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Microbiology > Bacteriology Exam 11 (Anaerobes > Flashcards

Bacteriology Exam 11 (Anaerobes Flashcards

1
Q

What is an obligate anaerobe?

A

Requires 0% oxygen to grow

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2
Q

What is an obligate aerobe?

A

Requires 15-23% oxygen to grow

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3
Q

What is a facultative anaerobe?

A

Requires 0-23% oxygen (can grow with or without)

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4
Q

What is a capnophilic organism?

A

Requires 5-10% CO2

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5
Q

What is an aerotolerant organism?

A

Requires reduced oxygen

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6
Q

What is a microaerophilic organism?

A

Requires 5% oxygen

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7
Q

Where would obligate aerobes vs obligate anaerobes grow in a tube?

A

Obligate aerobes - top
Obligate anaerobes - bottom

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8
Q

Where would facultative anaerobes vs aerotolerant anaerobes grow?

A

Facultative - all throughout the tube, mostly at top
Aerotolerant - throughout the tube

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9
Q

Are endogenous or exogenous organisms more common cause of human disease?

A

Endogenous

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10
Q

Anaerobic environments should consist of what?

A

85% nitrogen
10% CO2
5% Hydrogen gas
0% oxygen

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11
Q

What are the clinical signs of anaerobic infection?

A

Pus producing
Infection near mucosal surface
Infection that persists despite aminoglycoside therapy
Foul odor
Large quantities of gas
Presence of sulfur granules
Infection secondary to human or animal bite

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12
Q

Unacceptable samples for anaerobe testing

A

Throat swabs
NP swabs
Most sputums
Mouth swabs
Feces
Midstream or catheterized urine
Exposed wounds

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13
Q

Acceptable samples for anaerobe testing

A

Aspirated body fluids
Tissue biopsy
Aspirated pus
Surgical samples
Eswabs
Sterile body site fluids
Suprapubic aspirates

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14
Q

What is an example of a medium to transport anaerobes in to the lab?

A

Cairy Blair medium

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15
Q

What are Eswabs stored in?

A

Amies liquid

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16
Q

How long do Eswabs maintain anaerobic conditions?

A

48 hours at room temp

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17
Q

What is PRAS?

A

Pre-reduced, anaerobically sterilized transport media

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18
Q

At what nm is fluorescence observed under UV light?

A

366 nm

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19
Q

What additional nutritional requirements are required for anaerobic plates?

A

Vitamin K
Hemin
Yeast extract

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20
Q

What are types of anaerobic plates?

A

CDC ANA/Brucella (non selective blood agar)
BBE (bacteroides bile esculin)
KVLB (Kanamycin and Vancomycin with Laked Sheep Blood)
PEA
CNA
Cooked meat broth
Thioglycolate broth

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21
Q

What is CDC ANA agar useful for?

A

Best for detection of anaerobic GPC
Useful for hemolysis detection

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22
Q

What is BBE agar useful for? What does it contain?

A

Contains gentamicin and bile to inhibit most aerobes and anaerobes
Helps to identify B. frag group and bile tolerant bacteroides spp.

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23
Q

What color will B. frag group turn on BBE agar?

A

Turns agar black

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24
Q

What is Brucella agar most useful for?

A

Best for GNR

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25
Q

What is KVLB agar most useful for? What does it contain?

A

Bacteroides and Prevotella spp., yeasts, and Kanamycin resistant GNR

Contains Kanamycin that inhibits most GNR
Contains Vancomycin that inhibits most GPO
Contains laked blood that facilitates Prevotella pigmentation (black/brown)

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26
Q

What is PEA agar most useful for?

A

Grows mostly gram positive organisms
Selective media to suppress Enterobacteriaceae

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27
Q

What is CCFA agar useful for? What does it look like?

A

Growth of C. diff with yellow ground glass colony morphology and horse stable odor

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28
Q

What do anaerobic containers contain? What is the purpose of each?

A

Catalyst (removes O2)
Desiccant (Removes condensation)
Anaerobic gas with H2, CO2, N
Indicator (Methylene blue or Resazurin)

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29
Q

If the indicator turns pink (Resazurin) or blue (Methylene blue) what does this mean?

A

This means oxidation has occurred and oxygen has gotten into the anaerobic conditions

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30
Q

If the indicator stays colorless, what does this mean?

A

This means the indicator was reduced and no oxygen is in the anaerobic conditions which is good

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31
Q

When can plates be examined if using anaerobic closed chambers? When can they be examined if using anaerobic jars or pouches?

