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Waterborne Diseases ©6/1/2018 483 (866) 557-1746 When was Sodium Hypochlorite Discovered? Around 1785 the Frenchman Berthollet developed liquid bleaching agents based on sodium hypochlorite order 200mg vantin with mastercard antibiotic resistant kennel cough. Characteristics of Sodium hypochlorite Sodium hypochlorite is a clear buy vantin 200 mg online antibiotic resistance efflux pump, slightly yellowish solution with a characteristic odor discount 100mg vantin with mastercard antibiotics zone reader. As a bleaching agent for domestic use it usually contains 5% sodium hypochlorite (with a pH of around 11 purchase vantin 200mg otc antibiotics for acne vibramycin, it is irritating). If it is more concentrated, it contains a concentration 10-15% sodium hypochlorite (with a pH of around 13, it burns and is corrosive). Chlorine evaporates at a rate of 0,75 gram active chlorine per day from the solution. This also happens when sodium hypochlorite comes in contact with acids, sunlight, certain metals and poisonous and corrosive gasses, including chlorine gas. Sodium hypochlorite is a strong oxidator and reacts with flammable compounds and reductors. These characteristics must be kept in mind during transport, storage and use of sodium hypochlorite. When sodium hypochlorite dissolves in water, two substances form, which play a role in oxidation and disinfection. Sulfuric acid is a strong acid that strongly reacts with bases and is very corrosive. Sodium hypochlorite can be produced in two ways: - By dissolving salt in softened water, which results in a concentrated brine solution. In households, hypochlorite is used frequently for the purification and disinfection of the house. Salt Electrolysis System The advantage of the salt electrolysis system is that no transport or storage of sodium hypochlorite is required. Another advantage of the onsite process is that chlorine lowers the pH and no other acid is required to lower pH. The hydrogen gas that is produced is explosive and as a result ventilation is required for explosion prevention. The maintenance and purchase of the electrolysis system is much more expensive than sodium hypochlorite. Because sodium hypochlorite is used both to oxidize pollutants (urine, sweat, cosmetics) and to remove pathogenic microorganisms, the required concentration of sodium hypochlorite depends on the concentrations of these pollutions. Especially the amount of organic pollutants helps determine the required concentration. If the water is filtered before sodium hypochlorite is applied, less sodium hypochlorite is needed. Waterborne Diseases ©6/1/2018 485 (866) 557-1746 Theory Disinfection with chlorine is very popular in water and wastewater treatment because of its low cost, ability to form a residual, and its effectiveness at low concentrations. Although it is used as a disinfectant, it is a dangerous and potentially fatal chemical if used improperly. Despite the fact the disinfection process may seem simple, it is actually a quite complicated process. When free chlorine is added to the wastewater, it takes on various forms depending on the pH of the wastewater. It is important to understand the forms of chlorine which are present because each has a different disinfecting capability. The graph below depicts the chlorine fractions at different pH values (Drawing by Erik Johnston). Ammonia present in the effluent can also cause problems as chloramines are formed, which have very little disinfecting power. Some methods to overcome the types of chlorine formed are to adjust the pH of the wastewater prior to chlorination or to simply add a larger amount of chlorine. An adjustment in the pH would allow the operators to form the most desired form of chlorine, hypochlorus acid, which has the greatest disinfecting power. Adding larger amounts of chlorine would be an excellent method to combat the chloramines because the ammonia present would bond to the chlorine but further addition of chlorine would stay in the hypochlorus acid or hypochlorite ion state. Waterborne Diseases ©6/1/2018 486 (866) 557-1746 Recommendations for Preparing/Handling/Feeding Sodium Hypochlorite Solutions As a result of the pressures brought to bear by Health and Safety requirements, some users of gas have chosen to seek alternative forms of disinfectants for their water and wastewater treatment plants. Product Stability The oxidizing nature of this substance means that it should be handled with extreme care. Waterborne Diseases ©6/1/2018 487 (866) 557-1746 Waterborne Diseases ©6/1/2018 488 (866) 557-1746 Exposure There is no threshold value for to sodium hypochlorite exposure. After swallowing sodium hypochlorite the effects are stomach ache, a burning sensation, coughing, diarrhea, a sore throat and vomiting. Routes of Exposure Inhalation Hypochlorite solutions can liberate toxic gases such as chlorine. Chlorine is heavier than air and may cause asphyxiation in poorly ventilated, enclosed, or low-lying areas. Children exposed to the same levels of gases as adults may receive a