2019/2020

Medical Microbiology and Parasitology

Code: 102933
ECTS Credits: 8

Degree Type Year Semester

2502442 Medicine OB 3 0

Errata

There has been a change in the teaching staff for this subject. Dr.Beatriz Mirelis Otero is replaced by Dr. Maria
Alba Rivera Martínez ([email protected])

Contact Use of Languages

Name: Tomas Pumarola Suñe Principal working language: catalan (cat)

Email: [email protected] Some groups entirely in English: No
Some groups entirely in Catalan: No
Some groups entirely in Spanish: No
Teachers

Rosa Maria Bartolomé Comas

Juana María Lourdes Matas Andreu
Beatriz Mirelis Otero
Carme Muñoz Batet
Nuria Rabella García
Antonia Andreu Domingo
Fernando Sánchez Reus
Estrella Caballero Requero
Maria Teresa Tórtola Fernández
Montserrat Giménez Pérez
Maria Nieves Larrosa Escartin
Ferran Navarro Risueño
María Gloria Soria Guerrero
Gema Fernandez Rivas
Dionisia Fontanals Aymerich
Isabel Sanfeliu Sala
Agueda Hernandez Rodriguez
Oscar Luis Cuevas Lobato
Mayli del Consuelo Lung Suarez

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Silvia Capilla Rubio
Tomas Pumarola Suñe
Maria Virginia Plasencia Miguel
Juan José González López
Ana Cristina Siverio Pares
Pere Joan Cardona Iglesias
Mateu Espasa Soley
Cristina Vilaplana Massaguer
Eduardo Padilla León
Cristina Prat Aymerich
Elena Sulleiro Igual

Prerequisites

General knowledge of cellular and molecular biology, anatomy, physiology and microscopic structure of human
organs and systems.

Objectives and Contextualisation

Medical Microbiology and Parasitology is placed in the Third Course in Medicine Degree, together with other
subjects, which place the student in the world of functional and structural human diseases.

The fact that a set of diseases are caused by microorganisms, presupposes a specific area of interrelation
between two living beings, whose relationship, in certain circumstances, result in pathological processes that
translate into infectious disease.

The subject is inserted in a year (third) in which General Pathology (pathophysiology), Pathological Anatomy
and Pharmacology are developed. An intense correlation is developed with these areas of knowledge, both
with the conceptual and the organizational sphere.

Infectious diseases respond to the action of a living causative agent, a specific and differential aspect with the
rest of pathology and that entails several particularities such as the mentioned biological interaction between
living beings and the transmission of microorganisms between people and therefore of the disease.

At the same time, these diseases are subject to treatment by means of antimicrobial medications, and immune
prophylaxis through vaccines.

To identify the causative microorganism of the disease, cardinal aspect to establish the treatment and the
prophylaxis, the location of the infections (focal and general) must be specified to take the appropriate samples
to refer them to the laboratory of microbiology, where the studies are done to determine the etiological
diagnosis. This aspect is important so that the treatment is directed and effective.

So, in Microbiology, we can differentiate knowledge objects and applied objectives: 1) microorganisms as
causative agents of disease, 2) injury caused by the microorganisms defined by their pathogenicity and
virulence 3) the host responses 4) the diagnostic processes and 5) the treatment and prophylaxis.

The processes of microbial injury and host response are inseparable and conform what we candefine as the
pathophysiology of infection.

In this context the training objectives include:

1- List the microorganisms that cause human illness (pathogenic microorganisms) and differentiate them from
the commensal microorganisms.

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2- Describe the biological characteristics of microorganisms, emphasizing the following aspects: morphology,
physiology and life cycles.

3- Name and describe the reservoirs of microorganisms and ways of transmission.

4- Describe the virulence factors and the mechanisms that explain the pathogenic capacity.

5- Describe the nonspecific and specific defense mechanisms of the host. Describe the interrelations between
the pathogen and the host (ie the pathophysiology of the infection). Describe the concept of opportunism.

6- Describe the normal microbiome. Enumerate its physiological functions and its relation to opportunism.

7- Determine the clinical samples of the focus of infection that must be collected and establish the measures
and procedures to collect them and to transfer them to the laboratory for their study.

8- Identify the tests that must be requested to the laboratory to make the etiological diagnosis of the process.

9- To know the antimicrobials and their indications.

10- Describe the sensitivity tests that must be used in the different microorganisms to direct the antimicrobial
treatment.

11- Establish the rules of immediate prophylaxis (isolation and immune prophylaxis) and long-term
(vaccination).

12- Based on the preceding information all microorganisms of human pathology are described to analyse and
revise their characteristics: 1) structure and physiology 2) general epidemiology, reservoir and transmission
mechanism 3) pathogenesis 4) clinical 5) etiologic diagnosis and 6) prophylaxis and treatment.

