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BACTE Flashcards

1
Q

best time to collect any type of spx for bacteriology

A

Acute phase of illness (w/n 72 hrs)

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2
Q

T/F

It is acceptable to collect spx once antibiotic therapy has started

A

F
no/less organism recovered

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3
Q

technique STRICTLY observed during collection and processing

A

Aseptic technique

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4
Q

allowable duration of the transportation of collected samples (*w/o delay)

A

30 mins – 2 hrs

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5
Q

LEVEL OF PRIORITIZATION

A
  1. Critical / Invasive
  2. UNPRESERVED
  3. Quantitation required
  4. Preserved
  5. Batch processing
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6
Q

example of critical spx or obtained thru invasive procedures

A

CSF
amniotic fluid
blood
pericardial fluid
heart valves

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7
Q

example of unpreserved spx

A

feces
sputum
wound drainage

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8
Q

example of spx with quanti required

A

catheter tip
urine
tissues for quantitation

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9
Q

ex of preserved spx

A

urine, feces, swab in holding media

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10
Q

ex of spx for batch processing

A

sputum
AFB culture

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11
Q

performed using colony counting to r/o UTI; delay w/ quantitation may affect the count

A

Urine C/S

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12
Q

PURPOSE OF BLOOD CULTURE

A

r/o:
Bacteremia
Septicemia/sepsis

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13
Q

high no. of bacteria in the blood but NOT ENOUGH TO CAUSE HARM or S/S to px

A

Bacteremia

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14
Q

high no. of bacteria in the blood, causing harm (S/S) to the px

A

Septicemia/sepsis

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15
Q

no.1 cause of community-acquired UTI; GIT flora

A

E. coli

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16
Q

Ex of Blood pathogens

A

E. coli
P. aeruginosa
S. aureus

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17
Q

blood pathogen that is NEVER a normal floraa

A

P. aeruginosa

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18
Q

most common cause of sepsis

A

S. aureus

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19
Q

normal flora but affects anterior nares

A

S. aureus

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20
Q

Process of cleansing the phleb site prior to collection to ensure that the blood submitted for culture is not contaminated

A

70-95% alcohol –>
Iodine scrub –>
Alcohol rinse

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21
Q

Common contaminants in blood submitted for culture

A

Viridans streptococci (S. anginosus, S. salivarius, S. sanguinis, S. mitis, S. mutans)

Staphylococcus epidermidis

Propionibacterium acnes (recent: Cutibacterium acnes)

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22
Q

Dilution of Blood to Media

A

1:10

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23
Q

Duration of Routine blood culture

A

7 days

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24
Q

Duration of Leptospirosis detection

A

8 weeks

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25
Q

Gold std for Leptospirosis detection?

Spx required?

A

MAT – Macro/micro agglutination test

SERUM – Ab detection

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26
Q

used in micro agglutination test

A

live leptospira

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27
Q

used in macro agglutination test

A

heat-killed leptospira

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28
Q

Duration of Brucellosis detection

A

3-4 weeks

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29
Q

Rapid test for Brucellosis detection

Optimal spx?

A

SAT (serum agglutination test)
Blood

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30
Q

T/F

All brucella spp. are animal normal flora but not of man.

A

T
In man: causes febrile disease (recurrent fever)

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31
Q

4 signif. brucella spp.

A

abortus
suis
canis
melitensis

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32
Q

T/F

brucella are culturable but culture is not usually done

A

T
most preferred test - SAT

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33
Q

no. of sets to be collected for blood culture

A

2-3 (usually 2 in practice)

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34
Q

best time to collect blood for blood culture

A

During peak of fever

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35
Q

blood amount to be collected for blood culture in the ff:

adult
pediatric
infants

A

Adult: >20 mL
Pediatric patients: 1-10 mL
Infants: 0.5-1 mL

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36
Q

How is 2 time collection done for blood culture?

A

both arms; 1 hr interval (2 sets: for aerobic & anaerobic culture)

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37
Q

1-time collection is only allowed in these cases. How many mL of blood must be collected for blood culture?

A

STAT cases
40 mL

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38
Q

routine anticoagulant for bacterial blood culture

A

0.025% SPS

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39
Q

disadvantage of 0.025% SPS
what is the remedy

A

inhibit: Neisseria, Gardnerella
+1% gelatin

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40
Q

anticoagulants used for molecular procedures only (PCR)

A

White top tube w/ EDTA

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41
Q

Media used for Blood culture

A
  • Tryptic Soy Broth (TSB)
  • Brain Heart Infusion (BHI) agar
  • Brucella broth – esp. for brucellosis det.
  • Castaneda bottle - brucella det. (biphasic)
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42
Q

spx collected to r/o bacteremia and septicemia

A

blood

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43
Q

spx collected to r/o bacterial meningitis

A

CSF

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44
Q

Process of CSF collection

A

Lumbar tap (invasive)

