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Chelsey Needs to Learn! > Bacteriology > Flashcards

Bacteriology Flashcards

1
Q

What is the treatment for MRSA prosthetic valve endocarditis?

A

Vancomycin + Rifampin + Gentamycin

6 weeks + 6 weeks + 2 weeks

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2
Q

For what organism is there evidence to use Ampicillin + Ceftriaxone in endocarditis?

A

Enterococcus
CID 2013
Instead of Amp + Gent

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2
Q

How to do sus testing for Bacillus species?

A

?

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3
Q

What does LAP test stand for and what does it detect?

A

LAP = Leucine aminopeptidase
Leucine naphthylamide is hydrolyzed by LAP to leucine and free naphthylamine
Disks are impregnated with Leucine naphtylamide. In the prescence of LAP from a positive organism there is hydrolysis and the free naphthylamine couples with the DMACA reagent and forms a red colour

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4
Q

What 5 catalase negative, gram positive cocci are LAP positive?

A 
Enterococcus species
Streptococcus pneumoniae
Streptococcus pyogenes
Pediococcus
Lactococcus
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5
Q

What does PYR stand for and what does it detect?

A

PYR = pyrrolidonyl aminopeptidase
L-pyroglutamic acid B-naphthylamide impregnated in disk, hydrolysis by PYR yields B-naphthylamide which couples with the DMACA reagent and makes a pink/red colour.

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6
Q

2 nonsuppurative sequelae of group A streptococcus?

A
  1. Rheumatic fever

2. Poststreptococcal acute glomerulonephritis

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7
Q

What is the capsule of Group A strep composed of and what is its function?

A

Hyaluronic acid - retards phagocytosis by PMNs and macrophages
Poor immunogen as it resembles human connective tissue

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8
Q

What is the main virulence factor of Group A Strep?

A

M Protein - inhibits phagocytosis by inhibiting activation of the alternate complement cascade

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9
Q

What gene encodes M protein in Strep pyogens?

A

emm gene

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10
Q

What is the difference between serotype and genotype in strep pyogenes?

A 
Serotype = antigenic difference of the M protein
Genotype = nucleotide difference of the M gene
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11
Q

For serological diagnoses what is the difference between

1) Whole blood
2) Plasma
3) Serum
4) Buffy Coat

A

Whole blood = all components of the blood
Plasma = The liquid component of blood that holds the blood cells in suspension - includes clotting factors, antibodies, proteins
Serum = Blood plasma without the clotting factors
Buffy coat = WBCs and Platelets, no erythrocytes

http://upload.wikimedia.org/wikipedia/commons/1/11/Blood-centrifugation-scheme.png

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12
Q

3 Neisseria species that are rods

A

N. elongata
N. bacilliformis
N. weaveri

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13
Q

3 Neiseria species that have yellow pigment

A

N. flavescens
N. sicca
N. subflava

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14
Q

1 Neisseria species that is catalase negative

A

N. elongata

(subspecies elongata and nitroreducens)

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15
Q

3 Neisseria species that are ascacholytic

A 
N. cinerea
N. elongata
N. flavescens
Also..
N. weaveri
N. bacilliformis
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16
Q

4 Antimicrobials in Modified Thayer Martin Agar

A

Vancomycin
Colistin
Nystatin
Trimethoprim (for swarming proteus)

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18
Q

4 Mechanisms of cephalosporin resistance for N. gonorrhea

A 
Alterations in:
penA:  PBP2
mtrA: depression in efflux pump
penB1b: porin
ponA: PBP2
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19
Q

4 Types and associated species of Shigella

A

A - S. dysteneriae
B - S. flexneri
C - S. boydii
D - S. sonnei

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20
Q

3 nonmotile members of Enterobacteriaceae

A

1) Shigella
2) Klebsiella
3) Plesiomonas

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21
Q

1 Shigella species that produces gas

A

Shigella flexneri serotype 6

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22
Q

Does shigella produce gas from glucose?

A

No

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23
Q

Incubation period for Shigella infection

A

1-3 days (up to one week maximum)

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24
Q

How long is Shigella shed in the stool for after infection?

A

1-4 weeks

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25
Q

3 virulence factors of Shigella

A

1) Invasiveness (220 KB plasmid)
2) Shiga toxin (prevents protein synthesis)
3) Type III Secretion System (injects about 20 proteins which stimulate bacterial entry into cells)

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26
Q

Sus testing for Shigella

A

Can test like any other Enterobacteraceae, but a lot of tested agents are not useful clinically (ex Cefuroxime, Cefazolin)
Usually test Amp, Septra and a Fluoroquinolone

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27
Q

1 drug used to treat Shigella which does not have CLSI interpretations

A

Azithromycin

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28
Q

What is the mechanism of resistance of Shigella to fluoroquinolones

A

Mutation in gyrA gene (encodes the DNA gyrase)

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29
Q

Empiric first line therapy for adult with Shigella

A

Cipro or Levo x 3 days, Alternate is Azithro x 3 day

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30
Q

Empiric therapy for children with Shigella

A

Ceftriaxone IV x 5 days , alternate azithro x 3 days

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31
Q

Why do we usually not give antibiotics for EColi 0157?

A

Due to the association with HUS

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32
Q

3 most common species of Yersinia

A

1) Y. pestis
2) Y. enterocolitica
3) Y. pseudotuberculosis

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33
Q

What causes plague?

A

Yersinia pestis

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34
Q

What is the vector for plague?

A

Fleas (rodents, squirrels) - bites human
Also can get from handling of animal tissues
Rarely from inhalation of cat resp secretions

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35
Q

How is plague spread human to human

A

Only pneumonic plague via coughing, droplet precatutions

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36
Q

What risk level is Y. pestis?

A

Level 3

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37
Q 
Oxidase
Urease
Catalase
Motility  
for Yersinia pestis
A

Ox neg, urease neg, catalase pos, nonmotile

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38
Q

2 distinguishing lab tests between Y. pests and Y. enterocolitica?

A

Urease and Motility. Y. pestis is negative for both, Y. enterocolitica is positive for both. Motility is only positive at room temperature.

