Universitat Internacional de Catalunya

Infectious Diseases

Infectious Diseases
4.5
12100
5
Second semester
OB
Main language of instruction: Catalan

Teaching staff


Dra. CALBO SEBASTIÁN, Esther - ecalbo@uic.es

Students may ask lecturers questions at the end of each class. For enquiries outside of class time, students must make an appointment by email:


RESPONSIBLE

Dra. Esther Calbo Sebastian: ecalbo@csc.uic.es

OTHERS

Dra. Carmen Muñoz: cmunoza@uic.es

Dra. Elisabet Lerma elermac@uic.es

Dra. Beatriz Dietl beatriz.dietl@uic.es

Dr. Josep Maria Guardiola: jmguardiola@uic.es

Dra. Lucía Boix: lboixp@uic.es

Dra. Natalia Papaleo npapaleo@uic.es

Dr. Josep Maria Badia: jmbadia@uic.es

Dra. Paloma Puyalto: ppuyalto@uic.es

 

 


Introduction

Infectious diseases are still nowadays a relevant cause of disease and death despite the advances achieved by medicine. The presentation form and the therapeutic approach of infectious diseases are submitted to multiple changes:  the increased population with immune deficiencies, the development of resistance mechanisms by frequent microorganisms that disable antimicrobials, globalization or the increasing outpatient management of sanitary assistance that forces to settle the bases of a deep knowledge of these diseases pathogenesis.

The pandemic caused by SARS-Cov-2 has been a great example of the challenge of diagnosing, treating and preventing an infectious disease.

This subject aims to provide the student the conceptual framework necessary for recognizing the infectious origin of a disease, identifying especially vulnerable hosts and establishing preventive strategies at individual and community level.

The purpose of this course is for the student to acquire the necessary theoretical knowledge, abilities and attitudes so that, added to the ones acquired previously in Microbiology, will be able to face clinical situations (general infectious syndromes) and establish a diagnostic orientation.

Pre-course requirements

És requisit imprescindible que l'alumne hagi cursat o estigui matriculat de les següents assignatures:

- Farmacologia

 

Haver superat les assignatures:

- Microbiologia

Objectives

The general aim of the course is to recognize the presentation form of infectious diseases as well as to develop the ability of rationalizing the use of diagnostic and therapeutic methods.

Specific objectives:

  • Recognize the infectious origin of a disease through a medical record and an oriented physical examination.
  • Know the main infectious agents, its epidemiology and principal biological features of clinical interest. 
  • Direct the diagnostic process of the main infectious syndromes according to its location, to the host and to the pathogen requesting the appropriate microbiological tests for each type of infection.
  • Know the medical and surgical treatment of some of the main infectious diseases.
  • Know the sensitivity of microorganisms to the different antimicrobials as well as the innate and acquired resistance mechanisms.
  • Know the main antimicrobial groups and the main therapeutic outline used in community. Acquire a compromise in the rational use of antimicrobials.
  • Know the main nosocomial infections and its surveillance and control (hand hygiene and isolations).
  • Direct prevention of infections associated to travels and identify the imported infectious pathology.

 

Competences/Learning outcomes of the degree programme

  • 07 - Understand and recognise normal structure and function of the human body at the molecular, cellular, tissue, and organ and systemetic levels, at different stages of life and in both sexes.
  • 09 - Understand and recognize the effects, mechanisms and manifestations of disease on the structure and function of the human body.
  • 10 - To understand and recognise the agents and risk factors which determine health status, and learn how they determine the symptoms and natural development of acute or chronic diseases in individuals and populations.
  • 12 - Understanding the foundations for action, the indications and efficacy of therapeutic interventions, based on available scientific evidence.
  • 15 - Ability to formulate an initial diagnosis and establish a rationalised diagnostic strategy.
  • 16 - Recognize and deal with situations that put life in immediate danger and those that require immediate attention.
  • 17 - Establish the diagnosis, prognosis and treatment, applying principles based on the best information possible and safe clinical practice..
  • 18 - To indicate the most appropriate (pharmacological, surgical, psychological, social or other) treatments that are pertinent to the most prevalent procedures, in terms of rehabilitation and also terminally ill patients, including an evaluation of their effectiveness.
  • 19 - Propose preventive measures appropriate to each clinical situation.
  • 25 - Recognize the determinants of public health; genetic and sex-dependent lifestyle, demographic, environmental, social, economic, psychological and cultural determinants.
  • 26 - Assume role in the prevention and protection from diseases, injuries or accidents and maintenance and promotion of health, both individual and at the community level.
  • 27 - Recognize role in multidisciplinary teams, assuming leadership when appropriate, for the delivery of health care, such as interventions for health promotion.
  • 28 - Obtaining and using epidemiological data and assess trends and risks in health related decision-making.
  • CB-1 - To have acquired advanced knowledge and demonstrated, within the context of highly specialised scientific and technological research, detailed comprehension based on theoretical and practical aspects and a working methodology from one or more fields of study.
  • CB-2 - To know how to apply and incorporate knowledge, an understanding of it and its scientific basis and the ability to solve problems in new and loosely defined environments, including multidisciplinary contexts that include both researchers and highly specialised professionals.

