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Microbiology > FINAL EXAM > Flashcards

FINAL EXAM Flashcards

1
Q
  • requires 15-21% oxygen for growth

- i.e., Mycobacteria

A

obligate aerobe

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2
Q
  • can grow with or without oxygen

- i.e., Enterobacteriaceae

A

facultative anaerobe

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3
Q
  • grow in reduced oxygen (< 5%)

- i.e., Campylobacter, Neisseria, Helicobacter

A

microaerophilic

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4
Q

cannot grow in the presence of oxygen

A

anaerobe

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5
Q
  • grow in the presence of 5-10% carbon dioxide

- Haemophilus, Neisseria

A

capnophilic

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6
Q
  • enriched media
  • contains blood cells
  • used to identify hemolysis
A

SBA

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7
Q
  • enriched media

- contains lysed blood cells that release NAD

A

Chocolate agar

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8
Q
  • enriched media
  • selective for organisms that require cysteine for growth
  • Legionella, Francisella
A

BCYE (Buffered Charcoal Yeast extract)

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9
Q
  • differential media for gram-negatives
  • contains lactose, bile salts, neutral red indicator, crystal violet
  • lactose-fermenters appear pink
A

MAC (MacConkey Agar)

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10
Q
  • selective media for gram-negative coliforms
  • permit isolation of stool pathogens
  • differential for lactose and sucrose fermentation
  • orange (non-pathogens), green/blue (pathogens)
A

HE (Hektoen enteric) media

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11
Q
  • selective media for gram-negative coliforms
  • permit isolation of stool pathogens
  • Citrobacter, E. coli are yellow on plate
  • Shigella is colorless
  • Salmonella is red with black centers
A

XLD (xylose-lysine-deoxycholate) agar

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12
Q
  • antibiotic media
  • chocolate agar
  • vancomycin, colistin, nystatin and trimethoprim
A

MTM (Modified Thayer Martin)

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13
Q

What do antibiotics in MTM inhibit?

A
  • Vancomycin inhibits gram-positives
  • Colistin inhibits gram-negatives
  • Nystatin inhibits yeasts
  • Trimethoprim inhibits swarmers (Proteus)
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14
Q

Micrococcaceae General Characteristics

A
  • Gram-positive cocci, catalase positive, singly, pairs or in clusters
  • Colony morphology: cream-colored, buttery on BA or CNA, some produce Beta hemolysis
  • aerobic or falcultative anaerobes, non motile, non spore forming, non encapsulated
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15
Q
  • gram positive cocci
  • catalase +, coagulase -
  • Bacitracin S
A

Micrococcus luteus

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16
Q
  • gram positive cocci
  • beta hemolytic
  • catalase +, coagulase +
A

Staphylococcus aureus

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17
Q
  • gram positive cocci
  • catalase +, coagulase -
  • Novobiocin R, Bacitracin R
  • UTI’s in young, sexually active women
A

Staphylococcus saprophyticus

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18
Q

S. aureus Virulence factors

A
  • coagulase, hyaluronidase, lipase
  • enterotoxins (A-E, G-I, exfoliative, cytolytic)
  • Protein A
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19
Q

Infections/Syndromes caused by S. aureus

A
  • gastric infections and food poisoning
  • LITERALLY ANYTHING
  • Toxic Shock Syndrome (tampons, DIC)
  • Scalded Skin Syndrome (SSS)
  • Toxic Epidermal Necrolysis (TEN)
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20
Q
  • selective for E. coli O157:H7 (doesn’t ferment sorbitol)

- looks for sorbitol fermentation

A

SMAC plate

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21
Q

Plate that X and V strips are added to for Haemophilus differentiation

A

Mueller-Hinton agar

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22
Q
  • contains lecithinase and lipase
  • C. perfringens is lecithinase +
  • used for anaerobes
A

Egg Yolk Agar (EYA)

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23
Q

differential media for gram positives

A

CNA

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24
Q
  • selective media for Vibrios
  • contains thiosulfate, citrate, bile salts and sucrose
  • cholera and alginolyticus turn yellow
A

