Bacterial Structure; Gram staining Flashcards
Ziehl-Neelsen, Kinyoun, Auramine-Rhodamine, Pappenheim, Baumgarten, Wadefite, Gabett
Acid Fast
Neisser’s, Albert’s, Ljubinsky, LAMB (Loeffler’s Alkaline Methylene Blue), Burke’s
Metachromatic granules
Dyar, Victoria Blue, Calcofluor white (for Fungal chitin)
Cell wall
Levaditi Silver Impregnation, Fontana tribondeau
Spirochetes
Dorner’s, Wirtz-Conklin, Schaeffer-Fulton (primary stain is malachite green, mordant is green, decolorizer is tap water, 2nd stain - safranin; Green spore, Pink bacteria)
Endospore
Gray’s, Leifson, Caesares Gil, Fisher-Conn
Flagella
Anthony’s, Nigrosin, India Ink = negative stain
Capsule/Negative stains
Acridine orange, Feulgen
Nucleic acid/DNA
Gimenez, Macchiavello
Rickettsia
Dienes stain
Mycoplasma
McFadyean
Bacillus anthracis
Toluidine blue
Helicobacter pylori
Wayson’s
Bipolar bodies (Y. pestis)
Structure that includes the cell wall, plasma membrane, and other components defining the bacterial surface.
Cell Envelope
Bacterial classification basis
Cell wall is the primary basis of bacterial classification.
Peptidoglycan layer
Composed of N-acetyl-D-glucosamine (NAG) & N-acetyl-D-muramic acid (NAM).
Absence of outer membrane and periplasmic space; thick peptidoglycan; teichoic acid present; 2 basal rings for flagella; resistant to physical destruction.
Gram-positive
Presence of outer membrane and periplasmic space; thin peptidoglycan; lipopolysaccharide present; 4 basal rings for flagella; sensitive to physical destruction.
Gram-negative
Most important differential staining test in microbiology; stains the microorganism’s cell wall.
GRAM STAIN
Most critical step in Gram stain
Decolorization.
Primary stain used in Gram staining.
Crystal violet
Mordant used in Gram staining.
Gram iodine
Alcohol-acetone mixture used in Gram staining.
Decolorizer
Counterstain used in Gram staining.
Safrinin
Color after 2nd stain (Gram-positive)
Purple.
Color after 2nd stain (Gram-negative)
Pink.
Overdecolorization, old culture, acidic iodine, B-lactam drugs treatment
Gram-positive bacteria may appear Gram-negative.
Underdecolorization, too thick smear
Gram-negative bacteria may appear Gram-positive.
Direct smear
From specimen.
Indirect smear
From culture media.
Smear preparation steps
Smear → Air-dry → Fixation (10 mins. at 60°C or 1 min. in 95% methanol).
Direct smear reporting
Gram reaction, morphology, arrangement, and other elements seen.
QC Gram-positive
Staphylococcus aureus (purple to deep blue).
QC Gram-negative
Escherichia coli (pink to deep magenta).
Resists Decolorization
Acinetobacter, Kingella, Psychrobacter, Methylobacterium (may appear Gram-positive).
Gram Neutral/Ghost form
Bacillus anthracis (ghost capsule), Mycobacteria (poorly stained).
Poorly stained with Gram stain
Campylobacter, Brucella, Tropheryma whipplei.
Poorly stained with Safranin
Legionella, Gram-negative anaerobes, Francisella.
Not stained
Intracellular (Chlamydia, Rickettsia, Ehrlichia, Coxiella), No cell wall (Mycoplasma/Ureaplasma), Spirochetes (Dark-field microscopy).
Quantitating Organisms: None
No organism seen.
Quantitating Organisms: Rare
1+ <10 on complete smear.
Quantitating Organisms: Few
2+ 3–5 per OIF.
Quantitating Organisms: Moderate
3+ 6–10 per OIF.
Quantitating Organisms: Many
4+ >20 per OIF.
Quantitating Host cells: None
No host cells seen.
Quantitating Host cells: Rare
1+ <2 per LPF.
Quantitating Host cells: Few
2+ 2–10 per LPF.
Quantitating Host cells: Moderate
3+ 10–25 per LPF.
Quantitating Host cells: Many
4+ >25 per LPF.
Ghost forms
Cryptosporidium.
Ghost spherule
Coccidioides.
Q Score for Grading Clinical Sample
Used to evaluate sample quality based on neutrophil count and squamous epithelial cells.
Q Score 0
Average neutrophils: 0; no squamous epithelial cells.
Q Score +1
Average neutrophils: 1-9 (few); squamous epithelial cells: -1.
Q Score +2
Average neutrophils: 10-24 (moderate); squamous epithelial cells: -2.
Q Score +3
Average neutrophils: ≥25 (many/numerous); squamous epithelial cells: -3.
