward in course level difficulty from 100 to 200 to 300, and so on, you need to develop greater responsibility for your own learning. The ultimate goal of college is to develop independent learners and critical thinkers. Therefore, you will find that less structured learning assistance is provided for you in this course. This does not mean that I am not still happy to help you with any material during my office hours.

 

In order to succeed in this course you should plan to attend all lectures, take careful notes, allow ample time to read and study assigned material and turn assignments in on time. You will get more out of lectures if you read (or at least skim) the assigned readings before lecture and then reread relevant material carefully soon after lecture.

 

You should plan on spending a minimum of two hours of study time for each hour of lecture. This is standard academic advice you will find in any book on how to study. This is a minimum requirement for most students to perform satisfactorily (C level). If you desire an "A", you will probably need to put in more time than this minimum recommendation. If you begin to fall behind, make every effort to catch up quickly, otherwise you may find yourself swamped with too much material to assimilate before a test. Tips for scheduling your time.


Many of you will find attending lectures and reading the text is all the support you will need to do well in the course. Some of you may have problems with some of the material. I offer several forms of assistance to help you with difficulties you may experience in this course.

1.      I will be happy to repeat information and/or answer questions during lecture, please do not hesitate to ask me to do so. Also feel free to email questions to me at any time.

2.      The textbook provides concept guides throughout the chapter as well as chapter end questions. The questions in the chapter should help guide your reading. If you can't answer the questions, then you should reread that section more closely. Use the chapter end questions to practice writing essays over the material.

3.      A web page is available for this course: http://www.cst.cmich.edu/users/alm1ew/medimicro.html. This web page will contain links to additional internet resources.

4.      There is an extra credit possibility in this course. See J. above for more information.

5.      I am available for individual consultation regarding any aspect of the course. If you have unanswered questions or concerns, or are in serious academic trouble, see me! I will provide whatever assistance I can to help you do well in this course; however, ultimately the grade you earn is your responsibility.

 

L. Recommended and optional material

Your grade will be based on how well you master the required elements listed above. In addition to required elements that all students must undertake, this course will provide recommended and optional elements. Recommended reading material marked FYI will be provided for students who are interested in exploring a particular topic in a little more detail. Optional material will be provided upon request for students with further interest or aptitude in medical microbiology. Undertaking recommended and optional material will not add to or subtract from your grade. This is purely a means for students to take the subject of medical microbiology as far as they are interested. If you have ideas about optional material, please feel free to come see me.

 

M. Annotated bibliography

There are dozens of interesting books on medical microbiology, particularly in the area of emerging diseases. Some that I have read and recommend include:

1.      The Coming Plague: Newly Emerging Diseases in a World out of Balance by Laurie Garrett. 1994. Penguin Books USA Inc. New York. This is a very interesting and scary book that follows several different disease outbreaks from Machupo virus, which emerged in Bolivia in the early 1960s; to HIV, which emerged simultaneously in Africa and the US in the 1970s; to the Hantavirus outbreak in the US 1993. I particularly found interesting the history of the AIDS pandemic. 750 pages. $14.95 paperback. ISBN 0 14 02.5091 3. Also available in hardback.

2.      The Hot Zone by Richard Preston. 1994. Anchor Books Doubleday. New York. Very exciting book that focuses on the true (but somewhat sensationalized) story of an outbreak of Ebola virus that occurred in Reston, Virginia in 1993. I highly recommend this book. 422 pages. $6.99 paperback. ISBN 0-385-47956-5.

3.      Breakout: The Evolving Threat of Drug-Resistant Disease by Marc Lappe. 1995. Sierra Club Books. San Francisco. Not as breathtaking as the above books but has an interesting Darwinian viewpoint on the evolution of antimicrobial resistance. 255 pages, $14.00 paperback. ISBN 0-87156-382-7.

4.      When Plague Strikes by James Cross Giblin. 1995. Harper Collins Publishers Inc. New York. A very easy to read history of three plagues, The Black Death, Smallpox, and AIDS. 212 pages, $6.95 paperback. ISBN 0-06-446195-5.

 


Tentative schedule - any schedule changes will be posted on the course web site

DATE

LECTURE TOPIC

READING

LABORATORY TOPIC

M

Aug 25

Unit 1 - The Players

Course introduction; Dynamics of infectious disease - concept check 1 available online.

Ch.1

Diagnostic Principles

Laboratory 1 - Gram stain and streak plate method of isolation

W

Aug 27

Part A - Review of the microbes

Symbiosis; Viruses and bacteria - concept check 2 available online.