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39
Q

7 Y. pestis virulence factors

A

1) F1 Antigen = capsule, antiphagocytic
2) Murine phospholipase = for flea midgut colonization
3) V Antigen
4) Type 3 Secretory System
5) Protease - bubonic and pneumonic forms
6) LPS
7) Requires iron for growth

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40
Q

3 clinical syndrome of plague

A

1) Bubonic
2) Pneumonic (via hematogenous spread)
3) Septicemic

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41
Q

Drug of choice for Yersinia pestis?

A

Aminoglycosides

Levofloxacin is FDA approved based on animal data

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42
Q

3 ways to catch Yersinia enterocolitica?

A

1) Ingestion of undercooked contaminated pork
2) Ingestion of unpasteurized milk
3) Fecal oral from another human

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43
Q

2 organisms that can grow at 4 degrees Celsius

A

Listeria

Yersinia

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44
Q

TSI reaction for Yersinia

A

A/A, no gas, no H2S

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45
Q

Incubation period for Yersinia enterocolitica?

A

4-7 days

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46
Q

3 clinical manifestations of Yersinia enterocolitica

A

1) Gastroenteritis
2) Septicemia
3) Mesenteric adenitis (pseudo-appendicitis)

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47
Q

Iron chelation therapy (desferozamine) increases risk for what 4 organisms?

A

1) Yersinia
2) Zygomyces
3) Vibrio vulnificus
4) Neisseria meningitis

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48
Q

1 Selective media for Yersinia enterocolitica

A 
CIN Media (cefsulodin-irgasan-novobiocin)
Bulls Eye colonies (pale with red center)
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49
Q

Name 3 organisms that Yersinia serology cross reacts with?

A

1) Brucella
2) Vibrio
3) Ecoli

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50
Q

2 situations when antibiotic therapy recommended for Yersinia enterocolitica?

A

Invasive infections
Immunocompromised patients

Gent, Septra, Doxy, Cipro

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51
Q

Vibrio:

motility, oxidase lactose and glucose fermentation reactions

A

Motility positive
Oxidase positive
Non lactose fermentation
Glucose fermentation positive

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52
Q

What are 2 Vibrio serogroups that produce cholera toxin?

A

1) O1

2) O139

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53
Q

How to differentiate between Classical and El-Tor Vibrio cholera

A

Beta hemolysis and VP reaction:

El Tor is generally beta hemolytic and VP is usually positive

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54
Q

What is the strain of the cholera outbreak now in Haiti?

A

Vibrio cholera, 01, El Tor

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55
Q

Enrichment broth for Vibrio cholera?

A

Alkaline peptone water

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56
Q

Media recommended for culturing Vibrio?

A

TCBS - Thiosulphate Citrate Bile Salt

Contains sucrose and sucrose fermentation turns the organism yellow

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57
Q

Susceptibility of 0129 disks for Vibrio and Aeromonas

A

Vibrio susceptible

Aeromonas resistant

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58
Q

Treatment of cholera in adult and pregnant woman?

A

Adult: Doxycycline 300 mg po X 1
Pregnant: Azithromycin 1 g po X 1

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59
Q

What colour are colonies of Vibrio vulnificans on TCBS agar?

A

Green (they are non sucrose fermenting)

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60
Q

Will vibrio choleae grow without salt added?

A

Yes

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61
Q

3 complexes in the family Aeromoniceae

A

1) A. hydrophila complex
2) A. caviar complex
3) A. veronii complex

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62
Q 
Aeromonas:
Hemolysis?
Glucose ferments?
Oxidase?
Ampicillin S or R?
Vibrio 0129 disks S or R?
A 
Beta hemolysis
Glucose fermenter
Oxidase positive
Ampicillin R
Vibrio 0129 disks R
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63
Q

Antibiotic therapy for Aeromonas

A

Cipro
Aminoglycosides, 3GC, Doxy sometimes in combination
Can develop beta lactamases (ESBL, maybe MBL)

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64
Q

Family of Plesiomonas shigelloides

A

Enterobacteriaceae (but it’s Ox pos!)

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65
Q 
Plesiomonas:
Hemolytic
MAC
Sucrose fermentation?
Oxidase
O/129
A 
Nonhemolytic
Late lactose fermenter
No sucrose fermentation (colorless or light green on HEK)
Oxidase positive
O-129 susceptible (like vibrio)
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66
Q

3 organisms that are glucose fermenting and oxidase positive

A

1) Vibrio
2) Aeromonas
3) Plesiomonas

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67
Q

Gas and motility reaction for an inactive Ecoli?

A

Gas - negative

Motility - negative

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68
Q

What genes are in the quinolone resistance determining region (QRDR) in Enterobacteracae?

A

gyrA - DNA gyrase
gyrB - DNA gyrase
parC - Topoisomerase IV
parE - Topoisomerase IV

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69
Q

What is the causative agent of Human Monocytic Ehrlichiosis (HME)?
Vector?

A

Erlichia chaffeensis

Lone Star Tick (Amblyomma americanum)

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70
Q

What is the causative agent of Human Granulocytic Anaplasmosis (HGA)?
Vector?

A

Anaplasma phagocytophilum

Ixodes perculcatus group

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71
Q

Treatment for Human Monocytic Ehrlichiosis?

A

Doxycycline 100 mg PO BID x 7-14 days

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72
Q

Treatment for Human Granulocytic Anaplasmosis?

A

Doxycycline 100 mg PO BID x 7-14 days

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73
Q

What are the 2 morphological forms of Coxiella brunettii?

A

1) Large Cell Variant - metabolically active within a vacuole of the host cell
2) Small Cell Variant - no active growth, survival and transmissible form (essentially spores). Can survive for years in the environment

Note Coxiella can be metabolically active in the extracellular phase as well (as a LCV)

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74
Q

Conditions to inactivate Coxiella burnetii transmissible form?

A

Small Cell Variant

Heat to 63 degrees Celsius for 40 min

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75
Q

What is the difference between Phase I and Phase II forms of Coxiella burnetii?

