Microbiology

Departmental Objectives:

Undergraduate medical students after completing the course on Microbiology will become well versed in the
etiology of microbial diseases, their pathogenesis, immunological responses involved and some important
clinical features that would enable them to plan and interpret necessary laboratory investigations for diagnosis,
treatment and prevention. The department will provide teaching-learning experiences to achieve the following
learning objectives.

KNOWLEDGE
At the end of the course, students will be able to:
 describe and understand the aetiopathogenesis of microbial agents such as bacteria, virus,
parasite and fungi commonly prevalent in Bangladesh
 explain the host-parasite relationship, normal flora of the body, pathogens and opportunistic
pathogens
 understand the principles and applications of immunology involved in the pathogenesis,
diagnosis and prevention of microbial and immunological diseases.
 understand hospital acquired infection and its prevention
 understand the emerging and re-emerging microbial diseases in Bangladesh and their diagnosis,
control and prevention
 understand antibiotic resistant pattern and selection of appropriate antibiotics and its rational use.

SKILL:
Students will be able to:
 plan necessary laboratory investigations selecting appropriate clinical samples at the right time, using the
right method of their collection and interpret the results of these laboratory investigations to arrive at
laboratory diagnosis of microbial and immunological diseases.
 perform simple laboratory tests available in Upazila Health Complex.
 carry out the techniques of asepsis, antisepsis and sterilization in day to day procedures.
 undertake universal precautions in laboratory and clinical practices.

ATTITUDE:
Students will be able to:
 demonstrate the attitude for further learning, research and continuing education for improvement of
efficiency and skill in the subject.

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List of Competencies to acquire:

After completion of graduation, an MBBS doctor is expected to achieve the following competency in the area
of Microbiology. An MBBS graduate will be competent to:

1. perceive the etio-pathogenesis of diseases caused by microbes commonly prevalent in Bangladesh

2. proceed for diagnosing a case caused by microbes in terms of :
a. appropriate specimens necessary for diagnosis
b. timing of specimen collection and appropriate transport
c. appropriate diagnostic tests to advise
3. interpret the values of tests and the test results.
4. identify the basic problems of hospital acquired infection and its prevention
5. select appropriate antimicrobial agents for the treatment of common microbial diseases
6. use of antibiotics rationally
7. provide Counseling regarding vaccination against common diseases and chemoprophylaxis
8. appraise the need for research on common microbial diseases encountered in medical practice
Note: Microbial diseases include: bacteria, parasites, viruses and fungi

Distribution of teaching - learning hours

Lecture Tutorial Practical Total Formative Exam Summative exam
Teaching
hours
Preparatory Exam time Preparat Exam time
leave ory leave
100 hrs 45 hrs 45 hrs 190 hrs 10 days 15 days 10 days 15 days

(Time for exam. preparatory leave and formative & summative assessment is common for all subjects of
the phase )

Teaching-learning methods, teaching aids and evaluation

Teaching Methods Teaching aids In course evaluation
Large Small Self Others
group group learning (integrated
teaching)
Computer and Multimedia  Item
Lecture Tutorial Assignment, Bino-ocular and teaching Examination
Practical Self study microscope  Card final
Microscope with projection  Term
(magnified) system Examination
Multimedia  Term final
Overhead projector (written, oral+
Slide projector , Fixed Learning practical)
Module (FLM)
Tape slide
Video
Coloured charts
Hand out
White board /chalk board

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3rd Professional Examination:
Marks distribution of Assessment of Microbiology:

Total marks – 300

 Written= 100 (MCQ 20+SAQ 70+formative Assessment Marks 10)
 Structured oral examination=100
 Practical =100 (OSPE-50+Traditional- 50)

Related Equipments:
Hot air oven, Bunsen burner, slide & cover slip, pipette, Micro pipette, Gram staining, Acid fast
staining and other staining materials, different reagent, Bino-ocular and teaching microscope,
Microscope with projection, (magnified) system, Centrifuge machine, Colorimeter,
Spectrophotometer, Incubator, Balance, Water bath, Cell Counter, Autoclave, Computer, Electrolyte
and gas analyzer, Elisa reader, Petri dish, media etc.

