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100 Cards in this Set
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Salmonella
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Morph: Clear on MAC, with black center on HE/XLD Oxidase: negative ONPG: negative H2S: positive Motile LDC: positive Found in poultry, typhoid fever, bacteremia |
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Helicobacter pylori |
Growth: nonselective media @ 37 in Campy incubator. Doesn't grow at 42. Slow growing Urease positive Rarely cultured. Rapid urease tests on gastric biopsy, urea breath test, PCR, serology. Gastritis, duodenal & peptic ulcers. Risk for gastric carcinoma. |
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Morganella morganii |
Oxidase: negative Lactose non-fermenter Indole: positive Motile ODC: positive MR: positive Citrate: negative PD: positive++ Urease: positive++ H2S: negative VP: negative Nosocomial, UTI, Wounds |
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Neisseria lactamica
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Morph: will growth on Thayer-Martin, resembles N. meningitidis but smaller. Glucose: positive Lactose: positive Maltose: positive ONPG: positive Normal respiratory tract of children. Must differentiate from N. meningitides by ONPG. |
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Shigella |
Morph: Clear on MAC Oxidase: negative Citrate: negative H2S: negative Non-motile MR: positive Most communicable bacterial diarrhea. Serotyping based on O antigens. S. Dysenteriae=serogroup A, mannitol and ONPG negative S. Sonnei=serogroup D, mannitol and ONPG positive, ODC positive |
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Edwardsiella tarda |
Morph: Clear on MAC, with black center on HE/XLD Oxidase: negative Citrate: negative VP: negative Urease: negative Indole: positive***, diff from Salmonella MR: positive H2S: positive Opportunistic, bacteremia, wounds. Lives in reptiles and freshwater fish. Positive indole differentiates from Salmonella. |
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Bacillus Species |
GS: Large GPR w/endospores Morph: Large, flat, beta hemolytic Facultative anaerobe Catalase: positive Motile Normal flora of skin |
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Corynebacterium Species |
GS: Club shaped/beaded with irregularly staining granules, pleomorphic, palisading. No spores Catalase: + Non-motile Bile esculin: - Normal flora of skin |
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Listeria monocytogenes |
GS: Small GPR (almost coccal) may be in pairs or short chains. No spores. Morph: small zone beta hemolysis. Small round, smooth, translucent. Facultative anaerobe. Catalase: positive Tumbling motility “umbrella shaped” Esculin hydrolysis: positive Sodium hippurate: positive AST: Susceptible to Penicillin, ampicillin, amino glycoside Resistant to any cepham Can grow at 4° C. Contaminated lunch meat/dairy. Neonates, elderly, alcoholics, Pregnant females. Bacteremia and meningitis in immunosuppressed. |
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Bacillus anthracis |
GS: Large, square-ended,GPR in singles/chains. Central spores not present in clinical samples. Morph: Non-hemolytic, large, gray flat colonies with irregular margins (Medusa head) Tube catalase: positive Tube motility: Non motile VF: capsule, exotoxins. AST: Penicillin sensitive, CDC recommends ciprofloxacin or doxycylcine Cutaneous and pulmonary infection. B. Cereus=same but Beta hemolytic, motile |
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Staph aureus |
GS: GPC, clusters Morph: opaque, smooth, white-golden, beta Mannitol salt agar: yellow colony, yellow zone Catalase: positive Coagulase: positive Latex Agglutination: positive PYR: negative AST: Yes, MRSA VF: Clumping factor (id'd by slide coagulase), Coagulase, Fibrinolysin, Hyaluronidase, Beta-lactamase, exotoxins, protein A (blocks phagocytosis) -normal flora of skin, opportunistic pathogen Otitis media, sinusitis, pneumonia in immunocompromised. Eye, Ear, Wound infections, osteomyelitis. |
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Staph saprophyticus |
GS: GPC in clusters Morph: Opaque, smooth, raised, glossy white-yellow, non-hemolytic Catalase: positive Coagulase: negative Bacitracin: Resistant Novobiocin: Resistant AST: Not routinely done UTI in young women |
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Staph lugdunensis |