A

Phase I - virulent form, found in animals and humans infected with Q fever
Phase II - avirulent form, found when organism is grown in lab tissue or embryonated eggs

In labs the phase I eventually changes to phase II (it’s a change in LPS, phase I has the intact LPS antigen but phase II lacks the complete LPS)

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76
Q

What is the main virulence factor of Coxiella burnetii?

A

Phase I LPS

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77
Q

2 ways humans get infected with Coxiella burnetii?

A

1) Aerosol transmission from parturient animals (goats, sheep, cattle)
2) Consumption of unpasteurized milk from infected animals

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78
Q

3 clinical forms of Coxiella burnetii infection?

A

1) Acute febrile illness
2) Chronic infection usually involving cardiovascular system
3) Postinfectious chronic fatigue syndome

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79
Q

Intracellular life cycle of Coxiella burnetii?

A

Phase I organism prevents phagocytosis of the host cell allowing the LCV to grow within host cell. When nutrients are deplete it reverts to the SCV and can survive in the cell in a latent state. During immunosupression can revert back to LCV and cause a Q fever relapse.

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80
Q

4 system based manifestations of chronic Q fever?

A

1) Cardiovascular - Endocarditis
2) Gastrointestinal - Granulomatous hepatitis
3) CNS - Meningitis, meningoencephalitis
4) Skeletal - Chronic osteomyelitis

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81
Q

What is the PCR target to detect Q fever from blood or buffy coat samples?

A

Multicopy IS1111 insertion sequence

Another target used is com1 which is single copy

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82
Q

What is the most sensitive method to isolate Coxiella burnetii?

A 
Animal inoculation (into mice then homogenize their spleen 2 weeks later)
Other methods include cell culture, embryonated eggs, or shell vial assay
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83
Q

What typing system to use to type Coxiella burnetii?

A

There is none!

Trick question

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84
Q

3 serological tests for Coxiella burnetii and which is the gold standard?

A

1) Indirect Immunofluorescence Antibody (IFA)
2) Complement Fixation (CF) - rarely used
3) ELISA - only for phase II

IFA = Gold Standard

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85
Q

What types of Antibodies does IFA for Coxiella burnetii detect?

A

IgG, IgM, and IgA for both Phase I and Phase II

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86
Q

2 definitions to diagnosis acute Q fever and 1 for chronic Q fever with indirect immunofluorescent antibody assay?

A

Acute:

1) Fourfold increase in Phase II IgG between acute and convalescent serology
2) Single sample with Phase II IgG titre >= 200 and a phase II IgM >=50

Chronic:
Phase I IgG titre >800

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87
Q

Treatment Q Fever?

1) Acute
2) Chronic
3) Infective Endocarditis
4) Pregnancy

A

1) Doxycycline 100 mg PO BID x 14 days
2) Chronic = Difficult to treat. Repeated Doxy with relapses
3) Infective Endocarditis = Doxycycline 100 mg PO BID + Hydroxychloroquine 600 mg/day for at least 18 months (24 months if PV)
4) Pregnancy = SMX-TMP 1600/320 x >=35 days

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88
Q

5 genera in Parvovirinae?

A

1) Erythrovirus - Genotype 1 = Human Parvovirus B19
2) Dependovirus
3) Parvovirus
4) Amdovirus
5) Bocavirus

6) PARV4 - not much known about this one

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89
Q

Where does Parvovirus B19 replicate?

A

The nucleus of erythroid precursor cells

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90
Q

What are the 2 cellular receptor for Parvovirus B19?

A

1) Blood group P antigen

2) Globoside

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91
Q

What 5 cells types have globoside receptors that can be bound to by Parvovirus B19?

A

1) Erythroid precursors
2) Cardiac myocytes
3) White blood cells
4) Platelets
5) Trophoblasts

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92
Q

What is the incubation period for parvovirus B19 infection?

A

6-10 days
That is for the fever, headache, myalgias, chills

EI comes later

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93
Q

3 ways that Parvovirus B19 is transmitted?

A

1) Respiratory route
2) Vertical transmission
3) Via blood products

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94
Q

What is the incubation period for Erythema Infectiousum?

A

17-19 days

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95
Q

5 clinical syndromes caused by Parvovirus B19?

A

1) Erythema Infectiousum
2) Transient Aplastic Crisis
3) NonImmune Hydrops Fetalis
4) Arthropathy
5) Chronic Pure Red Cell Aplasia

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96
Q

What is the treatment for Chronic Red Cell Aplasia due to Parvovirus B19?

A

IVIG

But you can get Parvo from IVIG… A vicious circle!

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97
Q

What is the pathognomotic finding on bone marrow aspirate for Parvovirus B19?

A

Giant Pronormoblasts (Giant Proerythroblasts)

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98
Q

How to grow Parvovirus B19 in culture?

A

Requires undifferentiated, actively replicating erythroid cells (i.e. bone marrow or fetal cord blood cells)
Only in research labs

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99
Q

2 organisms inhibited by SPS in blood culture bottles?

A

1) Neisseria gonorrhea

2) Capnocytophaga canimorsus

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100
Q

2 risk factors for Capnocytophaga septicaemia?

A

1) Neutropenia

2) Splenectomy

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101
Q

2 Catalase and Oxidase positive species of Capnocytophaga?

A

1) Capnocytophaga canimorsus
2) Capnocytophaga cynodegmi

The other 7 species are Catalase and Oxidase negative

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102
Q

What is the indole reaction for Capnocytophaga species?

A

Negative

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103
Q

3 Antibiotics with limited activity against Capnocytophaga?

A

1) Aminoglycosides
2) TMP-SMX
3) Fluoroquinolones

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104
Q

2 clinical syndromes caused by Acanthamoeba species?

A

1) Acanthamoeba Keratitis

2) Chronic granulomatous amoebic encephalitis (GAE)

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105
Q

3 media to grow Bordetella pertussis?

A

1) Regan-Lowe
2) Bordet-Gengou
3) Stainer-Schlote

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106
Q

Name 3 oxidase negative Bordetella species?

