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Bacterial Differentials (General) Flashcards

1
Q

Gram Neg Diplococci

A

Neisseria

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2
Q

Gram Neg Cocobacilli

A

Acinetobacter
Morganella
Haemophilus (CHOC only, wet mouse)

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3
Q

Gram Neg Rods - lactose fermenters

A 
E. coli
Klebsiella
Enterobacter
Serratia
Citrobacter
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4
Q

Gram Neg Rods - non-lactose fermenters

A 
Pseudomonas (grape)
Burkholderia
Stenotrophomonas
Salmonella
Shigella
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5
Q

Curved Gram Neg Rod

A

Campylobacter
Helicobacter
Vibrio
Flexispira

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6
Q

Gram Neg Rods - special atmosphere

A

HACEK

Eikenella (bleach)

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7
Q

Gram Neg Rods - special media

A

Yersinia
Brucella
Fransicella

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8
Q

Gram Neg Rods - strict anerobe

A

Bacteroides

Fusobacterium

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9
Q

Gram Pos Cocci - clusters

A 
Staph (catalase pos)
Micrococcus
Finegoldia
Rothia
Aerococcus
Pediococcus
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10
Q

Gram Pos Cocci - pairs and chains

A 
Streptococci (catalase neg)
Enterococci (catalase neg)
Leuconstoc
Lactococcus
Gemella
Globictella
Vagococcus
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11
Q

Gram Pos Rods - anaerobic

A

Clostridium
Proprionibacterium
Actinomyces

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12
Q

Gram Pos Rods - aerobic

A 
Bacillus
Corynebacterium
Listeria
Erysipelothrix
Lactobacillus
Arcanobacterium
Mycobacteria (beaded)
Nocardia (beaded)
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13
Q

Gram Pos Rods - beaded

A

Nocardia
Actinomyces (anaerobic)
Mycobacteria

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14
Q

Gram Pos Rods - pallisading

A

Corynebacterium

Arcanobacterium

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15
Q

Gram Pos Rods - box car shaped

A

Clostridium

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16
Q

Gram Pos Rods - Nest like

A

Proprionibacterium acnes

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17
Q

Which bug produces double-zone hemolysis?

A

Clostridium perfringens

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18
Q

Smells like Indole?

A

E. coli

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19
Q

Smells like grapes?

A

Pseudomonas

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20
Q

Smells like Butterscotch?

A

Strep. anginosis

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21
Q

Smells like wet mouse?

A

Haemophilus

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22
Q

Smells like bleach?

A

Eikenella

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23
Q

Which biochemical differentiates between Staph and Strep?

A

Catalase

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24
Q

Catalase positive organisms

A 
Staphylococcus
Micrococcus
Listeria
Bacillus
Corynebacterium
Most Gram Negs
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25
Q

Catalase positive GPCs

A

Micrococcus
Aliococcus
Staphylococcus
Rothia mucilaginosa

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26
Q

The CAMP test is for presumptive identification of what?

A

Group B Streptococcus (S. agalactiae)

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27
Q

CAMP positive organisms

A

GBS
Listeria
P. acnes
Turicella otitidis

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28
Q

Reverse CAMP test is specific for which orgs?

A

C. perfringens

Archanobacterium haemolyticum

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29
Q

What does hippurate hydrolysis test for?

A

The presence of hippurate hydrolase, which hydrolyses hippuric acid to benzoic acid and glycine

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30
Q

Hippurate hydrolysis positive orgs

A

GBS
Campylobacter jejuni

Lengionella pneumophila
Gardnerella vaginalis
Listeria monocytogenes
Bacillus
Aerococcus
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31
Q

Group A Strep (Morphology and defining biochemicals)

A

GPC, chains, “string of pearls” very round cells
Beta-hemolytic on SBA
Catalase neg, PYR pos, Bacitracin sensitive

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32
Q

Strep pneumoniae (Morphology and defining biochemicals)

A 
Lancet shaped GPC pairs, with capsule
Alpha-hemolytic on SBA
Donut shaped (dent in middle) colonies
Optichin sensitive (presumptive)
Bile soluble (confirmatory)
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33
Q

Viridans Streptococci groups

A 
Mutans
Anginosis (milleri)
Mitis
Salivarius
Bovis
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34
Q

Strep mutans group (characteristics)

