Bacteriology Flashcards
1
Q
Name all Gram Positive Cocci [8]
A
Staph, Strep, Enterococcus, Granulicatella/Abiotrophia, Peptostreptococcus, parvimonas micra, finegoldia magna, Staph saccharolyticus
2
Q
Name all Gram Positive Rods [8]
A
Bacillus, Corynebacterium, Listeria, Erysipelothrix, Clostridium, Actinomyces,Propionibacterium, Eggerthella/Eubacterium
3
Q
Name all Gram Negative Cocci [3]
A
Neisseria, Moraxella, Veillonella
4
Q
Name all Gram Negative Rods [8]
A
Enterobacteriacaeae, Nonfermentors [Aceinetobacter, Pseudomonas], Pasteurella, HACEK organisms, Bacteroides, Fusobacterium, Prevotella, Porphyyromonas
5
Q
Name aerobic gram positive cocci [4]
A
Staph, Strep, Enterococcus, Granulicatella/Abiotrophia
6
Q
Name aerobic gram positive rods [4]
A
Bacillus, Corynebacterium, Listeria, Erysipelothrix
7
Q
Name aerobic gram negative cocci [2]
A
Neisseria, Moraxella
8
Q
Name aerobic gram negative rods [4]
A
Enterobacteriacaeae, Nonfermentors [Aceinetobacter, Pseudomonas], Pasteurella, HACEK organisms
9
Q
Name Anaerobic Gram Positive Cocci [4]
A
Peptostreptococcus, parvimonas micra, finegoldia magna, Staph saccharolyticus
10
Q
Name Anaerobic Gram positive rods [4]
A
Clostridium, Actinomyces,Propionibacterium, Eggerthella/Eubacterium
11
Q
Name Anaerobic Gram negative rods [4]
A
Bacteriodes, Fusobacterium, Prevotella, Porphyromoas
12
Q
Name Anaerobic Gram negative Cocci [1]
A
Veillonella
13
Q
Common contaminant bacteria [10]
A
Peptostreptococcus, parvimona, finegoldia magna, staph [coag negative, saccharolyticus], currently forming gram-positive rods, viridans group strep
14
Q
Organisms associated with gastrointestinal neoplasia
A
Strep gallolyticus, infantarius, alactolyticus, lutetiensis, equinus [all formally strep bovis group], and clostridium septicum
15
Q
Spirochete type bacteria [3]
A
Borrelia, leptospira, treponema
16
Q
Obligate intracellular bacteria [6]
A
Chlamydia, Coxiella, Rickettsia, Anaplasma, Ehrlichia, Oreintia
17
Q
Differential for gram-positive cocci in clusters [5]
A
Staph aureus and coagulase-negative staph, micrococcus, Aerococcus, Rothia
18
Q
Differential for gram-positive cocci in pairs
A
Streptococcus pneumoniae (may stain Gram variable or gram-negative)
19
Q
Gram-positive cocci in pairs and chains differential
A
Viridans group strep, beta-hemolytic strep such as strep pyogenes, enterococcus, abiotropia and Granulicatella
20
Q
Gram-positive rods differential
A
Bacillus, Clostridium, Listeria, lactobacillus, Eggerthella
21
Q
Which bacteria may be big and boxy with spores
A
Bacillus, Clostridium
22
Q
Which bacteria may be coccobacillary?
A
Listeria
23
Q
Coryneform gram-positive rods
A
Corynebacterium, actinomyces, Cutibacterium, Erysipelothrix
24
Q
Which bacteria may have sulfur granules
A
Actinomyces
25
Beaded gram-positive rods
Mycobacterium, nocardia, actinomyces
26
Branching filamentous gram-positive rods
Nocardia, streptomyces, Gordonia, Tsukamurella
27
Gram variable rods
Clostridium, Gardnerella, bacillus, leptotrichia
28
Gram-negative coccus
Veillonella, Acidaminococcus, Megasphaera
29
Gram-negative diplococci
Neisseria meningitidis and gonorrhea, moraxella catarrhalis
30
Gram-negative coccobacilli differential
Haemophilus, Acinetobacter, Moraxella, Pasteurella, bacteroides, Brucella, tularensis, aggregatibacter
31
Tiny gram-negative rod/junky Gram stain
Tularemia, Brucella
32
Gram-negative rods
Enterobacter, Pseudomonas, Acinetobacter, Achromobacter, HACEK organisms, pasteurella
33
Organisms that are gram-positive rods but may stain gram-negative
Bacillus, Clostridium. Both of these can stain gram variable or gram-negative.