GS: GPC clusters Morph: Opaque, very white, non-hemolytic, can be beta. Catalse: positive Coagulase: negative Latex Agglutination: positive but clumpy Polymyxin: Resistant Rapid ornithine: positive Bacitracin: Resistant PYR: positive AST: Same guidelines as Staph aureus. ID to species level. May possess mecA Seen in aggressive endocarditis septicemia, meningitis, skin and soft tissue infections, UTI and septic shock |
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Staph epidermidis |
GS: GPC clusters Morph: opaque, smooth, raised, gray-white, non-hemolytic Catalase: positive Coagulase: negative Bacitracin: Resistant Novobiocin: Susceptible VF: PGA capsule (adherence), Biofilm (inhibit antimicrobial peptides) AST: Routine Normal skin flora, UTI, meningitis, subacute bacterial endocarditis, wound, peritonitis, after surgery, prosthetic devices |
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Strep pyogenes |
GS: GPC in chains Morph: large zone beta hemolytic, small, glossy, smooth Catalase: negative PYR: positive Bacitracin: Sensitive VF: M protein, lipoteichoic acid and Protein F, Erythrogenic toxin (scarlet fever), Streptolysin O, S, Hyaluronidase, DNase, NADase, Streptokinase AST: Susceptible to Penicillin Group A strep throat, acute glomerular nephritis, rheumatic fever, Erysipelas, Impetigo, Cellulitis, Scarlet Fever, Puerperal fever, Necrotizing fasciitis, TSS Direct rapid antigen testing available for throat specimens. |
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Strep agalactaie |
GS: GPC chains Morph: beta hemolytic Chromagar: pink Catalase: negative PYR: negative Na Hippurate: positive Bacitracin: Resistant CAMP test: positive AST: Susceptible to Penicillin Normal flora of vaginal tract. Invasive disease of the newborn, vaginitis, osteomyelitis |
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Strep pneumo |
GS: GPC-lancet shaped in pairs Morph: checker or mucoid, alpha hemolytic Catalase: negative Optochin: sensitive Bile solubility: positive Urine antigen test AST: screen for penicillin resistance using KB disk. Use Mueller-Hinton with 5% sheep's blood incubated in CO2 If oxacillin zone <19, MIC test needed Normal resp. flora in rare amounts. Must be present in nasopharynx and pt deficient in antibody. Community acquired bacterial pneumonia, Otitis media, sinusitis |
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Bordatella pertussis |
GS: small, faint GNCB Morph: fastidious, Bordet=slightly beta, smooth, shiny, bisected pearls. Regan-Lowe=domed and shiny with pearl luster, BAP=no growth, MAC=no growth Oxidase: positive Nitrate: negative Urea: negative Non motile VF: exotoxin, cell wall endotoxin, pertussis toxin causes systemic effects Nasopharyngeal swab is specimen of choice DFA, PCR AST: not routine. Erythromycin drug of choice. Vaccination! Whooping cough/Pertussis |
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Bordetella parapertussis |
GS: faint GNR Morph: Bordet/Regan=gray-brown, beta hemolytic. BAP=growth, MAC=variable. Oxidase: negative Urea: positive Non-motile Nitrate: negative Mucous membranes, acute respiratory tract infection |
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Bordatella bronchiseptica |
GS: faint GNR Morph: Bordet/Regan=Large, flat, dull beta hemolytic. BAP=growth, MAC=growth Oxidase: positive Urea: positive Motile Nitrate: positive DFA & PCR used. Serology: four-fold rise in titer Mucous membranes animals. Respiratory infection in animals. Wound, blood, respiratory infections in immunocompromised. |
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Francisella tularensis |
GS: Pale, very tiny GNCB Morph: BAP=no growth, Choc=small, gray white, smooth at 48 hrs, MAC=no growth Grows on Thayer Martin and BCYE Oxidase: negative Tube Catalase: negative or weak pos Urease: negative Beta lactamase: positive Ferments glucose Non-motile Requires cysteine for growth Incubate at 35C with 5-10% CO2 for 7 days Ulcer formation at site of inoculation, enlargement of lymph nodes CDC Category A DFA, PCR, Serology testing AST: not routine. Streptomycin/doxycycline drug of choice. Direct contact with infected animals (rabbits). Common laboratory acquired infection. |
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Legionella pneumophila |