A

Closed chambers - after 24 hours
Jars/bags - after 48 hours

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32
Q

How long are anaerobic cultures held for?

A

5-7 days

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33
Q

If an organism grows on CO2 plates and Aerobic plates, but not anaerobic plates, what is it?

A

Obligate aerobe

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34
Q

If an organism grows on CO2 plates only, but not anaerobic or aerobic plates, what is it?

A

Capnophile

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35
Q

If an organism grows on CO2 plates, aerobic, and anaerobic plates, what is it?

A

Facultative anaerobe

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36
Q

If an organism grows on anaerobic plates, but not CO2 or aerobic plates, what is it?

A

Obligate anaerobe

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37
Q

What rapid biochemical testing is typically done on Anaerobes?

A

Fluorescence under UV light
Catalase
Spot indole
Urease
Motility
Antimicrobial disks (Kanamycin, vancomycin, colistin disks)
SPS disks

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38
Q

What is Egg Yolk agar selective for?

A

C. perfringens

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39
Q

Positive vs negative lecithinase test

A

Positive: appearance of white, opaque, diffuse zone that extends into the medium surrounding the colonies

Negative: absence of that zone extending from the edge of the colony

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40
Q

Positive vs negative lipase test

A

Positive: appearance of an iridescent sheen
Negative: absence of an iridescent sheen

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41
Q

What anaerobes are gram positive and spore forming?

A

Clostridium sp.

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42
Q

Where are Clostridium species naturally found?

A

Soil

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43
Q

What is Clostridium species very close to and hard to tell apart from? what is the difference?

A

Bacillus sp.
Bacillus is aerobic
Clostridium is anaerobic

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44
Q

What Clostridium sp. have a terminal spore? (of interest)

A

C. tetani

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45
Q

What Clostridium sp. have a subterminal spore? (of interest)

A

C. botulinum
C. difficile

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46
Q

What spore forming organism that we discussed has a central spore, but is aerobic?

A

Bacillus

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47
Q

C. perfringens: Swarming? Double zone hemolysis? Fluorescence? Gram stain? Spore location? Motility? Lecithinase? Lipase? Urease?

A

Swarming: NO
Double zone hemolysis: YES
Fluorescence: NO
Gram stain: POS
Spore location: SUB TERMINAL
Motility: NO
Lecithinase: POS
Lipase: NEG
Urease: NEG

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48
Q

What organism has a double zone of hemolysis?

A

C. perfringens

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49
Q

What organism has a “box car” gram stain morphology?

A

C. perfringens

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50
Q

T/F: C. perfringens is CAMP POS

A

False; it is REVERSE CAMP POS

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51
Q

C. perfringen sens/resis to vancomycin and kanamycin

A

Sensitive to both

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52
Q

Disease associations with C. perfringens

A

Gas gangrene
Food poisoning
Necrotizing bowl diease –> Pig bel disease

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53
Q

What is Pig Bel disease?

A

Associated with C. perfringens –> complication of infection by the Type C strain, mistaken sometimes as the 24 hour bug

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54
Q

What organism is the positive Nagler test used for? What is it?

A

C perfringens, positive result is lecithinase activity after streaking plate with organism and reagent (C perfringens type A antitoxin)

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55
Q

What type of hemolysis does the reverse camp test display for C. perfringens?

A

Bow tie zone of hemolysis towards GBS

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56
Q

C. Difficile: Swaming? Double zone hemolysis? Fluorescence? Gram stain? Spore location? Motility? Lecithinase? Lipase? Urease?

A

Swarming: NO
Double zone: NO
Fluorescence: Chartreuse YES
Gram stain: POS
Spore location: ST
Motility: YES
Lecithinase: NEG
Lipase: NEG
Urease: NEG

57
Q

What is the primary stool pathogen identified on CCFA agar with a yellow ground glass colony?

A

C. diff

58
Q

T/F: C. diff can be normal flora in up to 20% of people In US

A

True

59
Q

What odor does C. Diff give off?

A

Horse stable odor

60
Q

What can C Diff cause?

A

Diarrhea and if not treated can lead to megacolon and pseudomembranous colitis

61
Q

What toxins does C diff release?

A

Toxin A and B

62
Q

What type of stool must C diff be tested on?

A

Runny stools only

63
Q

T/F: C diff is always an infection

A

False; some people can naturally be colonized without issues

64
Q

How do you read the C diff Quik Chek Complete?