34
Examples of gram-negative rods in a fusiform pattern
Fusobacterium, leptotrichia, capnocytophaga
35
Curved gram-negative rods
Campylobacter, Helicobacter, vibrio, acrobacter, anaerobiospirillum
36
Causes of gram negative diplococci in the CSF?
Neisseria meningitidis
37
Cause of gram-negative diplococci from joint fluid?
Neisseria gonorrhoaea
38
Cause of gram-negative diplococci from respiratory source?
Moraxella catarrhalis
39
Organisms that stain gram variable
Acinetobacter, Bacillus, Clostridium, Leptotrichia, Strep pneumo
40
Buzzword: Seagull shaped or gull wings
Campylobacter
41
AVOID anaerobic cultures in the following locations
Mouth, throat, stool, superficial wounds, urine, vagina/cervix
42
Appropriate place to get anaerobic cultures
Blood, deep wounds, abscesses, sterile body fluids, tissues
43
Pathogens of infection in bite wounds
Anaerobic oral flora [Prevotella], Eikenella, Pasteurella, Staph intermedius/pseudointermedius, Strep anginosus group
44
Pathogens that cause culture negative endocarditis
Haemophilus, Aggregatibacter, Cardiobacterium, Eikenlla corrodens, Kingella [HACEK], Bartonella, Brucella, Chlamydia, Coxiella, Legionella, Mycoplasma, Tropheryma Whipplei
45
Utility of blood agar?
Demonstrates hemolysis
46
What does not grow on blood agar?
Haemophilus, Francisella, Granulicatella/Abiotrophia, Neisseria gonorrhoeae
47
What organisms ONLY grow on chocolate agar?
Haemophilus, Aggregatibacter, N. gonorrhea. Francisella, Granulicatella/Abiotrophia
48
What does NOT grow on chocolate agar?
Corynebacterium
49
What is the utility of MacConkey agar?
Looks at lactose fermentation. Gram-negative rods that are NONfastidious grow on this agar.
50
What does NOT grow on MacConkey agar?
Gram-positives [though Bacillus might], fastidious gram-negativess such as Brucella, HACEK, Francisella, Moraxella, Neisseria, Pasteurella
51
What organisms are alpha-hemolytic?
Viridans group strep and enterococci
52
What organisms are beta-hemolytic?
Staph auerus, Clostridium perfringens, Aeromonas, E. coli, Pseudmonas
53
What organisms are catalase positive?
Staph, Bacillus, Corynebacterium
54
What organisms are catalase negative?
Enterococcus, Strep, Aerococcus, Actinomyces, Clostridium
55
What organisms are coagulase positive?
S. aureus, intermedius, pseudointermedius, schleiferi
56
What organisms are oxidase positive?
Aeromonas, moraxella, neisseria, pasteurella, plesiomonas shigelloides, Pseudmonas [except oryzihabitans and luteola]
57
What organisms are oxidase negative?
All enterobacteriaceae except P. shigelloides, Acinetobacter, Stenotrophomonas maltophilia
58
What organisms are indole positive
Aeromonas, E. coli, Morganella morganii, Plesiomonas shigelloides, Proteus vulgaris, Providencia, Pasteurella
59
What organisms are indole negative?
Acinetobacter, Pseudomonas
60
GNR, beta-hemolytic, metallic sheen, green pigment on MacConkey Agar, Oxidase positive organism
Pseudomonas
61
GRN, beta hemolytic, oxidase negative, indole positive, lactose fermenting
E. coli
62
GPC in clusters, beta hemolytic, yellow pigment, catalase positive
Staph aureus
63
What diseases do fleas transmit?