GS: faint, short GNR Morph: BAP and MAC=no growth. Choc=may grow slowly. BCYE=convex, grayish white, glistening, ground glass yellow-green fluorescence with Wood's Lamp Oxidase: weak pos Catalase: weak pos Gelatin: pos Motile: positive by polar flagella Organism exists in natural/man-made water systems and soil. Urine Antigen Test common. AST: Not routine. Macrolide drug of choice. Community acquired pneumonia Legionnaires: malaise, myalgia dry cough and fever. Fatal if not treated. Pontiac fever: fever, headache, no pneumonia |
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Haemophilus influenzea |
GS: Pleomorphic tiny GNCB, Capnophilic, Fastidious Morph: Requires both hemin and NAD. Choc=tannish, translucent, mousy odor. BAP=no growth, MAC=no growth. Capnophilic (5-10% CO2) Exhibits satellitism on SBA around NAD (V) Catalase: positive Oxidase: positive Porphyrin: no fluorescence. Non-hemolytic on horse blood. VF: capsule AST: Beta-lactamase testing. Ampicillin resistance developing. Must use Mueller-Hinton supplemented with X and V. Respiratory infections (community acquired pneumonia in children and elderly), conjunctivitis, Otitis Media, normal flora in man Treatment: Life-threatening: Cefotaxime/ceftriazone. Non-life threatening: Amoxicillin-clavulanate. |
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Haemophilus parainfluenzae |
GS: GNCB Morph: Requires V factor for growth Porphyrin: red-orange fluorescence |
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Haemophilus ducreyi |
GS: GNCB, school of fish Morph: Requires X factor for growth. Choc=small, gray, yellow/tan. Hard to pick up Painful genital ulcers |
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Stenotrophomonas maltophilia |
GS: GNR Morph: pale yellow to lavender green color. No growth at 42 Oxidase: negative** Catalase: positive Motile** LDC: positive DNase: positive Polymyxin: Susceptible Glucose: oxidizer Maltose: strong oxidizer AST: Susceptible to trimethoprim-sulfamethoxazole, resistant to many abs Respiratory infections, nosocomial infections, cystic fibrosis, not normal flora Ammonia odor |
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Pseudomonas aeruginosa |
GS: GNR Morph: Spreading, flat, irregular edge, gray-green with metallic sheen MAC=clear Glucose: oxidizer Oxidase: positive Catalase: positive Growth at 42 ADH: positive Nitrate: positive Motile Polymyxin: Susceptible VF: Pili, endotoxin, exotoxin A, proteolytic enzymes, slime/capsule AST: Resistance to common antibiotics. (ampicillin) Susceptible to aminoglycosides, some 3rd and 4th generation cephalosporins COPD, Otitis externa, pneumonia, cystic fibrosis patients |
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Burkholderia cepacia |
GS: GNR Morph: smooth, slightly raised, mucoid, strong earthy odor. MAC=punctate and tenacious, may be dark pink-red. OFPBL=yellow. PC=pink. Glucose: oxidizer Oxidase: weak positive LDC: positive Polymyxin: Resistant Motile AST: Resistant to aminoglycosides. Susceptible to trimethoprim-sulfamethoxazole. Opportunistic for cystic fibrosis patients. |
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Acinetobacter |
GS: plump GNR in pairs, GNCB Morph: Translucent, convex. MAC=colorless/slightly pink, purplish Oxidase: negative** Catalase: positive Nitrate: negative Glucose: oxidizer or Intermediate Nonmotile AST: Resistant to variety of antibiotics. Susceptibility must be performed. Normal skin/vaginal flora. Opportunistic, nosocomial infections of respiratory tract, UTI, wounds, blood. |
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Alcaligenes/Achromobacter |
GS: GNCB Morph: flat, thin, spreading, rough. Apple odor Oxidase: positive Glucose: oxidizer Urease: negative Motile LDC: negative AST: varies, must perform. nosocomial infections, cystic fibrosis patients
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Moraxella catarrhalis |
GS: GNDC Morph: smooth, opaque, gray-white, hockey puck Catalase: positive Oxidase: positive DNase: positive Nitrate: positive Butyrate Esterase: positive No growth on Thayer Martin AST: Not routine, Beta lactamase testing (most are positive) May be normal respiratory flora. Pneumonia, bronchitis in immunocompromised, otitis media, maxillary sinusitis |
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Neisseria gonorrheae |
GS: GNDC Morph: Choc=small, tan translucent Chocolate & Thayer Martin, 2-8% CO2 Oxidase: positive Carb: Dextrose positive DNase: negative Nitrate: negative Butyrate: negative Pro: positive AST: Not routine. Beta lactamase testing Gonorrhea, pharyngitis |