A

Rod morphology off agar, cocci morphology off broth

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35
Q

Strep mutans group (species)

A

S. mutans

S. sobrinus

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36
Q

Strep anginosis group (characteristics)

A

Butterscotch odor

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37
Q

Strep anginosis group (species)

A

S. anginosis
S. constellatus
S. intermedius

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38
Q

Strep mitis group (characteristics)

A

Optichin sensitive, bile soluble

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39
Q

Strep mitis group (species)

A 
S. mitis
S. pneumoniae
S. sanguinis
S. gordonii
S. oralis
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40
Q

Strep salivarius group (species)

A

S. salivarius

S. vestibularis

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41
Q

Strep bovis group (characteristics)

A

Bile esculin positive, cannot survive 6.5% NaCl

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42
Q

Strep bovis group (species)

A

S. gallolyticus subsp gallolyticus
S. gallolyticus subsp pasteurians
S. infantarius
S. alactolyticus

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43
Q

Nutritionally Variant Streptococci (species)

A

Abiotrophia

Granulicatella

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44
Q

Nutritionally Variant Streptococci requirements to grow

A

pyrodoxal or cysteine

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45
Q

Nutritionally Variant Streptococci grow on which agar?

A

CHOC

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46
Q

Nutritionally Variant Streptococci are usually resistant to which antibiotic?

A

Penicillin

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47
Q

What test is presumptive for Enterococcus

A

Bile Esculin (turns BEZ dark brown to black)

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48
Q

Bile esculin positive organisms

A 
Enterococcus
S. bovis group
Lactococcus
Vagococcus
B. fragilis
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49
Q

PYR positive GPCs

A

Enterococcus
S. pyogenes
Staphylococcus (lugdunensis, schleferi, intermedius, haemolyticus)
NVS (Abiotrophia, Granulicatella)

Aerococcus viridans
Aliococcus
Gemella
Globicatella
Lactococcus
Vagococcus
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50
Q

Enterococcus sp (defining biochemicals)

A

PYR positive
Bile esculin positive
grow in 6.5% NaCl

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51
Q

Non-enterococci GPCs that are Bile esculin positive

A

Lactococcus

Vagococcus

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52
Q

Non-enterococci GPCs that grow in NaCl

A

Leuconostoc

Lactococcus

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53
Q

Glucose fermenters

A

Enterobacteriaceae
Vibrio
Aeromonas
Pasteurella

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54
Q

Non-glucose fermenters

A

Pseduomonas
Burkholderia
Stenotrophomonas
Acinetobacter

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55
Q

What member of the Enterobacteriaceae is oxidase positive?

A

Plesiomonas

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56
Q

Oxidase positive orgs

A

Pseudomonas aeruginosa
Burkholderia cepacia
Plesiomonas

Aeromonas
Vibrio
Moraxella
Neisseria
Bordatella parapertussis
Burkholderia pseduomallei
Capnocytophaga (dog species)
Brucella
Campylobacter
Helicobacter
H-CEK
Chromobacterium violaceum
Methylobacterium
Ochrobactrum
Pasteurella
Psychrobacter
Roseomonas
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57
Q

What does spot indole test for?

A

The ability to split indole into tryptophan

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58
Q

Indole pos orgs

A 
E. coli
Klebsiella oxytoca
Klebsiella ornithinolytica
Proteus vulgaris
Proteus penneri
Citrobacter koseri

Cardiobacterium hominis
Aeromonas
Pasteurella multocida
Vibrio
Pleisiomonas
Proprionibacterium acnes
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59
Q

H2S positive orgs

A 
Salmonella
Erysipelothrix (on TSI)
Proteus vulgaris
Proteus mirabilis
Proteus penneri
Edwardsiella tarda
Citrobacter freundii

Brucella abortus
Campylobacter coli
Aeromonas hydrophila

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60
Q

Gram negatives that are CATALASE NEGATIVE

A

Bartonella
Capnocytophaga
Streptobacillus
H-CEKs

61
Q

Gram negatives that are OXIDASE NEGATIVE

A 
Enterobacteriaceae (not Pleisiomonas)
Stenotrophomonas
Bartonella
Francisella
Burkholderia gladiolii
Bordetella parapertussis
Bordetella holmseii
Pseudomonas luteola
Pseudomonas oryzihabitans
Aggregatibacter
Acinetobacter
Capnocytophaga (human)
62
Q