A

1) B. parapertussis
2) B. holmesii
3) B. trematum

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107
Q

Name 3 motility positive Bordetella?

A

1) B. bronchoseptica
2) B. hinzii
3) B. trematum

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108
Q

How do aminoglycosides get across the gram negative outer cell membrane?

A

Oxygen dependant transporter (aminoglycosides do not work in anaerobic environment)

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109
Q

Indole reaction of Klebsiella oxytoca?

A

Positive

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110
Q

2 partially acid fast gram positive rods with yellow or orange pigment?

A

1) Gordonia

2) Rhodococcus

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111
Q

Only spore forming aerobic gram positive rod?

A

Bacillus species

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112
Q

Motility reaction for Listeria and Erysipelothrix?

A

Listeria - Positive at 20-25 degrees celcius

Erysipelothrix - Negative

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113
Q

Catalase reaction of Lactobacillus, Archanobacterium and Bacillus?

A

Lactobacillus - Negative
Arcanobacterium - Negative
Bacillus - Mostly Positive

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114
Q

3 major clinical forms of anthrax?

A

1) Cutaneous
2) Inhalational
3) Ingestion

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115
Q

3 protein components of anthrax toxin?

A

1) Lethal toxin
2) Edema toxin
3) Protective antigen

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116
Q

2 food poisoning syndromes of Bacillus cerus?

A

1) Diarrheal type

2) Emetic type

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117
Q

3 toxins implicated in diarrheal illness of Bacillus cerus?

A

1) Hemolycin BL (Hbl)
2) Nonhemolytic enterotoxin (Nhe)
3) Cytotoxin K (CytK)

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118
Q

1 toxin implicated in emetic illness of Bacillus cerus?

A

Cerulide

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119
Q

2 stains to detect Bacillus anthracis capsule?

A

1) India ink

2) M’Fadyean

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120
Q

Method to stain spores from Bacillus species?

A

Heat fix
Flood with 10% aqueous malachite green for 45 min
Wash
Counterstain with safranin for 30 seconds

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121
Q

Unique feature on gram stain of Paenibacillus alvei?

A

Tapered ends

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122
Q

4 members of Bacillus cereus group?

A

1) B. cereus
2) B. anthracis
3) B. thuringiensis
4) B. mycoides

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123
Q

2 Bacillus species that are motility negative?

A

1) B. anthracis

2) B. mycoides

124
Q

Egg yolk reaction of Bacillus cereus group?

A

Positive (B. cereus and anthracis)

125
Q

3 methods of genotyping Bacillus anthracis?

A

11) MLST
2) MLVA (Multiple-Locus Variable-Number Tandem Repeat Analysis)
3) Single nucleotide polymorphism

126
Q

3 treatment options for Bacillus anthracis in Penicillin allergic patients?

A

1) Fluoroquinolones
2) Chloramphenicol
3) Tetracylcines

** Cephalosporins are not appropriate to treat anthrax, even if test susceptible in vitro**

127
Q

Post exposure prophylaxis for inhalational anthrax?

A

60 days of either Cipro, Doxy or Levo

PLUS 3 doses of anthrax vaccine

128
Q

Treatment of anthrax in pregnant women and children?

A

Amoxicillin

129
Q

Can Bacillus cereus be treated with Penicillin?

A

No - it has a broad spectrum B-lactamase. Resistant to all aminopenicillins and cephalosporins

Also is resistant to trimethoprim.

130
Q

Treatment for ophthalmic infection with Bacillus cereus?

A

Clindamycin + Gentamycin

131
Q

Listeria:

  • Catalase
  • Oxidase
  • VP
  • Methyl Red
  • Esculin hydrolysis
A

All positive except Oxidase is negative

132
Q

Listeria:

  • Urease
  • Gelatin
  • Indole
  • H2S
A

All negative

133
Q

4 select agars to culture Listeria?

A

1) Lithium chloride-phenylethanol-moxalactam (LPM)
2) Oxford
3) Modified-Oxford
4) PALCAM

134
Q

Listeria monocytogenes and Listeria ivanovii reactions on CAMP?

A

L. monocytogenes + with S. aureus

L. ivanovii + with R. equi

135
Q

Listeria monocytogenes:

  • Mannose reaction
  • Rhamnose reaction
  • Xylose reaction?
A

Mannose +
Rhamose +
Xylose -

136
Q

Typing method for Listeria?

A

PFGE (ApaI and AscI)

Also MLVA, MLST, SNP, DNA Microarray, and sequence based

137
Q

Treatment for Listeria?

A

Ampicillin + Gentamicin

138
Q

Treatment for Listeria in penicillin allergy?

A

Trimethoprim-sulfamethoxazole

139
Q

Method of antimicrobial susceptibility testing for Listeria?

A

Microbroth dilution (pen, amp, tmp-smx)

140
Q

1 species of Erysipelothrix?

A

E. rhusiopathie

141
Q

Erysipelothrix:

  • Indole
  • VP
  • Methyl red
  • Urease
  • H2S
A

All negative except H2S

142
Q

Colony morphology of Erysipelothrix?

A

1) Smooth - pinpoint, then entire edges, transparent
2) Rough - fatter, opaque, irregular edge
Alpha hemolysis

143
Q

Erysipelotrix:
Glucose
Lactose
Sucrose

A

Glucose - Positive
Lactose - Positive
Sucrose - Negative

144
Q

3 typing methods for Erysipelothrix?

A

1) PFGE
2) RAPD
3) Ribotyping

145
Q

Treatment for Erysipelothrix? Any intrinsic resistance?

A

Treatment = Penicillin or Ampicillin, alternatives broad spectrum Ceph or Fluoroquinolones

Intrinsic resistance = Vancomycin!
Also usually R to Aminoglycosides and TMP-SMX

146
Q

2 species and gram stains for Rothia.

A

1) R. dentocariosa: GPB

2) R. mucilaginosa: GPC

147
Q

3 corynebacterium that lack mycolic acids?

A

1) C. amycolatum
2) C. atypicum
3) C. kroppenstedtii

** Even coryne with mycolic acids though are NOT partially acid fast**

148
Q

Catalse reaction for Cellumonas? Exceptions?

