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232 Cards in this Set
- Front
- Back
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What are the 9 gram positive cocci that we are working with?
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S. aureaus, S. epidermidis, S. saprophyticus, S. agalactiae, S. pneumoniae, S. bovis, Enterococcus, Viridans
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What is the key characterisitics of Staph. Aureus?
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coag pos, produces lots of toxins
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What is the key characteristics of Staph. Epidermidis?
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novobiocin sensitive
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What are the key characteristics of S. saprophyticus?
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Novobiocin resistant, primary cause of UTI
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What are the key characteristics of S. pyogenens?
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necrotizing, bacitracin susceptible
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What are the key chartacteristics of S. agalactiae?
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Hipp hydrolysis pos, CAMP pos, infection transfers from mother to newborn
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What are the key characteristics of S. pneumoniae?
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Optichin susceptible, bile soluble
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What are the key characteristics of S. bovis?
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Neoplasms of the GI tract, PYR neg, 6.5% salt neg, bile esculin pos
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What are the key characteristics of Enterococcus?
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PYR pos, 6.5% salt pos, bile esculin pos
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What are the key characteristics of Viridans?
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bile insoluble, bile esculin neg, optochin resistant
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How do you distinguish between staph and strep?
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Staph is catalase pos, strep is catalase neg
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Which staph is coagulase positive?
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Staph aureus
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What gram positive rods are non spore formers?
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Corynebacterium, listeria, actinomycetes, lactobacillus
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Which gram pos rods are catalase pos?
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Listeria and corynebacterium
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Which gram pos rod is catalase pos and has motility and is bile esculin pos?
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Listeria
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Which gram pos rod is catalase pos and has motility and is bile esculin neg?
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Corynebacterium
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Which gram positive rods are catalase neg?
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Actinomycetes, lactobacillus
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What gram positive rod can not produce H2S?
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actinomycetes and lactobacillus
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What streps are beta hemolytics?
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Group A, Group B, Group D, Entercoccus
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What streps are alpha hemolytic?
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Step. Pneumoniae, viridans, Enterococcus, Group D
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What streps are gamma hemolytic?
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Enterococcus and Group D
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What strep is PYR positive / sensitive?
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Strep. Pyogenes
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What strep is CAMP pos?
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Strep. Agalactiae
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What strep is bile esculin pos?
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entercoccus and group D
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What strep is sensitive to optochin?
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Strep. Pneumoniae
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What strep is bile esculin neg?
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viridans group
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What strep is PYR 6.5% salt pos?
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enterococcus
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What is the components of the gram negative cell wall?
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lipopolysacccharide, lipoprotein, peptidoglycan and the cell membrane
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What are the components of the gram positive cell wall?
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teichoic acid, peptidoglycan, cell membraen
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What are the key features of the bacterial cell wall?
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target of some antibiotics, maintains cell shape, protects from bursting, provides attachment sites, appendages are found here (pili or flagella), differentiate gram pos from gram neg
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What is LPS and antoher name for it?
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lipopolysaccharide aka endotoxin
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What type of toxins do gram positive bacteria produce?
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exotoxins
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What type of toxins do gram negative bacteria produce?
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mostly endotoxins
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Describe transformation.
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bacterial uptake of naked or free DNA
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Describe transduction.
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viruses or bacteriophages inject their DNA into bacteria
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Describe conjugation.
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needs cell to cell contact so 2 bacteria can exchange DNA
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What type of bacterial spores are the most toxic?
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endospores
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What are the general characteristics of gram pos cocci in clusters?
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nonmotile, non spore forming, aerobic to facultatively anaerobic, yellow to white colonies, catalase pos, normal skin and mucous memebrane flora
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What are most reservirs for staph?
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health care staff, patients, inanimate objects
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What are the characteristics of Staph. Aureus?
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most virulent staph, only human assoc. staph that produces coagulase, most common cause of skin infections, tolerates high salt content, ferments mannitol and is beta hemolytic
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What is TSST?
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Toxic Shock Syndrome Toxin 1 - multisystem disease with high fever, hyptension, shock
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What diseases are causes by Staph. Aureaus?
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cutaneous infections, deep lesions and diseases due to toxin production
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What are some of the clinical infections of Staph aureus?