Non-motile Enterobacteriaceae @ 37 degrees C

A

(SKY)
Shigella
Klebsiella
Yersinia

63
Q

Enterobacteriaceae - General characterisitcs

A 
Glucose fermenters
Biopolar staining (Gram)
Oxidase negative (exp. Pleisiomonas)
Catalase positive
Motile @ 37C (exp SKY)
Both LF and NLF
64
Q

Enterobacteriaceae - Lactose Fermenters

A 
Enterobacter
E. coli
Klebsiella
Citrobacter (late)
Serratia (Late)
65
Q

Enterobacteriaceae - Non-lactose Fermenters

A 
Edwardsiella
Hafnia alvei
Morganella
Proteus
Providencia
Salmonella
Shigella
Yersinia
66
Q

Common cause of infection from cat or dog bites

A

Pasteurella multocida

67
Q

Pasteurella multocida general features

A 
Gram neg cocobacillus
NO GROWTH on MAC
From mouth of dogs or CATS
Glucose fermenter
Musty odor
"COIN"
- Catalase +
- Oxidase +
- Indole +
- Nitrate +
68
Q

Klebsiella general characteristics

A

Lactose fermenters
Short, fat, chubby, w/ and w/o capsule
Bipolar staining

69
Q

K. oxytoca - features/disease

A

Indole +

ABx associated hemorrhagic colitis

70
Q

K. pnuemoniae - disease

A

“Red currant jelly” sputum
Multiple lung abscesses
Freilander’s pneumonia
High mortality

71
Q

K. pneumoniae K1 capsular Ag - characteristics/disease

A

Hyper-viscous
Pyogenic liver abscess (Asia, diabetes)
Monomicrobial, solitary lesion

72
Q

K. rhinoscleromatis - disease

A

Rhinoscleroma (can spread to trachea and larynx)

DDx: Histo, Actino, Nocardia, Wegener’s

73
Q

K. ozaenae - disease

A

Atrophic rhinitis (restricted to nose)

74
Q

K. granulomatis - disease/features

A 
Granuloma inguinale (painless ulcers, swelling genitalia, can spread to bones, joints, liver)
Donovan bodies
75
Q

Salmonella - general features

A

NLF on MAC

H2S +

76
Q

Salmonella that cause enteric fever

A

Salmonella serotype Typhi

Salmonella serotype Paratyphi A, B, C

77
Q

Yersinia pestis - features

A 
GNR, safety pin shaped
Slow growing, "fried egg"
Grows better at 25-28C
NLF on MAC
Non-motile at 35C and RT
Oxidase -
Catalase +
Indole -
Urea -
78
Q

Yersinia entercolitica - features

A

Growth on CIN @ 25c
Sequelae: Reiter’s syndrome (immune relate arthritis)
Reservoir is domesticated pigs (worldwide)
>50 serotypes, O3, O8, O9 majority of disease

79
Q

Aeromonas - features

A

K/A +Gas production
Indole +

Typically NLF
Oxidase +
Catalase +

80
Q

Aeromonas that cause gastroenteritis

A

Due to toxin genes
A. cavie
A. veronii

81
Q

What does catalase test for?

A

The ability to convert H2O2 (hydrogen peroxide) into O2 and H2O

82
Q

What does tube coagulase test detect?

A

Presence of FREE and BOUND coagulase

83
Q

What does slide coagulase test detect?

A

Presence of clumping factor (in 85-95% in S. aureus)

84
Q

Which orgs cause false positives for slide coagulase test? How do you tell them apart from S. aureus?

A

S. lugdunensis and S. schleferi (also produce clumping factor, but not coagulase)
Both are PYR positive, S. aureus is PYR negative

85
Q

Which orgs cause false positives for tube coagulase test? How do you tell them apart from S. aureus?

A

S. intermedius and S. hyicus are tube coagulase pos
S. intermedius is PYR positive, S. aureus is PYR negative
Erysipelothrix is coagulase pos (is a GPR)

86
Q

What does Staphaurex detect? What does this do?

A

Detects clumping factor AND Protein A (spec. to S. aureus)

Removes false positives (99.8% sensitive, 99.5% specific)

87
Q

What tests are presumptive ID for S. pyogenes (Group A Strep)?

