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ID Review > Bacteriology > Flashcards

Bacteriology Flashcards

1
Q

Name all Gram Positive Cocci [8]

A

Staph, Strep, Enterococcus, Granulicatella/Abiotrophia, Peptostreptococcus, parvimonas micra, finegoldia magna, Staph saccharolyticus

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2
Q

Name all Gram Positive Rods [8]

A

Bacillus, Corynebacterium, Listeria, Erysipelothrix, Clostridium, Actinomyces,Propionibacterium, Eggerthella/Eubacterium

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3
Q

Name all Gram Negative Cocci [3]

A

Neisseria, Moraxella, Veillonella

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4
Q

Name all Gram Negative Rods [8]

A

Enterobacteriacaeae, Nonfermentors [Aceinetobacter, Pseudomonas], Pasteurella, HACEK organisms, Bacteroides, Fusobacterium, Prevotella, Porphyyromonas

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5
Q

Name aerobic gram positive cocci [4]

A

Staph, Strep, Enterococcus, Granulicatella/Abiotrophia

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6
Q

Name aerobic gram positive rods [4]

A

Bacillus, Corynebacterium, Listeria, Erysipelothrix

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7
Q

Name aerobic gram negative cocci [2]

A

Neisseria, Moraxella

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8
Q

Name aerobic gram negative rods [4]

A

Enterobacteriacaeae, Nonfermentors [Aceinetobacter, Pseudomonas], Pasteurella, HACEK organisms

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9
Q

Name Anaerobic Gram Positive Cocci [4]

A

Peptostreptococcus, parvimonas micra, finegoldia magna, Staph saccharolyticus

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10
Q

Name Anaerobic Gram positive rods [4]

A

Clostridium, Actinomyces,Propionibacterium, Eggerthella/Eubacterium

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11
Q

Name Anaerobic Gram negative rods [4]

A

Bacteriodes, Fusobacterium, Prevotella, Porphyromoas

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12
Q

Name Anaerobic Gram negative Cocci [1]

A

Veillonella

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13
Q

Common contaminant bacteria [10]

A

Peptostreptococcus, parvimona, finegoldia magna, staph [coag negative, saccharolyticus], currently forming gram-positive rods, viridans group strep

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14
Q

Organisms associated with gastrointestinal neoplasia

A

Strep gallolyticus, infantarius, alactolyticus, lutetiensis, equinus [all formally strep bovis group], and clostridium septicum

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15
Q

Spirochete type bacteria [3]

A

Borrelia, leptospira, treponema

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16
Q

Obligate intracellular bacteria [6]

A

Chlamydia, Coxiella, Rickettsia, Anaplasma, Ehrlichia, Oreintia

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17
Q

Differential for gram-positive cocci in clusters [5]

A

Staph aureus and coagulase-negative staph, micrococcus, Aerococcus, Rothia

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18
Q

Differential for gram-positive cocci in pairs

A

Streptococcus pneumoniae (may stain Gram variable or gram-negative)

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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

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20
Q

Gram-positive rods differential

A

Bacillus, Clostridium, Listeria, lactobacillus, Eggerthella

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21
Q

Which bacteria may be big and boxy with spores

A

Bacillus, Clostridium

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22
Q

Which bacteria may be coccobacillary?

A

Listeria

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23
Q

Coryneform gram-positive rods

A

Corynebacterium, actinomyces, Cutibacterium, Erysipelothrix

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24
Q

Which bacteria may have sulfur granules

A

Actinomyces

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25
Q

Beaded gram-positive rods

A

Mycobacterium, nocardia, actinomyces

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26
Q

Branching filamentous gram-positive rods

A

Nocardia, streptomyces, Gordonia, Tsukamurella

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27
Q

Gram variable rods

A

Clostridium, Gardnerella, bacillus, leptotrichia

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28
Q

Gram-negative coccus

A

Veillonella, Acidaminococcus, Megasphaera

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29
Q

Gram-negative diplococci

A

Neisseria meningitidis and gonorrhea, moraxella catarrhalis

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30
Q

Gram-negative coccobacilli differential

A

Haemophilus, Acinetobacter, Moraxella, Pasteurella, bacteroides, Brucella, tularensis, aggregatibacter

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31
Q

Tiny gram-negative rod/junky Gram stain

A

Tularemia, Brucella

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32
Q

Gram-negative rods

A

Enterobacter, Pseudomonas, Acinetobacter, Achromobacter, HACEK organisms, pasteurella

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33
Q

Organisms that are gram-positive rods but may stain gram-negative

A

Bacillus, Clostridium. Both of these can stain gram variable or gram-negative.