Rickettsia typhi, Yersinia pestis
64
What diseases do lice transmit?
Bartonella quintana [trench fever], Borrelia recurrentis [relapsing fever], Rickettsia prowazekii [Epidemic typhus]
65
What diseases do mites transmit?
Rickettsia akari [Rickettsialpox] and Orientia tsutsugamushi [Scrub typhus]
66
How is Shiga toxin-producing E. coli detected?
MacConkey with sorbitol to detect O157. EIA to detect all other serotypes. BOTH methods are recommended by the CDC
67
Which shiga toxin is more severe
2 > 1
68
What is MALDI-TOF MS?
Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry. IDs bacteria based on the relative abundance of ribosomal proteins in the cell.
1. Add colony to MALDI plate
2. Add matrix to embed bacteria or fungal cells so when they are hit by laser they are not fragmented and can be analyzed
3. Hit plate with laser
4. Laser causes desorption and ionization
5. Positively charged ionized molecules move toward a negatively charged detector and the time of flight is measured which correlates to the weights of proteins
6. Mass spectrum is made and compared to data base
69
Bioterror: Big boxy gram positive rods in chains, catalase positive, non-hemolytic, non-motile
Anthrax [Bacillus anthracis]
70
Bioterror: Tiny gram-negative rods that are oxidase and urease positive. MALDI says Ochrobactrum.
Brucella
71
Brucella endemic areas
Mexico, South and Central America, Caribbean, Mediterranean basin, Eastern Europe, Middle East
72
Risk factors for Brucella?
Undercooked meat, raw dairy, veterinarians, Abattoir workers, hunters.
73
What causes Glanders?
Burkholderia mallei
74
Gram-negative coccbacilli, slow growing, variable growth on MacConkey agar, oxidase variable, colistin resistant
Burkholderia mallei
75
Burkholderia mallei endemic areas?
Central and South America, Middle East, Asia, Africa
76
Occupations with risk for Burkholderia mallei?
Abattoir workers, Horse caretakers, vets
77
What causes Melioidosis?
Burkholderia pseudomallei
78
GNR with "cracked/dry earth" appearance of colonies. Oxidase positive, colistin resistant. MALDI says it is B. thailandensis. Agar has a "musty odor"
Burkholderia pseudomallei.
79
Burkholderia pseudomallei endemic areas?
Tropics, Southeast Asia, Austrialia
80
Burkholderia pseudomallei occupational risks?
Agricultural workers, this with open skin wounds, DM, CKD
81
Tiny gram negative rods that are oxidase negative, weakly catalase positive. Only grows on chocolate agar.
Tularemia
82
Tularemia endemic areas?
North America, Europe, Asia
83
Tularemia risk factors
Hunters who skin rabbits muskrats, prairie dogs. Tick and deer fly bites, mowing over a rabbit's nest.
84
Safety-pin/bipolar staining on Giemsa stain. Commonly missed on gram stain. "Fried egg" appearance on stain. Oxidase negative. Indole negative. Nonlactose fermener. Nonmotile
Yersinia pestis
85
Plague endemic areas?
Western US, South America, Africa.
86
Risk factors for plague?
Flea bites, hunters who skin rabbits and rodents.
87
Actinotignum schaalii is emerging to cause..?
UTIs
88
Corynebacterium propinquum is emerging to cause..?
Respiratory infections and endocarditis
89
Corynebacterium kroppenstedtii is emerging to cause..?
Beast abscesses
90
Leptotrichia is emerging to cause..?
Bacteremia in neutropenic patiants
91
Staph pseudintermedius is emerging to cause..?
Dog bite infections
92
Bacteria associated with birds?
Chlamydia psittacia
93
Bacteria associated with cats?
Bartonella henselae, Pasteurella
94
Bacteria associated with farm animals?
Anthax, Brucella, Coxiella, E. coli, Campylobscter, Erysipelothrix rhusiopathiae, Leptospira, Salmonella
95
Bacteria associated with fish?
E. rhusiopathiae, Strep iniae, Vibrio
96
Bacteria associated with dogs?
Leptospira, Pasteurella, Staph intermedius and pseudointermedis
97
Bacteria associated with leeches?
