Course:PATHW2/Case 4 - UBC Wiki
Extracting and Visualising Biographical Events from Wikipedia. Irene Russo*,T ommaso Caselli**, and multimodal information (Novak et al., ) can meet. the needs of users from the .. January Antske Fokkens. Seventy-year-old identical twins Louise and Martine Fokken have become celebrities after a lifetime selling sex in Amsterdam's famous red. In they featured in the documentary Meet The Fokkens – at which point Louise had In Versailles, France, the deputies of the Third Estate, which represent.
The city then stopped regulating prostitution. Titillating activities like dancing, fairs and prostitution were sometimes outlawed. This morality did not, however, always correspond with the views and customs of the people.
Prostitution in the Netherlands
During the Golden seventeenth century sexuality was openly displayed in paintings and in literature. The image of the prostitute in literature was very negative.
Prostitutes were portrayed as unreliable, impudent, lazy, and often ugly and dirty. In paintings, the image of the prostitute was more positive.
Brothel-scenes were an important subject and prostitutes were painted as beautiful young women. The clients, however, were portrayed as fools who allowed themselves to be deceived. In both literature and paintings the madams were portrayed as evil profiteers. The authorities could not uphold the laws against prostitution and tended to leave brothels alone if they did not cause trouble.
There was a growing middle class which tried to distinguish itself by a strong work ethic and self-control. By restrained sexual behavior, the middle class could separate itself from the 'loose' lower class as well as the indecent nobility.
Rich and poor also began to separate geographically. Prior to this period different social classes lived side by side, but they now lived in separate neighborhoods. The image of women also changed. Bourgeois women were seen by men of their class as faithful and chaste, but working-class women were viewed by middle class men as potential prostitutes. The working conditions of prostitutes were very poor.
There was no proper birth controlcondoms were not widely available and there were no effective cures against venereal diseases. Prostitutes often became pregnant and, because of venereal diseases they eventually became infertile. This situation would not improve before the twentieth century.
Prostitutes allowed very little sexual variation. The only sexual positions which were tolerated were the missionary position and standing upright, face to face. Prostitutes were forced to register and were subjected to mandatory medical examinations.
Registered prostitutes were handed a red card which was a sort of work permit. If they were found to be infected, their red card was taken and they were given a white card instead while they were prohibited from working and were only allowed to work when declared fit. After the French occupation the Dutch government stopped regulating prostitution, but during several decades slowly began to regulate prostitutes again in the same style as under the French occupation.
Many scientists during the nineteenth century believed that sexual abstinence for men was unhealthy. In their eyes it was unavoidable that a number of women had to sacrifice themselves to protect the rest of the women from destruction of an even more revolting kind. The women who had to sacrifice themselves were supposed to be lower class.
Prostitutes themselves, however, were still despised and portrayed as disgusting creatures. Lower-class people themselves detested prostitutes.
Prostitutes stood outside society. In the beginning, this movement consisted of wealthy orthodox-Protestant Christians, but it later got support from other movements like Catholics, socialists, feminists and progressive liberals. They attacked the idea that men could not abstain from sex. Clients were viewed as low, dirty lechersand the clients were not the young unmarried men prostitution was meant for, but were often well-off middle-aged married men.
They also attacked the mandatory medical examinations, which were deemed degrading and ineffective to stop the spread of venereal diseases.
Meet the Fokkens: Amsterdam's oldest prostitutes - BBC News
Many prostitutes lived in the brothels and were bound to the madams by debts to pay off expensive working clothes. Prostitutes were often sold among madams, were subjected to fines, and could only leave the brothel under supervision. Medical expenses were added to their debt. Brothel keepers throughout Europe sold women among each other. The abolitionist movement in the Netherlands was largely connected to the international abolitionist movement. The movement slowly gained more influence, and during the last decades of the nineteenth century city governments slowly started to abolish regulated prostitution.