A

PYR positive, Bacitracin susceptible

also has small colony and large zone of hemolysis

88
Q

What tests are presumptive ID for S. agalactiae (Group B Strep)?

A

Hippurate positive, CAMP test positive

also has large colony and small zone of hemolysis ‘candlelight’

89
Q

Group A Strep - Diseases

A

Rheumatic fever
Acute glomerulonephritis

Pharyngitis
Scarlet fever
Pyoderma/Impetigo
Erysipelas
Cellulitis
Necrotizing fasciitis
TSS
90
Q

Aeromonas that cause soft tissue infections

A

A. veronii (leeches)

91
Q

Aeromonas that cause sepsis and necrotizing fasciitis

A

A. hydrophila
A. veronii
A. jandaei

92
Q

Vibrio - features

A

Curved GNR
Grows on TCBS selective agar
K/A no gas
String test +

NLF
Catalase +
Oxidase +
Mostly Beta-hemolytic

93
Q

How do you tell Vibrio from Aeromonas?

A

String test:
Vibrio +
Aeromonas -

94
Q

Vibrio cholerae - disease serotypes

A

O1 and O139 (rice water diarrhea)

Non-O1 and Non-O139 - milder diarrhea (raw oysters)

95
Q

Vibrio that are indole positive

A

V. cholerae
V. parahaemolyticus
V. vulnificus

96
Q

Vibrio - Yellow on TCBS

A

V. cholerae
V. fulvialis
V. alginolyticus

97
Q

Vibrio - Green on TCBS

A

V. parahaemolyticus
V. mimicus
V. vulnificus

98
Q

Pseudomonas - General features

A 
Long, thin GNR
Glucose non-fermenter
NLF
Oxidase + (except P. oryzihabitans and P. luteola)
R to bactrim (trim/sulfa)
S to colistin
Yellow/green colonies
99
Q

Stenotrophomonas - General features

A

Long, thin GNR
Non-glucose fermenter
NLF
Oxidase negative
Los of intrinsic resistance inc. natural metallo beta-lactamases
Treat with Trim/Sulfa, then fluoroqunilone

100
Q

Burkholderia - General features

A 
Long, thin GNR
Non-glucose fermenter
NLF
Gen. sensitive to bactrim (trim/sulfa)
resistant to colistin

Endemic in SE Asia, N Australia, Carribbean
Soil, rice paddies, rodents

101
Q

Bartonella - General features

A 
Oxidase negative
Catalase negative
Urease negative
5-15 days to grow (v. hemin dependent)
Grows on CHOC, slowly on SB and blood Cx
NG on MAC
Small GNR, slightly curved
PCR is best for diagnosis
102
Q

Causative agent of cat scratch fever, disease symptoms, and vector?

A

Bartonella henselae
Nodule at scratch, cutaneous lesions
Cat vector

103
Q

Causative agent of trench fever, disease symptoms, and vector?

A

Bartonella quintana
3-8 febrile paroxysms, or continuous fever
Flea vector

104
Q

Causative agent of oroya fever, disease symptoms, and vector?

A

Bartonella bacilliformis
Fever, profound anemia, skin lesions (miliary to nodular)
Sand fly vector

105
Q

Pasturella multocida - Gram stain and common source

A

Gram negative coccobacilli

Mouth of dogs and cats

106
Q

Pasturella multocida - Colony morphology and culture

A

Mucoid colonies on SB and CHOC
No growth on MAC
Musty odor

107
Q

Pasturella multocida - Biochemical reactions

A

“COIN”

Catalase +, Oxidase +, Indole +, Nitrate +

108
Q

Burkholderia cepacia complex - biochemicals, growth conditions, colony morphology

A 
Catalase +
Oxidase +
Grows on MAC
variable growth at 42 deg
Cols turn purple on MAC
Dirt like odor
109
Q

Burkholderia gladiolii - biochemicals, growth conditions, colony morphology

A

Catalase +
Oxidase variable
Grows on MAC
NG at 42 deg

110
Q

Burkholderia mallei - biochemicals, growth conditions, colony morphology

A 
BSL3 PATHOGEN
Catalase +
Oxidase variable
Indole -
Grows on MAC
NG at 42 deg
Poor growth on SB and CHOC
111
Q

Burkholderia pseudomallei - biochemicals, growth conditions, colony morphology

A 
BSL3 PATHOGEN
Catalase +
Oxidase +
Indole -
Grows on MAC
Grows at 42 deg
Grows on SB
Musty odor
Dry wrinkled cols
112
Q

