Module - Mycology and Parasitology (SLS223)

STP

Aim of this module

This module will provide the trainee with knowledge and understanding of fungal and parasitic infections and their role in health and disease, including the role of the clinical microbiology laboratory. In the work-based module they will be expected to apply this knowledge as they perform and interpret a range of clinical and laboratory investigations used in the diagnosis and management of fungal and parasitic diseases, including health and safety issues and the reporting of results in the correct clinical context.

Work-based learning outcomes

1. Receive, process and store clinical and environmental specimens referred for mycology investigation in line with health and safety and laboratory procedures.
2. Perform clinical and laboratory investigation of fungal diseases, including management, health and safety issues and the reporting of results in the correct clinical context.
3. Perform clinical and laboratory investigation parasitic diseases, including management, health and safety issues, and the reporting of results in the correct clinical context.
4. Interpret and report on clinical and laboratory investigations and management of parasitic and fungal diseases.
5. Work in partnership with other clinical specialisms in the investigation and management of fungal and parasitic diseases.
6. Comply with quality management system in the laboratory (and point of care) associated with investigation of the pathogens related to this module.

Work-based Competencies

Learning outcome Title Knowledge
1 1,6

Receive, process and store clinical and environmental specimens referred for mycology investigation, to include:

  • fungal investigations
  • parasitic investigations.
  • Health and safety and laboratory procedures relating to the receipt, handling, storage and processing of clinical and environmental specimens for laboratory investigation, including the repertoire, specimen requirements and turnaround times of the investigations performed by the department and referred to specialist centres.
  • Fungal and parasitic investigations, including:
    • ACDP categorisation, correct use of containment facilities and microbiological safety cabinets
    • sample preparation, including aseptic technique
    • microscopy, including staining and direct examination
    • culture, including different types of media and incubation conditions
    • identifying medically important fungi (e.g. morphology, microscopy, NAAT)
    • antifungal susceptibility assays
    • serology
    • rapid and point-of-care test.
2 2

Perform assays to investigate endemic fungal infections.
  • The aetiology, risk factors, clinical presentation and management of systemic and endemic mycoses.
  • Fungal assays performed using standard operating procedures in your hospital(s), including:
    • specimen types (e.g. hair, nails, skin, blood, tissue, CSF, respiratory samples).
    • Specialised referred tests.
  • Turnaround times associated with fungal investigations.
  • The aetiology, risk factors, clinical presentation and management of systemic and endemic fungal infections, including:
    • candidosis
    • aspergillosis
    • cryptococcosis
    • histoplasmosis
    • coccidioidomycosis
    • blastomycosis.
3 2

Perform clinical and laboratory investigations of superficial fungal infections of:

  • skin
  • hair
  • nails
  • mucous membranes.
  • The aetiology, risk factors, clinical presentation and management of common superficial fungal infections, including:
    • dermatophytes
    • Candida spp.
4 3

Perform assays for parasitology investigations, including:

  • malaria
  • intestinal protozoa
  • intestinal helminths
  • leishmaniasis
  • trypanosomiasis
  • filariasis
  • schistosomiasis.
  • The aetiology, risk factors, clinical presentation and management of imported parasitic infections.
  • Assays performed using standard operating procedures in your hospital(s), including:
    • specimen types (e.g. blood, tissue, CSF, sputum, stool, urine, etc.)
    • Specialised referred tests,
    • Turnaround times associated with parasitic investigations,
5 4

Interpret and report the results of the laboratory investigation of patients being investigated for fungal infection.
  • The significance of medically important fungi within the clinical context, and the need for timely reporting during investigation.
  • The implication of these results and the need to follow national guidance in diagnosis.
6 5

Advise on management of fungal infection.
  • Treatment options, including the role of local and national guidance.
  • The need to report significant results to local or regional bodies (including statutory notification of diseases).
7 5

Recommend management of endemic parasitic infections.
  • The aetiology, risk factors, clinical presentation and management of endemic parasitic infections, including:
    • toxoplasmosis
    • toxocariasis
    • giardiasis
    • hydatid disease
    • parasitic infections associated with severely immunocompromised patients (e.g. microsporidiosis, cryptosporidiosis).
8 4

Interpret and report the results of the laboratory investigation of patients being investigated for parasitic infection.
  • Significance and timely reporting of medically important parasites within the clinical context.
  • Treatment options, including the role of local and national guidance.
  • The need to report significant results to local or regional bodies (including statutory notification of diseases).
9 6

Perform quality assurance and quality control tasks within the laboratory in the investigation of parasitic and fungal infections (including the monitoring the effectiveness of therapeutic agents).

The quality management system, including:

  • validation
  • IQC
  • IQA
  • EQA schemes, such as NEQAS
  • audit.

Work-based assessment

Complete 2 Case-Based Discussion(s)
Complete 2 of the following DOPS and/or OCEs
Type Title
DOPS Pepare, examine and identify gastrointestinal parasites in five stool samples using light microscopy
DOPS Prepare and examine ten thick and thin blood films for the diagnosis of malaria. Identify the species and percentage parasitaemia
DOPS Prepare and examine blood films for the diagnosis and identification of blood parasites other than malaria.
DOPS Identify dermatophytes using microscopy and culture
DOPS Identify yeasts using microscopy, culture and commercially available systems
DOPS Perform and interpret a malaria antigen detection assay
DOPS Isolate and identify fungal isolates from clinically significant sites e.g. ENT, respiratory
OCE Under supervision obtain a patient history from a normal volunteer or typical patient referred to your service and present the findings to a colleague or peer
OCE Participate in a multidisciplinary clinical meeting ward round where the management of fungal infections in the immunocompomised is discussed