At first, the abolitionist movement mainly targeted mandatory health checks for prostitutes, but when the movement became more successful the focus shifted towards the people who profited from prostitution. In living on the avails of prostitution and owning a brothel were prohibited by law. Prostitution itself was not prohibited. During the s, in the wake of the sex trips to South-East Asia by Dutch men, the sex operators brought in women from Thailand and the Philippines.
In the s there was a second wave from Latin America and Africa. In the s, after the fall of the Soviet Unionwomen came from Eastern Europe. Foreign prostitutes are economically motivated to come to the Netherlands, and they tend to travel to engage in sex work between the Netherlands, Germany, Belgium, and other European societies. During the second half of the twentieth century, prostitution and brothels were condoned and tolerated by many local governments.
The police only interfered when public order was at stake or in cases of human trafficking. The reasoning behind this gedoogbeleid policy of tolerance was harm reductionand the belief that the enforcement of the anti-prostitution laws would be counterproductive, and that the best way to protect the women was to tolerate prostitution.
This genuine Dutch policy of tolerating formally illegal activities for harm reduction purposes has been and still is also applied towards illegal drugs in the Netherlands. The Red Thread de Rode Draad is a support and advocacy association for prostitutes that was founded in and works for the legitimization and against the stigmatization of prostitutes.
Prostitution was defined as a legal profession in January Brothel prohibition made it difficult to set rules for the sex industry. During the eighties many municipalities urged the national government to lift the ban on brothels. In minister Korthals Altes had presented an amendment to the law on prostitution. It took until 1 October for brothels to leave the half-legal status of being tolerated and to become fully legal and licensed businesses. Prostitutes may work as regular employees, though the vast majority work as independent contractors.
Streptococci are also divided into three groups by the hype of hemolysis on blood agar: Streptococci can be seen as members of normal flora, and strains that are not part of group A do not have any defined virulent factors Baron, When they infect pregnant women and their infants, they can become a leading cause of neonatal septicemia and meningitis and significantly changing clinical spectrums of a disease Baron, Shape of Group B streptococci bacteria Group B streptococci often become resistant to tetracycline antibiotics, but clinically achievable blood levels of penicillin can still be used for an effective treatment against the pathogen Baron, Duration of penicillin therapy varies within the degree of invasiveness, but it is typically used to treat within 10 days of antibiotic therapy Baron, Erythromycin, clindamycin, and newer macrolides may also be used as possible treatments against group B streptococci Baron, This particular family of bacterial pathogens includes E.
They are rod shaped, all gram-negative, and are typically diagnosed in the laboratory with the use of the MacConkey agar plates Schukken et.
Like all gram-negative bacteria, this bacterial family all have outer membranes on their cell wall that consists mainly of lipopolysaccharides, which gives them increased protection and strength Schukken et.
Because of how many bacterial members there are within the Enterobacteriaceae family, I will only focus on highlighting information about a couple bacteria. There are differences in pathogenicity between the different family members of Enterobacteriaceae when it comes to mastitis disease Schukken et. Klebsiella spp and Serratia spp, for instance, is in need of longer durations of infection compared to E. Klebsiella spp is seen to occur more frequently and more severely compared to other bacteria species in this family, making it troublesome to treat Schukken et.
In the case of Serratia spp, infections with this bacteria can be clinical or subclinical, and they can alternate between the two states Schukken et. Individual infections with Serratia spp can last as long as ten months to three years Schukken et. There has been reports about successful treatment with neomycin, but other reports also state that Serratia spp also delivers poor responses to antibiotic treatment Schukken et.
Much of the reported Serratia spp infections seem to cure spontaneously Schukken et. Staphylococcus aureus and Group B streptococcus seem to be the two that have the most potential to be pathogenic species for mastitis Kvist et. However, Coagulase-negative staphylococci seems to be one of the most prevalent when it comes to animal forms of the mastitis infection, and a possible pathogen for human infections as well Gomes et.