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 Learning Objectives and Course Contents in Microbiology
General Bacteriology
Learning Objectives Contents Teaching
hours

CORE:
Students will be able to : Introduction of Microbiology:
 Brief historical background
 describe historical background and outline the scope and  Branches of Microbiology L–1
importance of Microbiology in medical science.  Concept of medical biotechnology in relation to Microbiology
 Importance and scope of microbiology in medical science.

 describe the prokaryotic and eukaryotic cells.

 describe different structures of bacterial cell and their functions. Bacterial cell:
 Prokaryotic and Eukaryotic cells with examples
 Different structures of bacterial cell and their functions.
 Brief description of cell wall of Gram positive and Gram L –2, T - 1
negative bacteria.
 Spores structure and clinical importance.
 L-forms, protoplast, spheroplast
 classify bacteria based on staining and morphology
Bacterial classification and staining: L –1, T - 1
 explain the theoretical basis of staining and clinical significance of  Nomenclature
certain staining including Gram and Z-N staining  Classification by staining and morphology.
 Staining- Theoretical basis and clinical significance of Gram
and Z-N
 Practical on staining: Gram, Z-N staining

NB: L = Lecture. T= Tutorial

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 Learning Objectives Contents Teaching
hours
Students will be able to: Nutrition and Cultivation of bacteria:
 describe the general requirements of microbial growth L–1
 classify bacteriological media and describe their uses  Nutritional requirement for the growth
 Growth curve: phases with clinical significance
 Common bacteriological media: classification and uses.
 define sterilization, disinfection and antisepsis
 describe certain methods of sterilization and disinfection, and
outline their application Sterilization and Disinfection: L – 2, T - 2
 select appropriate method of sterilization in their clinical practice.  Definition, classification and applications of sterilization,
 explain the mechanism of action of certain anti-microbial agents disinfection and antisepsis
 select appropriate antimicrobial agents  Methods of sterilizations: details of autoclaving, hot air oven
and chemical methods.
 Sterilization of medical equipments: Critical. Semi-critical and
non-critical devices
 Disinfection body fluid spillage
L –3, T-1
Antimicrobial agents:
 Definition of antibiotics, antimicrobial agents, bacteriostatic,
bacteriocidal, synergism, antagonism, selective toxicity etc.
 Mechanism of action on bacteria with examples
 Drug resistance: origin, mechanism, transmission and
prevention
 Indication of combination of antibiotics in bacterial infection
 Hazards of indiscriminate use of antibiotics

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 Systemic Bacteriology

Learning Objectives Contents Teaching

hours

CORE:

 describe the different aspects of host-parasite relationship Host-Parasite relationship:

differentiate between normal, opportunistic and pathogenic  Terms and Definitions. L–1
bacteria and explain their clinical importance.  Parasite and Host attributes
 Normal flora, opportunistic pathogens and their clinical
importance.

 enumerate the virulence factors and explain their role in Pathogenesis of bacterial diseases: L–1
pathogenesis  Transmission of bacterial agents.
 Koch’s Postulates
 Virulence factors e.g. toxins, enzymes, invasiveness and their
role in pathogenesis of diseases with some examples.

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 Learning Objectives Contents Teaching
hours
Student will be able to:  Staphylococci: S. aureus, S. epidermidis, S. saprophyticus. L –2, T-1
 enumerate the common bacterial agents in Bangladesh: describe
epidemiology, their morphology, classification and important  Streptococci : Gr A and Streptococcus pneumoniae L –2, T -2
cultural characteristics  Neissreia: N. gonorrhoea, N. meningitides L –1, T-1
 mention their virulence factors and describe pathogenesis and
brief clinical features.  Corynebacterium diphtheriae L –1
 describe the laboratory diagnosis: selection, collection,  Enterobacteriaceae: Classification, Salmonella, Shigella, and Esch. coli, L –3, T-2
transportation and preservation of clinical samples, laboratory
tests and their interpretation  Vibrio cholerae L –1, T-1
L –1
 Helicobacter pylori
 Mycobacterium: M. tuberculosis, Atypical mycrobacteria L –3, T-2
and M. leprae.
 Anaerobic bacteria: Clostridium: Cl. tetani, Cl. botulinum, Cl. perfringens L –3, T-1
 Spirochaetes: Treponemma palladium L-1, T-1
 Important characteristics and diseases produced by: Rickettssia
Haemophilus Influenza, Haemophilus ducrey, Mycoplasma, Chlamydia, , L-3, T-2
Nocardia, Actinomycetes species

 list the important characteristics and diseases produced by Additional:

bacteria  Strpt. Group B, D
 Klebsiella, Proteus , Pseudomonas: Ps. aeruginosa , Aeromonas, L-2, T-2
Plesiomonas, Campylobacter jejuni
 Bacteroides species
 Clostridium deficille
 Listeria