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34
Q

Examples of gram-negative rods in a fusiform pattern

A

Fusobacterium, leptotrichia, capnocytophaga

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35
Q

Curved gram-negative rods

A

Campylobacter, Helicobacter, vibrio, acrobacter, anaerobiospirillum

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36
Q

Causes of gram negative diplococci in the CSF?

A

Neisseria meningitidis

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37
Q

Cause of gram-negative diplococci from joint fluid?

A

Neisseria gonorrhoaea

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38
Q

Cause of gram-negative diplococci from respiratory source?

A

Moraxella catarrhalis

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39
Q

Organisms that stain gram variable

A

Acinetobacter, Bacillus, Clostridium, Leptotrichia, Strep pneumo

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40
Q

Buzzword: Seagull shaped or gull wings

A

Campylobacter

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41
Q

AVOID anaerobic cultures in the following locations

A

Mouth, throat, stool, superficial wounds, urine, vagina/cervix

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42
Q

Appropriate place to get anaerobic cultures

A

Blood, deep wounds, abscesses, sterile body fluids, tissues

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43
Q

Pathogens of infection in bite wounds

A

Anaerobic oral flora [Prevotella], Eikenella, Pasteurella, Staph intermedius/pseudointermedius, Strep anginosus group

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44
Q

Pathogens that cause culture negative endocarditis

A

Haemophilus, Aggregatibacter, Cardiobacterium, Eikenlla corrodens, Kingella [HACEK], Bartonella, Brucella, Chlamydia, Coxiella, Legionella, Mycoplasma, Tropheryma Whipplei

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45
Q

Utility of blood agar?

A

Demonstrates hemolysis

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46
Q

What does not grow on blood agar?

A

Haemophilus, Francisella, Granulicatella/Abiotrophia, Neisseria gonorrhoeae

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47
Q

What organisms ONLY grow on chocolate agar?

A

Haemophilus, Aggregatibacter, N. gonorrhea. Francisella, Granulicatella/Abiotrophia

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48
Q

What does NOT grow on chocolate agar?

A

Corynebacterium

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49
Q

What is the utility of MacConkey agar?

A

Looks at lactose fermentation. Gram-negative rods that are NONfastidious grow on this agar.

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50
Q

What does NOT grow on MacConkey agar?

A

Gram-positives [though Bacillus might], fastidious gram-negativess such as Brucella, HACEK, Francisella, Moraxella, Neisseria, Pasteurella

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51
Q

What organisms are alpha-hemolytic?

A

Viridans group strep and enterococci

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52
Q

What organisms are beta-hemolytic?

A

Staph auerus, Clostridium perfringens, Aeromonas, E. coli, Pseudmonas

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53
Q

What organisms are catalase positive?

A

Staph, Bacillus, Corynebacterium

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54
Q

What organisms are catalase negative?

A

Enterococcus, Strep, Aerococcus, Actinomyces, Clostridium

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55
Q

What organisms are coagulase positive?

A

S. aureus, intermedius, pseudointermedius, schleiferi

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56
Q

What organisms are oxidase positive?

A

Aeromonas, moraxella, neisseria, pasteurella, plesiomonas shigelloides, Pseudmonas [except oryzihabitans and luteola]

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57
Q

What organisms are oxidase negative?

A

All enterobacteriaceae except P. shigelloides, Acinetobacter, Stenotrophomonas maltophilia

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58
Q

What organisms are indole positive

A

Aeromonas, E. coli, Morganella morganii, Plesiomonas shigelloides, Proteus vulgaris, Providencia, Pasteurella

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59
Q

What organisms are indole negative?

A

Acinetobacter, Pseudomonas

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60
Q

GNR, beta-hemolytic, metallic sheen, green pigment on MacConkey Agar, Oxidase positive organism

A

Pseudomonas

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61
Q

GRN, beta hemolytic, oxidase negative, indole positive, lactose fermenting

A

E. coli

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62
Q

GPC in clusters, beta hemolytic, yellow pigment, catalase positive

A

Staph aureus

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63
Q

What diseases do fleas transmit?

