Define Nonfermenter Flashcards
- Define nonfermentative?
- Bacteria do not ferment glucose but may or may not oxidize glucose.
- Aerobic, nonsporeforming, nonfermenting GNRs.
- Cause disease primarily in immune compromised.
- State 4 “clues” that suggests that a GNR is a nonfermenter.
- Lack of glucose fermentation (TSI K/K, glucose negative on Enterotube or API).
- Oxidase = positive
- No growth / poor growth on MAC (if growth, clear colonies NLF)
- Resistant to antibiotics: (aminoglycosides, cephalosporins, imipenem, penicillins)
- Describe and explain the possible reactions of the OF glucose test.
a. Use special tubes with a constriction in the tube or 2 tubes with same media, but one is overlaid with mineral oil (closed tube). The other is left exposed to air (open tube).
b. Interpretation:
1. Acid produced in both open and closed = fermenter (A/A)
2. No acid produced in the closed tube, acid produced in the open tube = Oxidize (A/K) 3. No acid in the closed tube and no acid in the open tube = Nonoxidizer, nonfermenter, inert, asaccharolytic (K/K)
- State the three most commonly isolated nonfermenters.
- Pseudomonas
- Stenotrophomonas maltophilia
- Acinetobacter
- Pseudomonas aeruginosa
A. gram stain. F. Colony morphology
B. Oxidase. G. Motility
C. Catalase. H. Growth at 42 degrees C
D. TSI. I. Growth on MAC
E. OF glucose. J. Pigment production
K. Clinical significance.
A. Gram stain = GNR B. Oxidase = positive (+) C. Catalase = positive (+) D. TSI = K/K, H2S (-) E. OF glucose = A/K (oxidized)
F. Colony morphology = beta hemolytic, large/spreads colonies, flat
“Grape-like odor, blue-green on SBA, MAC.
Discoloration of media, silvery sheen on SBA.
G. Motility = polar, monotrichous flagellum.
H. Temperature = grwoth at 42 C (but better pigment production at RT).
I. They grow on MAC (NLF).
J. Pigment production = EMB pigments produced
1. Pyocyanin = green/blue 2. Pyorubin = red 3. Pyoverdin = yellow/ green, fluorescent 4. Pyomelanin = brown.
K. Clinical significance :
1. bactermeia 2. Wound infection related to trauma 3. Pulmonary disease - especially with cystic fibrosis. 4. Nosocomial infections = UTI - in dwelling catheters. 5. Endocarditis 6. Burn wound infections 7. Colonizers hot tubs, jacuzzis, etc. - cause infections 8. Causes swimmer’s ear 9. Over all = opportunistic infection
- Stenotrophomonas maltophilia
- Gram stain = nonfermentative GNR
- Oxidase = negative (-)
- Catalase = positive (+)
- TST = K/K
- OF glucose = oxidizes glucose and maltose (A/K)
- Colony morphology = rough, lavender/green/ pale yellow
Ammonia-like odor - Motility = positive (+)
- Growth at 42 C
- Grow at MAC (NLF)
- Pigment production = No pigments produced
- Clinical Significance:
A. Plant pathogen
B. Seen as nosocomial pathogen in hospitals.
C. Not part of normal human flora.
5(c). Acinetobacter
A. Gram stain = GNCB
B. Oxidase. = negative (-)
C. Catalase. = positive (+)
D. TSI = K/K or K/N (N= neutral)
E. OF glucose : Acinetobacter baumannii = A/K (oxidizer)
Acinetobacter lwoffi = K/K (asaccharolytic)
F. Colony morphology
0.5 - 2.0 mm colonies, white to gray, convex, entire, gamma
Hemolytic, “fishy odor”
G. Motility = nonmotile (-)
H. Grow at 42 C
I. Grow on MAC = colonies have faint purple - blue tint (NLF). May look like LF.
J . Grow on EMB = colonies are a deep cornflower blue color.
K. Pigment production = neither one is pigmented
L. Clinical Significance:
1. Normal flora mucous membranes and skin
2. Ubiquitous in the environment ( grow at anywhere).
3. Nosocomial infections
4. Opportunistic pathogen : pneumonia, UTI, endocarditis, septicemia, meningitis, cellulitis.
- State gram stain, oxidase and significance of Moraxella. (What may Moraxella be confused with from a genital source on GS.
- Gram stain = bipolar GNR or GNCB
- Oxidase. = positive
- Significance of Moraxella = small colonies (push colonies) on SBA.
- Can confuse with Neisseria in the female genital tract
. Nessieria are fermenters, Moraxella are not
. Moraxella are normal flora in respiratory tract, genitourinary tract.
- State gram stain, oxidase, indole, and clinical significance of Chryseobacterium meningosepticum.
- Gram stain = GNR : long, thin with bulbous ends.
- Oxidase. = positive
- Indole. = positive in most species.
- Clinical significance = not normal flora in humans
. Cause opportunistic infections.
. Delayed fermentation
- State gram stain, oxidase, colony morphology, and clinical significance of Eikenella corrodes.
- Gram stain. = GNR
- Oxidase. = positive
- Colony morphology : produce yellow pigmented colonies
Pits the agar (“corrodens”).
Bleach-like odor - Clinical significance :
. Normal oral cavity flora (mouth), and GI flora
. Found in dental infections, root canals, human bite wounds,
. Needle/skin poppers (where IV drug users wet the needle with saliva)
. Clenched fist injuries where traumatic implantation/ puncture occurs
. Forcing the organism to the bone
- State gram stain and oxidase of Alcaligenes.
- Gram stain = GNR = aerobic
- Colony morphology = fruity odor
Like the freshly peeled green peel of green summer apples. - Oxidase = positive
- Found in swimming pools, tap water, dialysis fluids.