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Neisseria meningitidis |
GS: GNDC Morph: bluish gray, smooth, convex, glistening on BAP. Choc=small, tan, convex. Chocolate & Thayer Martin, 2-8% CO2 Oxidase: positive Carb: Dextrose, maltose positive Glut: positive ONPG: negative DNase: negative Nitrate: negative Butyrate: negative VF: pili, capsules AST: not routinely done. Beta lactamase testing. Meningitis in close populations. Common laboratory acquired infection. |
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Nocardia |
GS: Branching GPR, beaded Morph: Aerobic growth, chalky, matte, velvety or dry and crumbly. Will grow on BAP, mycology media, LJ media. Partially acid-fast positive. Catalase: positive sulfur granules Mycetoma, lymphocutaneous infection, skin abscess, Pulmonary infection |
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Mycobacterium tuberculosis |
GS: Does not stain, high lipid content. Appears GPR and beaded. Acid-fast: red Slow growing Morph: LJ media: small, dry, rough, buff-colored. "rough and buff" Tuberculosis Found in water, soil, animals. Aerobic. Slow growing (high lipid content). Niacin positive Nitrate positive Heat stable catalase negative Primary, Latent, Reactivation of disease AST: sent out, >1% of bacilli in test population resistant. Treatment: multi-drug regimen. Long treatment (6-9 months) |
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Corynebacterium diphtheriae |
GS: club-shaped, beaded, pleomorphic, palisading GPR Morph: Plate to Loeffler's, Tellurite plate: black GPR. Brown halo around colony. BAP: white Incubate 35C, CO2, 24-48 hours Non-lipophilic Catalase: positive Non-motile Glucose and Maltose fermenter Urea: negative Toxigenic: infected by beta-bacteriophage Albert's stain: metachromatic granules on Loeffler media Must demonstrate toxin production: guinea pig, ELEK, EIA, PCR for tox gene. Treatment: antitoxin. Prevention: DPT immunization. Disease of respiratory tract. Death by congestive heart failure. |
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Corynebacterium jekeium |
GS: Pleomorphic, club-shaped in V forms GPR. Morph: BAP: 48-72 hrs, 5% CO2, small, gray to white, non hemolyic Lipophilic Catalase: positive Glucose: oxidizer Sucrose: negative Urea: negative Nitrate: negative AST: resistance to multiple antibiotics. Susceptible to vancomycin. Immunosuppressed patients--septicemia, meningitis, pulmonary disease. Diphtheroid prosthetic valve endocarditis. |
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Mycobacterium bovis |
Part of M. tuberculosis complex Slower growing than M. tuberculosis Morph: buff, small, smooth/rough Primarily in cattle, can cause pulmonary disease in humans |
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Mycobacterium kansasii |
Symptoms similar to M. tuberculosis. Growth: 2-3 weeks at 37 Morph: rough centers with smooth edges. GS: acid fast longer, thicker, more beaded. Niacin negative Nitrate positive. Yellow to orange pigment production after exposureto light. Pulmonary disease. DNA probes available. Found in tap water. Treatment: multi-drug regimen. Known resistance to pyrazinamide. |
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Mycobacterium marinum |
GS: acid fast, long rods. Growth: 5-15 days at 28-30 C Morph: buff in dark, yellow in light Niacin variable Nitrate negative Yellow to orange pigment after light exposure. Skin lesions (swimming pool granuloma) |
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Mycobacterium gordonae |
Produce pigment in both light and dark. Urease negative Rarely associated with disease. Found in tap water/soil. |
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Mycobacterium scrofulaceum |
Produce pigment in both light and dark. Cervical lymphadenitis in children. Biochemical ID Treatment: surgical incision and drainage. |
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Mycobacterium avium complex |
GS: acid fast positive Growth: 3-6 weeks at 37 Morph: vary from smooth, thin and transparent to rough. Nonpigmented or buff Non photo-reactive Niacin negative Nitrate negative Tellurite reduction positive DNA probes available Chronic pulmonary disease Disseminated disease especially in AIDS. Infection from inhalation or ingestion. |
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Mycobacterium fortuitum-chelonae complex |