A

Rickettsia typhi, Yersinia pestis

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64
Q

What diseases do lice transmit?

A

Bartonella quintana [trench fever], Borrelia recurrentis [relapsing fever], Rickettsia prowazekii [Epidemic typhus]

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65
Q

What diseases do mites transmit?

A

Rickettsia akari [Rickettsialpox] and Orientia tsutsugamushi [Scrub typhus]

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66
Q

How is Shiga toxin-producing E. coli detected?

A

MacConkey with sorbitol to detect O157. EIA to detect all other serotypes. BOTH methods are recommended by the CDC

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67
Q

Which shiga toxin is more severe

A

2 > 1

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68
Q

What is MALDI-TOF MS?

A

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
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69
Q

Bioterror: Big boxy gram positive rods in chains, catalase positive, non-hemolytic, non-motile

A

Anthrax [Bacillus anthracis]

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70
Q

Bioterror: Tiny gram-negative rods that are oxidase and urease positive. MALDI says Ochrobactrum.

A

Brucella

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71
Q

Brucella endemic areas

A

Mexico, South and Central America, Caribbean, Mediterranean basin, Eastern Europe, Middle East

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72
Q

Risk factors for Brucella?

A

Undercooked meat, raw dairy, veterinarians, Abattoir workers, hunters.

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73
Q

What causes Glanders?

A

Burkholderia mallei

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74
Q

Gram-negative coccbacilli, slow growing, variable growth on MacConkey agar, oxidase variable, colistin resistant

A

Burkholderia mallei

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75
Q

Burkholderia mallei endemic areas?

A

Central and South America, Middle East, Asia, Africa

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76
Q

Occupations with risk for Burkholderia mallei?

A

Abattoir workers, Horse caretakers, vets

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77
Q

What causes Melioidosis?

A

Burkholderia pseudomallei

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78
Q

GNR with “cracked/dry earth” appearance of colonies. Oxidase positive, colistin resistant. MALDI says it is B. thailandensis. Agar has a “musty odor”

A

Burkholderia pseudomallei.

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79
Q

Burkholderia pseudomallei endemic areas?

A

Tropics, Southeast Asia, Austrialia

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80
Q

Burkholderia pseudomallei occupational risks?

A

Agricultural workers, this with open skin wounds, DM, CKD

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81
Q

Tiny gram negative rods that are oxidase negative, weakly catalase positive. Only grows on chocolate agar.

A

Tularemia

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82
Q

Tularemia endemic areas?

A

North America, Europe, Asia

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83
Q

Tularemia risk factors

A

Hunters who skin rabbits muskrats, prairie dogs. Tick and deer fly bites, mowing over a rabbit’s nest.

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84
Q

Safety-pin/bipolar staining on Giemsa stain. Commonly missed on gram stain. “Fried egg” appearance on stain. Oxidase negative. Indole negative. Nonlactose fermener. Nonmotile

A

Yersinia pestis

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85
Q

Plague endemic areas?

A

Western US, South America, Africa.

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86
Q

Risk factors for plague?

A

Flea bites, hunters who skin rabbits and rodents.

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87
Q

Actinotignum schaalii is emerging to cause..?

A

UTIs

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88
Q

Corynebacterium propinquum is emerging to cause..?

A

Respiratory infections and endocarditis

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89
Q

Corynebacterium kroppenstedtii is emerging to cause..?

A

Beast abscesses

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90
Q

Leptotrichia is emerging to cause..?

A

Bacteremia in neutropenic patiants

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91
Q

Staph pseudintermedius is emerging to cause..?

A

Dog bite infections

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92
Q

Bacteria associated with birds?

A

Chlamydia psittacia

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93
Q

Bacteria associated with cats?

A

Bartonella henselae, Pasteurella

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94
Q

Bacteria associated with farm animals?

A

Anthax, Brucella, Coxiella, E. coli, Campylobscter, Erysipelothrix rhusiopathiae, Leptospira, Salmonella

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95
Q

Bacteria associated with fish?

A

E. rhusiopathiae, Strep iniae, Vibrio

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96
Q

Bacteria associated with dogs?

A

Leptospira, Pasteurella, Staph intermedius and pseudointermedis

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97
Q

Bacteria associated with leeches?

A

Aeromonas

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98
Q

Bacteria associated with reptiles?

A

Salmonella

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99
Q

Bacteria associated with Rodents?

