Bioterrorism

Question 1

Bacillus anthracis

Answer 1

COLONY: growth on BAP/CHOC (not on MAC), ground-glass, tenacious, non-hemolytic

GRAM STAIN: GPB in chains, central/subterminal spores
Stains in “bamboo rod” appearance

CAT +
Motility -

Transmission: inhalation, ingestion, direct contact
Penicillin susceptible

TX: Pen, Chlor

Question 2

Brucella

Answer 2

COLONY: growth on BAP/CHOC (not on MAC), pinpoint, non-hemolytic

GRAM STAIN: tiny GNCB

CAT+
OX +
Urea +
Satellite -

Transmission: inhalation, unpasteurized dairy products

Question 3

Burkholderia mallei

Answer 3

COLONY: smooth non-hemolytic gray on BAP, NG/PP on MAC

GRAM STAIN: GNB

CAT +
OX variable
Indole -
Motiity -
NG at 42 degrees
Poly B/colistin resistant
Pen resistant
Amoxicillin-clavulanate susceptible

Transmission: inhalation, contact with infected animals, wound contamination

Question 4

Burkholderia pseudomallei

Answer 4

COLONY: non-hemolytic white on BAP, growth on MAC, musty odor

GRAM STAIN: straight or slightly curved GNB

CAT +
OX +
Indole -
Motility +
Poly B/colistin resistant
Pen resistant
amoxicillin-clavulanate susceptible
GROWTH at 42 degrees

Transmission: inhalation, wound contamination

Question 5

Francisella tularensis

Answer 5

COLONY: NG on BAP/MAC, grey shiny growth on CHOC

GRAM STAIN: tiny GNCB

CAT -
OX -
Satellite -
Beta lactamase +

Transmission: inhalation, insect bite, contact with rabbits/rodents, increased during hunting season due to skinning animals

Question 6

Yersinia pestis

Answer 6

COLONY: gray translucent on BAP, NLF on MAC

GRAM STAIN: GNB, “safety pin” staining

CAT +
OX-
Indole -
Urea -

Transmission: inhalation, flea bite, contact with contaminated tissue

Question 7

Anthrax

Answer 7

1) Pulmonary: “wool sorter’s disease”
2) Gastrointestinal: ingest contaminated food -> vomit, diarrhea, shock, death
3) cutaneous: small red lesion -> necrotic/black eschar

Anthrax toxins: PA (protective Ag), EF (edema factor), LF (lethal factor)