TCBS agar

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25
Q

selective media for Burkholderia cepacia

A

OFPBL

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26
Q
  • shows Prevotella pigment

- B. fragilis grows on it

A

KVLB agar

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27
Q
  • gram positive cocci
  • catalase +, coagulase -
  • Novobiocin S, Bacitracin R
A

Staphylococcus epidermidis

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28
Q
  • gram positive cocci
  • catalase -, beta hemolytic
  • PYR +, CAMP -
  • Optochin R, Bacitracin S
A

Group A Strep (S. pyogenes)

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29
Q
  • gram positive cocci
  • catalase -, alpha hemolytic
  • Optochin S, sodium desoxycholate +
A

Streptococcus pneumoniae

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30
Q
  • gram positive cocci
  • alpha hemolysis
  • bile esculin +, 6.5% NaCl -, PYR -
A

Group D Strep (S. bovis)

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31
Q

S. pyogenes Virulence factors

A
  • Protein M, Protein F, DNase, hyaluronidase, Streptolysin

- capsule, toxins

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32
Q

Infections of Group A Strep

A
  • Streptococcus Toxic Shock Syndrome
  • skin infections, scarlet fever, necrotizing fasciatus
  • Complications: acute rheumatic fever, acute glomerular nephritis
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33
Q
  • gram positive cocci
  • catalase -, beta hemolytic
  • PYR -, CAMP +
  • Bacitracin R, hippurate hydrolysis + (+ = purple)
A

Group B Strep (S. agalactiae)

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34
Q

Group B Strep Virulence factors

A
  • capsule

- DNase, protease

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35
Q

Infections of Group B Strep

A
  • invasive disease in newborns

- endometritis and endocarditis

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36
Q

S. pneumo Virulence Factors

A
  • capsule

- IgA protease, hyaluronidase

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37
Q

Infections of S. pneumo

A 
#1 pneumonia agent in adults
#1 agent of adult meningitis
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38
Q
  • gram positive cocci
  • catalase -, bile esculin +
  • 6.5% NaCl +, PYR +
A

Enterococcus

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39
Q
  • gram negative diplococci
  • oxidase +, catalase +, superoxol +
  • grows on MTM
  • utilizes glucose
A

Neisseria gonorrhoeae

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40
Q
  • gram negative diplococci
  • oxidase +, catalase +
  • utilizes glucose and maltose
A

Neisseria meningitidis

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41
Q
  • gram negative diplococci
  • oxidase +, catalase +
  • grows on MTM
  • utilizes glucose, maltose and lactose
A

Neisseria lactamica

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42
Q

N. gonorrhoeae Virulence Factors

A

pili, capsule, IgA protease

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43
Q

Infections of N. gonorrhoeae

A
  • Males: dysuria, discharge, prostatitis, urethral stricture

- Females: up to 80% asymptomatic, discharge, leads to PID

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44
Q
  • gram negative cocci, non-motile
  • oxidase +
  • asaccharolytic
A

Moraxella catarrhalis

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45
Q
  • gram positive bacilli
  • catalase +, non-motile, bile esculin -
  • Babe-Ernst granules (seen on Loeffler’s serum agar)
A

Corynebacterium diphtheriae

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46
Q

C. diphtheriae Virulence factors

A
  • diphtheria exotoxin

- test for toxin with Elek test

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47
Q

Infections of C. diphtheriae

A

Respiratory infection spread by aerosols

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48
Q
  • gram positive bacilli
  • catalase +, CAMP + (block)
  • growth at 4C, tumbling motility, umbrella motility
  • bile esculin +
A

Listeria monocytogenes

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49
Q
  • gram positive bacilli
  • catalase -, non-motile
  • TSI is H2S +
  • mostly occupational exposure (animals)
A

Eresipelothrix rhusiopathiae

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50
Q
  • gram positive bacilli (variable)
  • resemble fungi
  • weakly acid fast
A