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45
Q

CSF tube no. used for micro

A

2
*if only 1 submitted, micro is the priority

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46
Q

Storage temp of CSF

A

37C

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47
Q

Transport temp of CSF

A

RT

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48
Q

CSF processing

A

Centrifuge CSF →
remove supernatant →
left are sediments (for smear preparation & culture use)

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49
Q

USUAL BACTERIAL ISOLATES IN CSF

A

Streptococcus agalactiae
Haemophilus influenzae serotype b
Streptococcus pneumoniae
Neisseria meningitidis
Listeria monocytogenes

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50
Q

agent of neonatal meningitis isolated in CSF

A

Streptococcus agalactiae

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51
Q

agent of children (<5 y/o) meningitis isolated in CSF

A

Haemophilus influenzae serotype b

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52
Q

agent of adult (>29 y/o) meningitis isolated in CSF

A

Streptococcus pneumoniae

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53
Q

agent of meningitis in 5-29 y/o isolated in CSF

A

Neisseria meningitidis

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54
Q

agent of meningitis in elderly/immunocompromised isolated in CSF

A

Listeria monocytogenes

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55
Q

To do after CSF collection from a shunt

A

Add thioglycolate

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56
Q

Very versatile media; allows growth of facultative anaerobes, strict aerobes, anaerobes

A

thioglycolate

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57
Q

spx to r/o repeated UTI

A

urine

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58
Q

usual request to r/o repeated UTI

A

Urine culture & sensitivity (C/S)

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59
Q

specimen of choice for bacterial culture to r/o repeated UTI

A

Clean catch midstream urine

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60
Q

spx for those unable to void urine

A

Catheterized urine

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61
Q

urine spx for anaerobic culture

A

Suprapubic urine

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62
Q

urine spx for molecular studies like PCR

A

First morning urine

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63
Q

CAUSATIVE AGENTS OF UTI

A

E. coli
S. saprophyticus
Klebsiella
Enterococcus faecalis

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64
Q

no. 1 cause of community-acquired UTI
gram negative rod; normal GIT flora

A

E. coli

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65
Q

1 cause of UTI in young female and in elderly

women with catheter

A

S. saprophyticus

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66
Q

same family w/ E. coli; under Enterobacteriaceae that can also cause UTI

A

Klebsiella

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67
Q

gram + cocci that can cause UTI

A

Enterococcus faecalis

68
Q

Determines the # of colonies / mL of urine by using a colony counter (ideal) or by manual counting

A

Colony count

69
Q

loop required in colony count

A

calibrated loop (1 or 10 uL)

*determine DF

70
Q

DF if loop size is 1 uL

A

1000

71
Q

DF if loop size is 10 uL

A

100

72
Q

formula for colony count

A

of colonies counted x dilution factor = colony count/ml of urine

73
Q

colony count considered as UTI

A

> 100,000

74
Q

media used in colony count

A

MHA

*usual media for susceptibility testing

75
Q

preferred urine preservative; maintains accurate colony count

A

Boric acid

76
Q

spx to r/o LRTIs (pneumonia, bronchitis, TB)

A

sputum

77
Q

Patient prep for sputum collection submitted for bacterial culture

A

Patient must be instructed to rinse/gargle with water prior to collection and cough deeply into container (5-10 mL sputum)

78
Q

amt. of sputum required for bacterial culture

A

5-10 mL sputum

79
Q

what must be done when spx submitted for sputum culture is NONSTERILE

A

evaluate quality → Bartlett’s Classification

80
Q

checks if the spx is sputum or saliva? what is the criteria to be considered as SPUTUM (TRUE RESPIRATORY SAMPLE)?

A

Bartlett’s Classification

SPUTUM (true respiratory sample) - alveolar macrophage

SALIVA (not a respiratory sample) - >10 SECs, <25 PMNs

81
Q

CAUSATIVE AGENTS OF PNEUMONIA

A

Pseudomonas aeruginosa
Klebsiella pneumoniae
Streptococcus pneumoniae
Haemophilus influenzae

82
Q

cause pneumonia in those w/ cystic fibrosis

A

Pseudomonas aeruginosa

83
Q

1 cause of ventilator-associated pneumonia (intubated px)

A

Pseudomonas aeruginosa

84
Q

TB agent; slow-growers (take weeks to produce growth)

A

Mycobacterium tuberculosis

85
Q

M. tuberculosis is what type of BSL pathogen? culture of this organism must be done using BSC class?

A

BSL 3 pathogen
BSC Class 2

86
Q

sputum for TB identification must undergo:

A

Decontamination – remove contaminants and normal flora

Digestion – liquefy the viscous sputum to free any trapped organisms

87
Q

Gold standard for digestion & decontamination

A

N-acetyl-L-cysteine (NALC) + NaOH

NALC – mucolytic/digestant
NaOH – decontaminant

88
Q

Frequently used agent; readily available; both a decontaminant and digestant

A

4% NaOH

89
Q

T/F
4% NaOH only act as decontaminant when + w/ NALC

A

T

90
Q

Added to sputum likely to contain P. aeruginosa

A

5% oxalic acid

91
Q

T/F
All spx for TB det. requires decontamination & digestion

A

F
only non-sterile spx

92
Q

types of sputum collection and no. to be considered (+)

A

1 spx collected in 3 days
(+): 2 out of 3

2 spx in 1 day
(+): 1 out of 2

93
Q

Recommended sputum collection by DOH (to reduce TB cases)? Type of sputum spx needed in each collection?

A

2 specimens in 1 day
(+): 1/2

1st collection – first morning sputum

2nd collection – random sputum

94
Q

Throat swab/Nasopharyngeal swab (NPS) is the spx for ID of?

A

Streptococcal infections (ex. pharyngitis) - S. pyogenes

Corynebacterium diphtheriae

Viridans strep

95
Q

major throat pathogen

A

Streptococcus pyogenes

96
Q

major throat flora

A

Viridans strep

97
Q

major cause of subacute bacterial endocarditis (SBE)

A

Viridans strep

98
Q

implicated in dental carries due to production of glucans and dextrans (enhances teeth attachment)

A

Viridans strep

99
Q

spx collected to detect Bordetella pertussis

A

NPS

100
Q

causes whooping cough

A

Bordetella pertussis

101
Q

specimen processed to detect carrier state of N. meningitidis

A

NPS

102
Q

spx required if N. meningitidis found in naso & oropharynx is normal flora (non-encapsulated)?

A

NPS

103
Q

spx required if N. meningitidis is found to be pathogenic (encapsulated)?

A

CSF

104
Q

Neisseria spp. is sensitive to 2Cs

A

cold temperature
cotton swab - contain fatty acids

Alternative: SWAB MADE FROM DACRON or CALCIUM ALGINATE

105
Q

Swabs are only suitable for what type of bacteria

A

AEROBIC

106
Q

Specimen to collect for culture when patient is on a ventilator/ intubated

A

Endotracheal aspirate

107
Q

Not to be used for VIRUSES; inhibits replication

A

Calcium alginate

108
Q

spx to r/o food poisoning, diarrhea, gastroenteritis

A

stool

109
Q

GIT pathogens

A

Salmonella
Shigella

(never a normal flora of GIT)

110
Q

invasive bacteria that causes bloody diarrhea

non-lactose fermenters & nonmotile (in general)

A

Shigella

111
Q

4 Shigella serogroups

A

A – S. dysenteriae
B – S. flexneri
C – S. boydii
D – S. sonnei (LLF)

112
Q

GIT pathogen with only 2 spp.? What are those?

A

Salmonella

S. enterica – human pathogen
S. bongori – animal pathogen

113
Q

may be collected if stool collection is not possible

A

Rectal swab

114
Q

Once stool is received, it is streaked immediately in?

A

EMB
MAC
SSA

115
Q

manner of stool streaking for culture with 4 quadrants streaked on plated media

A

Semi-quantitation technique/isolation streak

116
Q

what is isolated in stool streaked using semi-quanti technique?

A

area 4 - with isolated single colonies

117
Q

automated program by ID of species through series of biochem tests and perform susceptibility testing

strictly requires PURE ISOLATES

A

VITEK system

118
Q

Examples of Critical Values in Microbiology

A
  • Positive blood culture
  • Positive CSF gram stain or culture
  • Positive cryptococcal antigen test or culture
  • Positive blood smear for malaria
  • S. pyogenes from a sterile site
  • Positive acid-fast smears or positive Mycobacterium culture
  • S. agalactiae or HSV from genital site of a pregnant woman at term
  • Detection of significant pathogen (ie. B. pertussis, Brucella, Legionella)
119
Q

What to do when critical values/ panic values are noted in micro:

A

REPORT THE RESULT ASAP

120
Q

Types of bacteria processed in the lab:

A

Facultative anaerobes
Aerobes
Strict aerobes

121
Q

bacteria that must not be exposed to air during incubation? what is required to prevent air exposure?