195
 Immunology

Learning Objectives Contents Teaching

hours
CORE:
1. Introduction: L-1
Students will be able to:  Brief historical background
 explain the importance of history and role of  Basic concepts of immunity: types and components with examples.
immunology in modern medicine 2. Immune system: L-2, T-1
 describe the basic components of immune  Organs, cells and soluble components
system 3. Antigens and Immunogens: L-1
 explain the normal defense mechanism  Terms and definitions, criteria of immunogenicity, hapten, epitopes and their clinical
 mention the disorders of the immune system significance.
 explain the immunological principles involved 4. Major histocompatibility complex (MHC/ HLA): L-1
in different diagnostic tests  Terms and definitions, types and distribution, clinical and biological significance.
5. Immunoglobulins and Antibodies:
 Terms and definitions, classification, structure, biological properties and functions. L-2, T-1
6. Complements:
 Terms and definitions, activation, biological functions and clinical significance. L-1
7. Mechanisms of immune response :
L -1
 Antibody and cell mediated immune response.
 Primary and secondary immune response
8. Hypersensitivity: L – 2, T-1
 Terms and definitions, classifications, mechanisms, clinical significance with examples.
9. Transplantation and Tumour immunity: L –2, T-1
 Terms and definitions, types and outline of prevention of graft rejection.
 Tumour antigens, role in diagnosis and clinical significance.
10. Autoimmunity: L –1
 Terms and definitions, basic concepts
11. Immunodeficiency disorders and immunotherapy: L –1
 Classification with examples
12. Agents of immunotherapy L –1
13. Immunodiagnostic tests
 Terms and definitions, types and applications in diagnostic medicine L –1

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 Parasitology
Learning Objectives Contents Teaching
hours

CORE:
Students will be able to: Introduction:
 mention the important characteristics Introduction to parasitology, common parasitic diseases of Bangladesh, Terms and L –2, T-1
and epidemiology of common definitions, classifications of parasites according to habitate,
parasitic diseases Intestinal, luminal and free living protozoa:
 describe pathogenesis Entamoeba histolytica: L –2, T-1
 list major complications and  Classification
laboratory diagnosis of common  Geographical distribution, morphology, disease, clinical features, pathogenesis,
parasites in Bangladesh. laboratory diagnosis

Giardia intestinalis and Trichomonas vaginalis:

 Morphology, transmission, disease, clinical features, pathogenesis, laboratory L –1
diagnosis
Blood and Tissue Protozoa:
Leishmania species:
Leishmania donovani and PKDL: L –2, T-1
Geographical distribution
morphology, lifecycle, disease, clinical features, pathogenesis
laboratory diagnosis

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Learning Objectives Contents Teaching
hours
Plasmodium species:
Epidemiology, morphology, lifecycle, disease, clinical features, pathogenesis, L –2, T-2
complications, laboratory diagnosis
Cestodes and Trematodes:
 Classify according to habitate with examples L –1
 Morphology, lifecycle, diseases, clinical features, pathogenesis, laboratory diagnosis
of Taenia saginata and Taenia solium:

Echinococcus granulosus:
 Morphology, lifecycle, disease, clinical features, pathogenesis and laboratory L –1
diagnosis
Intestinal Nematodes:
 Geographical distribution, morphology, lifecycle, disease, clinical features,
pathogenesis, laboratory diagnosis of Ascaris lumbricoides, Hook worm, Trichuris L-3, T- 2
trichiura, Enterobious vermicularis, Strongyloides stercoralis and larva migrans
Tissue nematodes:
Wuchareria bancrofti:
 Morphology, lifecycle, disease (classical and occult filariasis, tropical pulmonary L –2, T-1
eosinophilia), clinical features, pathogenesis, complications, laboratory diagnosis

Additional:
1. Important characteristics and disease produced by:
 Acanthemoeba and Negleria
 Toxoplasma gondii, Crytosporidium, Balantidium coli
L –2, T-2
 Hymenolepes nana, Diphylobothrium latum
 Trypanosoma
 Loa loa, Onchosercous volvulous
 Fasiolopsis buski, Faciola hepatica: habitate, disease, clinical features, laboratory
diagnosis