It is important to note that many sources out there involving mastitis infections involve infections seen in cow herds, and there is still scarce collections of information about the disease that involves humans Delgado et. Therefore, it is hard to say that all of the information being mentioned above can be directly linked with human forms of the disease as well Delgado et.
One must be careful before thinking that the infection forms in animals are the same as the infection forms found in female humans Delgado et. Treatment of infectious mastitis during lactation: Clinical Infectious Diseases, 50 12 Medical Microbiology, 4th edition. Journal of mammary gland biology and neoplasia, 16 4 Staphylococcus epidermidis strains isolated from breast milk of women suffering infectious mastitis: BMC microbiology, 9 1 Characterization of Staphylococus aureus strains involved in human and bovine mastitis.
FEMS Immunology and medical microbiology, Pathogens and disease, The role of bacteria in lactational mastitis and some considerations of the use of antibiotic treatment.
International breastfeeding journal, 3. Frontiers in microbiology, 8, Microbial diversity in milk of women with mastitis: Journal of Human Lactation, 33 2 Staphylococcus epidermidis - the 'accidental' pathogen. Nature Reviews Microbiology, 7 8 Cause, Detection, and Control. New concepts in the causes and control of mastitis. Retrieved March 30,from http: Breast milk samples, though rare, are ideal for laboratory testing in this scenario. Culture is rarely taken to confirm bacterial infection of the milk.
Detection of pathogens in breast milk is not always possible, and the results of milk culture may not be a useful guide for therapy. This is because, positive results may be due to normal bacterial colonization and also because negative results do not necessarily rule out mastitis Jeanne S, The agents most frequently identified in milk culture would be S.
However, as mentioned above, these may be contaminants or skin flora. One way to distinguish between an infection and simple colonization of the bacteria is to search for specific antibodies that are coating the bacteria WHO, IgA and IgG coated bacteria indicates that there was an immune response that was mounted against that bacteria. However, the antibodies test is not routinely done and there are no proper means to do so WHO, Acquiring culture of the breast milk has been recommended in certain situations however.
According to the World Health Organization, milk samples must be taken from patient when… Amir LH, - There is no response to antibiotics within 2 days - Mastitis recurs - It is a hospital acquired mastitis - Patient is allergic to therapeutic antibiotics - Is severe or unusual cases - MRSA Methicillin-resistant Staphylococcus aureus Kvist.
Hence, administration of an appropriate procedure. The breast milk sample will be acquired in a sterile container Amir LH, The mother should first cleanse her nipple with alcohol, hand express some of the milk, and discard it.
Then she must express her milk into the sterile container without her nipples touching to prevent contamination with the normal skin flora Jeanne S, If the expression of milk from the mother is deemed too painful, first line painkillers may be used to ease of the pain.
Though it is not clearly mentioned in the case study description of the case, if Elizabeth has any abscesses around her breast, the fluid can also be collected and used for laboratory testing. However, since there is no mention of Elizabeth having any abscesses, breast milk samples are more likely to be used.
In many cases, a physical examination of the breast area with signs and symptoms of such as redness, malaise, unilateral breast tenderness and fatigue is considered to be adequate evidence of a mastitis infection and antibiotics are prescribed based on these observations Spencer, Cultures are only occasionally obtained for laboratory testing and definitive diagnosis.
It is recommended to have laboratory testing done if the infection is severe, hospital acquired or does not respond to antibiotic treatment Spencer, Since there is a prevalence in resistance to antibiotics in strains of S. Antibiotic susceptibility testing is also not always done when presented with a case that resembles mastitis Marin et al.
The use of broad-spectrum antibiotics prior to any laboratory testing are often used risking therapeutic failure. Microbiology Laboratory testing is important in diagnosing the specific species and strain of the bacteria that is causing mastitis. Phenotypic and genotypic investigation allows for this identification. Knowing the specific pathogen present allows for more specific and effective antibiotic treatment.