A

All catalase positive except C. fermentans and C. humilata

149
Q

Catalase reaction for Arcanobacteria and Gardnerella?

A

Negative

150
Q

3 systemic effects of diphtheria exotoxin?

A

1) Myocarditis
2) Neuritis
3) Kidney damage

151
Q

2 organisms susceptible to SPS in blood culture bottles?

A

1) Gardnerella vaginalis

2) Neisseria gonorrhea

152
Q

3 species of Corynebacterium able to harbour the diphtheria tox gene?

A

1) C. diphtheriae
2) C. ulcerans
3) C. pseudotuberculosis

153
Q

2 selective media for C. diptheriae?

A

1) Tinsdale

2) Cystine-Tellurite Blood Agar (CTBA)

154
Q

What do colonies of C. diptheriae look like on Tinsdale agar?

A

Black colonies (tellurite reductase) with brown halo (cystinase)

155
Q

CAMP reaction of Arcanobacterium haemolyticum?

A

CAMP inhibition reaction (inhibits the hemolysis of the S. aureus)

156
Q

Name 5 urease positive corynebacterium?

A

1) C. urealyticum
2) C. ulcerans
3) C. pseudotuberculosis
4) C. pseudodiphtheriticum
5) C. riegelii

157
Q

2 Corynebacterium that hydrolyses esculin?

A

1) C. kroppenstedtii

2) C. glucuronolyticum

158
Q

2 Corynebacterium that are reverse camp positive (CAMP inhibition)?

A

1) C. ulcerans
2) C. pseudotuberculosis

*C. diphthericiae is CAMP negative

159
Q

3 Corynebacterium that are O/129 resistant?

A

1) C. pseudotuberculosis
2) C. amycolatum
3) C. imitans

160
Q

6 Corynebacterium with yellow pigment?

A

1) C. aurimucosum
2) C. falsenii
3) C. glucuronolyticum
4) C. liptophiloflavum
5) C. mucifaciens
6) C. timonense

161
Q

Treatment for C. diphtheriae?

A

Penicillins or Macrolides

PLUS Antitoxin

162
Q

Corynebacterium that can cause pneumonia?

A

C. pseudodiphtheriticum

163
Q

1 other corynebacterium besides C. diphthericiae that can cause diphtheria?

A

C. ulcerans

164
Q

2 multidrug resistant Corynebacterium?

A

1) C. urealyticum

2) C. jeikeium

165
Q

3 characteristics of Leifsonia aquatica?

A

1) Motile
2) DNase activity
3) Yellow pigment

166
Q

1 method for typing of C. diphtheriae?

A

Ribotyping

167
Q

Method and media for corynebacterium susceptibility testing?

A

Broth microdilution method

Cation Adjusted Mueller Hinton broth with 2-5% lysed horse blood

168
Q

Test to verify toxin producing C. diptherium?

A

Elek test

169
Q

Where is the tox gene for C. diptherium?

A

On a bacteriophage

170
Q

Incubation period of diphtheria?

A

2-5 days

171
Q

Another form of diphtheria aside from pharyngitis?

A

Cutaneous diphtheria

172
Q

How to stain for metachromatic granules in C. diphtherium?

A

Loeffler’s stain

173
Q

Tube motility reaction of Listeria?

A

Umbrella

174
Q

Rash in a baby with listeria in utero exposure?

A

Granulosum infantosepticum

175
Q

List 4 branching gram positive aerobic rods?

- Which are modified acid fast?

A

1) Actinomadura
2) Dermatophilus
3) Nocardia - Only one that is acid fast
4) Streptomyces

Rhodococcus can have individual cells that can branch and it is modified acid fast.

176
Q

List 6 aerobic acid fast gram positive rods?

A

1) Gordonia
2) Mycobacterium
3) Nocardia
4) Rhodococcus
5) Segniliparus
6) Tsukamurella

177
Q

Does Rhodococcus equi have ariel hyphae?

A

No (may be occasionally seen microscopically)

178
Q

What is the causative agent of Madura foot?

A 
Acinomadura species (madurae and pelletieri)
Molecular methods to get species

(draining sinuses, traumatic, chronic, slow)

179
Q

2 species of Nocardia resistant to Ceftriaxone?

A

1) N. farcinica

2) N. otitidiscaviarum

180
Q

1 species of Nocardia resistant to Amikacin?

A

N. transvalensis complex

181
Q

Are nocardia species susceptible or resistant to Clarithromyin? What are 2 exceptions?

A

Resistant

Except: N. nova complex and N. pseudobraziliensis

182
Q

Pulmonary finding of rhodococcus?

A

Cavitation

183
Q

Difference between the modified acid fast stain and the acid fast stain?

A

Modified uses a weaker decolorizer (1%H2SO4) than the mycobacterial stain (3% HCl).

184
Q

2 agents of infection where granules may be seen?

A

1) Nocardia braziliensis

2) Actinomyces

185
Q

2 selective media for isolating Nocardia?

A

1) Modified Thayer Martin Agar

2) Selective BCYE

186
Q

What antimicrobials are in selective BCYE agar?

A

Polymyxin B
Anisomycin
Vancomycin or Cefamandole

187
Q

2 aerobic actinomycetes that generally produce aerial hyphae?

A

1) Nocardia

2) Streptomyces

188
Q

2 aerobic actinomycetes that are resistant to lysozyme (i.e. grow in broth containing lysozyme)?

A

1) Nocardia

2) Tsukamurella

189
Q

1 Nocardia species that will grow at 45 degrees?

A

N. wallacei

190
Q

Urease reaction of Nocardia and 1 exception?

A

Positive

Except Nocardia cyriacigeorgica is negative

191
Q

Rhamose reaction of Nocardia and 1 exception?

A

Negative

Except Nocardia farcinica is able to utilize rhamose

192
Q

Identification of Nocardia to the species level?

A

Molecular methods - Gene sequencing

16S rRNA gene, HSP gene, secA1 gene

193
Q

Antimicrobial susceptibility method for Nocardia?