larger dose because they have greater lung surface area/body weight ratios and higher minute volumes/weight ratios. Children may be more vulnerable to corrosive agents than adults because of the smaller diameter of their airways. In addition, they may be exposed to higher levels than adults in the same location because of their short stature and the higher levels of chlorine found nearer to the ground. Skin/Eye Contact Direct contact with hypochlorite solutions, powder, or concentrated vapor causes severe chemical burns, leading to cell death and ulceration. Because of their relatively larger surface area/weight ratio, children are more vulnerable to toxicants affecting the skin. Ingestion Ingestion of hypochlorite solutions causes vomiting and corrosive injury to the gastrointestinal tract. Household bleaches (3 to 6% sodium hypochlorite) usually cause esophageal irritation, but rarely cause strictures or serious injury such as perforation. Commercial bleaches may contain higher concentrations of sodium hypochlorite and are more likely to cause serious injury. Metabolic acidosis is rare, but has been reported following the ingestion of household bleach. Pulmonary complications resulting from aspiration may also be seen after ingestion. Sources/Uses Sodium and calcium hypochlorite are manufactured by the chlorination of sodium hydroxide or lime. Sodium and calcium hypochlorite are used primarily as oxidizing and bleaching agents or disinfectants. They are components of commercial bleaches, cleaning solutions, and disinfectants for drinking water and waste water purification systems and swimming pools. Sodium Hypochlorite as a Disinfectant has the Following Advantages: It can be easily stored and transported when it is produced on-site.
Contraindications: Acute febrile illness or severe adverse event to previous dose of same vaccine Diphtheria (severe local or prolonged high-pitched screaming Type of vaccine: Active immunization with diphtheria more than four hours; convulsion) vantin 200mg discount antibiotics jock itch. Notes: The risk of vaccine related neurological problems Primary course: Usually 3 doses purchase vantin 200 mg on-line antibiotic resistance evolves in bacteria because. Malaise purchase vantin 200mg visa antibiotic quick reference, transient fever and headache Type of vaccine: Active vaccination with live may occur cheap vantin 200mg with visa antimicrobial jewelry. Notes: A lower dose of vaccine is usually given to Primary course: Usually 3 doses. Tetanus Contraindications: Acute febrile illness, untreated Type of vaccine: Active vaccination with tetanus malignant disease, immunocompromised status, toxoid (often given with diphtheria and pertussis). Notes: There is an exceptionally small risk of Adverse reactions: Swelling and redness at the encephalitis or encephalopathy related to injection site, malaise, transient fever and headaches vaccination. Contraindications: Acute febrile illness, severe Pertussis adverse event to previous dose of same vaccine. Type of vaccine: Active vaccination with inactivated Notes: Tetanus toxoid and/or tetanus organisms, usually with diphtheria and tetanus. Heaf test (or multiple puncture test) at a later date: yellow fever (for those living in 2. Using a firm pressure, press the Heaf gun head down on to the arm and six needles from the Heaf head will be released and protrude 2mm into Page 47 the skin. Results of a Heaf test Heaf grades 3 or 4 and Mantoux tests of 15 mm Heaf grade Result Appearance induration or more, are considered to be strongly No induration at the puncture sites. Discrete induration of three or positive and should be referred for further 0 fewer needle sites is acceptable. Induration around each needle site merging with the next, forming a ring of induration but with 2 a clear centre. The test should be read 48–72 thumb and forefinger of one hand; the other hand hours later. A bleb typically of 7 mm diameter follows 4mm induration are regarded as negative. National immunization days have been carried out in 82 countries, and over 140 countries now conduct surveillance for cases of acute flaccid paralysis in children. The incidence of polio has followed a downward trend, and an increasing number of areas in the world are becoming free of the disease. Whilst success is in (For further information on skin testing and sight, zones and countries where there is armed screening of high-risk groups such as contacts with conflict remain difficult to implement effective tuberculosis and new immigrants, see Module 5). In 1994 it was estimated that the actual control or elimination of major around 733 000 deaths due to neonatal tetanus childhood diseases is now the focus. A key component countries in South America, the Middle East, of this strategy is the routine immunization of all Southeast Asia and the Pacific Islands, have included women in antenatal clinics. Routine programmes are still needed Clean delivery practices (a complementary strategy) in sub-Saharan Africa, the Indian subcontinent and have improved in recent years although most babies the Newly