Competences

Communicate clearly, orally and in writing, with other professionals and the media.
Demonstrate understanding of the causal agents and the risk factors that determine states of health and
the progression of illnesses.
Demonstrate, in professional activity, a perspective that is critical, creative and research-oriented.
Establish a diagnostic approach and a well thought-out strategy for action, taking account of the results
of the anamnesis and the physical examination, and the results of the appropriate complementary tests
carried out subsequently.
Indicate the basic diagnosis techniques and procedures and analyse and interpret the results so as to
better pinpoint the nature of the problems.
Maintain and sharpen one's professional competence, in particular by independently learning new
material and techniques and by focusing on quality.
Use information and communication technologies in professional practice.

Learning Outcomes

1. Communicate clearly, orally and in writing, with other professionals and the media.
2. Demonstrate, in professional activity, a perspective that is critical, creative and research-oriented.
3. Describe the host-parasite interrelationship: mechanisms of pathogenicity and defence.
4. Describe the main infectious syndromes caused by the various microorganisms.
5. Describe the methods of microbiological diagnosis of infectious diseases comprehensively and
holistically, from a theoretical and a practical perspective.
6. Establish a diagnostic approach and a specific strategy for action for each of the microorganisms
responsible for infectious diseases.
7. Explain the basic concepts of microbial genetics and its relationship to pathogenicity and resistance to
antimicrobial agents.
8. Explain the concept and the biological types of microorganisms.

9. Identify the actions to prevent and protect against infectious diseases.

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 9. Identify the actions to prevent and protect against infectious diseases.
10. Identify the causal agents and the risk and diagnostic factors of infectious diseases.
11. Identify the importance of symbiosis as a way of living. Commensalism and parasitism as forms of
symbiosis.
12. Identify the indications of microbiological tests.
13. Identify the main mechanisms of resistance to antimicrobial agents.
14. Identify the performance of the different diagnostic techniques and interpret their results.
15. Identify the principles behind microbiology and parasitology.
16. Identify, individually, the biological, epidemiological (reservoir and transmission), pathogenic, clinical,
diagnostic and therapeutic features of the different microorganisms responsible for infectious diseases.
17. Indicate the basic techniques and procedures for diagnosing the major syndromes of infectious
pathology.
18. Indicate the clinical samples necessary for the microbiological diagnosis of syndromes, and how they
are to be collected and transported to the laboratory.
19. Maintain and sharpen one's professional competence, in particular by independently learning new
material and techniques and by focusing on quality.
20. Use information and communication technologies in professional practice.

Content

Introduction to medical microbiology. Agents causing infectious diseases. Epidemiology. Main infectious
syndromes. Microbial genetics. Mechanisms of pathogenicity. Defense mechanisms. Diagnosis of infectious
diseases. Normal flora Treatment of infectious diseases. Mechanisms of resistance. Techniques for the study
of the sensitivity to antimicrobials.

• Bacterial structure. Antibacterial drugs. Staphylococci. Streptococci. Neisseria meningitidis and Neisseria
gonorrhoeae. Colonizing and pathogenic Enterobacteriaceae. Gram-negative non-fermenting bacilli. Vibrios.
Parvobacteria. Legionella. Mycobacteria. Anaerobic bacteria. Treponematoses. Mycoplasma Chlamydia.
Rickettsia.

• General characteristics of fungi. Antifungal agents. Yeasts. Molds. Dermatophytoses. Dimorphic fungi.

• General characteristics of viruses. Antiviral drugs. Enterovirus. Picornavirus and viruses that cause enteritis.
Respiratory viruses Herpesvirus: herpes simplex virus, varicella, cytomegalovirus and Epstein Barr virus.
Papillomavirus and Polyamavirus. Viruses causing exanthema diseases. Hepatitis virus. Viruses of human
immunodeficiency. Arbovirus and emerging viruses.

• General characteristics of parasites. Anti-parasitic drugs. Protozoa of open cavities. Systemic protozoa.
Helminths. Arthropods of interest in medicine.

