don't swim in the pool!

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Don't Swim in the Pool! A case study by Robert and Lauren

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Page 1: Don't swim in the pool!

Don't Swim in the Pool!

A case study by Robert and Lauren

Page 2: Don't swim in the pool!

Background

Skin rash infection Hotel A in Bangor Maine

February 18-27 2000 Nine people affected Stayed in either the hot tub or pool

Seven stayed in both

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Patient Symptoms

Folliculitis Rash lasted 7 days or less Some had an infection of the outer ear

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About the Facilities

Hot tub & pool within 5 feet of each other Separate filtration systems

Pool had automated chlorination system Hot tub levels were maintained manually During outbreak, chlorine levels were low

<1.0mg/L State requirement: 1 to 3 mg/L

Facilities were thoroughly cleaned Samples from the top of the pool filter

and draining of an ear were cultured

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More About Folliculitus

Inflamed hair follicles Can occur anywhere on the skin Can be bacterial, fungal, viral, or non-

infectious Symptoms: rash, pimples/ustules, itching

skin, spreading through improper treatment

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Gram Staining

Cells are added to a slide Stained with Crystal Violet, rinsed with

water Covered with Grams iodine, rinsed with

acetone-alcohol Safranin is added Gram (+) is purple; (-) is pink Patient sample is gram (-)

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Selective Differential Media

Chose MacConkey Agar Only allows gram negative to grow

Contains lactose

Spread cells and allowed to grow Results

E. coli (control) was gram (-) and had lactose digestion

Patient sample couldn't digest lactose, but showed growth

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Antimicrobial Susceptibility

Plate was completely covered with patient sample bacteria

Added the antibiotics: Streptomycin, Penicillin, Chloramphenicol, Tetracycline, Gentamicin, Vancomycin

Patient sample was resistant to everything, except intermediate to Streptomycin and sensitive to Gentamicin

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Pseudomonas aeruginosa Overview

Can cause disease in animals Can be found in soil, WATER, skin flora,

most man-made environments Symptoms usually include inflammation

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Pseudomonas aeruginosa Cell

Bacterium Aerobic Rod—shaped Single-polar flagellum Gram negative

Cell wall has thin layer of peptidoglycan and thick layer of lipopolysaccharide

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Pseudomonas aeruginosa

Metabolism requires little nutrients Acetate as a source for Carbon Ammonium sulfate for Nitrogen

Infecting cells Can infect respiratory and urinary

systems, too Uses virulence factor extoxin A to inhibit

protein synthesis in eukaryotic cells