Learning outcomes of the subject

  • Do a syndromes’ diagnostic approach to a patient with an infectious disease.
  • Argue the justification of additional diagnostic tests and stratify its interest and indication.  Make a reasoned use of diagnostic methods.
  • Establish adequate medical and surgical treatments.
  • Identify preventive strategies at an individual and population level.

Syllabus

LECTURES (CM)

Introduction to Infectious Diseases

  • Pathogenesis and clinical manifestations

  • Host defence mechanisms

  • Epidemiology

  • Bacteria: structure and classification

  • Viruses: structure and replication

  • Sample collection and transport

  • Direct and indirect microbiological diagnosis

Gram-positive infections

  • S. aureus: skin and soft-tissue disease, SSSS, sepsis, endocarditis, osteoarticular infection, meningitis

  • Coagulase-negative staphylococci: device-associated infections

  • Streptococcus: classification, microbiology, clinical syndromes

  • Corynebacterium, Rhodococcus, Bacillus, Erysipelothrix

Gram-negative infections. Sepsis and septic shock

  • Sepsis, bacteraemia, septic shock

  • Pathophysiology and complications

  • Enterobacterales

  • Pseudomonas

Soft-tissue infections

  • Cellulitis

  • Gas gangrene

Endocarditis and vascular infections

  • Native-valve and prosthetic-valve endocarditis

  • Intravenous drug users

  • Endovascular catheter infections

Infectious diarrhoea

  • Salmonella, Shigella, Campylobacter

  • Clostridioides difficile

  • Enteric viruses

  • Protozoa (Giardia, Entamoeba)

  • HIV-related and chronic diarrhoea

Miscellaneous

  • Spore-forming anaerobes: tetanus, botulism

  • Actinomycosis and nocardiosis

  • Leptospirosis

  • Brucella, Pasteurella, Yersinia

HIV and AIDS (class I and II)

  • Epidemiology and natural history

  • Opportunistic infections

  • Malignancies

  • Diagnosis, treatment, and prophylaxis

  • Prevention

Infections in the non-HIV immunocompromised host

  • Neutropenia, transplant recipients

  • Splenectomy, complement deficiencies

  • Dysgammaglobulinaemias

Mycobacterial infections

  • Pulmonary and extrapulmonary tuberculosis

  • Nontuberculous mycobacteria

Fungal infections

  • Classification

  • Candidiasis, cryptococcosis, aspergillosis, mucormycosis

  • Antifungal therapy

Protozoan infections

  • Leishmaniasis, toxoplasmosis, giardiasis, amebiasis

Cestodes, trematodes, and nematodes

  • Taeniasis, cysticercosis, hydatidosis

  • Schistosomiasis

  • Filariasis, onchocerciasis, toxocariasis, anisakiasis, strongyloidiasis, ascariasis

CASE-BASED METHODS (MC / MCC)

Fever of unknown origin

  • Rash

  • Lymphadenopathy / splenomegaly

  • Mononucleosis-like syndrome

  • Herpesviruses

  • Lyme disease

  • Rickettsioses (Mediterranean spotted fever, typhus, Q fever)