Distributive blocks

A. Introduction to Microbiology

B. Bacteriology

C. Mycology

D. Virology

E. Parasitology

Schedule lectures (49 sessions of 60 ')

1. Introduction to Microbiology. Medical microbiology: vision as a whole

2. Pathogens causing infectious diseases. Autochthonous flora

3. Infectious diseases

4. Microbial genetics
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4. Microbial genetics

5. Mechanisms of microbial pathogenicity

6. Host defense mechanisms

7. Epidemiology and prevention of infectious diseases

8. Classical diagnosis of infectious diseases

9. Molecular and serological diagnosis of infectious diseases

10. Structure and bacterial metabolism

11. Antibacterial drugs

12. Staphylococci

13. Streptococci

14. Neisseria

15. Pathogenic Enterobacteriaceae

16. Commensal enterobacteria and gram-negative non-fermenting bacilli

17. Campylobacter, Helicobacter and Vibrio

18. Parvobacteria and Legionella

19. Mycobacteria. Mycobacterium tuberculosis complex

20. Opportunistic environmental mycobacteria

21. Anaerobic bacteria

22. Spirochetes

23. Chlamydia

24. Mycoplasma and Rickettsia

25. Structure and metabolism of fungi

26. Antifungal agents

27. Yeasts

28. Dermatophytoses

29. Dimorphic fungi

30. Molds

31. Structure and propagation of viruses

32. Antiviral agents

33. Enterovirus. Picornavirus. Virus causing enteritis

34. Respiratory Virus: Flu. Syncytic respiratory virus. Other respiratory viruses

35. Herpes simplex virus. Chicken pox

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35. Herpes simplex virus. Chicken pox

36. Citomegalovirus. Virus Epstein- Barr. Other herpesvirus

37. Papillomavirus and Polyamavirus

38. Viruses causing exanthemic diseases

39. Hepatitis viruses (1)

40. Hepatitis viruses (2)

41. Viruses of human immunodeficiency

42. Arbovirus. Emerging viruses

43. General characteristics of protozoa and helminths

44. General characteristics of parasitic diseases. Arthropods of medical interest

45. Protozoa of open cavities

46. Systemic protozoa. Leishmania and Tripanosoma

47. Systemic protozoa. Toxoplasma and Plasmodium

48. Platelmints: Trematodes. Beasts

49. Intestinal and tissues nematodes

Laboratory practices (10 sessions of 90 ')

1. Conventional diagnosis of infectious diseases. Direct examination: Gram staining and Ziehl-Neelsen.

2. Techniques and means of cultivation. Identification

3. Study of the sensitivity to antimicrobials. Antibiogram

4. Diagnosis of special bacteria: Mycobacteria and anaerobic bacteria

5. Quick diagnosis. Antigen detection

6. Molecular diagnosis of infectious diseases

7. Fungi

8. Viruses

9. Parasites

10. Serological diagnosis of infectious diseases

Specialized seminars (15 sessions of 60 ')

a) Fundamentals of practical education

1. Concept of infectious disease, focus of infection and clinical sample

2. Direct examination. Cultivation and Identification

3. Sensitivity to antimicrobials

4. Quick diagnosis. Antigen detection Techniques of molecular biology

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5. Indirect etiologic diagnosis.

b) Clinical syndromes

1. Urinary infection

2. Sexually transmitted infection

3. Enteritis

4. Infection of the central nervous system

5. Respiratory infection

6. Infection of skin and soft parts

7. Osteo-articular infections

8. Hepatitis

9. Nosocomial infection

10. AIDS

Oral presentation (5 sessions of 120 ')

Presentation of work by students

Methodology

This Guide describes the framework, contents, methodology and general norms of the subject, in accordance
with the current curriculum. The final organization of the subject with regard to the number and size of groups,
distribution in the calendar and dates of examinations, specific criteria of evaluation and review of exams, will
be specified in each one of the Hospital Teaching Units (UUDDHH), who will explain it through their web pages
and the first day of class of each subject, through the teachers responsible for the subject at the UUDHH.

For the 2019-2020 academic year, the professors designated by the Departments as responsible for the
subject at the Faculty level and the UUDHH are:

Responsible department(s): Department of Genetics and Microbiology. Area of Microbiology Head of Faculty:
Tomás Pumarola

UUDHH Responsible

UD Vall d'Hebron: Tomás Pumarola

UD Germans Trias i Pujol: Lurdes Matas

UD Sant Pau: Carme Muñoz

UD Parc Taulí: Isabel Sanfeliu

Methodology

The teaching methodology will consist of theoretical classes, laboratory work, specialized seminars and clinical
cases presentation.

Theoretical classes will be taught in the form of master classes and constitute a basic knowledge base on
which all the rest of the learning activity is supported.

The seminars will be held in groups of 20 students. In these seminars, the basic principles of the etiologic
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The seminars will be held in groups of 20 students. In these seminars, the basic principles of the etiologic
diagnosis of infectious diseases will be reviewed and discussed with students. These seminars are the
theoretical basis for the correct realization of the laboratory work.

The laboratory work will be carried out in groups of 5-6 students. In these practices the students will develop
different techniques to familiarize themselves with the methods of work of the Microbiology laboratory used for
the etiologic diagnosis of infectious diseases.