Burkholderia thailandensis - biochemicals, growth conditions, colony morphology

A 
Catalase +
Oxidase +
Indole -
Grows on MAC
Grows at 42 deg
Ferments arabinose (pseudolmallei does not)
113
Q

Bordetella species - common biochemicals, gram stain, specimen type to collect, best test for Dx

A

Catalase +
Gram neg coccobacillus
NP wash or NP swab for diagnosis
PCR is best for Dx

114
Q

Bordetella pertussis - biochemicals, growth in Cx, disease

A

Oxidase +
Urea -
Non motile
NG on routine Cx media
Grows on Regan-Low or Bordet Gangou media
Has “mercury drop” col morph
Causes whooping cough (humans only, severe)

115
Q

Bordetella parapertussis - biochemicals, growth in Cx, disease

A 
Oxidase -
Urea + (24 hrs)
Non motile
Grows on routine media
Less severe infections, can be mixed with B. pertussis
116
Q

Bordetella bronchiseptica - biochemicals, growth in Cx, disease

A 
Oxidase +
Urea + (4 hrs)
Motile
Grows on routine media
Kennel cough, disease in immuno supp., bacteremia, pertussis, meningitis
Has B-lacatamase, ofter R to SXT
117
Q

Bordetella holmseii - biochemicals, growth in Cx, disease

A 
Oxidase - 
Urea -
Non motile
Grows on routine media
Causes bacteremia in aslpenic patients
118
Q

Helicobacter pylori - diaease, Gram stain, biochemicals. media

A

Group 1 carcinogen: gastric cancer, mucosa-associated lymphoid tissue (MALT) lymphoma
Curved Gram neg rod
Oxidase +
Catalase +
Urease + (CLO test)
BHI agar, Brucella agar, Trypticase soy agar

119
Q

H. pylori - Diagnostic tests (non invasive)

A 
Urea breath test
Stool antigen (good sens and spec, used for Dx and monitoring)
Serology IgG (IgM not useful, used for Rx monitoring)
120
Q

H. pylori - Diagnostic tests (invasive)

A

Gastric biopsy
Gram stain or Warthin-Starry (silver) stain
Cx: 10 days, humid microaeropphilic environment (5% H2), Cx for AST

121
Q

Campylobacter species - Gran stain, biochemicals, Cx conditions

A 
Curved Gram neg rod (sea gull)
Catalase + (except C. upsaliensis)
Oxidase +
Darting motility
Grows on selective media (CVA) in microaerophilic environment
122
Q

Campylobacter jejuni and C. coli - disease, vectors, Cx and biochemicals

A 
Bloody diarrhea with WBCs (up to 2 wks)
Guillan-Barre, reactive arthritis
Poultry, puppies, kittens
Cx: 42 deg on selective media
Hippurate +
123
Q

Campylobacter fetus - disease, Cx

A

Bacteremia in immuno supp. and pregnant patients
DOES NOT grow at 42 deg
Suscept to 1st gen Cephalosporin (cephalotin)

124
Q

Campylobacter upsaliensis - disease, Cx and biochemicals

A

Diarrhea, bacteremia
42 deg selective media
Hippurate -
Catalase -

125
Q

Campylobacter species - treatment and resistance

A

Treat with Macrolides (azithro, erythro)
Resistance to fluoroquinolones
Resistance to B-lactams (except imi?)

126
Q

Spirochetes - Organisms (and disease)

A 
Leptospira interrogans (Leptospirosis)
Treponema pallidum (Syphillis)
Borrelia sp. (Tick borne relapsing fever)
Borrelia recurrentis (Relapsing fever)
Borellia burgdorferi (Lyme disease)
Spirillium minus (rat bite fever)
127
Q