GS: acid fast. Growth: Rapid grower, 3-7 days at 30 or 35 Morph: smooth to rough, may be filamentous. Nonpigmented to buff with/without light. Arylsulfatase positive at 3 days. Growth on MAC without crystal violet. Skin/soft tissue, pulmonary disease M. fortuitum: nitrate positive M. chelonae: nitrate negative Primarily found in surgical wounds or trauma. |
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Mycobacterium leprae |
Causes leprosy. Obligate intracellular parasite. Will not grow on artificial media. Diagnosis based on clinical presentation and acid fast stain of biopsy. |
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Beta-lactams |
Inhibit cell wall synthesis -Penicillins -Cephalosporins (cefotaxime, ceftriaxone, ceftazidime) -Monobactams (aztreonam) -Carbapenems (imipenem, meropenem) Beta-lactamase: hydrolyze the beta-lactam ring in antibiotics |
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Inhibit protein synthesis |
Aminoglycosides |
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Inhibit protein synthesis |
Macrolides |
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Inhibitions of folic acid synthesis |
Sulfa compounds |
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Interfere with nucleic acid synthesis |
Nalidixic acid/ciprofloxaxin Levofloxacin/Quinolones/fluoroquinolones |
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Inhibit cell wall synthesis |
Glycopeptides |
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Inhibit protein synthesis |
Chloramphenicol |
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Inhibit protein synthesis |
Tetracycline |
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Enterococcus |
GS: GPC in chains Morph: small, grey, smooth Catalase: weak positive PYR: positive Bile esculin: positive Growth in 6.5% NaCl Endocarditis, UTI, wound, nosocomial infections. AST: Vanco resistant strains (incubate full 24 hours). Must do testing. Resistance to aminiglycosides, beta-lactams, glycopeptides When isolated from sterile sites use synergy screen. Do beta-lactamase on blood and CSF. |
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Streptomyces |
GS: GPR, branching, chains Morph: Aerobic growth, waxy, bumpy, velvety rugose, cream to brown-black. Will grow on BAP, mycology, LJ Aerobic Acid-fast negative Mycetoma |
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Actinomyces |
GS: Branching GPR Facultative anaerobe, Molar tooth Abcesses in mouth, lungs, GI tract. Lumpy jaw, subcutaneous infection. Mycetomas Not acid fast |
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E. coli |
GS: GNR Morph: Non-swarming, beta EMB: metallic sheen Oxidase: negative Indole: positive Citrate: negative VP: negative PYR: negative Lactose fermenter MR: positive Rapid tests to detect toxin: EIA, PCR Mac-Sorbitol: O157:H7 will grow clear. Enterohemorrhagic produces shiga like toxin Mechanisms of resistance: Beta-lactamase, ESBL, carbapenemase production #1 agent of UTI
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Klebsiella pneumoniae |
GS: GNR Morph: mucoid, Pink on MAC Lactose fermenter Glucose fermenter Oxidase: negative Nitrate: positive ODC: negative LDC: positive Indole: negative Citrate: positive VP: positive Non-motile PD positive (slow) VF: large capsule AST: Known resistance to ampicillin Destructive pneumonia |
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Klebsiella oxytoca |
GS: GNR Morph: mucoid, pink on MAC Lactose fermenter Oxidase negative Glucose fermenter Nitrate positive ODC: negative LDC: positive Indole: positive Citrate: positive VP: positive PD positive (slow) Non-motile |
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Citrobacter freundii |
GS: GNR Oxidase: negative Lactose fermenter/variable Glucose fermenter Nitrate: positive LDC & LDA negative ONPG: positive Motile Produces H2S KCN positive ONPG positive*, diff from salmonella LDC neg* Nosocomial infections of respiratory, urinary, blood. |
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Serratia |
GS: GNR Oxidase negative Glucose fermenter Nitrate: positive Produces red pigment on SBA and MAC Lactose nonfermenter VP positive like Kleb, Entero LDA/TDA negative Nosocomial infection |
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Enterobacter cloacae |
GS: GNR Oxidase negative Nitrate positive Glucose fermenter Lactose fermenter ODC: positive LDC: negative Indole: negative Citrate: positive VP: positive Motile Resistance to ampicillin and 1st generation cephalosporins Opportunistic pathogen |