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impetigo, furuncles, carbunles, boils, surgical would infections, food poisoning, scalded skin syndrome, TSST, bacterema, osteomyelitis
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What are some outcomes of deep lesion infection with Staph aureus?
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cellulitis, osteomyelitis, arthritis, abscess, endocardiditis, pneumonia, enterocolitis
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What is the treatment of choice for non-beta-lactamase producing S. aureus?
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methicillin, nafcillin, oxacillin, dicloxacillin (synthetic penecillins)
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What si the treatment of choice for MRSA?
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vancomycin
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How is Staph aureus able to resist the "cillins"?
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presence of MEC gene, alters the site where methicillin binds to kill bacteria
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What type of media is used to detect MRSA?
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Chromagar - MRSA will appear as pink or mauve colored on plate
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What are the common coagulase negative staph species?
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Staph. Epidermidis, Staph saprophyticus and Staph haemolyticus
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What are some common disease from Staph epidermidis?
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nococomial infections, endocarditis, bacteremia
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What are some common diseases from Staph saprophyticus?
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UTI
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What does Staph aureus look like BAP?
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smooth, white to yellow, creamy colonies with beta hemolysis
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What do the non coagulase staph look like on BAP?
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smooth, creamy, white, small but usually non hemolytic. Staph saprophyticus may be yellow
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Which is the only coagulase neg staph that is novobiocin resistant?
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Staph saprophyticus
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What are 5 genera of Streptococcocea?
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Steptococcus, Aerococcus, Leuconostoc, Gamella, Pediococcus
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What are the 5 species of Streptococcus?
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S. pyogenes (group A), S. Agalactiae (group B), viridans, S. pneumoniae, Group D (includes enterococcus and nonenterococcal group D)
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How are streps classified?
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hemolytic properties, antigientic properties like their lancefield groups and M protiens, biochemical properties
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What does alpha hemolysis on BAP look like?
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greenish discoloration around colonies becase of incomplete hemolysis
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What does beta hemolysis on BAP look like?
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clear, colorless zone around colony due to complete hemolysis
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What are the most common Lancefield groups of Strep?
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A, B, C, D, F, G but can go all the way through O
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Which strep genera lack any Lancefield groups?
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viridans group
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How are lancefield groups tested?
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using latex ag testing - takes about 2 minutes
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Which streps has M protiens?
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group A strep, done with the precipitin test
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Which strep are in Group A strep?
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S pyogenes
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Which strep are in Group B strep?
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S agalactiae
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Which strep are in Group C strep?
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S. Equisimillis
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Which strep are group D non enterococcus?
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S bovis and S equinus
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Which strep are group D entercoccus?
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E faecalis, E faecium, E durans
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Which strep are in the Viridans groups?
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S sanguis, S salivarius, S mitis, S mutans
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Which strep are in the Pneumococcus groups?
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S pneumoniae
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How does Strep pyogenes show up on chromagar?
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greenish sheen
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What is Strep pyogenes associated with (what disease)?
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flesh eating bacterial infections
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What are the different hemolysins associated with strep?
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Streptolysin O (oxygen labiale) and Streptolysin S(oxygen stabile)
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Describe Streptolysin O.
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oxygen labile, active in deep colonies where oxygen is low, media must be stabbed
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Describe Streptolysin S.
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oxygen stable, cell bound, inhibit chemotaxis, causes cellulitis
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Which Strep group causes Scarlet Fever?
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Group A that produces erythrogenic toxin
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What is hyaluronidase?
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enzyme that degrades hyaluronic acid in connective tissue, facilitates spread of strep in connective tissue
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What infections does Group A strep cause?
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acute pharyngitis ( most common ), scarlet fever, pyodermal infections like impetigo and erysipelas
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What infections are caused by the invasive group A streps?
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TSST or streptococcal toxic shock syndrome, necrotizing fascitis (cellulitis)
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What can conditions can arise post group A strep infection?
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Acute rheumatic fever, acute glomerulonphritis
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what does the gram stain show for Group A strep?
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gram positive cocci in chains
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What is the morphology of Group A strep on BAP?
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transparent, smooth, with Beta hemolysis
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What are the tests done to ID group A strep?