Independent States. The reduction in neonatal tetanus deaths is the result of impressive progress in certain high-risk counties. A reduction in cases of and deaths from measles In 1998 it was estimated that the global coverage of the measles vaccine had reached 75%, and the number of reported cases fell from 4 billion (4 thousand million) in 1980 to fewer than 1 billion in 1998 and is now 900 000 deaths per year. For many countries where the measles vaccine was not introduced until 1985, however, the disease reduction goals will be hard to reach. Since then, although the global numbers of reported measles cases have fallen, high transmission rates are still found in densely populated areas. This means that uniform measles vaccine coverage is necessary, especially when the one dose schedule is used. Mass campaigns in the Americas have resulted in the virtual disappearance of measles from the continents. Accelerated introduction of new vaccines One of the current priority areas of work for the immunization programme is to introduce new vaccines into the world’s poorest countries with a special emphasis on introducing Hepatitis B vaccine. Module 2 Page 51 Page 52 Appendix 1 The immunization centre safe vaccine storage protocol Aims and objectives 1. All vaccines delivered to the Immunization Centre are accepted in the knowledge that they have been transported safely. All vaccines accepted are stored within the recommended manufacturer guidelines (usually between 2–8° C). All equipment used for vaccine storage should be of an acceptable standard and regularly maintained. Procedures for vaccine administration should maintain the cold chain at all times thus offering maximum efficacy. Staff involved All staff at the immunization centre should be aware of the importance of the safe storage of vaccines and the maintenance of the cold chain. One person is designated to be the overall responsible person for this and in her/his absence the deputy is responsible. Module 2 Page 53 Appendix 1 (continued) Responsibilities of the vaccine coordinator 1. Vaccine delivery: • Ensure that the delivery has taken no more than 48 hours • Place the vaccines in the refrigerator immediately • Ensure the delivery contents are correct 2. Vaccine storage: • Ensure the vaccine storage refrigerator is used for storage of vaccines only • Ensure the refrigerator is maintained regularly • The refrigerator should ideally be a self defrosting model • The maximum/minimum thermometer should be placed in the centre of the middle shelf so that it can measure the core temperature • The thermometer should be read and recorded daily • The temperature should usually be maintained between 2–8° C. Vaccine stocks: • The refrigerator should be stocked so that air can easily circulate internally, care should be taken to prevent over stocking • Ensure that sufficient stock is available to meet the demand • Vaccines should not be stored in the refrigerator door Staff Training All staff should be aware of the importance of maintaining the cold chain. The vaccine coordinator should ensure that all staff have access to information on the safe and effective storage of vaccines. Diarrhoea is the most common and the resultant dehydration is responsible for serious morbidity and mortality. Increased knowledge and awareness will lead to: • greater awareness of prevention measures; • early recognition of clinical signs and symptoms; • prompt and effective intervention, treatment and nursing care, and • improved public health measures. Dehydration is the main cause • Failing to continue breastfeeding until at least of death from acute diarrhoea although other one year of age: prolonged breastfeeding reduces important causes are septic shock, peritonitis and the incidence or severity malnutrition. The patient with diarrhoea not only of certain types of eats less, but also has an inability to absorb nutrients diseases causing at a time when nutrients are more in demand as a diarrhoea, such as result of the infection. Diarrhoea is also an economic burden bottles: these easily on developing countries; working days are lost and become contaminated expensive hospitalization for treatment may be with faecal bacteria and Breastfeeding. When milk is added to an unclean bottle it Definition becomes contaminated and if it is not consumed Diarrhoea is a clinical syndrome in which there is immediately, further bacterial growth occurs. If food is kept for several hours at room Mode of transmission temperature, bacteria in it can multiply many Infectious diarrhoea is spread by the faecal-oral times. The most common sources are • Drinking water that is contaminated with faecal contaminated food and water, person-to-person bacteria: water may be contaminated at its source contact and direct contact with infected faeces. Enteropathogens survive in ice and untreated • Contamination in the home may occur when a swimming pools. Protozoan parasites can survive storage container is not covered, or when a as cysts even in water that seems adequately contaminated hand comes into contact with water chlorinated.