A

MUST be a dotted line in the Control area to be valid!
Solid line for Ag = positive Ag
Solid line for Tox = positive tox
No dotted line in C = INVALID

65
Q

C. DIff treatment

A

Take patient off antibiotic causing CDAD
Give metronidazole and vancomycin

66
Q

C. tetani: Swarming? Double zone hemolysis? Fluorescence? Gram stain? Spore location? Motility? Lecithinase? Lipase? Urease?

A

Swarming: YES
Double zone hemolysis: NO
Fluorescence: NO
Gram stain: POS
Spore location: Terminal
Motility: YES
Lecithinase: NEG
Lipase: NEG
Urease: NEG

67
Q

What does C. tetani cause?

A

Tetanus aka lockjaw - RIGID PARALYSIS

68
Q

What vaccine aid in the prevention of C. tetani?

A

TdaP and DtaP

69
Q

Natural environment of C. tetani

A

Soil

70
Q

What organism produces “drum stick” gram stain morphology?

A

C. tetani

71
Q

What toxin does C. tetani release? What does it block?

A

Tetanospasmin; blocks release of neurotransmitters, glycine, and GABA

72
Q

C. botulinum: Swarming? Double zone hemolysis? Fluorescence? Gram stain? Spore location? Motility? Lecithinase? Lipase? Urease?

A

Swarming: YES
hemolysis: NO
Fluorescence: NO
Gram stain: POS
Spore location: ST
Motility: POS (neg sometimes)
Lecithinase: NEG
Lipase: POS
Urease: NEG

73
Q

What is the only lecithinase positive clostridium discussed? What is the only lipase positive clostridium discussed?

A

Lecithinase: C. perfringens
Lipase: C. botulinum

74
Q

What does C. botulinum cause?

A

Botulism - FLACCID PARALYSIS

75
Q

What toxin does C. botulinum release? What does it block?

A

Botulin toxin, blocks release of acetylcholine release from receptor

76
Q

Where is C. botulinum naturally found?

A

Soil

77
Q

How is C. botulinum often transmitted?

A

Through ingestion of spores from improperly canned vegetables and gardening

78
Q

How to treat Botulism?

A

Penicillin

79
Q

What clostridium species has a medusa head colony morphology and is associated with carcinoma of the colon?

A

C. septicum

80
Q

What organisms discussed fluoresce chartreuse under UV light?

A

Fusobacterium and C. diff

81
Q

What organisms discussed fluoresce brick red under UV light?

A

Prevotella sp

82
Q

What are the anaerobic non-spore forming GPRs discussed?

A

Actinomyces, Bifidobacterium, Eubacterium, Lactobacillus, Mobiluncus, Propionibacterium

83
Q

What anaerobic GPR has a spider-like, wooly, breadcrumb, or molar tooth colony morphology?

A

Actinomyces sp.

84
Q

Where is actinomyces normally found?

A

Normal flora of oral cavity, tonsillar crypts, dental plaque, intestinal and female genital tracts

85
Q

What is Actinomycosis?

A

Chronic granulomatous infection that causes development of sinus tracts containing sulfur granules

86
Q

What type of infections does Actinomyces cause?

A

Oral cavity infections/female genital tract infections

87
Q

Where is bifidobacterium normally found?

A

Vaginal area and colon

88
Q

What organism has a “Y” shape gram stain described as rods with forked or “bifurcated ends”

A

Bifidobacterium

89
Q

What anaerobic GPR has (+) 48 hr colony <1 mm, rough colonies, is branched, and has A L S as GLC products?

A

Actinomyces

90
Q

What anaerobic GPR is negative for all biochemicals noted and has A and L as GLC products?

A

Bifidobacterium sp.

91
Q

Where is Eggerthella found? What does the gram stain look like?

A

Normal flora of the colon
GS looks like “birds in flight”

92
Q

Pinpoint alpha hemolytic colonies are growing on aerobic and anaerobic plates. It is normal flora of the vaginal canal and catalase negative. What is it?

A

Lactobacillus sp

93
Q

where is Propionibacterium sp. normally found

A

Normal flora of the skin

94
Q

What are the anaerobic GNR we discussed?

A

Prevotella, Fusobacteria, Bacteroides

95
Q

What bacteria are long, thin, rods with tapered ends?

A

Fusobacterium sp.

96
Q

Fusobacterium: vancomycin and kanamycin R or S? Red fluorescence? Chartreuse fluorescence?

A

Vancomycin R
Kanamycin S
Red fluorescence = neg
Chartreuse = pos

97
Q

What disease does Fusobacterium cause?

A

Lemierre’s syndrome, infectious thrombophlebitis of the internal jugular vein, resembles strep throat

98
Q

What organism has a ground glass appearance colony?