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Catalase neg, bacitracin susceptible, PYR pos, bile esculin neg, 6.5% NACl neg
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What is another name from Strep agalactiae?
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Group B strep
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What is used to detect Group B strep? (special media)
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carrot broth
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What are the diseases in infants from Group B strep?
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pneumonia, sepsis, meningitis; the babies are contaminated with it during delivery
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What are the diseases in children and adults from Group B strep?
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purpural fever, URI, meningitis, bacteremia, endocarditis, UTI, diabetic foot ulcers
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What does the morphology of Group B strep look like on BAP?
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grayish to white, mucoid, creamy colonies with a narrow zone of beta hemolysis
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What the presumptive ID tests for Group B strep?
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catalase neg, bacitracin resistant, bile esculin neg, 6.5% NaCl neg, CAMP pos
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Describe the CAMP test?
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S agalactiae shows the arrow shaped hemolysis near the staph streak. This indicates positive CAMP test.
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What is another name for Strep pneumoniae?
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Pneumococcus or Diplococcus
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What diseases are caused by Pneumococcus?
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pneumonia, meningitis, URI, peritonitis, endocardiditis, arthritis
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What is the most common virulence factor of Pneumococcus?
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capsule that can be seen on gram stain
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What is the common microscopic morph of Pneumococcus?
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GPC in pairs, lancet shaped
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What does the morphology of Pneumococcus look like on BAP?
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smooth, glistening, wet, mucoid with alpha hemolysis. CO2 enhances growth
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What are the presumptive ID of Pneumococcus?
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catalase neg, optochin susceptible, bile soluble pos
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What is included in the Group D Strep?
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Enterococci and non-enterococci
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What is VRE?
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vancomycin resistant enterococcus
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What does Group D strep look like on BAP?
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most are non hemolytic (some may be alpha or beta)
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What are the presumptive ID of enterococcus?
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catalase may be weak pos, hydrolyze bile esculin
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What is the most common cause of subacute bacterial endocarditis?
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Strep Viridans group
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What are the diseases caused by Viridans group strep?
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sub acute bacterial endocarditis, abscesses
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Which strep groups are normal flor of the vagina and instestines?
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Group B and D
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Which strep groups are normal flora of the Upper respiratory tract?
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Pneumococcus and viridans strep
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How are most strep infections treated?
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penicillin
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What is Pneumococcus treated with?
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3rd generation cephalosporins and quinolones
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What does PYR hydrolysis test for?
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differentiates Group A & Group D from others, hydrolyze PYR, all group A and 99% of group D are positive
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What is the HIPP test for?
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diagnostic for Group B strep. Detects the production of hippurase.
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What is the Quelling reaction?
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Swelling of the capsule, typing of pneumococci via capsular antigen
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What are the aerobic gram positive bacilli?
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corynebacterium, carcanobacterium, rhodococcus, lactobacillus, listeria, erysipelothrix, gardnerella
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What are the spore forming gram positive bacilli?
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Bacillus species
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What are the branching or filamentrous GPB?
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Partially acid fast are nocaria, rhodococcus, gordona, tsukamurella. Non acid fast are streptomyces and actinomadura.
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What is another name for corynebacterium species?
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Diphtheroids
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What are the common corynebacterium species?
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Corynebacterium diphtheriae, pseudotuberculosis, ulcerans, urealyticum, jeikeium, pseudodiphtheriticum, striatum and xerosis
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Where are corynebacteria found?
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normal skin flora
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What are the common gram stain morphology of corynebacterium species?
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gram positive bacilli with unparallel sides and slightly wider ends (club shape). Ofgen found in pairs of V or L shapes sometimes called chinese letters. Can also be found stacking (pallisades)
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What are the infections ususally caused by corynebacterium?
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pustule, chronic nonhealing ulcers, exudate formed on tonsils, pharyngitis, tonsilitis
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What is a common symptom / side effect fo C diphtheriae infection?
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severe conjunctivitis, bull neck (large swollen neck)
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How is corynebacterium usualy diagnosed?
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gram positive pleomorphic rods, chinese lettering form, non spore forming, non motile
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What special media can be used to culture corynebacterium?
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loefflers, tinsdale, cysteine tellurite blood agars
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Which species of corynebacterium carry the diphtheria toxin?