Aeromonas
98
Bacteria associated with reptiles?
Salmonella
99
Bacteria associated with Rodents?
Leptospira, Spirillum minus, Streptobacillus moniliformis, Yersinia pestis
100
Bacteria associated with chitlins?
Yersinia enterocolticia
101
Bacteria associated with eggs?
Salmonella
102
Bacteria associated with gravy?
Clostridium perfringens
103
Bacteria associated with home-canned goods?
Clostridium botulinum
104
Bacteria associated with honey?
C. botulinum
105
Bacteria associated with oysters?
Vibro vulnificus
106
Bacteria associated with chicken?
Campylobacter, salmonella
107
Bacteria associated with raw mil/cheese?
STEC, Brucella, Campylobacter, Coxiella burnetti, Listeria, Salmonella
108
Bacteria associated with rice?
Bacillus cereus
109
Describe the inherent error of MIC?
It is +/- one doubling dilution; so reported MIC of 2 ug/mL may be either 1 or 4 ug/mL.
110
What are aerobic GRN intrinsically resistant to?
Clinda and vanco
111
What is Burkholderia cepacia complex intrinsically resistant to?
Penicillins, 1st and 2nd gen cephalosporins, ertapenem, colistin, fosfomycin
112
What is Citrobacter koseri intrinsically resistant to?
Ampicillin, piperacillin, ticarcillin
113
What is E. coli intrinsically resistant to?
Nothing
114
What is Klebsiella intrinsically resistant to?
Ampicillin, Ticarcillin
115
What is proteae intrinsically resistant to? [Proteus, Morganella, Providencia]
Colistin, nitrofurantoin, tetracyclines and tigecycline.
116
What is Salmonella and shigella intrinsically resistant to?
1stand 2nd gen cephalosporins, cephamycins, aminoglycosides
117
What is serratia marcescens intrinsically resistant to?
Nitrofurantoin, colistin
118
What is stenotrophomonas maltophilia intrinsically resistant to?
Penicillins, Cephalosporins 1-3rd gen [except ceftaz], cephamycins, aztreonam, carbapenems, aminoglycosiddes, tetracyline, fosfomycin
119
What is enterococcus intrinsically resistant to?
Cephalosporins, aminoglycosides, clinda, bactrim
120
What is E. faecalis intrinsically resistant to?
Cephalosporins, aminoglycosides, clinda, bactrim, quinupristin/dalfopristin
121
What is listeria intrinsically resistant to?
Cephalosporins
122
What are the SPICE organisms?
Serratia, Pseudomonas, Indole-positive protea [Proteus vulgaris, Providencia, Morganella morganii], Citrobacter freundii complex, Enterobacter spp.
123
What are the SPICE organisms resistant to?
Penicillins, cephalosporins, ertapenem.
124
What bacteria are resistant to colistin? [7]
Gram positives, Burkholderia, Inquilinus limosus, Neisseria, Pandoraea, Protea [Proteus, Providencia, Morganella], Serratia
125
What bacteria are vancomycin resistant?
Gram-negatives, Colstridium innocuum, Enterococcus gallinarum and casseliflavus, Erysipelothrix rhusiopathiae, Lactobacillus, Leuconostoc, Pediococcus, Weissella
126
What is mecA and mecC?
Gene that encodes penicillin binding proteint 2a, responsible for MRSA. mecA is most common in US and World. mecC is reported in Europe, rare in US
127
What beta-lactams might cover MRSA?
Ceftaroline and ceftobiprole [not in US]
128
What is responsible for VISA?
Not acquired or intrinsic; phenotype is due to expression changes in Staph aureus when exposed to vanco. Multiple genomic changes can be responsible, most notable is increased thickness of cell wall.
129
Describe vanA and vanB
Encodes for cell wall precursors that end with D-alanyl-D-lactate rather than D-alanyl-D-alaine. This allows for VRSA and VRE. vanA is most common in US and resistant to teicoplanin. vanB is less common in US and susceptible to teicoplanin
130
What is KPC?