A

Broth microdilution

194
Q

2 antimicrobials most species of Nocardia are susceptible to?

A

1) Trimethoprim-Sulfamethoxazole

2) Linezolid

195
Q

3 cases where Septra may not be adequate to treat Nocardia?

A

1) CNS nocardiosis
2) Disseminated disease
3) HIV infection

196
Q

2 species of streptococcus that are PYR positive?

A

1) Streptococcus pyogenes

2) Streptococcus pneumoniae

197
Q

3 gram positive cocci with intrinsic vancomycin resistance?

A

1) Leuconostoc
2) Weissiella
3) Pediococcus

198
Q

4 gram positive cocci susceptible to bacitracin (10-25 mm)?

A

1) Micrococcus
2) Aerococcus
3) Kocuria
4) Rothia

199
Q

2 gram positive cocci that are oxidase positive?

A

1) Micrococcus

2) Staphylococcus intermedius

200
Q

3 staphylococci that are positive for clumping factor?

A

1) Staph auerus
2) Staph lugdenensis
3) Staph schleiferi subsp. schleiferi

201
Q

7 staphylococci that are positive for tube coagulase?

A

1) Staph aureus
2) Staph aureus subsp. anaerobius
3) Staph delphini
4) S. intermedius
5) S. pseudointermedius
6) S. schleiferi subsp. coagulans
7) S. lutrae

202
Q

Does Pasteurella grow on MacConkey?

A

NO!!!!

203
Q

Treatment of Vibrio vulnificans?

A

Ceftriaxone + Ciprofloxacin

204
Q

Etiology of a 2 week old afebrile baby with conjunctivitis followed 2 weeks later by a pneumonia, with peripheral eosinophils?

A

Chlamydia trachomatis

205
Q

Treatment of inhalational anthrax?

A

Ciprofloxacin + Meropenem + Linezolid

206
Q

What enzyme does an ONPG test detect?

A

B-galactosidase

207
Q

What is the difference between monotrichous flagella and peritrichous flagella?

A

Monotrichous has only one polar flagella, but peritrichous has multiple projecting in all directions

208
Q

How can flexirubin pigment production be detected?

A

Put a loopful of cells in a drop of 20% KOH on a slide, a red colour indicates flexirubin pigments

209
Q

What clinically relevant gram negative non fermenter is H2S positive?

A

Shewanella species

210
Q

3 gram negative non fermenters that are indole positive?

A

1) Chryseobacterium
2) Elizabethkingia
3) Empedobacter

211
Q

For which gram negative non fermenter is motility best demonstrated at room temperature?

A

Sphingomonas species

212
Q

KIA interpretations:

  • butt and slant yellow
  • only butt yellow
  • no yellow
A

Butt and slant yellow = ferments lactose and glucose
Only butt yellow = negative for lactose fermentation, positive for glucose fermentation
No yellow = Nonfermenter

213
Q

4 oxidase negative gram negative non fermenters?

A

1) Acinetobacter
2) Stenotrophomonas
3) Bordetella parapertussis and holmesii
4) Pseudomonas luteola and oryzihabitans

214
Q

6 yellow gram negative non fermenters?

A

1) Elizabethkingia meningoseptica
2) Chrysiobacterium
3) Pseudomonas luteola, oryzihabitans, stutzeri
4) Sphingomonas
5) Burkholderia cenocepacia
6) Paracoccus yeei

215
Q

1 purple pigmented non fermenter?

A

Chromobacterium violacium

216
Q

4 pink pigmented non fermenters?

A

1) Roseomonas
2) Methylobacterium
3) Azospirillum
4) Asaia

217
Q

Methylobacterium reactions:

  • Urease
  • Trypsin
  • B-Galactosidase
  • Nitrate reductase
  • Desferrioxamine
A 
Positive
Positive
Negative
Negative
Resistant
218
Q

4 Gram Negative bacteria that require Chocolate agar for growth?

A

1) Neisseria gonorrhoeae
2) Haemophilus spp
3) Bartonella
4) Francisella spp.

219
Q

Francisella reactions:

  • Oxidase
  • Urease
  • Growth on Blood Agar
  • What 2 agars does it grow well on?
A

Negative
Negative
Weak growth on BA
Grows well on Chocolate and BCYE

220
Q

Stenotrophomonas maltophilia reactions:

  • Oxidase
  • Indole
  • Trypsin
  • PYR
  • H2S
A 
Negative
Negative
Positive
Negative
Negative
221
Q

Elizabethkingia meningoseptica reactions:

  • Oxidase
  • Urease
  • Trypsin
  • Indole
  • H2S
  • PYR
  • Mannitol
  • Glucose
A 
Oxidase Positive
Urease Negative
Trypsin Positive
Indole Positive
H2S Negative
PYR Positive
Mannitol Positive
Glucose Positive
222
Q

Gram negative bacteria susceptible to Vancomycin?

A

1) Sphingomonas

223
Q

Sphingomonas species reactions:

  • Oxidase
  • Trypsin
  • Indole
  • PYR
  • Urease
  • H2S
  • Esculin
  • Alkaline phosphatase
  • Vancomyin
  • Desferrioxamine
A
  • Oxidase Positive
  • Trypsin Positive
  • Indole Negative
  • PYR Negative
  • Urease Negative
  • H2S Negative
  • Esculin Positive
  • Alkaline phosphatase Positive
  • Vancomyin S
  • Desferrioxamine R
224
Q

Do Neisseria species have flagella?

A

No

225
Q

How many different serogroups of Neisseria meningitis are there?
List them

A

12

A, B, C, H, I, K, L, X, Y, Z, W135, 29E

226
Q

Catalase reaction of Neisseria species and 2 exceptions?

A

Positive

Except N. elongata subsp elongata and subsp nitroreducens are catalase negative

227
Q

What 3 underlying conditions are at increased risk for invasive meningococcal disease?

A

1) Properdin deficiencies
2) Late complement deficiencies
3) Splenic impairment (incl asplenia)

228
Q

Symptoms of Neisseria gonorrhoeae in males?