In addition vantin 100mg lowest price medication for uti bladder spasm, these reports lack either convincible control or universally accepted criterion for the evaluation of efficacy cheap vantin 100 mg fast delivery antibiotic used for bladder infection. In some studies published in English discount 200 mg vantin visa virus 1980, stroke patients under acupuncture treatment showed less ankle spasticity and better gait-cycle parameters (Chen et al generic vantin 200mg with mastercard antibiotics for uti with e coli. Naeser et al (1992) compared the real acupuncture with sham acupuncture, and observed that real acupuncture is more beneficial to patients whose lesion area covers less than half of the involved motor pathway, than the sham acupuncture. Wong et al (1999) compared the electrical stimulation at acupoints with standard rehabilitation treatment. Their results demonstrated that patients under acupuncture along with standard treatment showed faster recovery, not only in the balance and mobility, but also in the quality of life, than those under standard medication only. Furthermore, no significant differences were observed between the groups in both the neurological scores and the daily living index scores after a 1-year follow-up. They selected patients with 5 10 days of stroke attack and delivered the treatments 30 min twice a week during the following 10-week period. At 3-month and 1-year follow-ups, they observed no statistically significant differences between the groups in either the measures of the functional outcome or the quality of life. Several reviews have covered these inconsistent results from different studies (Naeser, 1997; Park et al. Shortly after acupuncture became one of the complementary therapies in the West, Naeser (1997) reviewed ten studies on the effect of acupuncture on paralysis resulting from stroke, and presumed that despite the different designs and qualities of these studies, acupuncture in addition to the standard treatment is always better than the standard treatment alone, thus, indicating that acupuncture is to some extent more beneficial than placebo in stroke therapy. Of the nine trials, six showed positive results and three demonstrated negative results, and only two studies obtained a Jadad score of >3. Owing to the lack of sufficient sample size, subject blinding, and sham-acupuncture control, the reviewers concluded that there is no compelling evidence to show that acupuncture is effective in stroke rehabilitation. Furthermore, regardless of their conclusion, their search in the Chinese literature was not exhaustive, and several randomized controlled trials were not covered. In addition, another larger meta-analysis was conducted by Sze et al (2002b), who analyzed 14 randomized controlled trials that compared the acupuncture treatment with no acupuncture treatment within 6 months after stroke. Their data analysis also failed to provide strong support on the efficacy of acupuncture on motor recovery; however, a small positive effect on disability was observed. The reviewers believed that this positive effect of acupuncture “may be due to a true placebo effect and varied study quality”. These reviews of the currently available randomized controlled trials indicate that the evidence to support the application of acupuncture in stroke rehabilitation is not sufficient, and this may be owing to several reasons. The first and most important reason is that the sample size of patients in these reviews is not large enough. As most of the trials have been published in Chinese language literature, they could not be accessed by the Western reviewers unless they are published in the English journals. In addition, most of the studies have been poorly designed, with insufficient control group or blinding. Several studies even failed to follow strict inclusion criteria, and as a result, the patients included varied with a wide array of severity of residual deficits and a large range of intervals since the onset of stroke. Hence, reviewers would certainly abandon these articles, because they do not necessarily meet the research criteria for contemporary medicine. As earlier clinical studies employed various approaches with different acupoints, controversies in the literature are inevitable. In a clinic trial, Johansson et al (2001) concluded that acupuncture had no effect on the functional improvement in stroke. However, when Shiflett et al (2001) reinspected the data using an admittedly subjective criterion of clinical importance, they observed that the data indicated the possible benefit of acupuncture in restoring the function of subacute stroke patients, and assumed that the negative results may be owing to the less-than-optimal choice of statistical techniques. However, it appears that the scientific support for acupuncture therapy in stroke is still limited, and the effectiveness of acupuncture therapy in stroke must be proved with more strict and scientific research design and analysis. Recently, some studies investigated the factors that could affect the efficacy of acupuncture. Intervention time point of acupuncture When is the best time for the stroke patients to receive acupuncture therapy? Most (but not all) of the acupuncturists in China believe that if the acupuncture is administered earlier, then the efficacy of the treatment for ischemic stroke would be better (Chen et al. It has been observed that acupuncture delivered during the early period of stroke may produce better outcome than that administered during the period of sequel, which has also been documented by our studies on experimental stroke (see later section). However, other treatment