This is Klebsiella pneumonia carbapenemase. Leads to resistance to all beta-lactams. Found in Enterobacteriaceae and nonfermenters.
131
What are the metallo-beta-lactamases?
NDM [New Dehli metallo-beta-lactamase], VIM [Verona imipenemase], IMP [Imipenem metallo-beta-lactamase]
132
What are oxacillinases?
These are resistant to carbapenems but retain susceptibility to cephalosporins
133
Treatment options for VRE?
Daptomycin, doxycycline, linezolid, tedizolid, oritavancin, quinupristin/dalfopristin [E. faecium only]
134
Treatment options for carbapenemase producing organisms?
Ceftazidim/avibactam [no activity against metallo-beta-lactamases], colistin, meropenem/vaborbactam [limited activity against metallo-beta-lactamases and oxacillinases], tigecycline
135
What antibiotics cover anaerobes?
Ampicillin/penicillin [only gram positive anaerobes], betalactam/beta-lactamase inhibitor combos, cephamycins, carbapenems, clinda, flagyl, moxifloxacin, tetracycline
136
What are aerobic actinomycetes?
They are filamentous bacteria found in soil that are not genetically related. They are typically GPR with some form of branching that grow slowly.
137
What are examples of aerobic actinomycetes? [5]
Gordonia, Norcardia, Rhodococcus, Streptomyces, Tsukamurella
138
Strategy to identify aerobic actinomycetes?
Grow on fungal culture due to slow growth rates. Obtain a modified acid-fast stain due to the presence of mycolic acids in their cell wall
139
Which aerobic actinmycete is NOT identified via a modified acid fast stain?
Streptomyces
140
What is a modified acid fast stain?
This uses sulfuric acid as a decolorizing step vs traditional which uses hydrochloric acid as a decolorizer. Aerobic actinomyetes are typically NEGATIVE with this type of stain.
141
Describe colonies of nocardia?
Chalky white, dry. Develop orange pigment with time
142
Describe the gram stain of nocardia
Beaded rods that are more delicate than streptomyces
143
How does streptomyces differ from nocardia?
Streptomyces rods are thicker than nocardia, streptomyces modified acid-fast is negative.
144
In whom is 5 or more mm of induration positive for TB?
Immunosuppressed patients [HIV, transplant, high-dose steroids], those with close contact with TB, those with fibrotic lung changes on CXR consistent with prior TB
145
In whom is 10 mm or more induration considered positive for TB?
Recent [<5 years] immigrants from high-burden countries, IVDU, mycobacteria lab personnel, Children <4.
146
How is anaplasma phagocytophilum diagnosed?
PCR/NAAT; serology 2 weeks post infection.
147
How is Barotnella diagnosed?
Serology, PCR/NAAT
148
How is bordetella pertussis diagnosed?
PCR/NAAT on respiratory specimens
149
How is borrelia burgdoferi diagnosed?
PCR/NAAT. Serology should NOT bed tested if the patient has NOT been in a lyme-endemic region due to false positives. Immunoblot to confirm
150
How is borrelia relapsing fever diagnosed?
Microscopy to look for spirochetes in blood, PCR/NAAT, serology
151
How is chlamydia psittaci diagnosed?
Serology [IgM and IgG]
152
How is Chlamydia pneumonia diagnosed?
PCR/NAAT on resp secretions
153
How is coxiella burnetii diagnosed?
Serology
154
What does Phase 1 > Phase 2 antibodies in coxiella burnetii indicate? Phase 2 > Phase 1?
1 > 2 = chronic or past infection.
| 2 > 1 = acute infection
155
How is Ehrlichia diagnosed
PCR/NAAT, Microscopy with giemsa stain of blood smear to receal morulae.
156
Which Ehrlichia can be diagnosed via serology?
Chaffeensis, E. ewingii cross-reacts
157
How is Kingella kingae diagnosed?
PCR/NAAT of joint fluids for septic arthritis. Blood culture for other presentations [endocarditis, woundd infection]
158
How is Klebsiella granulomatis diagnosed?
Visualization of Donovan bodies on tissue crush preperation or biopsy
159
How is haemophilis ducreyi diagnosed?