This could prevent antimicrobial resistance and lower treatment costs Marin et al. Frontiers in Microbiology, In Basal Convention Stockholm Convention. Links to an external site. American Family Physician, 78 6. Question 3 Explain the tests that will be performed on the samples in order to detect any of the potential bacterial pathogens causing this disease. Tests are performed to identify the bacterial concentrations present in the mastitic milk samples. It has been hypothesized that mastitis is caused by an imbalance of microbes resulting in the domination of one bacterial pathogen within the milk Mediano et al.
Milk samples are also diluted with peptone water and plated on other various agar plates for species identification. A variety of growth agars are used to identify all the potential pathogens as different pathogens have different growth requirements. For culturing and identification, clinical samples can be utilized which would be breast milk in this scenario.
Columbia blood agar CNA; identifies streptococci, staphylococci, and similar bacteria: SDC contains chloramphenicol to inhibit many gram-positive and gram-negative bacteria and allow the growth of fungi and yeasts. Yeasts will present themselves as white or creamy colonies. Molds can grow as a variety of colours Acumedia, b.
The presence of "round, white or grey colonies" "surrounded by black zones" in Kanamycin Aesculin Azide agar indicates the presence of enterococci. Kanamycin sulphate and sodium azide are selective inhibitors that only allow the growth of enterococci Oxoid limited, Kanamycin Aesculin Azide Agar - Identifies Enterococci Violet red bile glucose plate identifies Enterobacteriaceae and other gram-negative bacteria: Violet red bile glucose plates is use to identify gram-negative bacteria that ferment glucose.
Bile salts and crystal violet is used to inhibit the growth of gram-positive bacteria. Peptones, yeast extract, and glucose are present to stimulate bacterial growth. Neutral Red is used to indicate the pH. If the isolate is capable of fermenting glucose, red and purple colonies will be present Hardy Diagnostics, b.
Violet red bile glucose plate - Identifies Enterobacteriaceae and other gram-negative bacteria Mannitol Salt Agar The mannitol salt agar is a selective growth medium which contains 7. This agar plate inhibits the growth of most bacteria except Staphylococci.
However, not all bacteria which can grow on MSA are actually able to ferment mannitol. Bacteria which are able to ferment mannitol lead to the production of an acid product and lowering of the pH of the medium which results in a coloud change to yellow Alexander et Strete, A gram stain would be performed to determine if the bacteria of interest is gram negative or positive; the primary difference between gram negative and positive bacteria is their cell wall composition.
Gram negative bacteria contain a thin peptidoglycan layer and an additional outer liposaccharide layer whereas gram negative bacteria have a thicker layer of peptidoglycan but do not have any outer layers Alexander et Strete, Gram positive bacteria are able to retain the crystal violet stain used in the test and display a purple colour. Gram negative bacteria will appear pink in the stain.
In a lab, gram stains would be performed on isolated bacterial species, not on the clinical sample. Gram-positive bacteria appear purple-blue and Gram negative bacteria appear red-pink Morphology: Microscopic Morphology include a combination of cell shape, size, special structures e.
Check the morphology of the bacteria in the morphology table. Morphological features of bacteria observed under the microscope help to pinpoint the identity of the bacterium. Different species of bacteria can have different physical traits. The bacterial isolates will then be further tested for catalase, oxidase, and coagulase activity. Catalase — positive The catalase test, a respiratory test, is used to detect if catalase is present in the bacteria.
Catalase has the ability to rapidly breakdown hydrogen peroxide into water and oxygen, this ability is indicative of whether or not the bacteria can use oxygen as a terminal electron acceptor Lammert, A positive test is marked by the occurrence of rapid bubbling, indicating the formation oxygen gas.
Oxidase — positive Another respiratory test, the oxidase test detects the presence of cytochrome oxidase in the bacteria. Cytochrome oxidase is an important component of the electron transport chain and facilitates the addition of electrons to oxygen Lammert, Coagulase — positive The coagulase tests for the presence of the enzyme coagulase which converts fibrin in plasma to insoluble fibrin.