Treponema pallidum - Distribution, disease, transmission

A

Worldwide
Syphilis
veneral, vertical, direct contact

128
Q

Leptospira interrogans - Distribution, disease, transmission

A

Worldwide (Hawaii)
Leptospirosis
Rodent urine, esp. contaminated water

129
Q

Borrelia species - Distribution, disease, transmission

A

Worldwide
Tick borne relapsing fever
Host: Rat, human, primate
Vector: Tick

130
Q

Borrelia recurrentis - Distribution, disease, transmission

A

S. America, Europe, Asia, Africa
Relapsing fever
Host: Human
Vector: Louse

131
Q

Borrelia burgdorferi - Distribution, disease, transmission

A

N. America, Europe
Lyme disease
Host: Rodents, deer
Vector: Ixodes scapularis (deer tick)

132
Q

Spirillium minus - Distribution, disease, transmission

A

Asia
Rat bite fever
Rat bite

133
Q

Leptospirosis Diagnosis - Culture, serology, specimen

A

Cx: Fletcher’s media, EMJH media, Media with tween and albumin
Incubate Cxs at 30 deg for 7-14 days
Serology can be done 5-7 days after symptom onset
Bld, CSF acceptable up to 10 days, urine up to 1 month
Can be seen on darkfield microscopy

134
Q

Syphillis Diagnosis - Culture, serology, specimen

A

Cx: Rabbit intratesticular inoculation
Serology: Screen with non-treponemal (RPR, VDRL), then confirm with treponemal test (FTA-ABS, TP-PA, EIA)
Serum or CSF
Darkfield microscopy of chancre scrapings

135
Q

Lyme Diagnosis - Culture, serology, specimen

A

Cx: Skin biopsy in Kelly’s media, incubate at 33 deg, microaerophilic
Serology: Screen with EIA, confirm wit WB (2/3 IgM bands, >=5 IgG bands)
Serum, CSF, Skin Bx

136
Q

HACEK organisms - species

A 
Aggrigatibacter aphrophilus
A. paraphrophilus
A. actinomycetecomitans
H. parainfluenzae
Cardiobacterium hominis
Eikenella corrodens
Kingella kingae
137
Q

Organisms that pit the agar in culture

A

Cardiobacterium hominis
Eikenella corrodens
Kingella kingae

138
Q

Organisms isolated from bite wounds (and type of bite)

A 
Eikenella corrodens (human)
Capnocytophaga (dog, human)
Pasteurella (cat, dog)
Streptibacillus (rat)
139
Q

Fastidious GNRs that grow in MAC

A 
Chromobacterium violcaceum
Pasteurella spp (not P. multocida)
140
Q

HACEK - Disease, Cx, Treatment

A

ENDOCARDITIS
Cx: will not grow on MAC, like increased CO2 and humidity
Produces B-lacatamse (R to Amp), so treat with 3rd gen cephalosporin

141
Q

Aggregatibacter aphrophilus - nutritional requirements

A

Does NOT require factors X (hemin) or V (NAD) to grow

142
Q

Aggrigatibacter paraaphrophilus and H. parainfluenzae - nutritional requirements

A

Both require only factor V (NAD)

143
Q

H. influenzae and H. parainfluenzae - biochemicals

A

Catalase +

Oxidase +

144
Q

Aggregatibacter aphrophilus and A. paraphrophilus - biochemicals

A

Catalase -

Oxidase -

145
Q

Aggregatibacter actinomycetecomitans - biochemicals

A

Catalase +

Oxidase -

146
Q

Aggregatibacter actinomycetecomitans - Disease, growth time, colony features

A

Formerly Actinobacillus
Periodontitis, endocarditis, bit wounds
grows in 2-3 days (slower)
Colonies adhere to glass or plastic (heart valves)

147
Q

Cardiobacterium hominis - Disease, growth time, GS features, biochemicals

A

Normal oral flora
Endocarditis, esp is pts with poor dental hygiene, recent dental work or previously damaged heart valve
Grows slowly, 4-7 days
Gram stain of GNR is picket fences or “rosettes” and sometime retain crystal violet
Catalase -
Oxidase +
Weakly indole + (all other HACKE are indole -)
Pits the agar

148
Q

Eikenella corrodens - Disease, Cx features, biochemicals, resistance

A 
Endocarditis (can be subacute)
Pits the agar
Smells like bleach
Catalase -
Oxidase +
Nitrate to nitrite +
R to macrolides and clindamycin
149
Q

Kingella kingae - disease, gram stain, Cx features, biochemicals, resistance

A

Endocarditis, septic arthritis (<4 years old)
GN coccobacillus
Beta hemolytic on SB, growth on CHOC, 48 hrs
Catalase -
Oxidase +
Some strains produce bets-lactamases

Bacterial Identification (3 decks)

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