Culture on special media [only in speciality labs, <80% sensitive]. Rule out syphilis and HSV prior to testing
160
How long must abx, PPI and bismuth compounds be stopped prior to H. pylori testing?
2-4 weeks
161
Which legionella group does the urine antigen test?
Group 1, this can be <50% of infections in some parts of the county.
162
How is leptospira diagnosed?
Culture of blood and CSF in the first week of symptoms.
Urine after 7-10 days of illness
Serology: IgM after 7-10 days
163
How is mycoplasma genitalium diagnosed?
PCR/NAAT
164
How is mycoplasma hominis diagnosed?
PCR/NAAT, culture on special media
165
How is mycoplasma pnemonia diagnosed?
PCR/NAAT
166
How is Orientia tsutsugamushi ddiagnosed?
Serology, PCR/NAAT
167
How is rickettsia diagnosed?
Serology
168
How is Spirllum minus diagnosed?
Visualization of blood and infected tissues with Giemsa stain, Wright stain, or darkfield microscopy. Broad-range bacterial PCR sequencing.
169
How is streptobacillus moniliformis diagnosed?
Culture with enriched liquid media
170
What are nontreponemal tests?
This detects antibodies against molecules released by cells damaged t. pallidum. RPR and VDRL are these tests. VDRL is only 30% sensitive but 99% specific.
171
What is the prozone effect?
This is high concentrations of RPR leading to a false negative. Asking the lab to dilute the specimen can overcome this.
172
What can cause false positive RPR?
Pertenue [causative agent of yaws], T. carateum [cause of pinta], rickettsial disease, TB
173
What are the treponemal tests?
These are specific to Treponema and cross react with other species.
TP-PA: T. pallidum particle agglutination
FTA-ABS: Fluorescent treponemal antibody - absorption
174
How is Tropheryme whipplei diagnosed?
Histopathology of intestinal biopsy.
Periodic acid-Schiff [PAS] stain for foamy macrophages
PCR/NAAT
175
What leads to false positive PPD [3]
Previous BCG vaccine or BCG cancer therapy, hyper-reactive skin, NTM/MOTT infection.
176
What can cause false negative PPD [6]
Recent TB infection [8-10 weeks of exposure], <6 months of age, very old infection, recent live-virus vaccination, overwhelming TB disease, measles and varicella infection
177
How does IGRA work?
Patient's blood is incubated with MTB antigens, if infected T-cells will recognize antigens and release interferon gamma.
178
What is the difference between quantiferon gold and TSPOT?
Quantiferon: Amount of interferon released
TSPOT: looks at number of interferon producing T-cells
179
What can cause false positives with IGRA? [1]
Infection with NTM/MOOT [kansaii, marinum, szulgai]
180
What can cause false negative IGRA? [3]
>65, immunodef, disseminated TB, extrapulmonary TB
181
What is Cepheid Xpert?
PCR detection of MTB and rifampin resistance from sputum collection. Must be used in conjunction with culture.
182
What is acid fast?
Mycolic acids stain with carbol fuchsin and are not readily decolorized by acids after staining.
183
What is rapid growing MB?
Growth within 7 days
184
What can cause a false positive rapid growing MB?
Sample from high burden specimen that can grow in as little as 3-4 days.
185
What can cause a false positive slow growing MB?
Sample from a low-burden specimen
186
Which mycobacterium have DNA probes?
MTB, MAC, kansasii, gordonae
187
How is MTB resistance testing done?
Two plates; one with Rifampin, isoniazid, ethambutol, pyrazinamide. This is compared to a control. If there is 1% or more growth on antimicrobial plate compared to control it is considered resistant to that drug.
188
What are the slow growing mycobacteria? [11]
TB, MAC, chimaera, gordonae, heamophilum, kansasii, leprae, marinum, szulgai, ulcerans, xenopi.
189
What are the rapid growing mycobacteria? [3]
Abscessus, chrlonae, fortuitum
190
What causes Lady Windermere syndrome?
MAC
191
What causes hot tub lung?
MAX
192
What causes infection during open-heart surgery due to contaminated heater cooler units?