Classroom practices are based on the development of aclinical case on the part of the students, previous
orientation on the part of the teachers about the content of the subject proposed, the way to develop it, as well
as the objectives that have to be done. Achieve, through support tutorials. Afterwards the students will orally
present in class the result of their work.

Activities

Title Hours ECTS Learning Outcomes

Type: Directed

Classroom practical work (PAUL) 10 0.4 1, 6, 16, 19, 20

Clinical cases seminars (SCC) 10 0.4 1, 6, 13, 16, 19

Laboratory practical work (PLAB) 5 0.2 6, 14, 13, 12, 16, 18, 17

Specialized seminars (SEM) 15 0.6 3, 4, 5, 6, 8, 7, 10, 15,

11, 9, 16

Theory (TE) 49 1.96 3, 4, 5, 6, 8, 7, 15, 13,

11, 9, 16, 17

Type: Autonomous

Autonomous activities: excercise writting, personal study, reading reports, 101 4.04 2, 6, 13, 16, 19, 20
reports of interest

Assessment

The subject will be evaluated by means of two partial exams. Each one of them will have a weight of 50% in
the final grade and correspond, approximately, to 50% of the syllabus. Both exams will be written assessments
and will consist of a part of the theory evaluation that will have a weight of 70% of the mark and a second part
of the evaluation of the practices that will have a weight of 30% of the mark. The theory exam will consist of a
part of multiple choice items and a part of restricted questions and / or correspondence items. The practical
exam will consist of restricted questions and / or resolution of problems and / or oral presentation of works. To
release the subject of the partial examinations, a mark of 6 or more is required. There will be a synthesis
evaluation where the student will examine the parts not released in the partial exams. This synthesis exam will
have the same structure and relative weight of the different parts as the partial examinations and will make an
average, if applicable, with the note obtained in the released part. To pass the subject, you will need to obtain
a global grade equal to or greater than 5 out of 10.

Attendance to classroom practices, laboratory work, clinical case seminars and specialized seminars is
mandatory and an essential condition to be able to be evaluated.

The review of the tests is considered a fundamental part of the learning. Holding their exam, the students will
listen to what the teachers expected from the various assessment activities. The day and time of the review of
the exam will be announced along with the marks both in the virtual Campus and at the notice board.

Students who do not perform both theoretical and practical evaluation tests will be considered as not evaluated
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Students who do not perform both theoretical and practical evaluation tests will be considered as not evaluated
and will be recorded in the minutes, exhausting the rights to the registration of the subject.

Assessment Activities

Title Weighting Hours ECTS Learning Outcomes

Evaluation through practical cases and problem 30% 4 0.16 1, 2, 6, 13, 16, 19, 20
solving

Written evaluation through objective tests 70% 6 0.24 3, 4, 5, 8, 7, 14, 10, 15, 11, 9, 12,
18, 17

Bibliography

Bibliografia específica

- Prats G. Microbiologia i Parasitologia mèdiques. Madrid. Editorial Panamericana. 2013

- Murray PR., Rossental KS., Pfaller MA. Medical Microbiology. 8th Ed. Philadelphia. Elsevier. 2016.

- Brooks GF, Carroll KC, Butel JS, Morse SA. Medical Microbiology. 24 Ed. New York: McGraw Hill. 2007

Bibliografia de consulta

- Mandell GL., Bennet JE., Dolin R. Mandell, Douglas and Bennet's - Principles and Practice of Infectious
Diseases. 6th Ed. Philadelphia: Elsevier Churchill Livingstone, 2009.

- Ausina V., Moreno Guillén S. Tratado SEIMC de Enfermedades Infecciosas y Microbiología Clínica. Madrid.
Editorial Médica Panamericana. 2006. Farreras-Rozman. Medicina Interna. 16th Ed. Elsevier España, S.L.
2009

Enllaços web d'interès

www.seimc.org
www.escmid.org
www.scmimc.org
www.asm.org
www.cdc.gov
http://www.microbelibrary.org. Pàgina oficial de la Societat Americana de Microbiologia (ASM). Conté
una gran varietat d'imatges i vídeos sobre el contingut de la matèria.
http://www.biofarma.net Clicar "Les cahiers". Llibres molt didàctics en francès i amb imatges molt
adequades de les parts principals de la matèria
http://www.seimc.org. Pàgina oficial de la Societat Espanyola de Malalties Infeccioses i Microbiologia
Clínica.
http://www.microbisome.com. Conté imatges de microbiologia y malalties infeccioses.
http://www.microbiologyinpictures.com. Conté imatges de cada microorganisme patògen important