- HÁČEK acronym
H. = Haemophilus sp
A = Aggregatibacter actinomycetemcomitans
C = Cardiobacterium hominids
E = Eikenella corrodens
K. = Kingella sp.
10 . Bordetella pertussis
- Gram stain = GNCB - pale - double safari not time.
- Special media = Border Gengou media (or) Reagan Lowe(blood
Charcoal agar). - Optimal specimen = Nasopharyngeal Swab
- Source of Infection = spread by respiratory aerosols
- Clinical Significance: Whooping cough
- Unique colony morphology : “Droplets of mercury”
Silvery sheen, shines, dome
- Brucella melitensis = goats
Brucella Suis. =. Pigs
Brucella Cainis = dogs
Brucella abortus = cattle
- Gram stain =
- Special media = SBA, CHOC, BCYE
- Specimen = blood
- Source of infection = contact with contaminated milk or animals/ paws.
- Clinical significance :
Cause “Brucellosis = undulant fever (up and down fever).
- Francisella tularensis = squirrels, rabbits beavers
Gram stain = GNB
- Special media = BCG ( blood Cysteine Glucose agar)
- Optimal specimen = sputum, skin biopsy, wound
- Source of infection = direct contact with, ingestion of meat, aerosol inhalation
Bites, handily infected bites
- Pasteurella multocia = dogs and cats
- Gram stain = GNCB
- Special media = grow on SBA, CHOC, MAC
No grow on MAC
Oxidase = positive
Spot indole = positive - Specimen. = exudate from bites/ scratches wounds
- Source of infection = transmitted through bites/ scratch
- Clinical significance
. Pasteurellosis
. NURF (normal upper respiratory flora) in dogs and cats. - Clinical significance = animal bite infections
- Colony morphology = gamma hemolysis, circular, entire, gray
“Musty, mushroom odors”
- Streptobacillus moniliformis = rats/ mice
- Gram stain =
- Special media = media must be supplemented with serum.
. Broth supplement with serum + patient’s specimen - Specimen = blood
- Source of infection = rat/mouse bite, contact with rodent urine.
Ingest contaminated milk/H2O - Clinical significance = Haverhill fever = ingest contaminated milk/water
- unique colony morphology = puff ball or fluff ball colonies in broth
- Legionella pneumophila
- Gram stain = GNR
- Special media = BCYE (Buffered charcoal yeast Extract)
- Specimen = sputum, bronchial washings/brushing, lung biopsy
- Source of infection:
Found in water sources: air conditioning, cooling water pipes, dentist office. - Clinical significance = Legionnarie’s disease - pneumonia - stystemic
Mortality rate 15 - 30%
Pontiac fever - milder - flu-like symptom - Unique colony morphology =
. “Speckled opalescence = ground glass
- Gardnerella vaginalis
State gram stain, oxidase, catalase, media required, colony morphology, confirmatory test and clinical significance.
- Gram stain = pleomorphic GVR
- Oxidase = negative (-)
- Catalase = negative (-)
- Media required = HBT (Human Bilager Tween)
- Colony morphology : small beta hemolysis colonies
Tiny pinpoint colonies on SBA, CHOC. - Confirmation test = hippurate hydrolysis, culture, GS, Selective HBT
- Clinical significance = bacterial vaginitis = vaginal discharge with odor
- Describe clue cell
Clue cell = squamous epithelial cells around with gram variable pleomorphic rods.
- Campylobacter pylori
Found in domestic animals = dogs, cats, chicken, water faucets, turkey
- Gram stain = GNR : seagulls , S shape
- Oxidase. = positive (+)
- Catalase = positive
- Motility = single polar flagella
- Definitive identification test = Differential susceptibility test
. Nalidixic Acid = S
Cephothin. = R - Media = Campy-BAP (Brucella (blood) agar plate), SBA + antibiotics.
- Temperature =42 c
Atmosphere required = microaerophilic = like decreased O2
Capnophilic
(5% oxygen, 10% CO2, 85% N2)
- Colony morphology = minimum 72 hours tendency to growth confluently along the streak line.
- Source of infection =
Ingestion of raw milk
Poorly cooked poultry, contaminated water, handling infected pets. - Clinical significance = bacterial gastroenteritis on a worldwide basic.
Gastroenteritis = abdominal pain, bloody urea, chilling, fever.
- Vibrio = fresh + Salt water, shellfish = oyster
- Gram stain = GNR
- Oxidase. = positive
- Catalase = positive
- Media = TCBS ( Thiosulfate Citrate Bile Salts Source)
Growth - yellow- sucrose fermenter
Growth - green color - V.parahemolyticas (+), V. Vulnificus. - Source of infection =
. Contaminated food/ water sources: shellfish - Clinical significance = cholera
. Dehydration, electrolyte imbalances - shock - death
. 10-30 days stool/day, “rice water” stool.
- Aeromonas
Gram stain = GNR
Oxidase = positive
Catalase = positive
Clinical infection = infected by freshwater exposure
Wound infection
- Plesiomonas shigelloides
- Gram stain = GNR
- Oxidase = positive
- Catalase = positive
- Clinical significance = infected through ingestion contaminated food/ water source
. Vets, zoo keepers, fish handlers
- State how to screen for Vibrio, Aeromonas and Plesiomonas.
Stool ———on SBA (sweep oxidase = heavy colonize area) Incubate for 18-24 hrs, oxygen, 35 C Sweep loop through heavy area of growth Oxidase (+) = suspicious = V,A, P Oxidase (-) = rule out = V, A, P
- State the clinical significance of Helicobacter pylori
- Peptic ulcer (vast majority cause peptic ulcer)
- Chronic superficial gastritis (type B gastrins)
- Rapid urease producer = within minute .