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Proteus mirabilis |
GS: GNR Morph: spreading Oxidase negative Glucose fermenter Nitrate positive Lactose Non-fermenter Urease: positive++ H2S: positive ODC: positive Indole: negative LDA/TDA: positive Ampicillin: Sensitive Resistant to nitrofurantoin and tertracycline Burned chocolate odor |
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HACEK organisms |
Haemopophilus parainfluezae Aggregatibacter species Cardiobacterium species Eikenella species Kingella species Subacute bacterial endocarditis in blood cultures. |
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Brucella species |
GS: small GNCB, faint but discrete. Can be mistaken for GPC. Morph: non-pigmented, non-hemolytic, moist, convex, may take 48-72 hours. Oxidase: positive Tube catalase: positive Urease: positive Nitrate: positive Glucose: oxidizer Treatment: Doxycycline and rifampin Hold in blood culture system 21 days. Direct contact with infected animals. Cause of brucellosis. Common laboratory acquired infection |
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Burkholderia pseudomallei |
GS: small, straight or slightly curved GNR Bipolar staining, safety pins. Poor growth at 24 hour. Morph: white colonies on BAP. Nonpigmented, nonhemolytic, wrinkled >72 hours. Growth on MAC (trigger point) variable. Oxidase: positive Tube catalase: positive Indole: negative Tube motility: positive Arginine: positive Growth at 42C. Melioidosis. Bone marrow, blood, tissue, urine, respiratory. |
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Yersinia pestis |
GS: medium sized, plump GNR Morph: pinpoint, gray-white, translucent on BAP. Small non-lactose fermenter on MAC. Grows at 25C. Older cultures: fried egg or hammered copper. Oxidase: negative Tube catalase: positive Indole: negative Urease: negative Tube motility: Non motile Cause of plague. Transmitted by flea bite. |
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Burkholderia mallei |
GS: faintly staining gram negative, straight or slightly curved rod with rounded ends. May be in pairs end-to-end. Morph: smooth, gray, translucent at 48 hrs. Poor/slow growth. Oxidase: negative Indole: negative Urease: negative Tube motility: negative Arginine: positive No growth at 42C. Cause of glanders. |
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Gemella |
GS: GPC pairs and chains, easily over decolorized Morph: resemble strep viridans, alpha or gamma, anaerobe PYR: variable Vanco: sensitive Glucose: non Fermenter Bile esculin: negative No growth in NaCl Opportunistic. Endocarditis, septicemia, wounds, abscesses, respiratory. |
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Streptococcus viridans |
GS: GPC chains Morph: tiny, gray, domed, alpha hemolytic Optochin: resistant Bile soluble: negative Bile esculin: negative No growth in NaCl LAP: positive Most common cause of subacute endocarditis. Liver abscesses, bacteremia. |
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Bacteroides fragilis |
GS: GNR, pale staining, pleomorphic. Safety pin. Morph: AnaBAP: non-hemolytic, white to gray, circular, smooth, convex. BBE: gray with browning medium. KV: growth Esculin hydrolysis: positive Colistin: Resistant Bile: Resistant. Growth on KV agar. Most common anaerobe isolated in lab. |
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Clostridium perfringens |
GS: Large GPR, terminal or subterminal spores. "box cars" Morph: double zone beta hemolysis. Rough, spreading KV agar: no growth Egg yolk: white, cloudy. Lecithinase positive. Obligate anaerobe. Litmus milk: stormy Non-motile Food poisoning: ingestion of entero-toxin strains. Beta and alpha toxins. Bloody diarrhea. Can be fatal. Treatment: Fluid replacement. Gas gangrene: wounds. Release exotoxins, alpha toxin causes necrosis of issue. Treatment: amputation of dead tissue. Massive doses of penicillin. Hyperbaric oxygen. Bacteremia. |
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Abiotrophia |
GPC: GPC in chains Nutritionally deficient Non-motile Requires Vitamin B6, pyridoxal to grow Normal flora, endocarditis |
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Pediococcus species |
GS: GPC pairs, tetrads, clusters Catalase: negative Morph: Resemble strep viridans. Can be alpha or gamma. PYR: negative LAP: positive Vanco: resistant Glucose: fermenter Bile esculin: positive Group D antigen positive** Opportunistic pathogen.