intervals, for example, once every other day, once a week, or twice a week, are also popular in some oriental countries. Till dateˈvery few studies have focused on the relationships between the different intervals or frequencies of acupuncture delivery and their efficacy (Bao et al. These studies have indicated that 235 Acupuncture Therapy of Neurological Diseases: A Neurobiological View insufficient acupuncture stimulation might produce weaker efficacy than that with more stimulation. Acupuncture combined with other therapies In stroke treatment, traditional Chinese doctors commonly administer acupuncture therapy along with Chinese herb medicine or standard clinic drugs. In fact, most of the trials discussed earlier in this chapter belong to this type of treatment. Other combinations include exercise, massage at acupoints, cupping therapy, ear acupuncture, qigong, and psychology therapy. Individual condition of patients The outcome of acupuncture therapy is more or less dependent on the individual patients. With different age, lesion site, and degree of injury, even the identical acupuncture approach may produce different outcomes. It has been reported that acupuncture is more effective in patients with slight or moderate stroke than those with severe stroke (Fan et al. Taken together, most clinical data indicate that acupuncture might be a potentially useful therapeutic treatment for stroke, although more scientific studies are needed to substantiate this notion. On the other hand, there is no doubt that acupuncture treatment is, to some extent, more convenient and inexpensive than standard strategies/medications. Hence, further investigation on the clinical efficacy and optimal conditions for acupuncture therapy might produce a significant impact on the clinical therapy for stroke. Owing to the difficulty and limitations in human research, experimental studies on efficacy, optimal condition, and the underlying mechanisms of acupuncture therapy for stroke are invaluable. Although the “black box” between acupuncture and neurological outcomes are not yet fully understood, recent works have drawn a sketch map of the mechanisms underlying acupuncture-induced brain protection from stroke. Today, it is still extremely difficult, if not impossible, to explore the cellular and molecular mechanisms in stroke patients, because of the ethical issues and complexity of the clinical research. More importantly, multiple experimental approaches can be adopted and repeated to dissect out a single delicate mechanism in the central nervous system. However, some researchers also use monkey, dog, cat, and rabbit to establish the stroke models (Harrington et al. Currently, the most frequently used animal models are the focal brain ischemia and global brain ischemia models (Carmichael 2005). These two models can further be subdivided into transient and permanent ischemia according to whether reperfusion is allowed or not. The advantage of this method is that reperfusion is achieved by slowly withdrawing the suture out of the cerebral artery. This model has a higher stability of infarction degree than nylon suture insertion method. However, it has the disadvantage of major injury owing to an open-skull operation, which may affect the outcome of the research.
Syndromes
- Fluid in the abdomen that causes swelling (ascites)
- Release joint contractures
- Corticosteroid medications to reduce swelling and relieve pressure on the nerve (when caused by a tumor or injury)
- Arrange for someone to drive you home after surgery and help you around your house for several days.
- Blood test to look for low arylsulfatase A enzyme levels
- Infectious mononucleosis
- Colds and allergies may cause too much mucus to be made or block the opening of the sinuses.
- Joints that show signs of rheumatoid arthritis
- Complete deafness
Because each hole discount vantin 100mg amex infection of the cervix, or plaque cheap vantin 100mg with mastercard antibiotics for uti dosage, developed from a single bacteriophage 200 mg vantin with mastercard antibiotic jock itch, this experiment provided the first method for counting infectious viruses (the plaque assay) order vantin 100 mg overnight delivery virus paralysis. In 1935 the American biochemist Wendell Meredith Stanley crystallized tobacco mosaic virus to demonstrate that viruses had regular shapes, and in 1939 tobacco mosaic virus was first visualized using the electron microscope. Frosch (both trained by Robert Koch) described foot-and-mouth disease virus as the first filterable agent of animals, and in 1900, the American bacteriologist Walter Reed and colleagues recognized yellow fever virus as the first human filterable agent. For several decades viruses were referred to as filterable agents, and gradually the term virus (Latin for “slimy liquid” or “poison”) was employed strictly for this new class of infectious agents. Through the 1940s and 1950s many critical discoveries were made about viruses through the study of bacteriophages because of the ease with which the bacteria they infect could be grown in the laboratory. Germ Theory of Disease History Louis Pasteur along with Robert Koch developed the germ theory of disease which states that "a specific disease is caused by a specific type of microorganism. Koch’s postulates not only proved the germ theory, but also gave a tremendous boost to the development of microbiology by stressing a laboratory culture and identification of microorganisms. Circumstances under which Koch’s postulates do not easily apply • Many healthy people carry pathogens but do not exhibit the symptoms of disease. These "carriers" may transmit the pathogens to others who then