A

Facultative anaerobes
Gaspak Jar

122
Q

bacteria requiring 21% O2 + 0.03% CO2 (placed at 37ºC, 18-24 hrs)

A

Aerobes

123
Q

other aerobes requiring ↑ CO2

A

CAPNOPHILIC
(must be ensured that they are supplied with inc. CO2 by using a candle jar)

124
Q

gaspak jar component that maintain anaerobiasis

A

Palladium pellets /catalyst

125
Q

function of indicators in gaspak jar? give an example and its corresponding negative and positive color

A

ensure no presence of air

In O2 presence:
Methylene blue (BLUE)
Resazurin (PINK)

In O2 absence:
Colorless

126
Q

Common failure of GasPak

A

inactivation of catalyst due to repeated use

127
Q

CO2 needed by capnophilic bacteria? give an example of this bacteria

A

5-10% CO2
Neisseria

128
Q

bacteria that is both Microaerophilic (5% O2) & Capnophilic

A

genus Campylobacter

129
Q

Darting motility
Cause gastroenteritis
Stool pathogens
Microscopic appearance: wings of seagulls

A

genus Campylobacter

130
Q

Anaerobic culture (gaspak jar) contents

A

5% CO2
10% H2
85% N2

131
Q

Microaerophilic culture (candle jar) contents

A

5% O2
10% CO2
85% N2

132
Q

2 general AST methods

A

Dilution method (quantitative)
Disk diffusion method – Kirby Bauer (qualitative)

133
Q

Lowest concentration of the antibiotic that inhibited bacterial growth

A

Minimum Inhibitory
Conc. (MIC)

134
Q

Lowest concentration of antibiotic that can kill bacteria

A

Minimum bactericidal conc./ Minimum lethal conc. (MBC/MLC)

135
Q

Required depth of MHA for Kirby Bauer

A

3-5 mm

136
Q

swab used and manner of streaking in MHA during Kirby Bauer tech

A

sterile cotton swab
overlap streaking

137
Q

Size of antibiotic disk used in Kirby Bauer Technique

A

6mm

138
Q

distance of the disks from the center used in Kirby Bauer Technique

A

24 mm

139
Q

distance between 2 disks used in Kirby Bauer Technique

A

15 mm

140
Q

RULE of stacking of plates in incubator for AST (kirby bauer)

A

not be >5 plates in 1 column

141
Q

Incubation temp and duration of plates for Kirby Bauer

A

37°C for 16-18 hours

142
Q

result in ZOI when:

  • too thin agar
  • very dry agar surface
  • too light inoculum
A

Larger ZOI
False sensitive

143
Q

result in ZOI when:

  • too thick agar
  • too much moisture on agar surface
  • too heavy inoculum and too long incubation time
A

Smaller ZOI
False resistant

144
Q

allowable no. of antibiotic disks on a 150 mm plate

A

No >12 disk

145
Q

allowable no. of disks on a 100 mm plate

A

No >5 disk

146
Q

Storage temp for antibiotic disks-working supply

A

2-8°C

147
Q

Cell wall inhibitors

A

Beta lactams: Penicillin, Cephalosporins, Carbapenems

Glycopeptide: Vancomycin

148
Q

Protein synthesis
inhibitors

A

Aminoglycosides: Gentamycin

Tetracycline

MLS (macrolide-lincosamide-streptogramin) – Erythromycin, Clarithromycin

149
Q

AST of Streptococci is done using what media

A

Use MHA + blood (required since strep is fastidious)

150
Q

Detects inducible clindamycin resistance among strains of S. aureus

A

D-test (double disk diffusion test)

151
Q

Required when initial result of Erythromycin to Clindamycin is DISCREPANT

A

D-test (double disk diffusion test)

152
Q

D-test (double disk diffusion test) is used to confirm the true result of what antibiotic

A

CLINDAMYCIN

153
Q

used in D-test

A

15 ug Erythromycin
2 ug Clindamycin

*15 mm apart

154
Q

gene that activates clindamycin resistance

A

erm gene

155
Q

POSITIVE result of D-test? What does it indicate?

A

blunting/flattening of Clindamycin zone to produce D pattern

(+): Clindamycin RESISTANT

156
Q

Uses a strip with single antibiotic of different conc. along its length

A

E-test/MIC on a stick

157
Q

E-test/MIC on a stick is quali or quanti?

A

Quantitative AST → Dilution method

158
Q

E-test/MIC on a stick is recommended for what type of bacteria

A

fastidious & aerobes

159
Q

what is measured in E-test?

A

tapering = MIC

160
Q

T/F
E-test/MIC on a stick is routinely used in the lab

A

F
Not routinely used; used in research

161
Q

(+) result of E-test

A

Ellipse of growth inhibition

162
Q

aka Serum Bactericidal Test

A

Schlichter test

163
Q

Measures activity of antibiotics in patient’s own serum against the pathogen, to detect if patient is receiving effective tx for infection

A

Serum Bactericidal Test/Schlichter test

164
Q

Screening test for carbapenemase-producing organisms

A

Modified Hodge Test

165
Q

+ result of Modified Hodge Test

A

clover leaf like pattern of ZOI

MTAP 1 (13 decks)

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