Chimaera
193
What will be misidentified as MAC by MALDI, MPLC?
Chimaera
194
Which slow growing mycobacteria is a likely contaminate?
Gordonae
195
What does mycobacterium haemophilum require for growth?
Incubation at 30-32 degrees and hemin
196
What is the 2nd most common cause of non-TB lung disease in the USA?
Kansasii
197
How is mycobacterium leprae diagnosed?
Slit-skin smears or skin scrapings. Does not grow on culture.
198
Is Staph aerobic or anaerobic
Aerobic
199
Is Strep aerobic or anaerobic
Aerobic
200
Is Enterococcus aerobic or anaerobic
Aerobic
201
Is Granulicatella/Abiotrophia aerobic or anaerobic
Aerobic
202
Is Bacillus aerobic or anaerobic
Aerobic
203
Is Corynebacterium aerobic or anaerobic
Aerobic
204
Is Listeria aerobic or anaerobic
Aerobic
205
Is Erysipelothrix aerobic or anaerobic
Aerobic
206
Is Neisseria aerobic or anaerobic
Aerobic
207
Is Moraxella aerobic or anaerobic
Aerobic
208
Is Enterobacteriacaeae aerobic or anaerobic
Aerobic
209
Are Nonfermentors [Aceinetobacter, Pseudomonas] aerobic or anaerobic
Aerobic
210
Is Pasteurella aerobic or anaerobic
Aerobic
211
Are HACEK organisms aerobic or anaerobic
Aerobic
212
At what temp does marinum grow?
28-30 degrees celsius
213
What organism causes Buruli ulcer?
Mycobacterium ulcerans
214
At what temp does mycobacterium ulcerans grow?
29-33 degrees celsius
215
What disease disease does mycobacterium xenopi cause?
Pulmonary infection in those with chronic lung disease
216
At what temp does xenopi grow?
42-43 degrees celsius
217
What is the most common rapidly growing mycobacterium
Abscessus
218
What type of disease dose abscessus cause?
Pulmonary infections, esp in those with CF. Disseminated disease in immunocompromised. Otitis media, soft tissue infections.
219
What is the erm gene
This is an inducible gene that allows abscessus to have resistance to macrolides.
220
Which subspecies have the erm gene?
Abscessus may contain this. Bolletii 100% has this. Massiliense does not.
221
What type of infections does mycobacterium chelonae cause?
Localized and disseminated cutaneous infections. Can be disseminated in immunosuppressed esp those on systemic steroids.
222
What is chelonae's preferred temperature for growth?
28-32 degrees celsius
223
What is molecular detection of drug resistance assay?
Uses PCR cobined with sequencing. It detects genetic loci associated with drug resistance to the following: RIPE drugs, fluoroquinolones, amikacin, capreomycin. Used only for MTB
224
Define multidrug resistant TB
Resistant to at least 2 primary first line drugs [isoniazid and rifampin]
225
Define Extensively or Extreme drug resistant TB
MDR TB that is resistant to 3 or more 2nd line drugs.
226
What is a giemsa stain?
This is used to diagnose H. pylori and H. heilmannii infections. Tough to interpret. Enhanced H and E stain
227
What is a H. pylori immunostain
More sensitive and specific giemsa stain but it is slow and expensive.
228
What is a PAS stain?
Detects polysaccharides including mucopolysaccharides.
229
What is a Warthin-Starry stain?
Silver nitrate stain for dection of Spirochetes [treponema, borrelia, leptospira], H. pylori, Bartonella henselae
230
What is the Fite stain used for?
Looking at M. leprae and Nocardia
231
What are the acid fast stains? [3]
Ziehl-Neelsen, Kinyoun, Fite
232
Are E. coli and shigella separated on MALDI?
No
233
What are the nutritionally variant strep?
Abiotrophia
| Granulicatella
234
Describe the agar brucella grows on
Grows on sheep blood and chocolate agar slowly
| MAY take 5-6 days to grow.
235
Describe the agar Burkholderia pseudomallei grows on
Grows on Grows on sheep blood, MacConkey and chocolate agar
- -> Difficult to isolate because in resp. secretions there are a lot of other flora that may crowd it out.