A

Fusobacterium nucleatum

99
Q

Does fusobacterium grow on KVLB?

A

No

100
Q

What organism has a fried egg appearance colony?

A

Fusobacterium necrophorum

101
Q

Does Fusobacterium necrophorum grow on KVLB?

A

Yes

102
Q

What is Lemierre’s syndrome cause by?

A

F. necrophorum

103
Q

Where is F. necrophorum normally found?

A

Body cavities

104
Q

Where is F. nucleatum normally found?

A

Gingival margin and sulcus

105
Q

What are the most prevalent anaerobes isolated from infections?

A

B. frag group (GNR)

106
Q

What Bacteroides group exhibits a high degree of antibiotic resistance?

A

B. frag

107
Q

Will Bacteroides grow on KVLB? BBE?

A

Both

108
Q

Does B. frag fluoresce?

A

No

109
Q

Vancomycin/Kanamycin/Colistin - B frag group

A

R to both

110
Q

What color will B. frag be on BBE? Why?

A

Black because it hydrolyzes esculin

111
Q

How to differentiate B. fragilis from B. thetaiotamicron from B. uniformis?

A

B. fragilis is the only indole negative in B. frag group

B. uniformis will not grow on BBE while the others will

112
Q

What group of anaerobes pits the agar?

A

B. uerolyticus group

113
Q

What is the only Bacteroides that is urease pos?

A

B. ureolyticus

114
Q

What is characteristic of all bile-resistant bacteroides?

A

Able to grow on BBE
Resistant to Colistin, Kanamycin, and Vancomycin - grows on KVLB

115
Q

What group is bile resistant? What group is bile sensitive/tolerant?

A

Bile resistant - B. frag
Bile sensitive - B. ureolyticus

116
Q

Where are bacteroides normally found?

A

Colon

117
Q

What organism(s) fluoresces brick red under UV light?

A

Porphyromonas sp. and Prevotella sp

118
Q

Porphyromonas: growth on KVLB?

A

No because sensitive to VAncomycin

119
Q

What is the colony morphology/color of Porphyromonas on ANA blood agar?

A

Black to brown pigmented due to the production of protoheme

120
Q

What plates will Prevotella grow on?

A

KVLB only. (R to Kanamycin and Vancomycin)
Not BBE (Bile sensitive)

121
Q

What sp produce protoporphyrin during metabolism of Hemin, producing a brown black colony?

A

Prevotella sp

122
Q

What organisms produce protoporphyrin?
What organisms produce protoheme?

A

Protoporphyrin - Prevotella
Protoheme - Porphyromonas

123
Q

How to tell Prevotella and Porphyrmonas apart?

A

Prevotella grows on KVLB (R to vanco) and produces protoporphyrin
Porphyromonas does not grow on KVLB (S to vanco) and produces protoheme

124
Q

Prevotella disease associations

A

Periodontal diseases

125
Q

What organism has a fish eye colony morphology on BBE?

A

Bilophilia wadsworthia

126
Q

Does Bilophilia fluoresce?

A

No

127
Q

Bilophilia disease associations/normal area on body

A

Normal flora of colon
Causes intraabdominal abscesses and gangrenous perforated appendicitis
Associated with appendicitis

128
Q

What is the anaerobic GPC we discussed? What is the anaerobic GNC we discussed?

A

Peptostreptococcus = GPC
Viellonella = GNC

129
Q

Peptostreptococcus (Kanamycin and Vancomycin R or S, does it fluoresce?)

A

Kanamycin S
Vancomycin S
No fluorescence

130
Q

Where is normal site for Peptostreptococcus?

A

Vaginal area, umbilicus, colon, GI

131
Q

Normal site for Veillonella sp?

A

Normal flora of the oral cavity

132
Q

How is Veillonella sp identified?

A

Gram negative cocci staining
Normal flora of the oral cavity
Nitrate reduction +
Catalase +
Red fluorescence

133
Q

What does Veillonella sp look like on CDC ANA?

A

Very very tiny pinpoint easy to miss

134
Q

What are most anaerobe infections treated with?

A

Metronidazole or clindamycin/penicillin

135
Q

Anaerobic GPR that are spore forming

A

Clostridium

136
Q

Anaerobic GNR

A

Bacteroides
Fusobacterium
Prevotella

137
Q

Anaerobic GNC

A

Veillonella

138
Q

Anaerobic GPR that do not form spores

A

Actinomyces
Bifidobacterium
Eubacterium
Lactobacillus
Propionibacterium

139
Q

Anaerobic GPC

A

Peptostreptococcus

Microbiology (24 decks)

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