Introduction

Ingestion of pathogens may result in different infections. These probably are confined to gastrointestinal tract or initiated in the gut before spreading to other parts of the body. There are many of microbial pathogens that are able to infect the gastrointestinal tract. These microbial pathogens are divided into different categories based on their size, characteristics and so on. Bacteria are the most common microbes that cause gastrointestinal tract infection. They can be acquired by the fecal-oral route through fecal-contaminated food, water and fingers. The pathogens usually must be ingested in adequate number to cause infection. There are several terms of symptomes used to describe the gastrointestinal tract infection. Firstly, gastroenteritis, this is characterized by gastrointestinal symptoms, (nausea, vomiting, diarrhea and abdominal discomfort). Salmonella, Shigella, Staphylococcus, Campylobacter jejuni, Clostridium, Escherichia coli and yersinia are the most common species of bacteria that cause gastroenteritis. Secondly, diarrhea, this is characterized by fluid stool and usually due to the disease of small intestine and involving increased fluid and electrolyte loss. Thirdly, dysentery, this is an inflammatory disorder of the gastrointestinal tract mostly associated with blood and pus in the feces. Pain, fever, and abdominal cramps are symptoms of this disorder and usually resulting from large intestine disease. Last description term is called enterocolitis; this is an inflammation involving the mucosa of both the small and large intestine (1). All of these terms are helpful in identifying the case. The clinical history of the patient also is very important to make the diagnosis. For example, the cases that we had to investigate which were three known cases, the fist one was for a 16 year old male presented to his

local doctor with 2 days history of gastroenteritis, his symptoms are nausea, vomiting followed by abdominal pains and diarrhea. These would help in the diagnosis because it seems to be one of the pathogens that cause gastrointestinal symptoms. In case study 2, the patient is suffering from fever, night sweat, severe headache and non productive cough. There is also a history for a cluster of cases of typhoid fever occurred in the country town of patient. These symptoms and history would give hint that the case supposed to be salmonella typhi although we cannot exclude other species unless we do further investigations. In the case study 3, the patient is 22 year old presented to her local doctor with a history abdominal pains, fever and watery diarrhea followed by classical dysentery including blood and mucus in his/her stool. These symptoms are typical for the third class description (dysentery) and doing further investigations are suggested to reach the final diagnosis. The importance of clinical history and symptoms in the provisional diagnosis is very clear as they lead us to the way that we should follow in the investigations and avoiding consuming many tests. It is very important to get the correct diagnosis of the case to can prescribe the treatment accurately; this will help the patient to recover quickly, moreover avoiding any complication of the disease. Therefore, to rashes that identifying the above organisms by examining their gram morphology and colony characteristics, with prime importance being given to simple biochemical tests Aims of the practical exercises is to provide practical knowledge and skills to work at graduate level in a diagnostic laboratory on the Enterics bench. To work most effectively, i.e. to interpret results and troubleshoot, it is essential that scientists understand the basic principles of diagnostic microbiology and are able to recognize and select potential pathogens in mixed culture. A good understanding of microbial pathogenesis is becoming

increasingly important with the use of tests to detect potential virulence factors, e.g. toxins.

Discussion

There were three unknown organisms successfully isolated and identified in the laboratory. It is very important to make sure that while identifying the organism; it is isolated, purely streaked and not contaminated with others. However, the process for investigation or diagnosis of any pathogens has to be followed correctly. Starting with identification and analyzing the clinical not of the patient for example, patient name, gender, age, type of specimen and symptoms that appear in the patient and finishing with interpretation the result all to be handled properly. The clinical history of the patient is the very important step to be considered to reach successful diagnosis. So for lab scientist the first important thing in the lab after conceder the clinical not is the choice of media, for example, in case study one, no growth on the plate of skirrows medium (SK) would exclude campylobacter spp, whereas the growth of bacteria on desoxycholate citrate agar (DCA), xylose lysine desoxycholate agar (XLD) and hektoen agar (HEK) would rule in salmonella and shigella spp. The morphological features may give a clue of the suspected bacteria. The biochemical tests are the next step to be considering so that it can be easy to differentiate between salmonella and shigella. Based on the results in table one and two the biochemical tests suggest that the case is more likely salmonella spp. in addition, API 10S and serology are supposed to give the exact serotype and if then sending the report to

the reference lab for the confirmation that will be more accurate to rich the correct identification. In case study one there is no unusual findings and all results are fit with the known case. In case no 2, the results are the same to case no 1 except the gas from glucose is negative which differentiates salmonella typhi from other salmonella serotypes. Ornithine decarboxylase also is suggested here because it gives negative result with salmonella typhi and positive with other salmonella serotypes (3). Unusual finding in this case study is that urea it was positive and that was from the second colony that has been choose from the media which may reflect non pathogenic disorders therefore it excluded. In the case study three , the selective media, morphological features and biochemical tests suggest that the case is more likely shigella spp. the serology test has been done and the result is positive with shigella flexneri. In this practical exercise we choose two colons in each case study because we sow slightly different colonies with size from what we normally suspect in thus cases. So in cause study one we choose two colonies from XLD agar first was red colonies with black center and the second was red colonies very small in size and the reason from that is just to be more accurate in identify the bacteria but the result was the same for the both colonies that have been picked but in cause study two we choose two colonies but the result was different. In case study two , two different colones was first choosen from HEK agar which is green most raised colonies and the second was blue green colonies with black center and the result where the same for both colonies exabte in urea test is was positive in the second colony and negative in the first one so we excluded the second colony because it is may reflect non pathogenic disorders and that thing is not our interest in this practical exrsaus. finaly in case study three we also chooses two different colonies first one from XLD agar red

colony and green colonies from HEK agar and the result where different from each other as it shown in table 3 above but we excluded the second colonies because it give us positive urea test and that reflect non pathogenic disorders. The purity plat for all case where cheeked and it was pure with no other bacteria growth but if it is not pure all the biochemical test cannot be readied and that mean also that we need to do the exrsaus from the beginning. Moreover, contamination of the specimens also does carry wrong diagnosis. That is why; all ten equipments were sterilized before use. It is being suggested to work closely to the flame inside microbiology lab to avoid any kind of contamination. Finally, procedures were followed accurately. It is very important to ensure that the total procedure has been conducted with appropriate steps, confirming to avoid any false justification. In this regard, taking time to think and analyze the situation, rather than hurrying with the total procedure, can ensure a realistic and true performance.

We can recommend the followings to improve the experiment of identifying unknown mixtures:

Organization: For each test, all the records need to be kept properly and accurately in an organised way. Also, all the tests are being advised to do separately rather than altogether.

There are few tests which might not provide positive or negative report; in this case, nothing to be worries, as still organism can be identified.

Period of time enhancement.