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Gemella |
GS: GPC pairs and chains, easily over decolorized Morph: resemble strep viridans, alpha or gamma PYR: variable Vanco: sensitive Glucose: non Fermenter Bile esculin: negative No growth in NaCl Opportunistic. Endocarditis, septicemia, wounds, abscesses, respiratory. |
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Leuconostoc |
GS: GPC in pairs and chains. Can be coccobacilli. Morph: anabap Resemble strep viridans. Alpha or gamma. Catalase: negative PYR/LAP: negative Glucose: fermenter Vanco: resistant Bile esculin: positive Opportunistic: septicemia, wounds, CSF |
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Erysipelothrix rhusiopathiae |
GS: short gpr and long filamentous rods. No spores. Morph: microaerophilic, non-hemolytic or alpha, pinpoint Catalase: negative Esculin hydrolysis: negative Nitrate: negative Urease: negative Non-motile "Test tube brush" growth pattern H2S positive Resistant to vancomycin AST: Penicillins, cephalosporins, erythromycin, clindamycin. In swine, direct contact with infected animal. Skin disease with intense pain (erysipeloid) Rare cases becomes serious: septicemia, endocarditis. Relapses common. |
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Lactobacillus |
GS: GPR, very pleomorphic. Long, slender in chains or short choccobacilli. No spores Morph: Aerotolerant anaerobes. Pinpoint alpha-hemolytic to medium rough gray. Catalase: negative Sucrose: fermenter Resistant to Vancomycin. Rarely pathogenic. Rare cases of endocarditis and meningitis. |
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ESBL |
E. Coli, proteus mirabilis, kleb species. Resistance to extended spectrum cephalosporins (cefotaxime, ceftriaxone, ceftazidime), monobactams. Clues: Azteronam and/or ceftazidime "I" or "R", yet other beta lactams "S" Normal patterns of resistance not followed. Aztreonam <27 or >2. Cefotaxime (R) with cefotaxime/clavulanic acid (S)=confirmed ESBL |
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Carbapenemases |
Screen Enterics for carbapenemase "I" or "R" to one or more carbapenems. Also resistant to subclass III cephalasporins Treat with colistin or polymixin |
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Inducible clindamycin resistance (D-zone test) |
Erthyromycin "R" and Clindamycin "S" staph or strep pneumo screen. Flattened zone (D) between two disks indicates inducible clindamycin resistance. |
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Vibrio vulnificus |
GS: straight or slightly curved GNR Morph: BAP: medium to large colonies that appear smooth, opaque, and iridescent with greenish hue. Mac: pink Oxidase: positive Glucose: fermenter Lactose: variable Sucrose: variable ODC: variable LDC: positive Indole: positive No growth in 0% salt Variable growth in 6% salt Intestinal, aquatic wound infections |
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Eikenella corrodens |
GS: small, slender, GNR Morph: tiny colonies at 48 hours. "Pits" the agar. Pale yellow pigment. Greening around colony. Bleach odor. No growth on MAC. Aerobic. Requires hemin. Oxidase: positive Catalase: negative Glucose: non-oxidizer Nitrate: positive Nonmotile AST: Not routine. Treat with penicillin, 3rd generation cephalosporins, tetracycline, quinolones. Normal flora of mouth, respiratory, GI tract. Opportunistic pathogen. Dental, neck, abscesses, human bite wounds, septicemia, endocarditis. |
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Strep anginosus |
GS: GPC chains Morph: may be alpha, beta, or no hemolysis. If beta, twice the size of the colony. Honeysuckle or butterscotch odor. Catalase: negative Optochin: Resistant Bile esculin: negative May have A, C, F, G, or no Lancefield antigen. Normal oral and GI flora. Deep wound infection. Abscess formation in oropharynx, brain, peritoneal cavity. |
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Pasteurella multocida |
GS: short, straight GNR Morph: convex, smooth, gray, nonhemolytic. Musty or mushroom odor. No growth on MAC. Oxidase: positive Catalase: positive Indole: positive ODC: positive Urease: negative Penicillin: Very Sensitive Glucose: fermenter (apple green) Polar flagella Wound infections (animal bites). Meningitis, brain abscess, abdominal abscess, septicemia, pulmonary infections. |