A

Leptospira, Spirillum minus, Streptobacillus moniliformis, Yersinia pestis

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100
Q

Bacteria associated with chitlins?

A

Yersinia enterocolticia

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101
Q

Bacteria associated with eggs?

A

Salmonella

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102
Q

Bacteria associated with gravy?

A

Clostridium perfringens

103
Q

Bacteria associated with home-canned goods?

A

Clostridium botulinum

104
Q

Bacteria associated with honey?

A

C. botulinum

105
Q

Bacteria associated with oysters?

A

Vibro vulnificus

106
Q

Bacteria associated with chicken?

A

Campylobacter, salmonella

107
Q

Bacteria associated with raw mil/cheese?

A

STEC, Brucella, Campylobacter, Coxiella burnetti, Listeria, Salmonella

108
Q

Bacteria associated with rice?

A

Bacillus cereus

109
Q

Describe the inherent error of MIC?

A

It is +/- one doubling dilution; so reported MIC of 2 ug/mL may be either 1 or 4 ug/mL.

110
Q

What are aerobic GRN intrinsically resistant to?

A

Clinda and vanco

111
Q

What is Burkholderia cepacia complex intrinsically resistant to?

A

Penicillins, 1st and 2nd gen cephalosporins, ertapenem, colistin, fosfomycin

112
Q

What is Citrobacter koseri intrinsically resistant to?

A

Ampicillin, piperacillin, ticarcillin

113
Q

What is E. coli intrinsically resistant to?

114
Q

What is Klebsiella intrinsically resistant to?

A

Ampicillin, Ticarcillin

115
Q

What is proteae intrinsically resistant to? [Proteus, Morganella, Providencia]

A

Colistin, nitrofurantoin, tetracyclines and tigecycline.

116
Q

What is Salmonella and shigella intrinsically resistant to?

A

1stand 2nd gen cephalosporins, cephamycins, aminoglycosides

117
Q

What is serratia marcescens intrinsically resistant to?

A

Nitrofurantoin, colistin

118
Q

What is stenotrophomonas maltophilia intrinsically resistant to?

A

Penicillins, Cephalosporins 1-3rd gen [except ceftaz], cephamycins, aztreonam, carbapenems, aminoglycosiddes, tetracyline, fosfomycin

119
Q

What is enterococcus intrinsically resistant to?

A

Cephalosporins, aminoglycosides, clinda, bactrim

120
Q

What is E. faecalis intrinsically resistant to?

A

Cephalosporins, aminoglycosides, clinda, bactrim, quinupristin/dalfopristin

121
Q

What is listeria intrinsically resistant to?

A

Cephalosporins

122
Q

What are the SPICE organisms?

A

Serratia, Pseudomonas, Indole-positive protea [Proteus vulgaris, Providencia, Morganella morganii], Citrobacter freundii complex, Enterobacter spp.

123
Q

What are the SPICE organisms resistant to?

A

Penicillins, cephalosporins, ertapenem.

124
Q

What bacteria are resistant to colistin? [7]

A

Gram positives, Burkholderia, Inquilinus limosus, Neisseria, Pandoraea, Protea [Proteus, Providencia, Morganella], Serratia

125
Q

What bacteria are vancomycin resistant?

A

Gram-negatives, Colstridium innocuum, Enterococcus gallinarum and casseliflavus, Erysipelothrix rhusiopathiae, Lactobacillus, Leuconostoc, Pediococcus, Weissella

126
Q

What is mecA and mecC?

A

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
Q

What beta-lactams might cover MRSA?

A

Ceftaroline and ceftobiprole [not in US]

128
Q

What is responsible for VISA?

A

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
Q

Describe vanA and vanB

A

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
Q

What is KPC?

A

This is Klebsiella pneumonia carbapenemase. Leads to resistance to all beta-lactams. Found in Enterobacteriaceae and nonfermenters.

131
Q

What are the metallo-beta-lactamases?

A

NDM [New Dehli metallo-beta-lactamase], VIM [Verona imipenemase], IMP [Imipenem metallo-beta-lactamase]

132
Q

What are oxacillinases?

A

These are resistant to carbapenems but retain susceptibility to cephalosporins

133
Q

Treatment options for VRE?

A

Daptomycin, doxycycline, linezolid, tedizolid, oritavancin, quinupristin/dalfopristin [E. faecium only]

134
Q

Treatment options for carbapenemase producing organisms?

