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71 Cards in this Set
- Front
- Back
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Non Fermenting GNR Gen Characteristics |
-Most: non fastidious, erobes grow well on SBA, TSA -Most: cytochrome oxidase POS -Gen, not use carbs or do so by biochem PW other than fermentation == "non fermenters" -small % pathogens - most opprotunistic -grow in faucets, aerators, resp therapy equip, sinks, water baths -- contam meds and sterile solutions -nosocomial -UTIs, septicemia, meningitis, osteomyelitis, wounds -resistant to many Ab used to treat enteric infections as well as disinfectantns and antiseptics -TXT: may req combo therapy |
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Non Fermenting GNR Biochem |
-ALL no reactors on TSI/LIA: (NS/NS) or (k/k) - can use OF medium -Long, thin GNR or coccobacilli -oxidase POS -resistant to Ab -nonreactive in 24hrs in most commercial kit sys (most rely on fermentation PW and/or anaerobic) |
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MOst common NF GNR |
Pseudomonas aeroginosa Acinetobacter baumannii stentrophomonas maltophilia |
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Pseudomonas aeroginosa: gen characteristics |
- cause most GNNF infections - hardly infect uncompromised tissue -4th most common isolated nosocomial path (burns, cancer, CF) |
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Pseudomonas aeroginosa: biochem/Colony morph |
-motile --> polar flagella -GNR - Oxidase POS -Catalase POS -TSI/LIA = K/K (NonF) -MAC- lactose NEG -mucoid exopolysacc = slime layer -CM: irregular, spreading, rough edged, "pitted", "fringy edge", metallic sheen - Most: blue green tint (pyocyanin); can be red (pyorubin), brown or black (pyomelanin), yellow (pyoverdin - flouresces in UV) @ 25-30C -P.aeru = Grape like odor, corn tortilla - weak beta heme @ 48hrs
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Pseudomonas aeroginosa: infections |
- UTI (noso) --usually long term foley catheter -resp sys infect --really bad pneumonia -dermatitits -otitis media -wound -eye infections - **scary, blindness w/in 72 hrs **LOVES PLASTICS** -bacteremia -bone/joint - usually diabetic feet -GI - noso due to surgery -systemic - burns, cancer, CF, aids pxts |
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Pseudomonas aeroginosa: ID |
Most labs, Usually 3 things: -metallic colonies -oxidase POS -Grape or corn tortilla ordor
-colonial morph, beta heme, pigments, growth @42C |
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Pseudomonas aeroginosa: virulence factors |
-Lipopolysacc- endotox, pyrogen -capsule - antiphago, inhib C' -proteases - dam host P -Hemolysins -exotoxin A - blocks protein synth -pyrocyanin - impairs ciliary activity (distinict pneumonia) -fimbriae - adherence factor |
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Acintobacter |
-GNR/cocci -Catalase POS -Oxidase NEG -non motile -oxidaztion or nothing -- NO cytochrome oxidase -grow @ 20-30C -resistance to many Ab -POTATOES |
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Acinetobacter baumanii |
-opportunistic: resp, UTI, wounds, septicemia -2nd most freq NF in clin lab -natural environ -moist surface in hospitals - esp resp therapy equip -**dry surface - skin -norm flora: oropharynx -empirical txt for acute infection: combo therapy |
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Acinetobacter baumanii: ID |
- cocci or coccobacilla -grow well on MAC (some pink some not grow) -cytochrome oxidase NEG -catalase POS -nonmotile |
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Stenotrophomonas maltophilia |
-nosocomial - 3rd mos commonly iso NF -wounds, UTI, blood -clin syndromes: -bacteremia, pneumonia, meningitis (rare), wound, UTI -prev in SW bc CF pxts |
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Stenotrophomonas maltophilia: epidemiology |
-hospital epidemics from contam moist reservoirs: inside disinfectant solutions, resp equip, ice machines, flower vases -risk factors: hositalization, immunocompromised (esp CF), long term broad spec AB (BM transplants) |
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Stenotrophomonas maltophilia: txt, prevention, control |
-resistance to multi Ab -susceptible to: trimethsulfa, chloramphenicol (if not responseive to others, last ditch effort), levofloxacin, timentin, ceftazimide |
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Stenotrophomonas maltophilia: ID |
-yellow pig on CHOC -Cytochrome oxidase NEG -acid prod on maltose, sometimes neg on glucose -->can be NEG OF media -Lysince decarboxylase (LDC) POS -ONPG POS (slow lactose ferm, no permease) -DNase POS (clearing on media)
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Burkholderia |
Burkholderia mallei and B pseudomallei = true path B. cepacia = pure opprotunisitic -VERY Ab resistant -all used to be pseudomonus |