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C diphtheriae, ulcerans and psuedotuberuclosis
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What antibiotics can be used to treat corynebacterium infections?
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penicillin or vancomycin
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Which is the most frequently isolated corynebacterium species?
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C urealyticum
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What are some presumptive ID tests to confirm C urealyticum?
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catalase pos, glucose fermentation neg, rapid urease pos, antibiotic resistance, strict anaerobe, slow growing usually isolated from urine culture
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What type of colony morphology is seen on BAP for corynebacterium species?
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flat, dry, gray to white colonies, very pinpoint, may appear as "dirty" staph
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Describe the general characteristics of Listeria species?
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GPB, pleomorphic, beta hemolytic, catalase pos, tumbling motility or umbrella motility, facultative anaerobe
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How is Listeria spread?
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contaminated food like milk, soft cheeses, meat, cabbage, cold cuts and hot dogs, mother to infant
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What are the definitive ID's of Listeria?
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positive catalase, hipp hyrdolysis pos, bile esculin pos, VP and methyl red pos, CAMP pos
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What are the general characteristics of Erysipelothrix?
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GPB, pleomorphic, microaerophilic, alpha hemolytic
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What are the 3 diseases of Erysipelothrix?
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Endocarditis, erysipeloid, septicemia
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Who is the most susceptible to Erysipelothrix?
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butchers, meat processors, farmers, poultry workers, fish handlers, veterinarians
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What is the laboratory diagnosis of Erysipelothrix?
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GPB, alpha hemolytic, non motile, catalase neg, H2S on TSA, VP neg, brush like pattern at 22 C
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What is Erysipelothrix treated with?
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penicillins, cephalosporins, erythromycin, clindamycin
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Describe the general characteristics of Lactobacillus.
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Aerobic, gram positive, highly pleomorphic, long, slender, chains that may spiral shape, non spore forming, non motile, optimal growth is at pH of 6
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Where is lactobacillus usually found?
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oral cavity, GI tract and female genital tract
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What do the colonies look like on BAP?
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small, pinpoint, alpha hemolytic, frequently isolated from vaginal and urine specimens
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What is the ID tests for Lactobacillus?
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catalase negative, not commonly ID since it is normal flora
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How is lactobacillus treated if it does cause infection?
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penicillin
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Describe gardnerella vaginilas?
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small, pleomorphic gram varialbe (salt n pepper), coccobacilli and short rods, small gray colonies.
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What is the media used to grow gardnerella vaginilas?
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HBT - Human Blood Bilayer Tween
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What infections does gardnerella cause?
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vaginosis, UTI, bacteremia
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What is the easiest way to diagnose garnerella?
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Clue cells in a wet mount
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Describe the general characteristics of aerobic gram positive spore forming bacilli.
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Bacillus species, large, gram positive bacilli, can see spores
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What are the species of bacillus that are of importance?
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B anthracis, cereus, subtilis
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Which of the Bacillus species are the most virulent?
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B anthracis
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What are the 3 forms of Antrhax?
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Cutaneous, pulmonary, gastrointestinal
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What is the microscopic morphology of Bacillilus?
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large, square, GPB, single or in chains, clear zones around cells that represent caplsules
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What do the colonies appear like on BAP of B anthracis?
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medium to large, non hemolytic, gray, flat, irregular margin, swirling projections (medusa head), when edges of colony lifted with loop they will stand upright (beaten eggs)
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What are some tests to ID bacillus anthracis?
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catalase pose, non motile, can grow on high salt (7%), low pH, susceptible to penicillin
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What are branching - acid fast and partially acid fast bacteria?
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Aerobic Actinomycetes
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What is the primary stain of acid fast staining?
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Carbolfushion
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Describe how bacteria stain with acid fast stain.
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acid fast stain red and non acid fast stain blue
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What are the clinically significant Actinomycetes?
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Nocardia, Actinomadura, Gordonia, Steptomyces, Tsukamurella
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What is the first test for commonly encountered gram neg rods?
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Oxidase
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Which gram neg rods are Oxidase positive?
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Vibrio, Aeromonas, Pleisomonas, Pseudomonas
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How do you tell the difference between the GNR that are oxidase positive?
