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60 Cards in this Set

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BCYE agar
Legionella
Thayer-Martin agar
Neisseria
MacConkey
GNBs
RED: Escherichia, Klebsiella, Enterobacter

PINK: Citrobacer, Providencia, Serratia, Hafnia

NONE: Proteus, Edwardsiella, Salmonella, Shigella
SS agar
Shigells: Colorless
Salmonella: Colorless with black center
Red colonies: any lactose fermenters
ODOR
Grapes
Burned chocolate
Bleach
Apples
Musty
Cabbage
Horsebarn
Butter
Grapes - pseudomonas
Burned chocolate /feet - Proteus
Bleach - Eikenella (Mex hats)
Apples - Alkaligenes
Musty - Nocardia
Cabbage - Citrobacter
Horsebarn - CDiff
Butter - GBS
Catalase test
First step in ID gpc's
+: Staph or micrococcus
-: strep
Furazolidone susceptibility test
Staph (susc) vs. micrococcus (resistant)
Coagulase test
S aureus (+) vs other staph (-)
Novobiocin susceptibility
To distinguish among the coag-neg staphs

S saptophyticus: resistant
S epidermidis: susceptible
Salt tolerance test
To separate group D enterococci from group D non-enterococci

Enterococcus spp is salt tolerant
GDS is not (S bovis)
What is the name of this test?

What organism produces this definitive arrow when close to Staphylococcus aureus?

What would be the expected results for this organism for PYR and Esculin?
CAMP test
(used to ID GBS. The hemolytic activity of S aureus is enhanced by a protein made by GBS. ARROWHEAD)

Group B streptococci (Streptococcus agalactiae)

Negative for both
PYR test
(+) GAS, GDS, enterococcus
Bile esculin test
Enterococci & GDS hydrolyze esculin
Unique biochemical test for S pneumo
S pneumo is soluble in bile (colonies disappear when bile drop added)

Also it is optochin SENSITIVE
Lactose +, indole + colonies on MacConkey
E coli
Defining characteristics of the Enterobacteriaceae
1. Oxidase negative
2. Glucose fermentation
3. Nitrate reduction
Enterobacteriaceae that is methyl red negative/ Voges-Proskauer positive
Klebsiella. All others are MR+

(MR & VP are opposite)
Urease positive organisms
PROTEUS (rapid)

Kleb (slow)
Esculin hydrolysis
To distinguish the species of Pseudomonas
What test is used to identify Haemophilus spp?
Staph streak test

Staph aureus synthesizes V factor, and releases X factor. Haemophilus grows around Staph = Satellitism.
Ways to distinguish Neisseria spp?
CHO utilization (glucose+ N gon; maltose + N mening; lactose+ N lactamica. all 3 neg is M catarrhalis)

Superoxol test (rapid + is N gon)

DNAse (Moraxella is only gram - coccus that produces DNAse (vs Neisseria))
GPB

(Spore stain)
Spore forming GPBs:

** Bacillus (AEROBIC)
Catalase +
(anthracis, cereus 2 most common)

Clostridia (ANAEROBIC)
Anaerobic
Clostridia

Anaerobic spore-forming GPB

BOXCAR shape

Known for being gram variable

(perfringens, botulinum, tetani, difficile, septicum)
Staphylococci

GPCs in clusters
Streptococcus pyogenes

GPCs in chains
Streptococcus pneumoniae

Gram+ diplococci

Lancet shaped
S. pneumo

GPC

alpha hemolysis
Bile soluble
Optochin sensitive (vs viridans)
Nocardia

aerobic GPB
extensive branching
BEADED
Partially acid fast
Chalky white colonies on agar

DDx: Actinomyces (anaerobic, not acid fast)
Neisseria gonorrhea

Intracellular, gram- diplococci
Group A strep (S.pyogenes)

GAS has small colonies with large zone of beta hemolysis (PYR+)

vs GBS: larger colonies, smaller zone of hemolysis (PYR-)
Staph

Round, yellow-white, convex colonies

(yellow: coag+; s. aureus)
(white: coag-)
S. pneumo

DDx mucoid colonies:
Pseudomonas
Klebsiella pna
Strep pna
Cryptococcus neoformans

(mucoid = capsules)
Nocardia

aerobic gpb
(smells like basement)

Chalky white colonies

Also think of Streptomyces
Proteus

SWARMER
Major virulence factor of Group A Strep?