Interpretation of Q Score
Higher score indicates better quality of sample; a score of zero means the sample is superficial and not cultured.
Resists Decolorization
Acinetobacter, Kingella, Psychrobacter, Methylobacterium (may appear Gram-positive)
Appears as Gram Neutral/Ghost
Mycobacteria (Poorly stained)
Poorly stained with Gram stain
Campylobacter, Brucella, Tropheryma whipplei
Poorly stained with Safranin
Legionella, Gram-negative anaerobes, Francisella
NOT STAINED
Intracellular (Chlamydia, Rickettsia, Ehrlichia, Coxiella), No cell wall (Mycoplasma/Ureaplasma), Spirochetes (Dark-field microscopy)
Demonstrates presence of Mycolic Acid or Hydroxymethoxy Acid in bacterial cell wall; confirms suspected TB cases if patient is symptomatic or CXR is suggestive
Acid Fast Stain
SPUTUM Quality Screening Bartlett’s classification
<10 epithelial cells, >25 pus cells under LPO
DSSM (Direct Sputum Smear Microscopy)
2x3 cm smear; 300 OIF examined
Present in the cell wall of Mycobacteria
Mycolic Acid
Ziehl-Neelsen Method (Hot Method)
1st Stain: Carbol Fuchsin; Mordant: Heat; Decolorizer: 3% Acid Alcohol; Counterstain: Methylene Blue; Acid-fast: Red/Pink; Non-acid fast: Blue
Kinyoun Method (Cold Method)
1st Stain: Carbol Fuchsin; Mordant: Phenol/Targetol; Decolorizer: 3% Acid Alcohol; Counterstain: Methylene Blue or Malachite Green; Acid-fast: Red/Pink; Non-acid fast: Green
Best Routine AFS Method
Ziehl-Neelsen
Best Tissue AFS Method
Kinyoun
Most Sensitive AFS Method
Auramine-Rhodamine (read 30 LPF)
Auramine-Rhodamine Method
1st Stain: Auramine Rhodamine; Decolorizer: 0.5% Acid Alcohol; Acid-fast: Yellow Fluorescence; Non-acid fast: No Fluorescence
Auramine-Rhodamine Quenching Agent
0.5% KMNO4/Potassium Permanganate
3% Acid Alcohol Composition
3% HCl and 95% Ethanol
AFB Smear Sensitivity
20-80%
Sensitivity of Acid-fast Stain
5,000 – 10,000 AFB/mL
Newly Required Number of Sputum Samples for TB Detection
2 samples (1 random, 1 early morning sputum)
Spot-Spot / Frontloading Method
2 samples, one-hour apart: 1 spot-AM & 1 spot-early morning
Confirmed Case of Tuberculosis
1/2 or 2/2 positive AFB samples
CDC AFB Grading - No AFB Seen
0 AFB/300 fields
CDC AFB Grading - Indeterminate
1-2 AFB/300 fields
CDC AFB Grading - 1+
1-9 AFB/100 fields
CDC AFB Grading - 2+
1-9 AFB/10 fields
CDC AFB Grading - 3+
1-9 AFB/field
CDC AFB Grading - 4+
> 9 AFB/field
DOH AFB Grading - 0
No AFB/300 fields
DOH AFB Grading - +n
n AFB/100 fields
DOH AFB Grading - 1+
10-99 AFB/100 fields
DOH AFB Grading - 2+
1-10 AFB/field (at least 50 fields)
DOH AFB Grading - 3+
> 10 AFB/field (at least 20 fields)
Fluorescence Issues - Photobleaching
Permanent loss of fluorescence due to chemical damage of fluorochrome
Fluorescence Issues - Quenching
Result of transfer of light energy to nearby molecules such as free radicals, salts of heavy metals, or halogens
Staining Methods - Pappenheim’s Staining (Urine)
M. smegmatis (Blue) vs M. tuberculosis (Red)
Staining Methods - Baumgarten’s Staining (Tissue)
M. leprae (Red) vs M. tuberculosis (Blue)
Staining Methods - Fite-Faraco Stain
Used for M. leprae
Modified Acid-Fast Stain
Used for partial acid-fast microorganisms like Nocardia, Coccidians (CIC); uses weak decolorizer such as 1% H2SO4 Alcohol
Found only in Gram-negative bacteria; Initial barrier to the environment; Composed of Lipopolysaccharide giving negative charge
Outer Membrane
Permeability barrier; Involved in cell wall synthesis; Site of energy/ATP synthesis (counterpart of mitochondria)
Inner Membrane
Found only in Gram-negative; Gel-like substance that captures nutrients and detoxifies solutes like antibiotics
Periplasm/Periplasmic Space
dsDNA
Bacterial DNA
Extrachromosomal DNA that carries antibiotic resistance genes
Plasmid
70s in bacteria; 80s in fungi; Responsible for protein synthesis
Ribosome
Can be removed by boiling (100°C); consists of polysaccharide/carbohydrates (except for B. anthracis) which has Poly-D-glutamic acid/protein; contributes to bacterial colonization and anti-phagocytic properties
Capsule
Encapsulated bacteria include N. meningitidis, S. pneumoniae, K. pneumoniae, H. influenzae, Cryptococcus neoformans; lab diagnosis via Neufeld Quellung reaction and K or Vi Ag typing
Encapsulated Bacteria
Food reserve granules that lessen osmotic pressure