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Vibrio, Aeromonas and pleisomonas can ferment carbs. Pseudomonas can not.
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How do lactose fermentors appear on MAC?
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Red colonies
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How do non lactose fermentors appear on MAC?
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white colonies
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What are the gram negative cocci that are pathogenic?
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N gonorrhoeae, N meningitidis, M catarrhalis
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Which of the GNC are always considered a pathogen?
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N gonorrhoeae
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How do you diagonse N gonorrhoeae?
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Oxidase pos, GNC (diplococci) usually intracellularly, non motile, non spore forming, rapidly ferments carbs
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What is the selective media for Neisseria?
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Modified Thayer Martin, Martin Lewis or New York City agar, JEMBEC
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What are general features of Moraxella catarrhalis?
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gram neg coccobacilli, oxidase pos, catalase pos, non fermentative, can not reduce nitrates into nitrites
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What is one of the most common causes of Otitis media and sinusitis in children?
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Moraxella catarrhalis
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How do M catarrhalis appear on BAP?
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small, greay to white, hocky pucks (remains intact when pushed across plate), oxidase pos, catalase pos, non fermentative, sometimes referred to Wagon wheel pattern on media
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What are the general characteristics of Haemophilus?
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gram neg pelomorphic rods/coccobacilli, non motile, ferment carbs, usually oxidase & catalase pos, reduces nitrates to nitrites
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What are the major pathogens of Haemophilus species?
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H influenza, H ducreyi, H aegyptius
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What are growth requirments for Haemophilus?
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X and V factors - X is hemin and V is NAD, can distinguish between species by their X and V factor requirements
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Where can you find X and V factors?
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both found in RBC's, both available on choc agar. X alone on BAP.V factor produced when grown around Staph aureus, Strep pneumo, and Neisseria sp.
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Which haemophilus is normally the cause of pink eye?
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H aegyptius
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What is a common feature of colonies of Haemophilus when on plates?
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mousy or bleach like odor
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What are the bacteria included in the HACEK group?
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Haemophilus aphrophilus, Actinobacillus actinomycetomentans, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae
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What are the general characteristics of the HACEK group?
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slow growers, colonies small and compact, do not grow on MAC, oxidase pos, need CO2
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What is a key characteristic of Eikenella on Choc agar?
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pit or corode agar, odor of bleach
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Where does Pateurella come from?
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Mostly zoonotic, called shipping fever in animals under stress
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What is the gram stain of Pateurella multocida look like?
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pleomorphic, gram neg coccobacilli, bipolar staining (safety pin appearance)
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What is the morphology of Pasteurella look like on BAP?
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smooth, convex, non hemolytic but green discoloration, distinct musty odor
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What are some tests to ID Pateurella mulocida?
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Acid butt in TSA, catalase pos, oxidase pos, no growth on MAC, indole pos, urease neg, ONPG pos
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How is Brucella differentiated?
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based on animal source
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What are the diseases caused by Brucella?
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Brucellosis, Undulant fever, Malta fever
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Describe the gram stain of Brucella?
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Small, coccobacilli, gram neg rod. (similar to haemophilus) requires long counterstain time
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What is the normal specimens that Brucella is found in?
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blood cultures, bone marrow, lymph node aspirates, CSF, abscess aspirates
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What are special requirments for growth of Brucella?
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requires thamine, niacin and biotin for growth
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What are some of the biochemical reactions of Brucella?
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urease pos, produces H2S
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What does Fancisella tularensis cause?
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Tularemia, Glandular fever, rabbit fever, tick fever, deerfly fever
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What else is Francisella called?
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Disease of wild animals
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What is the morphology and staining of Francisella tularensis?
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small, coccobacilli to long filamentous forms, shows bipolar staining, gram negative
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What are the types of Bordetella that are of clinical importance?
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B pertussus, parapertussis, bronchiseptica
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What is FHA?
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filamentous hemagglutinin found in B pertussis
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What are the diseases that Bordetella causes?
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Whooping cough, pneumonia, convulsions, hemorrhage, hernia
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How is Bordetella treated?
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erythromycin
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What are special requirements for Bordetella?