Positive results are indicated by the formation of a clot in the tube. Tube coagulase testing begins with emulsifying the isolate with rabbit plasma in a test tube. If a clot forms, it represents a coagulase-positive test. No formation of a clot indicates a coagulase-negative test Acharya, These methods may be quicker than the biochemical tests, given that many of the biochemical tests require long periods of incubation. The housekeeping gene 16S rRNA is good for determining bacterial genera. For example, additional species identification testing for CNS and similar species, streptococci, and corynebacteria can be done through 16S rRNA gene sequencing Mediano et al.
The 16s rRNA region is chosen for amplification because it is highly conserved within the species but differs at broader levels of classification. In order to do this, milk samples are centrifuged to extract the genomic DNA and the supernatant is discarded. For examining the 16S rRNA gene, amplification occurs using a fusion bacterial primer.
A similar process occurs for the other housekeeping genes, using PCR amplification and using sequence analysis to identify the bacteria present. Antibiotic Susceptibility Testing The VITEK 2 system is capable of identifying gram-positive cocci and the minimum inhibitory concentrations for those pathogens. Sterile swabs of the bacterial culture are suspended in 3ml of sterile saline test tube as well as on a identification card.
The suspensions of isolates need to be prepared to appropriate standards of turbidity and culture age as well as under proper conditions Pincus, n. Suspensions of isolates need to be prepared to appropriate standards of turbidity and culture age before the system can automatically perform the steps required for identification Ligozzi et al.
It "combines multichannel fluorimeter and photometer readings to record fluorescence, turbidity, and colorimetric signals" Ligozzi et al.
Antibiotic susceptibility of the bacteria can also be studied through a diffusion antibiotic disc assay. A broth culture of the isolated bacterial species is spread onto an agar plate and then antibiotic discs are placed on the agar.
After a period of inoculation, the plates are analyzed for any zones of inhibitions which are areas around an antibiotic disc with no bacterial growth. The zones of inhibition are then measured and compared to an imperative standard to determine if the bacteria is resistant, intermediate or susceptible to the antibiotic Alexander et Strete, Even within a single species, various strains of bacteria respond differently to antibiotics and therefore the results of this assay can not only help identify the strain of the bacteria but also provide more information in coming up with an antibiotic treatment plan.
Principle, procedure and interpretation.
Columbia Blood Agar Base A photographic atlas for the laboratory. American Society for Microbiology. Upper Saddle River, NJ: Evaluation of the VITEK 2 system for identification and antimicrobial susceptibility testing of medically relevant gram-positive cocci.
Journal of Clinical Microbiology, 40 5 Potential role of coagulase-negative staphylococci, viridans group streptococci, and corynebacteria. Kanamycin Aesculin Azide Agar Base. Thermo Fisher Scientific Inc. Culture independent assessment of human milk microbial community in lactational mastitis. Scientific Reports Nature Publisher Group7, 1. Species identification of coagulase-negative staphylococci: Genotyping is superior to phenotyping.
Veterinary Microbiology, 1 If the bacteria is S. This results in the phenol red indicator in the medium turning yellow. Therefore, we should observe growth on the agar and appearance of the colour yellow on the agar Alexander et Strete, We would not expect S.
Tube Coagulase testing allows for differentiating between the coagulase positive S. A clot should form to identify the bacteria is coagulase-positive. A positive catalase test confirms the presence of the enzyme catalase and is marked by the occurrence of rapid bubbling, indicating the formation oxygen gas Lammert, A positive oxidase test is marked by the colour change to dark purple through the interaction with the oxidase agent.
Gram-positive bacteria, such as S. Under the microscope, S. Their morphological features include small, circular cocci, that are convex and 0. In an antibiotic disc assay particular to S. The specific results of the antibiotic assay will vary depending on the strain of S.
Their morphology involves an elevated, round, "gray or grayish-white" colour, and translucent bacteria found in colonies. Isolation and characterization of staphylococci from human skin II.