A

Ceftazidim/avibactam [no activity against metallo-beta-lactamases], colistin, meropenem/vaborbactam [limited activity against metallo-beta-lactamases and oxacillinases], tigecycline

135
Q

What antibiotics cover anaerobes?

A

Ampicillin/penicillin [only gram positive anaerobes], betalactam/beta-lactamase inhibitor combos, cephamycins, carbapenems, clinda, flagyl, moxifloxacin, tetracycline

136
Q

What are aerobic actinomycetes?

A

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
Q

What are examples of aerobic actinomycetes? [5]

A

Gordonia, Norcardia, Rhodococcus, Streptomyces, Tsukamurella

138
Q

Strategy to identify aerobic actinomycetes?

A

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
Q

Which aerobic actinmycete is NOT identified via a modified acid fast stain?

A

Streptomyces

140
Q

What is a modified acid fast stain?

A

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
Q

Describe colonies of nocardia?

A

Chalky white, dry. Develop orange pigment with time

142
Q

Describe the gram stain of nocardia

A

Beaded rods that are more delicate than streptomyces

143
Q

How does streptomyces differ from nocardia?

A

Streptomyces rods are thicker than nocardia, streptomyces modified acid-fast is negative.

144
Q

In whom is 5 or more mm of induration positive for TB?

A

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
Q

In whom is 10 mm or more induration considered positive for TB?

A

Recent [<5 years] immigrants from high-burden countries, IVDU, mycobacteria lab personnel, Children <4.

146
Q

How is anaplasma phagocytophilum diagnosed?

A

PCR/NAAT; serology 2 weeks post infection.

147
Q

How is Barotnella diagnosed?

A

Serology, PCR/NAAT

148
Q

How is bordetella pertussis diagnosed?

A

PCR/NAAT on respiratory specimens

149
Q

How is borrelia burgdoferi diagnosed?

A

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
Q

How is borrelia relapsing fever diagnosed?

A

Microscopy to look for spirochetes in blood, PCR/NAAT, serology

151
Q

How is chlamydia psittaci diagnosed?

A

Serology [IgM and IgG]

152
Q

How is Chlamydia pneumonia diagnosed?

A

PCR/NAAT on resp secretions

153
Q

How is coxiella burnetii diagnosed?

154
Q

What does Phase 1 > Phase 2 antibodies in coxiella burnetii indicate? Phase 2 > Phase 1?

A

1 > 2 = chronic or past infection.

2 > 1 = acute infection

155
Q

How is Ehrlichia diagnosed

A

PCR/NAAT, Microscopy with giemsa stain of blood smear to receal morulae.

156
Q

Which Ehrlichia can be diagnosed via serology?

A

Chaffeensis, E. ewingii cross-reacts

157
Q

How is Kingella kingae diagnosed?

A

PCR/NAAT of joint fluids for septic arthritis. Blood culture for other presentations [endocarditis, woundd infection]

158
Q

How is Klebsiella granulomatis diagnosed?

A

Visualization of Donovan bodies on tissue crush preperation or biopsy

159
Q

How is haemophilis ducreyi diagnosed?

A

Culture on special media [only in speciality labs, <80% sensitive]. Rule out syphilis and HSV prior to testing

160
Q

How long must abx, PPI and bismuth compounds be stopped prior to H. pylori testing?

161
Q

Which legionella group does the urine antigen test?

A

Group 1, this can be <50% of infections in some parts of the county.

162
Q

How is leptospira diagnosed?

A

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
Q

How is mycoplasma genitalium diagnosed?

164
Q

How is mycoplasma hominis diagnosed?

A

PCR/NAAT, culture on special media

165
Q

How is mycoplasma pnemonia diagnosed?

166
Q

How is Orientia tsutsugamushi ddiagnosed?

A

Serology, PCR/NAAT

167
Q

How is rickettsia diagnosed?

168
Q

How is Spirllum minus diagnosed?

A

Visualization of blood and infected tissues with Giemsa stain, Wright stain, or darkfield microscopy. Broad-range bacterial PCR sequencing.

169
Q

How is streptobacillus moniliformis diagnosed?

A

Culture with enriched liquid media

170
Q

What are nontreponemal tests?

A

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
Q

What is the prozone effect?

A

This is high concentrations of RPR leading to a false negative. Asking the lab to dilute the specimen can overcome this.