Nocardia

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51
Q
  • gram positive bacilli
  • agent of anthrax
  • medusa head or egg whites, non-motile
  • lecithinase +, string of pearls morphology
A

Bacillus anthracis

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52
Q

Infections/Virulence of B. anthracis

A
  • virulence: exotoxin
  • cutaneous anthrax
  • pulmonary anthrax
  • GI anthrax
  • injection anthrax
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53
Q
  • gram positive bacilli
  • catalase +
  • motile (flagella)
A

Bacillus cereus

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54
Q

Enterobacteriaceae General Characteristics

A
  • ferment glucose
  • reduce nitrate to nitrites
  • oxidase negative (except Plesiomonas)
  • motile at body temperature (except Klebseilla, Shigella, Yersinia)
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55
Q
  • gram negative bacilli
  • lactose fermenter, beta hemolytic, A/A
  • ferments glucose, lactose, trehalose, and xylose
  • H2S -, DNase -, urease -, PAD -, and citrate -
  • IMVC (+ + - -)
A

E. coli

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56
Q

Types of E. coli GI Infections

A
  • Enteropathogenic: infantile diarrhea (no blood)
  • Enterotoxigenic: Traveler’s diarrhea (large inoculum)
  • Enteroinvasive: like Shigella (large inoculum), blood, WBCs
  • Enterohemorrhagic: bloody diarrhea, no WBC’s, O157:H7, Shiga-like toxin
  • Enteroadherent: DAEC and EAEC (UTI’s)
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57
Q
  • gram negative bacilli, non-motile
  • lactose fermenter, A/A
  • citrate +, H2S -, PAD -, urease -, MR -
  • Indole - (oxytoca is +)
  • IMVC - - + +
A

Klebsiella

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58
Q
  • gram negative bacilli
  • lactose fermenter, A/A
  • citrate +, H2S -, PAD -, urease -, MR -
  • IMVC - - + +
  • lysine + (except cloacae), ODC +
A

Enterobacter

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59
Q
  • gram negative bacilli
  • NLF, citrate +, H2S -, PAD -, urease -, MR -, A/A
  • IMVC - - + +
  • ONPG +, slow lactose, DNase +
A

Serratia

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60
Q
  • gram negative bacilli
  • swarming on lab media, NLF
  • PAD +, K/A H2S +
  • lactose -, urease +, indole -, ODC +, MR +
A

Proteus mirabilis

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61
Q
  • gram negative bacilli
  • swarming on lab media, NLF
  • PAD +, A/A H2S +,
  • lactose -, urease +, indole +, ODC -, MR +
A

Proteus vulgaris

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62
Q
  • gram negative bacilli
  • lactose fermenter
  • MR +, VP -, LDC -
  • citrate +
A

Citrobacter

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63
Q
  • gram negative bacilli
  • NLF, motile
  • MR +, PAD +, H2S -, citrate -
A

Morganella

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64
Q
  • gram negative bacilli
  • nosocomial infections, NLF, K/A
  • MR +, indole +, PAD +, H2S -, citrate +
A

Providencia

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65
Q
  • gram negative bacilli
  • NLF, motile, K/A H2S+
  • LDC +, urea -, indole +, MR +, PAD -
A

Edwardsiella

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66
Q
  • gram negative bacilli
  • NLF
  • K/A H2S +, indole -, VP -, PAD -, urease -, MR +, citrate + (typhi is -), lysine +
A

Salmonella

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67
Q
  • gram negative bacilli
  • NLF, non-motile
  • K/A H2S -, ONPG +, ODC +, urease -, H2S -, LDC -, MR +
A

Shigella

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68
Q

Four Types of Shigella

A
  • (A) S. dysenteriae: most serious
  • (B) S. flexneri: 2nd most common in US
  • (C) S. boydii: in developing countries
  • (D) S. sonnei: most common in US
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69
Q
  • gram negative bacilli, NLF
  • K/A H2S -, non-motile at 37C
  • grows at cold temps
  • ODC +, MR +, PAD -
  • enterocolita = target growth on CIN agar
A

Yersinia

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70
Q

Lysine decarboxylase (breakdown)