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must be collected on Dacron swabs, transport on Regan Lowe medium and can do direct testing on swab specimens, can grow on bordet-gengou media
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How do Bordetella appear on BAP?
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slow growing, small , gran neg coccobacilli, glistening, compact colonies, apearance of pearls or drops of mercury
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How can you differentiate B pertussis from parapertussis or bronchiseptica?
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Pertussis is very fastidious and requires charcoal or other elemetns for growth, the others are much less fastidious and can grow on BAP and MAC
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What is Legionnaire's Disease?
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acute pneumonia, oppotunistic disease of smokers, alcoholics and COPD, aerosolized in AC ducts at a Legionnaire's convention-Caused by Legionella
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What is Pontiac Fever?
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acute, self limiting, febrille illness with headache, dizziness, muscle pain caused by Legionella
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How is Legionella treated?
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erythromycin
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Describe the gram stain of Legionella.
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gram neg, pleomorphic coccobacilli, motile, does not gram stain well but can extend stain for 10 minutes or use carbol fuchsin as counterstain
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What are the growth requirements for Legionella?
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Isolation difficult, requires ferric iron and cysteine, inhibited by sodium, BCYE is a normal agar for growth it is buffered charcoal yeast extract, aerobic but CO2 enhances its growth
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What is another name for the enteric GNR?
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Enterobacteriaceae
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What are the intestinal pathogens that are enteric GNR?
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Salmonella, Shigella, Yersinia
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What are NOT considered normal flora of the intestines?
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Salmonella, Shigella, Yersinia and E coli O157:H7
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Where is O antigen found?
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in the cell wall of enteric GNR
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Where is H antigen found?
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flagella of enteric GNR
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Where is K antigen found?
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in the capsule of enteric GNR
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What are the general features of Escherichia coli?
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ferments carbs, indole pos, methyl red pos, VP neg, H2S production is neg, urease neg, can not use citrate as sole carbon
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What is the IMViC of E coli?
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"I = pos
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What does IMViC stand for?
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"I = indole red
M = methyl red V = Vogues proskauer C = citrate" |
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What is EHEC?
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E coli O157:H7 (aka Enterhemorrhagic E Coli)
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What is the IMVic of K pneumoniae?
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"I = neg
M = neg V = pos C = pos" |
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What is the IMViC of E cloacae?
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"I = neg
M = neg V = pos C = pos" |
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How do you differentiate K pneumo from E cloacae since the IMViC is the same?
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OD of E cloacae is purple. K pneumo is yellow
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Which of the following produce H2S in the TSI slant: Proteus, Pseudomonas, Shigella, Salmonella?
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Proteus and Salmonella
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What is the TSI results of Salmonella?
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R/Y or K/A
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What is the TSI results of Shigella?
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R/Y or K/A
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What is the TSI results of E coli?
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Y/Y or A/A
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What is the TSI results of Proteus?
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Y/Y or A/A
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What is the TSI results of Pseudomonas?
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R/R or K/K
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What does Serratia marcescens look like on MAC?
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bright red, brick red colonies, easy to determine
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What grows with a green sheen on EMB?
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E coli
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What is responsible for 3% of all nosocomial infections in the US?
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Proteus
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Which ones will produce gas in a TSI?
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E coli and Proteus
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What does indole detect?
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tryptophanase
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What does methyl red indicate?
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strong acid production
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What does Voges Proskauer detect?
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production of acetymethyl carbinol (acetoin) from glucose fermentation
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What does the citrate detect in the IMViC results?
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detects a bugs ability to utilize citrate as a sole source of carbon and nitrogen. Utilization of citrate will raise the pH in the tube and produce a blue color
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What are common selective media (stool media especially)?
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HE (hektoen enteric), Xylose Lysine Deoxycholate (XLD), Salmonella-shigella (SS), Cefsuldin-ingasan-novobiocin (CIN) and SMAC (macconkey-sorbitol)
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What is EMB?
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Eosin methylene blue, isolates enteric bacilli
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What is SMAC used for?
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to isolate E Coli O157:H7
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What is HE used for?
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isolates Salmonella and Shelgella from other organisms
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What is CIN used for?
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selective for Yersinia. But can also grow Aeromonas
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What is XLD used for?
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isolation of Salmonella and Shigella
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