172
Q

What can cause false positive RPR?

A

Pertenue [causative agent of yaws], T. carateum [cause of pinta], rickettsial disease, TB

173
Q

What are the treponemal tests?

A

These are specific to Treponema and cross react with other species.
TP-PA: T. pallidum particle agglutination
FTA-ABS: Fluorescent treponemal antibody - absorption

174
Q

How is Tropheryme whipplei diagnosed?

A

Histopathology of intestinal biopsy.
Periodic acid-Schiff [PAS] stain for foamy macrophages
PCR/NAAT

175
Q

What leads to false positive PPD [3]

A

Previous BCG vaccine or BCG cancer therapy, hyper-reactive skin, NTM/MOTT infection.

176
Q

What can cause false negative PPD [6]

A

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
Q

How does IGRA work?

A

Patient’s blood is incubated with MTB antigens, if infected T-cells will recognize antigens and release interferon gamma.

178
Q

What is the difference between quantiferon gold and TSPOT?

A

Quantiferon: Amount of interferon released
TSPOT: looks at number of interferon producing T-cells

179
Q

What can cause false positives with IGRA? [1]

A

Infection with NTM/MOOT [kansaii, marinum, szulgai]

180
Q

What can cause false negative IGRA? [3]

A

> 65, immunodef, disseminated TB, extrapulmonary TB

181
Q

What is Cepheid Xpert?

A

PCR detection of MTB and rifampin resistance from sputum collection. Must be used in conjunction with culture.

182
Q

What is acid fast?

A

Mycolic acids stain with carbol fuchsin and are not readily decolorized by acids after staining.

183
Q

What is rapid growing MB?

A

Growth within 7 days

184
Q

What can cause a false positive rapid growing MB?

A

Sample from high burden specimen that can grow in as little as 3-4 days.

185
Q

What can cause a false positive slow growing MB?

A

Sample from a low-burden specimen

186
Q

Which mycobacterium have DNA probes?

A

MTB, MAC, kansasii, gordonae

187
Q

How is MTB resistance testing done?

A

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
Q

What are the slow growing mycobacteria? [11]

A

TB, MAC, chimaera, gordonae, heamophilum, kansasii, leprae, marinum, szulgai, ulcerans, xenopi.

189
Q

What are the rapid growing mycobacteria? [3]

A

Abscessus, chrlonae, fortuitum

190
Q

What causes Lady Windermere syndrome?

191
Q

What causes hot tub lung?

192
Q

What causes infection during open-heart surgery due to contaminated heater cooler units?

193
Q

What will be misidentified as MAC by MALDI, MPLC?

194
Q

Which slow growing mycobacteria is a likely contaminate?

195
Q

What does mycobacterium haemophilum require for growth?

A

Incubation at 30-32 degrees and hemin

196
Q

What is the 2nd most common cause of non-TB lung disease in the USA?

197
Q

How is mycobacterium leprae diagnosed?

A

Slit-skin smears or skin scrapings. Does not grow on culture.

198
Q

Is Staph aerobic or anaerobic

199
Q

Is Strep aerobic or anaerobic

200
Q

Is Enterococcus aerobic or anaerobic

201
Q

Is Granulicatella/Abiotrophia aerobic or anaerobic

202
Q

Is Bacillus aerobic or anaerobic

203
Q

Is Corynebacterium aerobic or anaerobic

204
Q

Is Listeria aerobic or anaerobic

205
Q

Is Erysipelothrix aerobic or anaerobic

206
Q

Is Neisseria aerobic or anaerobic

207
Q

Is Moraxella aerobic or anaerobic

208
Q

Is Enterobacteriacaeae aerobic or anaerobic

209
Q

Are Nonfermentors [Aceinetobacter, Pseudomonas] aerobic or anaerobic

210
Q

Is Pasteurella aerobic or anaerobic

211
Q

Are HACEK organisms aerobic or anaerobic

212
Q

At what temp does marinum grow?

A

28-30 degrees celsius

213
Q

What organism causes Buruli ulcer?

A

Mycobacterium ulcerans

214
Q

At what temp does mycobacterium ulcerans grow?

A

29-33 degrees celsius

215
Q

What disease disease does mycobacterium xenopi cause?

A

Pulmonary infection in those with chronic lung disease

216
Q

At what temp does xenopi grow?