Meningoencephalitis

  • Pyogenic meningitis

  • Neisseria meningitidis

  • Lymphocytic meningitis

  • Encephalitis, myelitis, neuritis

  • Brain abscesses

Upper respiratory tract infections

  • Sinusitis, otitis, pharyngitis

  • Common cold, influenza

  • Acute and chronic bronchitis

Lower respiratory tract infections

  • Community-acquired and nosocomial pneumonia

  • SARS-CoV-2

  • Lung abscess, anaerobes, empyema

Fever in the traveller

  • Malaria

  • Dengue

  • Chikungunya

  • Typhoid fever

  • Viral haemorrhagic fevers

  • Rabies

URINARY TRACT INFECTIONS

  • Cystitis, pyelonephritis

  • Prostatitis, epididymitis, orchitis

SEXUALLY TRANSMITTED INFECTIONS

  • Urethritis, vaginitis, cervicitis

  • Gonorrhoea

  • Syphilis and treponematoses

  • Genital ulcers

  • Pelvic inflammatory disease

PERITONITIS AND INTRA-ABDOMINAL INFECTIONS

  • Anaerobes

  • Hepatic, splenic, perirenal, and retroperitoneal abscesses

  • Primary, secondary, and tertiary peritonitis

SEPTIC ARTHRITIS AND OSTEOMYELITIS

  • Community-acquired

  • Associated with prosthetic or osteosynthesis material

 

SKILLS LAB (LH)

Nosocomial infections and infection control

  • Major HAIs

  • Isolation measures

  • Hand hygiene

  • Post-exposure and surgical prophylaxis

  • Epidemiological surveillance

  • Notifiable diseases

Antibiogram and rapid diagnostics

  • Gram-positive and Gram-negative resistance

  • Antimicrobial stewardship (AMS)

  • Rapid diagnostic methods

Radiology of infectious diseases

  • Radiological anatomy

  • Interventional radiology

  • Scintigraphy

Pathology

  • Major infectious lesions

PROBLEM-BASED LEARNING (PBL)
  • Diarrhoeal syndrome

 

Teaching and learning activities

In person



The masterclass is the scene in which a lecturer transmits knowledge in a classroom to the whole group of students.  The format, however, allows the introduction of small group activities inside the classroom and the deployment of strategies that promote the active participation of students.

The method case is the solution process of clinical cases. They are group activities that are solved with the active participation of the professor after the deliberation of students.

Problem- based learning is similar to the method case but makes students responsible to find a solution to the problem. The professor acts as a tutor that facilitates the learning process from their metacognitive abilities. It can also be done in groups.  

The skills laboratory is in an area in which the student can develop basic communication and physical examination abilities with mannequins, robots and also simulated patients and real sick ones. They are done in small groups.

Evaluation systems and criteria

In person



1. Participation in the Skills Laboratory: Practical content delivered in the skills laboratory. Students must demonstrate the competencies acquired in the clinical simulation lab. Attendance at laboratory sessions is mandatory in order to be assessed. Practical content will account for 5% of the final grade.

2. Examination:

a. Midterm exam: multiple-choice test. Incorrect answers subtract 1/3 of the value of the question (MIR format). 10% of the final grade.

b. Final exam: multiple-choice test. Incorrect answers subtract 1/3 of the value of the question (MIR format). 60% of the final grade.

3. Continuous assessment:

Participation in the PROMIR ESTUDIO programme, 15% of the final grade.

4. PBL (Problem-Based Learning):

  • The combined evaluation of the different components (theoretical, attitudes, and competencies) described in the PBL student guide will account for 10% of the final grade.

FINAL GRADE:

  • Weighted sum of continuous assessment (15%), midterm exam (10%), final test (60%), PBL (10%), and Skills Laboratory assessment (5%).

  • Students must pass both the final test and the Skills Laboratory assessment independently with a score ≥ 5 in order to pass the course. The percentages are not applied if the final exam is not passed.

Bibliography and resources

  • Fauci, Braunwald, Kasper, Hauser, Longo, Jameson, and Loscalzo, Eds. HARRISON PRINCIPIOS DE MEDICINA INTERNA.17a edición. McGraw Hill, 2009. ISBN: 9789701067888
  • Rozman y Cardellach F. Farreras: MEDICINA INTERNA 16º edición. Hacourt Brace de España, SA. 2008
  • Mandell, Bennett, Dolin. Enfermedades infecciosas. Principios y Práctica. Editorial Médica Panamericana.
  • V. Ausina Ruiz, S. Moreno Guillen.Tratado SEIMC de Enfermedades Infecciosas y Microbiología Clínica. Editorial Médica Panamericana
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