Chs. 2, 3

Laboratory 2 - Colony morphology

M Sep 1

Labor Day - No Class

 

 

W

Sep 3

Eucaryotic microbial pathogens and normal microbiota

 

Laboratory 3 - Initial grouping of unknown clinical bacteria

M

Sep 8

Part B - Host defenses

Nonspecific host defenses against microbial invaders - concept check 3 available online.

Ch.4

Laboratory 4 - Identification of Gram-positive cocci

W Sep10

Nonspecific continued

 

Laboratory 5 - continued

M

Sep 15

Specific host defenses against microbial invaders

 

Chs.5, 6

QUIZ 1 - Labs 1-5

Laboratory 6 - Identification of Enterobacteriaceae

T Sep16

 

 

Read results from Laboratory 6

W Sep17

Specific defenses continued

 

Laboratory 7 - continued

M

Sep 22

TEST ONE - UNIT ONE

 

Laboratory 8 - Identification of Oxidase-positive Gram-negative Rods and Cocci

W

Sep 24

Unit 2 - Conflicts Between Host and Pathogens

How are pathogens acquired and transmitted?

Chs.7, 8

Laboratory 9 - Identification of Gram-positive Rods

M

Sep 29

Conflicts continued- concept check 4 available online

Chs.9,10

Laboratory 10 - Bacterial Unknown assigned; An Introduction to Anaerobes

T Sep30

 

 

Work on Unknown

W

Oct 1

How do pathogens escape nonspecific host defenses?

 

Ch.11

QUIZ 2 - Labs 6-10

Laboratory 11 - Intro to yeasts/ Continue Unknowns

R, F

Oct 2,3

 

 

Continue Unknown if necessary

M

Oct 6

How do pathogens escape specific host defenses?- concept check 5 available online.

Microbial spread

Laboratory 12 - Intro to Molds

W

Oct 8

 

Ch.12

Open Lab - Review for midterm; Unknown reports due by 5 pm.

M

Oct 13

Continued

 

LABORATORY PRACTICAL EXAM

Laboratories 1 through 12


 

W

Oct 15

TEST TWO - UNIT TWO

Comprehensive with an emphasis on Unit 2

 

Ch 15

Unit 3 - Clinical Manifestations of Infection

Clinical Case Problem-Solving; Upper Respiratory Tract Infections

M

Oct 20

Lower Respiratory Tract Infections

Ch. 17

Clinical Case 1 due 2 pm

Laboratory 13 - Lower Respiratory Tract Infections

W

Oct 22

 

 

Laboratory 14 - continued

M

Oct 27

QUIZ 3 -RTI

Urinary Tract Infections and Sexually Transmitted Diseases

Chs.18, 19

Clinical Cases 2 and 3 due 2 pm

Laboratory 15 - UTI and STD

W

Oct 29

 

 

Laboratory 16 - continued

M

Nov 3

QUIZ 4 -UTI and STD

Gastrointestinal infections

Ch.20

 

Clinical Cases 4 and 5 due 2 pm

Laboratory 17 - GI infections

W

Nov 5

 

 

Laboratory 18 - continued

M

Nov 10

QUIZ 5 - GI

Nervous System Infections

Ch.22

Clinical Case 6 due 2 pm

Laboratory 19 - CNS

W

Nov 12

 

 

Laboratory 20 - continued,

M

Nov 17

QUIZ 6 - CNS

Infections of the skin and wounds

Ch.23

Clinical Cases 7 and 8 due 2 pm

Laboratory 21 - Skin and Wound Infections

W

Nov 19

 

 

Laboratory 22 - continued

M

Nov 24

QUIZ 7 - SKIN

Unit 4 - Control of Microbial Infections

Antimicrobial action

Chs.29, 30

Clinical Cases 9 and 10 due 2 pm

Laboratory 23 - Antibiotic Susceptibility Testing

T

Nov 25

 

 

continued

W

Nov 26

Antimicrobial action continued

 

Laboratory 24 - continued

M

Dec 1

Antimicrobial resistance

 

Laboratory 25 - Transfer of Antibiotic Resistance

W

Dec 3

Immunization strategy; Probiotic and prophage therapy

Ch.31

Laboratory 26 - continued

M

Dec 8

FINAL EXAM

Comprehensive with an emphasis on Units 3 and 4

BR 201 2-3:50 pm