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Berkholderia cepacia |
-MOST likely to see -aerobic -straight, GNR -oxidase POS -particularly in endstage CF pxts and those with chronic granulamotous dz (WBC dz) -septicemia, rare UTI |
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Burkholderia pseudomallei |
-need consistant exposure -CDC select agent list -causes mellioidosis, (prim SE asia in soil and water) -contam of wounds or via inhalation or ingestion -dz ranges from unapparent, acute pulmonary infection or chronic pulmonary dz to overwhelming septicemia -"Vietnamese Time Bomb" |
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Burkholderia Mallei |
-CDC select agent list -glanders in equines -dz appears as: chronic pulm dz, cutaneous w/multi skin abscesses, subq w/lymphatic involv or acute fatal septicemia == almost always fatal -antimicrobial sensitivity test == essential |
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GNR Curved |
vibrio campylobacter helicobacter |
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vibrio spp |
-helophiles - LOVE salt -V. cholerae, V. parahaemolytics, V. vulnificus -marine habitats -ALL water borne dz -temp sensitive - more common summer months -raw or udercooked shellfish - #1 oysters -GNR curved -polar flagella in broth; peritrichous in solid -facultative anaerobes -prefer alkaline pH 8-9.5 -most oxidase POS -suscep to vibriostatic compound 0/129 -string test POS -iso most common from stool, wounds, blood |
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Vibrio culture |
SBA and CHOC: med to large, smooth, opaque colonies MAC: NLF except V. vulnificus TCBS: V cholerae - yellow = sucrose ferm V vulnificus - green = NF |
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Vibrio cholerae |
-pH 8-9.5 -highly motile w/single polar flagellum -oxidase POS -antigenic structure based on 0 antigen: 139 serogrps -VC 01 and 0139: cause epidemic cholera -VC subdivided into: biotype El Tor or Classical biotype |
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Vibrio cholerae: virulence factors |
-pili -enterotoxin A-B toxin: activation of adenylcyclase = causes hypersecretion of sodium, potassium, and bicarb ions ==> fluid accumulation in lumen of intestine (all water sucked out of tissue) |
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Vibrio cholerae: epidemiology |
-survive in salty water but not necessary -transmission: fecal oral -fecal contam shellfish, untreated drinking water, P-to-P unusual -clin manifestation - sudden onset, mild gastroenteritis to cholera - nausea and vomiting -rice water stool -no abdom pain, symp due to dehydration -loss of fluid and electro = cardiac and renal failure -acidosis, hypokalemia, mortality rate w/o treatment 40-60% |
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Vibrio cholerae: txt and prevention |
-fluid replacement -Ab: doxy, tetracycline, trimethsulfa for children -no perfect vax -clean water and food supply |
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Vibrio cholerae: lab dx |
-MAC: lactose NEG -oxidase POS -TCBS media: thiosulfate-citrate-bile-sucrose = vibro media -agglutination in 01 or non 01 antisera -El Tor subgrp: VP POS, hemolyze RBCs, inhib by polymixin B -KIA = K/A; TSI = A/A; LIA = K/K -"darting" motility -POS string test |
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TCBS media |
-T/C = strong alkalinity inhibit enterobacteriaceae -Bile = supress enterococci (Gram P) -any coliform bac CAN"T metabolize sucrose thymol blue - bromothymol blue pH = yellow in acid
-V cholera: yellow, no NaCl, ferment sucrose -V parahaemolyticus: green, NaCl req -V vulnificus: green, NaCl req |
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Vibrio parahaemolyticus |
-marine org, along coast of US -rel rare in US, maj cause of diarrhea in Japan -enterotoxin mediated -incubation : 5-72hrs -dz spectrum: mild to sev cholera like diarrhea -nausea, vomiting, abdom cramps, fever -self limiting about 3d |
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Vibrio vulnificus |
-wound and blood -fulminant (gaseous) necrotizing wound infections -septicemia follwoing consumption of contam shellfish esp oysters -pxt w/liver dysfunc @ greater risk (bc inc lvls of Fe) -**mortality rate w/o txt = 50% |
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Vibrio - presumptive ID |
-oxidase POS --distinguish from enterobacteriaceae -fermentation metabolism --distinguish from oxidative pseudomonas |
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helicobacter pylori |
-microaerophilc -multiple polar sheathed flagella (corkscrew motion) -Urease enzyme - to NH4 and CO2 w/dec in stomach acidity and allows it to survive in stomach at pH2-3 |
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helicobacter pylori: virulence factor |