may become diseased. Example: viruses, chlamydia, rickettsias, and bacteria that cause leprosy and syphilis. Some of the fastidious organisms can now be grown in cultures of human or animal cells or in small animals. These secondary invaders or opportunists cause disease only when a person is ill or recovering from another disease. For example, in the case of pneumonia and ear infections following influenza, isolation of bacteria-causing pneumonia may mislead the isolation of influenza virus. Still others, such as cancer of the lungs and skin, are influenced by environmental factors. Cells Robert Hooke observed small empty chambers in the structure of cork with the help of his crude microscope. With the help of advanced microscopes it is now known that a cell is composed of many different substances and contains tiny particles called organelles that have important functions. Rudolph Virchow completed the cell theory with the idea that all cells must arise from preexisting cells. In biology, a cell is defined as the fundamental living unit of any organism and exhibits the basic characteristics of life. A cell obtains food from the environment to produce energy and nutrients for metabolism. Metabolism 23 Bacteriological Diseases 1/1/2018 Metabolism is a term that describes all the chemical reactions by which food is transformed for use by the cells. Through its metabolism, a cell can grow, reproduce, and it can respond to changes in its environment. As a result of accidental changes in its environment, a cell can undergo changes in its genetic material. Bacteria have been found that can live in temperatures above the boiling point and in cold that would freeze your blood. Bacteria are prokaryotes (Kingdom Monera), which means that they have no true nucleus. Most bacteria lack or have very few internal membranes, which means that they don’t have some kinds of organelles (like mitochondria or chloroplasts). Most bacteria are benign (benign = good, friendly, kind) or beneficial, and only a few are “bad guys” or pathogens. There are some bacteria relatives that can do photosynthesis--they don’t have chloroplasts, but their chlorophyll and other needed chemicals are built into their cell membranes. These organisms are called Cyanobacteria (cyano = blue, dark blue) or bluegreen algae, although they’re not really algae (real algae are in Kingdom Protista). Like us, some kinds of bacteria need and do best in O , while others are poisoned or killed by it. All other life forms are Eukaryotes (you-carry-oats), creatures whose cells have nuclei. Many believe that more complex cells developed as once free-living bacteria took up residence in other cells, eventually becoming the organelles in modern complex cells. There are thousands of species of bacteria, but all of them are basically one of three different shapes. Some bacterial cells exist as individuals while others cluster together to form pairs, chains, squares or other groupings. A single teaspoon of topsoil contains more than a billion (1,000,000,000) bacteria. Peptidoglycan Most bacteria secrete a covering for themselves which we call a cell wall. However, bacterial cell walls are a totally different thing than the cell walls we talk about plants having. Bacterial cell walls are made mostly of a chemical called peptidoglycan (made of polypeptides bonded to modified sugars), but the amount and location of the peptidoglycan are different in the two possible types of cell walls, depending on the species of bacterium. Some antibiotics, like penicillin, inhibit the formation of the chemical cross linkages needed to make peptidoglycan. These antibiotics don’t kill the bacteria outright, just stop them from being able to make more cell wall so they can grow. That’s why antibiotics must typically be taken for ten days until the bacteria, unable to grow, die of “old age”. If a person stops taking the antibiotic sooner, any living bacteria could start making peptidoglycan, grow, and reproduce. Thus it is important, before beginning antibiotic treatment, to determine with which of the two types of bacteria one is dealing. Hans Christian Gram, a Danish physician, invented a staining process to tell these two types of bacteria apart, and in his honor, this process is called Gram stain. In this process, the amount of peptidoglycan in the cell walls of the bacteria under study will determine how those bacteria absorb the dyes with which they are stained; thus, bacterial cells can be Gram or Gram. Gram bacteria have simpler cell walls with lots of+ - + peptidoglycan, and stain a dark purple color. Gram bacteria have more complex cell walls- with less peptidoglycan, thus absorb less of the purple dye used and stain a pinkish color instead. Also, Gram bacteria often incorporate toxic chemicals into their cell walls, and thus tend- to cause worse reactions in our bodies. Because Gram bacteria have less peptidoglycan,- antibiotics like penicillin are less effective against them. As we have discussed before, taking antibiotics that don’t work can be bad for you, thus a good doctor should always have a culture done before prescribing antibiotics to make sure the person is getting something that will help. Pseudomonas aeruginosa is a strictly aerobic, oxidase positive, gram-negative nonfermentative bacterium. The Gram-stain appearance is not particularly characteristic, although rods are somewhat thinner than those seen for the enteric-like bacteria. Mucoid strains that produce an extracellular polysaccharide are frequently isolated from patients with cystic fibrosis and this capsular material can be seen in the photo.
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