- -> Ashdown agar can be used
- -> CF media can be used
236
Describe the conditions which campylobacter grows
Nutritional enrichment
| LOWER concentrations of O2
237
Describe the conditions which tularensis grows
CAN grow on blood and chocolate agar but not well.
Prefers buffered charcoal yeast extract
238
Examples of acid fast organisms
Mycobacterium
239
Examples of modified acid fast organisms [5]
```
Nocardia species
Rhodococcus species
Gordonia species
Tsukamurella species
Dietzia species
```
240
Describe when PEP is needed for Burkholdheria
| pseudomallei [2]
IF low risk - none
IF high risk - Bactrim [doxy or augmentin alt]
NOTE: May be resistant to all 3 above drugs so resistance testing is a must.
241
Describe LOW risk Burkholdheria exposure [5]
1. Inadvertent opening of the lid of an agar plate growing B. pseudomallei outside a biologic safety cabinet
2. Inadvertent sniffing of agar plate growing B. pseudomallei in the absence of contact between worker and bacterium
3. Splash event leading to visible contact of B. pseudomallei with gloved hand or protected body, in the absence of any evidence of aerosol
4. Spillage of small volume of liquid culture (<1mL) within a functioning biologic safety cabinet
5. Contamination of intact skin with culture
242
Describe HIGH risk Burkholdheria exposure [5]
1. The presence of any predisposing condition without proper personal protective equipment (PPE): diabetes mellitus; chronic liver or kidney disease; alcohol abuse; long-term steroid use; hematologic malignancy; neutropenia or neutrophil dysfunction; chronic lung
disease (including cystic fibrosis); thalassemia; any other form of immunosuppression
2. Needlestick or other penetrating injury
3. Bite or scratch by experimental animal infected with B. pseudomallei
4. Splash event leading to contamination of mouth or eyes
Generation of aerosol outside biologic safety cabinet (e.g., sonication, centrifuge incident)
243
What is the most common cause of lab transmitted infections?
Brucella
| --> Just opening the plate is enough to cause infection
244
Describe how lab works should be keeps safe from N. meaningitidis?
They should all be vaccinated with BOTH vaccines.
AND
PEP if exposed
245
What organisms should the lab be notified of if they are in your differential due to infectivity? [17]
```
Avian influenza
Bacillus anthracis
Brucella species
Burkholdheria pseudomallei
Burkholdheria mallei
Clostridium botulinum
Coxiella burnetii
Coccidioides immitis/posadasii
Hemorrhagic fever viruses
(e.g., Ebola, Marburg, Chapare, Crimean-Congo,
Guanarito, Hanta, Junin, Kayasnur Forest Disease, Lassa
fever, Lujo, Machupo, Omsk Hemorrhagic Fever, Sabia)
Francisella tularensis
Measles
MERS, SARS-associated coronavirus
Nipah virus, Hendra virus
Smallpox
Yersinia pestis
```
246
How is bla KPC different from New Delhi KPC?
New Delhi KPC is resistant to ceftolazane/avibactam
247
What test detects carbapenemase production?
Carba NP test
248
How does the carba NP test work?
1. Take organism and intubate with imipenem
2. If the organism has a carbapenemase, it will hydrolyze it creating CO2, reducing pH
3. Change in pH will turn media from red to yellow
249
What is VanC?
Found in genome of E. gallinarum or E. casseliflavus/flavescens
Leads to intermediate vanco MICs
NOT transmittable.
250
Describe the role of tigecycline in the treatment of acinetobacter
Has failed clinically even when active in vitro
251
What type of infection does metamycoplasma hominis cause?
Post-cardiothoracic transplant, Pleuritis [pleural effusion], surgical site infection and/or mediastinitis.
252
Treatment of metamycoplasma hominis?
Doxy preferred
Clinda or fluroquinolones alternative.
--> NOTE: Unlike other mycoplasma it is intrinsically resistant to macrocodes
253
Why is metamycoplasma hominis difficult to isolate?
Requires special media to grow
| Does not have a cell wall so does not gram stain.