A

Lysine –> cadaverine + CO2

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71
Q

Ornithine decarboxylase (breakdown)

A

Ornithine –> putrescine

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72
Q

Arginine dihydrolase (breakdown)

A

arginine –> citrulline –> ornithine –> putrescine

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73
Q

Vibrio cholera infections/symptoms

A
  • rice water stool
  • extreme loss of electrolytes
  • cholera toxin
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74
Q
  • gram negative bacilli, curved rods
  • catalase +, oxidase +, reduce nitrate
  • Vibriostat (0/129) S, String test +
  • yellow on TCBS, grows in 0% NaCl
A

Vibrio cholera

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75
Q
  • gram negative bacilli, curved rods, oxidase +
  • summer diarrhea in Japan
  • associated with seafood
  • some are urease +
  • green on TCBS
A

Vibrio parahaemolyticus

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76
Q
  • gram negative bacilli, curved rods, oxidase +
  • associated with raw or undercooked seafood (oysters)
  • lactose + vibrio
  • green on TCBS
A

Vibrio vulnificus

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77
Q
  • gram negative bacilli, curved rods, oxidase +

- mimics cholera, yellow on TCBS

A

Vibrio alginolyticus

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78
Q
  • gram negative rods
  • oxidase +, glucose fermenting, beta hemolytic
  • straight gram-negative rods, indole +
  • mesophilic and psychophilic groups
  • infection associated with contaminated water
  • string test -, Vibriostat disk R
  • growth in 0% NaCl, inositol -
A

Aeromonas

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79
Q
  • gram-negative rods
  • similar to Shigella, but lower virulence
  • oxidase +, Vibriostat S, growth in 0% NaCl
  • NLF, motile, IBB agar, ODC +, LDC +, ADH +
A

Plesiomonas

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80
Q
  • gram negative rod
  • microaerophilic (5% O2)
  • non-spore forming rods (seagull-wing shape)
  • oxidase +, catalase +
  • darting motility
  • # 1 cause of diarrhea world-wide
  • Campy BAP, Skirrow media
A

Campylobacter jejuni

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81
Q
  • gram negative rod
  • urease +
  • causes ulcers, leads to gastric carcinoma
A

Helicobacter pylori

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82
Q
  • gram negative bacilli
  • blue/green hue on MAC , grape-like odor
  • oxidase +, catalase +, glucose oxidizer
  • motile, capsule, DNase, protease, Exotoxin A
  • growth at 42C, ADH +, citrate +, K/K
A

Psuedomonas aeruginosa

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83
Q

Psuedomonas dyes

A

pyocyanin (green hue) and pyoverdin (fluorescence)

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84
Q

Infections/syndromes of Psuedomonas

A
  • nosocomial infections
  • pneumonia in CF patients
  • Hot tub syndrome
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85
Q
  • gram negative coccobacilli
  • oxidase -, catalase -, non-motile, NLF
  • purple on MAC, K/K
A

Acinetobacter baumanii

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86
Q
  • gram negative bacilli, rough colonies
  • lavender/green hue on MAC, NLF, ammonia odor
  • oxidase -, catalase +, non-oxidizer of glucose
  • DNase +, Esculin +, LDC +, Gelatin +, K/K
A

Stenotrophomonas maltophila

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87
Q
  • gram negative bacilli, motile
  • slow oxidase +, glucose oxidizer
  • ONPG +, LDC +, K/K
  • OFPBL, BCSA selective agars
A

Burkholderia cepacia

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88
Q
  • gram negative long/thin bacilli, non-motile
  • hospital contaminants
  • DNase +, oxidase +, Gelatin +, indole +
  • Doesn’t grow on MAC
  • meningitis and septicemia in newborns
A

Elizabethkingia meningoseptica

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89
Q
  • gram negative bacilli
  • smooth, brown/tan colonies on SBA, grows on Mac
  • motile (polar flagella), oxidase +, H2S + on TSI
A