Metachromatic Granules
Babes-Ernst bodies are associated with this bacterium
C. diphtheria
Bipolar bodies are associated with this bacterium
Y. pestis
Bacteria that produce many granules, related to this disease
M. tuberculosis
Bacteria associated with sulfur granules
Nocardia
Structure for attachment (common pili); also involved in gene transfer (sex pili, F factor)
Pili or Fimbriae
Bacteria with pili for attachment include N. gonorrhoeae and B. pertussis
Pili or Fimbriae (Attachment)
Process involving the uptake of naked or free DNA
Transformation
Gene transfer method involving transposons, plasmids, and a sex pilus
Conjugation
Gene transfer method involving a bacteriophage (virus)
Transduction
Structure composed of Calcium dipicolinate, providing resistance to heat, chemicals, nutrient deprivation, and drying
Endospore
Endospore location for Bacillus anthracis
Center
Endospore location for Clostridium tetani
Terminal
Endospore location for Clostridium botulinum
Subterminal
Structure responsible for locomotion in bacteria
Flagella
Flagella arrangement where no flagella are present
A-trichous
Flagella arrangement with a single flagellum at one end of the cell
Mono-trichous
Flagella arrangement with a single flagellum at both ends of the cell
Amphi-trichous
Flagella arrangement with a group of flagella located at one end of the cell
Lophotrichous
Flagella arrangement with multiple flagella around the surface of the cell
Peritrichous
Flagella composed of an axial filament, used for spirochetes to move in a corkscrew motion
Endoflagella
Fluid containing thousands of enzymes and the site of protein synthesis in the cell
Cytosol
Region of the cell containing the bacterial chromosome, which is circular and complexed with RNA
Nucleoid
Genomic regions where virulence factors are encoded
Pathogenicity islands (PAIs)
Bacteria involved in biofilm production
S. aureus, Streptococcus, Listeria, Pseudomonas, Candida
Composition of biofilm
Monomicrobic or polymicrobic group of bacteria housed in a complex biochemical matrix
Function of biofilm in relation to implants and prosthetic devices
Adheres to implants and prosthetic devices; contributes to antibiotic resistance
State of cells in a biofilm that are starved, nutrient-deprived, and slow-growing, displaying reduced susceptibility to antimicrobial agents
Persister cells
Signaling mechanism in Gram-negative bacteria
Acyl homoserine lactone (AHL)
Signaling mechanism in Gram-positive bacteria
Oligopeptides
Bacteria known to produce biofilm
S. aureus, CONS, Streptococcus, Listeria monocytogenes, P. aeruginosa, Acinetobacter, Aeromonas, Aggregatibacter spp., Salmonella spp., Enterobacter, Enterococcus, Escherichia coli, Klebsiella, Proteus, Serratia, Citrobacter koseri, and Candida albicans
Definition of toxins in relation to host cells
Biochemically active substances that have particular effects on host cells
Exotoxins production
Produced by Gram-positive and Gram-negative bacteria
Chemical nature of exotoxins
Protein
Mode of release for exotoxins
Secreted
Heat stability of exotoxins
Destroyed at 100°C
Detoxification method for exotoxins
Formaldehyde detoxified
Immunogenicity of exotoxins
Immunologic, convertible to toxoid vaccine
Specificity of exotoxins
Specific; localized infection
Effects of exotoxins on host cells
Kills host cells, interferes in cell signals and protein synthesis
Endotoxins production
Produced by Gram-negative bacteria
Chemical nature of endotoxins
Protein-lipid-polysaccharide (example: LPS)
Release of endotoxins
Reacted upon lysis, intact
Detoxification of endotoxins
Not detoxified
Immunogenicity of endotoxins
Non-immunologic, not neutralized by antitoxin
Specificity of endotoxins
Broad; systemic infection
Effects of endotoxins on the body
Either disrupt or form clots (DIC), fever, activation of complement/immune system, hypotension, shock, death
Toxin testing includes
Immunodiffusion, PCR, Tissue culture, EIA, RIA, Limulus amebocyte lysate
Blood cell that is separated from plasma and lysing them makes a “lysate”, when mixed with endotoxin, it will form clots/precipitates and cause turbidity
Horseshoe crab (Limulus polyphemus) - amebocyte
For detection of toxins of Clostridium difficile, E. coli O157, and Rotavirus
Latex agglutination