-**urease - protect from stomach acid -motility - enables org to propel thru mucous layer -adherence factors - anchor bac at the intracellular junc of enteric cells -heat labile cytotoxin -gastric mucin protease - breaks down mucus to get to lining -hemolysin -microaerophilic - enables survival w/in mucus |
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helicobacter pylori: epidemiology |
-45% show Ab to H pylori -up to 100% of pxt with peptic ulcers + H pylori -chronic superficial gastritis (type b strain) -assoc w/inc risk of gastric carcinoma -transmission: unk |
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helicobacter pylori: lab dx |
-endoscopic biopsy and stain -Gram = poor, use carbo fuscin counter stain -Silver = histology -Culture: skirrows, incub 2-5d @ 35C, 5%O2 -Rapid Urease, oxidase, catalase POS -hippurate NEG
-Usual Dx test: urease breath test - labeled C13 ingested and labeled CO2 detected -ELISA |
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Campylobacter |
-dies easy outsside body --non spore forming, curved, "s" shaped -Oxidase POS -"darting" motility = polar flagellum -req selective media and microaerophilic -slow growing, fastidious -most common cause bacterial gastroenteritis worldwide |
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Campylobacter - epidemiology |
-campy "bloom" in summer esp after July 4th -transmission: -ENTERIC: jejuni, coli -animals, infected pets, mayo -contaminated water and dairy prod -improperly cooked chicken -BLOODBORNE: fetus -immunocomp and elderly -rarely assoc w/enteritis -causes abortion in cattle, sheep, hogs -can be sexually transmitted -safranin counterstain 2-3min, or carbofusion -42C in microaerophilic and elev CO2 |
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Campylobacter - pathogenesis, clin manifest |
-incubation: 1-7d -fever, headache, myalgia, malaise -low dose org -diarrhea or dysentery or both -freq self limiting w/improvement in days |
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Campylobacter - Lab Dx |
-collection and transport -fetus: blood culture -jejuni and coli: rectal swabs or fecal samples -cary blair transport if longer 2hrs -selective media to suppres norm flora -microaerophilc -42C and 35C (coli poor growth @42, fetus NO growth @42) -"darting" motility -oxidase, catalase POS campy agar |
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Campylobacter - presumptive ID/definitive ID |
- Colony morph: -enteric: moist, round, raised or flat, non heme -fetus (blood): smooth, raised, clear -Microscopic: curved, GNR -long spirals, s shaped, gull wing -oxidase POS -motile
-gram stain morph -darting motility in hanging drop -oxidase, catalase POS -hippurate POS |
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Campylobacter - txt, prevention |
-susceptibility not usualy done -most no txt -erythromycin = enteric -gentamicin = systemic -cook meat and poultry thoroughly -pasturize milk -chlorinate water -avoid cross contam of food |
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Misc GNR |
aeromonas plesiomonas |
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Aeromonas |
-common stool, wound, some UTI -oxidase POS -Glucose Ferm -motile -iso from produce and meat -gastroenteritis from consump of contam seafood, esp raw oysters and clams --> usually self limiting -wound from A. hydrophilia -- from traumatic fresh water related wounds |
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Aeromonas |
water loving: fresh or salt water A. hydrophila and A sobria - most common A caviae and A salmonicida |
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Aeromonas hydrophilia: ID |
-fresh water -Indole, oxidase POS -can be lactose ferm -motile (except A salmonicida) -lactose ferm -KIA and TSA: A/A -LDC POS -ODC NEG -DNase POS |
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Aeromonas hydrophilia |
-cellulitis - after exposure to contam water or soil -enterotoxigenic (watery diarrhea) - sim to cholera -septicemia -optimal temp = 22-28C -beta heme -some don't grow @ 35C
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Plesiomonas |
-Single sp: P. shigelloides -soil and aquatic environ -many animal hosts: dogs, cats, pigs, vultures, snakes, lizards, fish, shellfish -gastroenteritis (typ from uncooked oysters or shrimp) -bacteremia or meningitis in immunocomp after animal exp |
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Plesiomonas: ID |
-Oxidase POS -Glucose ferm -faculatative anaerobic GNR -**ferm of inositol -inhib by high salt and no salt req -Omithine, lysine, arginine POS |
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Resident flora - human UT |
-lactobacillus -alpha heme streptococcus -diptheroids -CoNS -Gardnerella vaginalis -yeast |
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Most common Path of UT |
CA: -E coil = most freq path iso -Klebsiella sp and other enterobacteriaceae -Staph saprophyticus
HA: -E. coli, Klebsiella, other enterobacteriaceae -Pseudomonas aeruginosa -enterococci and staphylococci |
