Aerobic Bacterial Infections of Soft Tissue

Question 1

Name the 4 bacteria in the Pseudomonas/Burkholderia group. Are they Gram(+) or (-)?

Answer 1

P. aeruginosa, B. cepacia, B. pseudomallei, and B. mallei; Gram(-)

Question 2

Are the Pseudomonas/Burkholderia bacteria aerobic or anaerobic, obligate or facultative, and do they express oxidase?

Answer 2

Obligate aerobic (so nonfermenting), oxidase (+)

Question 3

Which of the Pseudomonas/Burkholderia is most commonly seen in the hospital setting?

Answer 3

Pseudomonas aeruginosa

Question 4

Give 4 ways that P. aeruginosa might be acquired in the community.

Answer 4

IV drug needles (endocarditis), underchlorinated hot tubs (otitis externis/folliculitis), sneaker punctures (osteochondritis), and under contact lenses (corneal infections)

Question 5

What patient population is most at risk from Pseudomonas/Burkholderia infections?

Answer 5

Cystic fibrosis patients

Question 6

What 2 factors give the Pseudomonas/Burkholderia natural antibiotic resistance? Which bacteria has the greatest resistance?

Answer 6

Low permeability of outer membrane + efflux pumps; P. aeruginosa is the most resistant

Question 7

Cystic fibrosis pneumonia is the primary presentation of which bacteria?

Answer 7

Burkholderia cepacia

Question 8

Which bacteria, also known as melioidosis, is found in veterinarians in developing countries, in travelers/immigrants, and in Vietnam veterans?

Answer 8

Burkholderia pseudomallei

Question 9

Which nonmotile bacteria, also known as glanders, is found in veterinarians in developing countries or in travelers/immigrants with a history of handling animals?

Answer 9

Burkholderia mallei

Question 10

Which of the Pseudomonas/Burkholderia infections can present with pneumonia and septicemia?

Answer 10

All of them (P. aeruginosa, B. cepacia, B. pseudomallei, and B. mallei)

Question 11

Which of the Pseudomonas/Burkholderia bacteria lives in animal reservoirs but not in the environment?

Answer 11

Burkholderia mallei

Question 12

Which of the Pseudomonas/Burkholderia bacteria easily cultures with a metallic sheen on triple-sugar-iron, with a green color on nutrient agar, and has a fruity aroma?

Answer 12

Pseudomonas aeruignosa

Question 13

Which of the Pseudomonas/Burkholderia bacteria easily cultures with “wrinkled” colony morphology; presents with flulike symptoms, muscle tightness, and light sensitivity, and can progress to abscesses in all organs?

Answer 13

Burkholderia pseudomallei

Question 14

What bacteria is associated with IV-associated septicemia, wound infections, foot rot in swamp-deployed military, and possibly an accelerated pneumonia with rapidly-fatal bacteremia?

Answer 14

Burkholderia cepacia