198
 Virology

Learning Objectives Contents Teaching

hours
CORE:
Students will be able to: 1. General virology:
 differentiate the basic structure of  Introduction to virology, common viral diseases in Bangladesh. L –2, T-1
virus from bacteria.  Basic structure of virus
 mention epidemiology, diseases,  Outline of viral replication
important clinical features,  Classification
pathogenesis and laboratory diagnosis  Antiviral agents
of common viral diseases 2. Herpes viruses:
 identify the appropriate measures for  Classification, important characteristics, diseases, important clinical features,
prevention. transmission, pathogenesis, complications, laboratory diagnosis and prevention L –2, T-1
3. Orthomyxo and paramyxo viruses
 Important characteristics, diseases, important clinical features, transmission,
pathogenesis, complications, laboratory diagnosis and prevention L –2, T-1
4. Hepatitis viruses:
 Classification, important characteristics, diseases, transmission, pathogenesis,
L –1, T-1
complications, laboratory diagnosis and prevention

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Learning Objectives Contents Teaching
hours
5. Polio virus
 Important characteristics, diseases, transmission, pathogenesis, laboratory diagnosis L –1
and prevention
 Merits and demerits of oral and injectable polio vaccine
6. Rabies virus:
 Important characteristics, diseases, transmission, pathogenesis, laboratory diagnosis L –1 (+7)
and prevention, merits and demerits of different types of vaccines
7. Rota virus:
 Diseases, transmission, pathogenesis, laboratory diagnosis and prevention
8. HIV:
 Classification, important characteristics, diseases (AIDS), transmission, pathogenesis, L –1
laboratory diagnosis and prevention
9. Dengue L–1
 Important characteristics, diseases (DHF, DSS), transmission, pathogenesis,
laboratory diagnosis and prevention
10. Emerging viral diseases
Avian flue, SARS, Nipah, Swine flue, etc. L – 2 (+ 11)
 Important characteristics of virus, important clinical features, transmission,
pathogenesis, laboratory diagnosis and prevention
11. Oncogenic virus
 Definitions, list of onchogenic viruses with their associated tumours

200
 Mycology
Learning Objectives Contents Teaching
hours

CORE:
1. Introduction:
Students will be able to:  Introduction to Mycology, beneficial and detrimental effects, morphology, L-1
 describe morphology, medically important classification
fungal agents and the diseases caused by  Difference between fungal and bacterial spores
them 2. Superficial and cutaneous mycoses:
 describe pathogenesis, important clinical  Aetiological agents and diseases L -2, T-1
features and laboratory diagnosis of  Transmission and pathogenesis, laboratory diagnosis of Pityriasis versicolor,
superficial, cutaneous, subcutaneous and Dermatophytosis, Candidiasis.
systemic mycosis 3. Subcutaneous
 Aetiological agents and diseases L –1
 Transmission and pathogenesis
 Laboratory diagnosis of Rhinosporiodiasis and Madura foot
4. Systemic mycoses (Primary and opportunistic ):
L – 2, T-1
 Aetiological agents and diseases
 Transmission and pathogenesis
 Laboratory diagnosis of histoplasmosis, cryptococcal meningitis, candidiasis
 Brief description of pneumocystis jerovici, fungus ball, mycotoxin

201
 Clinical Microbiology

Learning Objectives Contents Teaching

hours
CORE:

Student will be able to: 1. Collection of samples, transportation and storage L –1, T-1
 know organisms causing diseases, plan and
select appropriate investigation for diagnosis 2. Microbial diseases of Gastrointestinal and Hepatobiliary diseases and Food L –2, T-1
 interpret the findings of the investigations poisoning
 design appropriate steps for antimicrobial therapy
and prevention 3. Microbial diseases of Genito-Urinary system L –2, T-1