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E coli ID |
-non swarming, beta heme -spot indole POS -oxidase NEG -non heme SBA, Lactose POS, PYR NEG -non heme SBA, Lactose NEG, rapid MUG POS -motile -GNR |
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E coli TSI, urea, indole, MR, VP, citrate, nitrate, LF, |
EMB - metallic sheen MAC - LF O/F - +/+ TSI - A/A (LF) or K/A gas (NLF) LIA - K/K/G/- Motiltiy - yes VP - neg MR - pos Indole ALWAYS pos citrate neg urease neg nitrate pos can be LF or NLF |
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Proteus spp ID |
-swarmer -indole: NEG - mirabilis/penneri -mirabilis: maltose NEG, ornithine POS, glu POS, citrate NEG -penneri: maltose POS, ornithine NEG POS - P. vulgaris |
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Proteus spp TSi, LIA, indole, motility, VP/MR, citrate, urease |
*no single colonies on BAP = "swarming" EMB - (colorless) NLF TSI A/A/G/+ LIA R/A/+/+ Indole: vulgaris = pos, mirabilis =neg motility yes VP neg MR pos citrate neg urease pos nitrate pos
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P. aeruginosa |
-Oxidase POS -typical smell of grape or corn tortilla -colony morph: metallic, rough, pigemented, mucoid -isolates from CF pxt may appear atypical |
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Enterobacter cloacae and E. aerogenes |
****Full biochem ID MAC: purple colonies EMB: black center |
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Enterobacter cloacae TSI, urea, indole, MR, VP, citrate |
TSI - A/A/G/- Urea pos indole neg MR neg VP pos Citrate pos |
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Enterococcus spp |
-GPC in chains -cocci or coccobacilli in pairs or chains ->1mm colonies -non heme (E faecium typ alpha) -catalase POS -PYR POS
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S agalactiae |
-GPC in pairs and chains -catalase NEG -narrow zone of Beta heme -rapid hippurate hydrolysis OR test for CAMP factor OR type by latex agglut
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Yeast |
-candida albicans: oval budding yeast -feet or mycelial projections (pseudohyphae) -germ tube POS <3hrs -C dubliniensis fail to grow @45C, germ tube NEG @ 42C -c tropicalis - mycelial fringe after 24hrs differentiated from feet -C glabrata - more resistant to antifungal meds small, oval to circular budding yeast small yeast on SBA trehalose POS @ 42C |
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Klebsiella pneumoniae LF, TSI, Citrate, LIA, indole, ornithine |
MAC - pink colonies (LF) EMB -dark O/F - +/+ lysine + citrate + indole - TSI a/a/G/- **non motile ornithine - urea + MR - VP + nitrate + **Klebsiella oxytoca: same except Indole POS
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citrobacter freundii tsi, lia, urea, citrate |
EMB Dark MAC LF O/F- +/+ TSI A/A/-/+ LIA K/A/-/G VP/MR = neg/pos urea neg citrate pos nitrate pos indole pos motile |
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salmonella |
EMB colorless MAC NLF O/F +/+ TSi K/A/-/+ VP/MR = neg/pos indole neg urea neg lysine + citrate + ONPG - malonate - MAC, EMB, Hek- nitrate + motile |
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Shigella spp |
*mostly neg EMB colorless (neg) NLF O/F +/+ TSI k/a (red/yellow) MR pos VP neg citrate neg indole neg urea neg nitrate + **KEY: motility neg |
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yersinia enterocolictica |
TSI A/A/g/- urea weak pos indole pos MR pos VP neg citrate neg |
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Serratia marcesens indole, TSI, LIA, mot, VP/MR, citrate, urease, nitrate, LF/NLF |
Indole neg TSI, K/A/G- LIA K/K/-/- motile VP/MR pos/neg citrate pos urease neg nitrate pos NLF |
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Enterobacter aerogenes IMVC, TSI, Urease, motile, LF/NLF, citrate |
Indole neg VP/MR pos/neg Citrate pos urease neg motile TSI A/A/G/- |
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M morganii indole, TSI, LIA, motility, VP/MR, citrate, urease, nitrate, LF/NLF |
indole pos TSI K/A/-/- LIA R/A/-/- motile VP/MR neg/pos citrate neg urease pos nitrate pos |
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ENterobacteriaceae: characteristics |
aka "enterics" GNR, non spore forming oxidase neg if motile, by peritrichous ALL reduce nitrate to nitrites True Paths: salmonella, shigella, yersinia pestis opprotunistic and noso paths: e. coli (#1), klebsiella, enterobacter, serratia, citrobacter |
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Enterics 4 major features |
glucose fermentor (dextrose) reduce nitrates to nitrites oxidase pos (except plesiomonas) all motile except klebsiella, shigella and yersinia |
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IMViC |
I = indole M= Methyl red (MR) V = voges-proskauer, acetoin production (VP i C= citrate |