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Aeromonas |
GS: straight GNR Morph: beta hemolytic, growth on MAC (NLF) Lactose: variable Inositol: non fermenter Sucrose: fermenter Oxidase: positive** Glucose: fermenter LDC: positive ADH: positive Indole: positive Esculin: positive Gelatin: positive ODC: negative Growth in 0% salt No growth in 6% salt Diarrhea, UTI, Wound infections, septicemia, osteomyelitis. |
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Plesiomonas |
GS: pleomorphic GNR, singlels, pairs, chains Morph: nonhemolytic* BAP, clear on MAC Oxidase: positive** Glucose: fermenter Lactose and Sucrose: non fermenter Inositol: fermenter LDC: positive ADH: positive ODC: positive Indole: positive Dnase negative Vp negative Esculin: negative Gelatin: negative Growth in 0% salt No growth in 6% salt Found in fresh water. Gastroenteritis. |
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Vibrio vulnificus |
GS: straight or slightly curved GNR Morph: BAP: mediumto large colonies that appear smooth, opaque, and iridescent with greenish hue. Mac: pink TCBS agar: colony is green. Growth on MAC Oxidase: positive Glucose: fermenter Lactose: variable Sucrose: variable ODC: variable LDC: positive Indole: positive No growth in 0% salt Variable growth in 6% salt Intestinal, aquatic wound infections |
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Prevotella |
GS: GNR in pairs, short chains Morph: colonies turn black or fluoresce brick red under long-wave UV lights with age. KV: growth No growth on BBE Oral, vaginal flora. Anaerobic infection of respiratory tract, abscesses in mouth, bites, UTI, osteomyelitis, bacteremia. Periodontal disease. |
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Porphymonas |
GS: GNCB Morph: turn brown/black or fluoresce brick red. KV: no growth Normal flora of oral cavity, GI tract |
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Fusobacterium |
GS: GN fusiform morphology. Vanco: resistant Colistin: susceptible Kanamycin: susceptible Will grow on KV Indole: positive Fluoresce chartreuse. Normal flora of oral cavity, GI, genital tract. |
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Veillonella |
GS: GNC Morph: Anaerobe, weak red fluorescence under UV light Catalase: positive Nitrate: positive Rare cases of osteomyelitis and endocarditis |
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Elizabethkingia meningoseptica (chryseobacterium) |
GS: thin GNR Morph: growth on BAP, no growth on MAC Oxidase: positive Glucose: delayed oxidizer Indole: weak positive Nonmotile Found in environment. NOT normal flora. Nosocomial and opportunistic pathogen. Neonatal meningitis and sepsis |
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Voges Proskauer reaction |
Positive=red Reaction of alpha napthol and diacetyl |
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Peptostreptococcus anaerobius |
GS: GPC in chains Morph: anabap small white gray. Sweet odor. Sensitive to SPS. Normal flora mouth, GI. Infections of skin, soft tissues, gi tract, female genital tract, bones, joints, lungs, brain. |
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Finegoldia magna |
GS: GPC clusters Morph: anabap small colonies Catalase negative Indole negative Resistant to SPS Normal flora on skin. Most common isolated/pathogenic anaerobic GPC |
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Propionibacterium |
GS: GPR, club shaped. Diptheroid-like. Anaerobe Catalase positive Indole positive Most common anaerobe GPR. Normal skin flora. |
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Lactobacillus |
GS: pleomorphic, long, thin, non spore forming GPR. Aerotolerant anaerobe. May resemble S. Viridans. Catalase negative. Normal flora of mouth, GI, vagina. Produces lactic acid. |
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Campy jejuni |
Curved GNR, "seagulls" Grown on campy bap, slow growing Darting corkscrew motility Oxidase: positive Catalase: positive Hippurate hydrolysis: positive |
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Vibrio cholerae |
GNR Growth: TCBS--yellow colonies Growth at 0% salt, 6% salt Oxidase positive Motile Rice water stools. Serological ID with antisera to O antigen. Notify public health. |