4. Microbial diseases of upper and lower Respiratory Tract infections L –1

5. Microbial diseases of CNS infection L –2

6. Hospital Acquired Infections L –1

7. Microbial diseases of Bone and Soft Tissue infection L –1

8. Microbial diseases of Cardiovascular System L –1

9. Microbial diseases of eye, ear, nose and throat L – 1, T-1

10. Pyrexia of unknown origin (Microbial cause with emphasis on blood culture). L- 1, T-1

202
 Practical
Learning Objectives Contents Teaching
hours
Students will be able to:
 perform and interpret Gram’s and Z-N stain. 1. Gram’s staining 4
 Observe the common bacteriological media with 2. Z-N staining 4
growth of Staphylococcus aureus, Streptococcus 3. Demonstration of culture media namely Nutrient agar, Blood agar, Chocolate 5
pyogenes, Escherechia coli,Salmonella, Shigella, agar, MacConkey’s agar, Lowenstein Jensen, Robertson’s cooked meat
Klebsiella, Proteus and Pseudomonas media, Blood culture media, transport media (Carry-Blair/Stuart/Peptone
 Observe the drug sensitivity test of bacteria. water) with and without bacterial growth

Students will be demonstrated: 4. Demonstration of colony morphology of common bacteria: Staphylococci, 3

 autoclave and Hot air oven. Streptococcus Lactose fermenters, Lactose nonfermenters, Proteus,
Pseudomonas.

5. Demonstration of inoculation, incubation (aerobic, CO2 and Anerobic 2

condition) and plate reading.

6. Demonstration of catalase, coagulase, and oxidase, TSI, MIU and Simmon’s 4

citrate tests

7. Demonstration of in vitro antibiotic sensitivity test by disk diffusion method, 4

8. Demonstration of sterilization by chemical agents autoclaving and hot air 2

oven.

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 Learning Objectives Contents Teaching
hours
Students will be able to: Demonstration
 prepare stool smear and examine under
microscope  Microscopic examination of stool for demonstration of cyst/trophozoites of 6
 observe cyst/trophozoites of intestinal and protozoa, ova/larva of intestinal helminthes, pus cells, macrophage and RBC.
luminal protozoa namely Entamoeba
histolytica, Giardia intestinalis, Trichomonas  Microscopic examination of urine for demonstration of epithelial cells, pus 2
 obsserve ova of A. lumbricoides, T. cells, RBC, etc.
trichiuria, Hook worms
 observe pus cell, macrophage and RBC in  Examination of blood smear for demonstration of malarial parasites 1
stool sample  Examination of bone marrow smear for LD body 1
 examine blood slide under microscope for
demonstration of Plasmodium species and  Microscopic examination of Gram stain smear of throat swab, wound swab,
microfilaria 2
urethral discharge.
 examine bone marrow smear for LD body
 Microspic examination of Z-N smear of sputum for AFB 1
 Observe and interpret the results of
immunological tests  Immunological tests: Demonstration and interpretation of Widal, RPR, ICT
 Observe skin scrapping for fungus.
for HBsAg, Dengue and Plasmodium 2
 observe pus cell and RBC in urine
 Microscopic examination of skin scrapping for demonstration of fungal 2
elements ( dermatophytes and candida)

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 Consolidated teaching hours for Microbiology

Subject Theoretical Practical Total

Lecture Tutorial
1. General Bacteriology 10 5 12 26
2. Systemic Bacteriology 23 15 02 41
3. Immunology 17 04 05 25
4. Parasitology 18 10 14 43
5. Virology 13 4 00 16
6. Mycology 6 2 2 10
7. Clinical Microbiology 13 5 10 29
Total 100 45 45 190

1st Term Allotted time ( 92 Hours) 2nd Term Allotted time (In 98 Hours)
Subject Lecture – Tutorial– Practical- Subject Lecture – Tutorial – Practical -
49 hours 24 hours 19 hours 51 hours 21 hours 26 hours
General 9 05 12 Parasitology 19 10 14
bacteriology
Systemic 24 15 02 Virology 12 04 00
Bacteriology
Immunology 16 04 05 Mycology 06 02 02
Clinical 14 05 10
Microbiology

Grand Total = 92+98 = 190 hours

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 Academic Calendar for Microbiology

4th Year (In months)

1 2 3 4 5 6 7 8 9 10 11 12

General Parasitology Preparation Prepatory 3rd Professional

Bacteriology Preparation + leave Exam
+ Virology
2nd Internal
Systemic 1st Internal Mycology
Assessment Assessment
Bacteriology
Clinical
Immunology Microbiology

There will be 2 (two) Cards

1. Item card 1: General Bacteriology, Systemic Bacteriology and Immunology
2. Item card 2: Parasitology, Virology, Mycology and Clinical Microbiology

206