GAS PYR status?
M protein

Causes ARF, APSGN

also has 2 hemolysins:
-streptolysin O (antigenic; can measure antistreptolysin O titers)
-SLS (non-antigenic)

GAS is PYR+; Beta-hemolytic

GAS is S. pyogenes
What does S. pneumoniae cause?
Sepsis, endocarditis, meningitis.

#1 community acquired bact pna
#1 adult meningitis
50% OM

2 colony morphologies: mucoid vs. checkerboard; alpha-hemolysis, bile soluble, optochin sens

Lancet shaped; polysaccharide capsule
S. viridans
alpha or gamma hemolysis
normal flora upper resp & GU
40% bacterial endocarditis
poor oral hygeine
GPC

hydrolyzes esculin
grows with 6.5% NaCl
PYR+
Enterococcus

Previously a group D strep (like s. bovis which also hydrolyzes esculin)

PYR POSITIVE
Hydrolyzes esculin

nl GI, GU, biliary
UTIs
Is staph beta-hemolytic?
Can be, especially S. aureus.
Do we worry about coag negative staph?
Yes.

S. epidermidis: #1 cause of CNS infections

S. saprophyticus: UTIs
GPC
catalase+
coagulase -
NOT staph

ID characteristics?
Micrococcus.

Do Furadolozone test (RESISTANT)
vs. staphs (susceptible)
yellow GPC
catalase+
coagulase -
novobiocin resistant
Staph saprophyticus

r/o in urine of women of childbearing age

(vs. S epidermidis: novobiocin SENSITIVE)
GNB
lactose -
indole -
urease -

DDx?
Nonmotile:
Shigella sonnei vs. Yersinia pestis

Motile: Salmonella (H2S) vs. Serratia (red)
H2S producing?
Proteus
Salmonella
Citrobacter
GNB

oxidase+
pseudomonas

metallic sheen
grapey odor
How to differentiate Pseudomonas spp?
Flo & Tech agar (tubes)

P. aer: only one to produce PYOCYANIN (blue on TECH)

Pyoverdin: yellow on FLO (P. aer, P. fluorescens, P. putida). FLUORESCES under UV light.
Gram negative coccobacilli
Moraxella
Acinetobacter (can retain stain)
Campylobacter jejuni

pleomorphic GNBs; curved spirals; seagulls

microaerophilic
oxidase-

causes diarrhea
Positive string test seen with Vibrio cholerae

Vibrio facts:
GNR
oxidase+
glucose fermenting
non-lactose fermenting
luminescent pigment
Haemophilus

small, poorly staining GNBs

**does not grow on SBA unless with staph. Grows on chocolate
Haemophilus satellitism

Staph streak on SBA. RBCs make X factor; staph makes V factor. Haem grows around staph; small colonies.
Fusobacter

Anaerobic GNB

Long slender; pointed ends
Anaerobic GNC
Veilonella is the only clinically important one!

Can cause endocarditis, bacteremia
Nl mouth, UR, GI, GU
Anaerobic GPC
Peptostreptococcus
Staph saccharolyticus
Gemella
Anaerobic GNB
Bacteroides
Prevotella
Porphyromonas
Fusobacter
Prevotella

Grows tan or black colonies

Prevotella/Porphyromonas has BRICK RED fluorescence under UV light
Anaerobic GBP, non-spore forming:
Actinomyces
Propionibacter
Lactobacillus
Anaerobic GPB with spores:
CLOSTRIDIUM

#1 clinically significant: C perfringens. can be nl. rare spores. double zone hemolysis. boxcar on gram stain. nonmotile

C septicum: associated with colon ca. SWARMS.
What 3 drugs to we use to identify the anaerobic GNBs?
Kanamycin
Penicillin
Rifampin
What are the K/P/R patterns for the anaerobic GNBs?
Bacteroides: R/R/S

P/P: R/S/R (although P bivia R/S/S)

Fusobacter: S/S/S