A

Acute urethritis

  • urethral discharge
  • dysuria

10% asymptomatic males
Untreated symptoms resolve in several weeks

229
Q

Complications of gonorrhoea in males?

A

1) Epididymitis
2) Penile edema
3) Abscess of glands

230
Q

Symptoms of gonnorhea in women?

A

1) Vaginal discharge
2) Dysuria
3) Intermenstrual bleeding

231
Q

4 manifestations of pelvic inflammatory disease?

A

1) Endometritis
2) Salpingitis
3) Tubo-ovarian abscess
4) Peritonitis

232
Q

What is Fitz-Hugh-Curtis syndrome?

A

Acute perihepaitis following direct extension of N. gonorrhoea from the fallopian tube to the liver capsule and surrounding peritoneum

233
Q

3 manifestations of disseminated gonococcal infection?

A

1) Septic arthritis
2) Polyarthritis
3) Dermatitis

234
Q

4 complications of invasive meningococcal disease

A

1) Arthritis
2) Pericarditis
3) Cranial nerve dysfunction
4) Cerebral infarct

235
Q

3 symptoms of chronic meningococcemia?

A

1) Low grade relapsing fever
2) Arthritis
3) Rash

236
Q

What type of swab to avoid for gonorrhoea and why?

A

Calcium alginate

- toxicity to organism and inhibit PCR reactions

237
Q

How to prevent the effects of SPS in blood culture bottles on Neisseria meningitis and gonorrhoea?

A

Add gelatine (1g/litre)

238
Q

2 advantages and 5 disadvantages of NAATs for diagnosis of Neisseria gonorrhoeae?

A

Advantages

1) Increased sensitivity compared to culture
2) Less stringent collection and transportation conditions

Disadvantages:

1) High cost
2) Carryover contamination
3) High QC requirements
4) Absence of antibiotic resistance data
5) Susceptible to inhibition

239
Q

4 selective media for culture of Neisseria gonorrhoeae?

A

1) Modified Thayer Martin
2) Martin Lewis (ansiomycin instead of nystatin)
3) GC-Lect Agar (allows for vanco sus GC)
4) New York City Agar

240
Q

Oxidase reaction of Neisseria species?

A

Positive

241
Q

5 asacchrolytic Neisseria species?

A

1) N. bacilliformis
2) N. elongata
3) N. weaveri
4) N. cinerea
5) N. flavescens

242
Q

N. gonorrhoeae typing systems (3)

A

1) PFGE
2) Mutiantigen sequence typing
3) MLST

243
Q

Required agar for susceptibility testing of Neisseria gonorrhoea?

A

GC Agar + 1% growth supplement

244
Q

Treatment of pharyngeal gonorrhoea?

A

IM Ceftriaxone

245
Q

Mechanism for rifampin resistant Neisseria meningititis?

A

Point mutation in rpoB gene (RNA polymerase B subunit)

246
Q

What is special about Neisseria meningititis conjunctivitis?

A

Requires chemophrophylaxis of close contacts due to high immediate risk of invasive disease

247
Q

What Neisseria species besides gonorrhoeae has caused ocular infections in infants?

A

Neisseria cinerea

248
Q

What 2 commensal Neisseria species have decreases susceptibility to penicillin?

A

1) N. mucosa

2) N. lactamica

249
Q 
Which of the following have a flagella?
Actinobacillus
Capnocytophaga
Eikenella
Kingella
Pasteurella
Chromobacterium
A

Chromobacterium

250
Q

What is a risk factor for Pasteurella infection?

A

Liver cirrhosis

251
Q

Risk factor for oxidase negative Capnocytophaga infection?

A

Neutropenia

252
Q

2 risk factors for Chromobacterium violaceum infection?

A

Chronic Granulomatous Disease

G6PD Deficiency

253
Q

What are the oxidase and catalase positive species of Capnocytophaga?

A

1) C. canimorsus

2) C. cynodegmi

254
Q

Where have most Dysgonomonas capnocytophagoides strains been isolated from?

A

Stools of immunocompromised patients

255
Q

How is Kingella kingae transmitted?

A

Respiratory droplets

256
Q

2 clinical syndromes from Streptobacillus moniliformis infection?

A

1) Rat bite fever (rodent bite)

2) Haverhill fever (consumption of contaminated food or water)

257
Q

2 infections that Aggregatibacter actinomycetemcomitans can cause?

A

1) Juvenille and adult periodontitis

2) Infective Endocarditits

258
Q

2 risk factors for Capnocytophaga canimorsum infection

A

1) Splenctomy

2) Alcoholics

259
Q

2 virulence factors of Kingella kingae?

A

1) RTX toxin

2) Type IV pili

260
Q

5 virulence factors of Pasteurella?

A

1) Capsule
2) LPS
3) RTX cytotoxin
4) Surface adhesins
5) Iron acquisition proteins

261
Q

3 clinical manifestations of rat bite fever?

A

1) Fever
2) Migratory polyarthritis
3) Maculopapular rash on the extremities

262
Q

Gram stain of Kingella spp?

A

Short gram negative rods with square ends, lie together in pairs or clusters

263
Q

Colony morphology of Actinobacillus actinomycetemcomitans?

A

Agar: star lik configuration
Liquid: granules

264
Q

Aggregatibacter:
Indole
Ornithine Decarboxylase
Urease

A

Negative
Negative
Negative

265
Q 
Chromobacterium
Hemoloysis
Oxidase
Catalase
Lysine
Maltose
Mannitol
A 
Beta
Oxidase Positive
Negative
Negative
Negative

(Nonpigmented strains can look like Aeromonas)

266
Q

Colony morphology of Streptobacillus?

A

Agar: Fried egg
Liquid: Puff balls

267
Q 
Eikenella: 
Catalase
Oxidase
Indole
Nitrate
Ornithine
A 
Catalase Negative
Oxidase Positive
Indole Negative
Nitrate Positive
Ornithine Positive
268
Q

Kingella kingae:
Catalse
Oxidase
Indole

A

Negative
Positive
Negative

269
Q

3 drugs Pasteurella are usually resistant to?