A

42-43 degrees celsius

217
Q

What is the most common rapidly growing mycobacterium

218
Q

What type of disease dose abscessus cause?

A

Pulmonary infections, esp in those with CF. Disseminated disease in immunocompromised. Otitis media, soft tissue infections.

219
Q

What is the erm gene

A

This is an inducible gene that allows abscessus to have resistance to macrolides.

220
Q

Which subspecies have the erm gene?

A

Abscessus may contain this. Bolletii 100% has this. Massiliense does not.

221
Q

What type of infections does mycobacterium chelonae cause?

A

Localized and disseminated cutaneous infections. Can be disseminated in immunosuppressed esp those on systemic steroids.

222
Q

What is chelonae’s preferred temperature for growth?

A

28-32 degrees celsius

223
Q

What is molecular detection of drug resistance assay?

A

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
Q

Define multidrug resistant TB

A

Resistant to at least 2 primary first line drugs [isoniazid and rifampin]

225
Q

Define Extensively or Extreme drug resistant TB

A

MDR TB that is resistant to 3 or more 2nd line drugs.

226
Q

What is a giemsa stain?

A

This is used to diagnose H. pylori and H. heilmannii infections. Tough to interpret. Enhanced H and E stain

227
Q

What is a H. pylori immunostain

A

More sensitive and specific giemsa stain but it is slow and expensive.

228
Q

What is a PAS stain?

A

Detects polysaccharides including mucopolysaccharides.

229
Q

What is a Warthin-Starry stain?

A

Silver nitrate stain for dection of Spirochetes [treponema, borrelia, leptospira], H. pylori, Bartonella henselae

230
Q

What is the Fite stain used for?

A

Looking at M. leprae and Nocardia

231
Q

What are the acid fast stains? [3]

A

Ziehl-Neelsen, Kinyoun, Fite

232
Q

Are E. coli and shigella separated on MALDI?

233
Q

What are the nutritionally variant strep?

A

Abiotrophia

Granulicatella

234
Q

Describe the agar brucella grows on

A

Grows on sheep blood and chocolate agar slowly

MAY take 5-6 days to grow.

235
Q

Describe the agar Burkholderia pseudomallei grows on

A

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
Q

Describe the conditions which campylobacter grows

A

Nutritional enrichment

LOWER concentrations of O2

237
Q

Describe the conditions which tularensis grows

A

CAN grow on blood and chocolate agar but not well.

Prefers buffered charcoal yeast extract

238
Q

Examples of acid fast organisms

A

Mycobacterium

239
Q

Examples of modified acid fast organisms [5]

A 
Nocardia species
Rhodococcus species
Gordonia species
Tsukamurella species
Dietzia species
240
Q

Describe when PEP is needed for Burkholdheria

pseudomallei [2]

A

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
Q

Describe LOW risk Burkholdheria exposure [5]

A
  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
Q

Describe HIGH risk Burkholdheria exposure [5]

A
  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
Q

What is the most common cause of lab transmitted infections?

A

Brucella

–> Just opening the plate is enough to cause infection

244
Q

Describe how lab works should be keeps safe from N. meaningitidis?

A

They should all be vaccinated with BOTH vaccines.
AND
PEP if exposed

245
Q

What organisms should the lab be notified of if they are in your differential due to infectivity? [17]

A 
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
Q

How is bla KPC different from New Delhi KPC?

A

New Delhi KPC is resistant to ceftolazane/avibactam

247
Q

What test detects carbapenemase production?

A

Carba NP test

248
Q

How does the carba NP test work?

A
  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
Q

What is VanC?

A

Found in genome of E. gallinarum or E. casseliflavus/flavescens
Leads to intermediate vanco MICs
NOT transmittable.

250
Q

Describe the role of tigecycline in the treatment of acinetobacter

A

Has failed clinically even when active in vitro

251
Q

What type of infection does metamycoplasma hominis cause?

A

Post-cardiothoracic transplant, Pleuritis [pleural effusion], surgical site infection and/or mediastinitis.

252
Q

Treatment of metamycoplasma hominis?

A

Doxy preferred
Clinda or fluroquinolones alternative.
–> NOTE: Unlike other mycoplasma it is intrinsically resistant to macrocodes

253
Q

Why is metamycoplasma hominis difficult to isolate?

A

Requires special media to grow

Does not have a cell wall so does not gram stain.

ID Review (25 decks)

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