A

1) Oral narrow spectrum cephalosporins
2) Macrolides
3) Amikacin

270
Q 
Pasteurella multocida:
Catalase
Oxidase
Indole
Urease
Ornithine
A

All positive, except Urease is negative

271
Q

What is X and V factor?

A 
X = protoporphyrin IX (metabolic intermediate in the hemin biosynthetic pathway)
V = Nicotniamide complexed as NAD or NADP
272
Q

Which haemophilus species require both X and V factor for growth?

A

1) H. influenzae
2) H. aegyptius
3) H. haemolyticus

273
Q

What are the different serotypes of the typable Haemophilus influenza species?

A

a, b, c, d, e, f

274
Q

Catalase reaction for Haemophilus and 1 exception?

A

Positive, except H. ducreyi is negative

275
Q

Difference between Haemophilus influenzae and H. aegyptius?

A

Xylose fermentation: Positive for H. influenzae

276
Q

Biochemical tests used to assign biotypes to H. influenzae and H. parainfluenzae?

A

Indole, Ornithine, Urease

277
Q

6 disease conditions that put persons at risk for systemic non typable H. influenza infection?

A

1) Functional or anatomic asplenia
2) Sickle cell disease
3) Complement deficiencies
4) Hodgkin’s Disease
5) Congenital or Aquired hypogammaglobulinemia
6) T cell immunodeficiency (HIV)

278
Q

Incubation period of Haemophilus ducreyi?

A

2-7 days

279
Q

SPS in blood culture bottles affects the growth of what 3 organisms?

A

1) Neisseria gonorrhoeae and meningititis
2) Capnocytophaga
3) Haemophilus parainfluenzae

280
Q

What causes Brazilian Purpuric fever?

A

Haemophilus influenzae biogroup III

281
Q

2 commercial media supplements that provide X and V factors?

A

1) IsoVitaleX

2) Vitox

282
Q

2 methods for capsular serotyping of H. influenzae?

A

1) Slide agglutination assay
2) Fluorescent microscopy
3) Molecular methods
4) PFGE

283
Q

What are the 2 Beta lactamases that can be produced by H. influenzae? And to what drugs do they confer resistance?

A

1) TEM1
2) ROB1

Resistance to Penicillin, Amoxicillin and Ampicillin
Plasmid associated

284
Q

What causes B-lactame resistance in B-lactam negative H. influenzae species?

A

Altered penicillin binding protein

285
Q

Media and test conditions for H. influenzae susceptibility testing?

A

Haemophilus Test Media Agar / Broth
Disk Diffusion / Broth Microdilution (no Etest!)
35 degrees 5-7% CO2 / Ambient
16-18 hours / 20-24 hours

286
Q

What is the incubation period for Haemophilus type b meningitis?

A

2-4 days post infection

287
Q

Who is Haemophilus influenza transmitted?

A

Respiratory droplet

Contact with oral or nasal secretions

288
Q

5 conditions that place patients at highest risk for haemophilus type b infection?

A

1) Splenic dysfunction
2) Antibody deficiency
3) Daycare attendance
4) Inuit community
5) Cochlear implant

289
Q

For what 5 conditions should persons >5 years of age receive 1 dose of Hib vaccine?

A

1) Primary immunodeficiency
2) Malignant hematological disorder
3) HIV
4) Anatomical or functional asplenia
5) Cochlear implant

290
Q

What is the Hib vaccine recommendations for solid organ transplants and HSCT?

A

SOT:
Pre transplant = 1 dose
Post transplant = 1 dose if not vaccinated pre transplant

HSCT:
Post transplant = 3 doses

291
Q

When do household contacts of an invasive case of Hib require Hib prophylaxis and with what?

A

If there is a child <48 months in the home who is immunocompromised or has not had a full primary series of vaccine then the entire household should have Rifampin daily for 4 days

292
Q

What are the hospital isolation requirements for invasive Haemophilus influenza?

A

Droplet isolation until 24 hours post effective antibiotics

293
Q

What are the hospital isolation requirements for invasive Haemophilus influenza?

A

Droplet isolation until 24 hours post effective antibiotics

294
Q

Name 5 species of Legionella?

A

1) pneumophila
2) micdadei
3) longbeachae
4) bozmanae
5) dumoffii

295
Q

What is one test to distinguish Camplyobacter jejuni from other Campylobacter species?

A

Hippurate hydrolysis

Positive for C. jejuni, negative for all other species

296
Q

What Campylobacter species will grow at 25 degrees?

A

Campylobacter fetus

297
Q

What is the name of the Dog Tick?

A

Dermacentor variabilis

298
Q

What is the name of the Wood Tick?

A

Dermacentor andersoni

299
Q

What is the name of the Lone Star Tick?

A

Amblyomma americanum

300
Q

What 4 diseases are transmited by the Lone Star Tick?

A

1) Erlichiosis
2) Tularemia
3) STARI
4) Heartland Virus

301
Q

What 3 diseases are transmitted by the Wood Tick?

A

1) RMSF
2) Tularemia
3) Colarado Tick Fever

302
Q

What 2 diseases are transmitted by the Dog Tick?

A

1) RMSF

2) Tularemia

303
Q

What 4 diseases are transmitted by the Black Legged Tick?

A

1) Lyme
2) Anaplasmosis
3) Babesia
4) Powassan

304
Q

What are the 6 syndromes that can be caused by Francisella tularensis?

A

1) Ulceroglandular
2) Glandular
3) Oculoglandular
4) Pharyngitis
5) Pneumonia
6) Typhoidal

305
Q

6 organisms which are related to Eschars?

A

1) Rickettsia africae
2) Rickettsia conorii
3) Rickettsia akari
4) Rickettsia felis
5) Rickettsia parkeri
6) Orientia tsutsugamushi

306
Q

What are the 3 stages of pertussis disease?

A

1) Catharral
2) Paroxsymal
3) Convalescent

307
Q

Treatment for Listeria in Pencillin allergic patients?

A

Septra

Chelsey Needs to Learn! (9 decks)

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