Shewanella

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90
Q
  • gram negative bacilli
  • capsule, sattelitism on BAP with S. aureus, IgA protease
  • Growth on chocolate
  • oxidase +, catalase +, reduce nitrate, porphyrin -
A

H. influenzae

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91
Q

Special growth requirements of Haemophilus

A
  • X & V factor: H. influenzae, H. aegyptius, H. hemolyticus (Quad I, IV)
  • V factor: H. parainfluenzae (Quad I, III, IV)
  • X factor: H. ducreyi
  • Mueller-Hinton agar with X and V strips
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92
Q

H. influenzae infections

A

Hib is the #1 cause of meningitis is unvaccinated children

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93
Q
  • gram negative bacilli
  • fastidious, requires X factor, no growth on MAC
  • pits agar, K/K, oxidase +, catalase -
  • bleach-like odor
A

Eikenella

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94
Q
  • gram negative bacilli, non-motile
  • oxidase +, catalase -, A/A
  • growth on MTM
  • affects bones/joints of kids
A

Kingella

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95
Q
  • gram negative coccobacilli, STI
  • painful chancroid, buboes
  • school of fish morphology
A

Haemophilus ducreyi

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96
Q

HACEK (organsims)

A
  • Haemophilus (Aggregatibacter aphrophilus)
  • Actinobacillus/Aggregatibacter actinomycetemcomitans
  • Cardiobacterium hominis
  • Eikenella corrodens
  • Kingella species
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97
Q

HACEK (characteristics)

A
  • Don’t grow on MAC, slow growers
  • usually bite wounds (mouth flora)
  • cause endocarditis
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98
Q
  • gram negative bacilli, non-motile
  • fastidious, no growth on MAC
  • bipolar staining, zoonotic infections
  • catalase +, oxidase +
A

Pasteurella multocida

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99
Q
  • gram negative bacilli
  • oxidase +, catalase +, H2S +
  • urease +
  • undulant fever, zoonotic infections
  • specimen: bone marrow*, test with growth in dyes
A

Brucella

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100
Q
  • gram negative bacilli
  • requires cysteine for growth (BCYE agar)
  • no growth on MAC, SBA
  • zoonotic infections, rabbit fever, tularemia
A

Francisella tularensis

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101
Q
  • gram negative bacilli (weakly staining)
  • require cysteine for growth (BCYE agar)
  • inhalation transmission, associated with AC units
  • invades and survives in macrophages
  • Pontiac fever
A

Legionella pneumophilia

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102
Q

Bordetella virulence factor

A

pertussis toxin

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103
Q
  • gram negative bacilli
  • smooth, silver pinpoint colonies (like mercury droplets)
  • whooping cough
  • specimen collected on Dacron swab
  • use Bordet-Gengou agar
A

Bordetella pertussis

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104
Q
  • can survive some oxygen exposure, but can’t perform metabolic processes unless in an anaerobic environment
  • i.e., Bacteroides
A

Aerotolerant anaerobe

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105
Q
  • requires strict anaerobic environment and are killed almost immediately in the presence of oxygen
  • i.e., Clostridium
A

Obligate anaerobe

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106
Q

Exogeneous anaerobes

A
  • exist outside of the body
  • infection develops at site of entry
  • i.e., Clostridium, Fusobacterium
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107
Q

Endogeneous anaerobes

A
  • exist inside the body
  • source of infection in/throughout body
  • usually polymicrobial infections
  • i.e., Bacteroides, Peptostreptococcus, Actinomyces
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108
Q

Skin anaerobes

A

Propionibacterium, Peptostreptococcus

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109
Q

Respiratory anaerobes

A

Prevotella, Porphyromonas, Fusobacterium

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110
Q

GI anaerobes

A

Bacteroides, Clostridium

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111
Q

Genitourinary tract anaerobes

A

Fusobacterium, Prevotella, Bacteroides, Lactobacillus

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112
Q
  • gram positive bacilli, anaerobic
  • spore forming, boxcar-shaped
  • double zone of beta hemolysis
  • lecithinase +, catalase -
  • causes gas gangrene (alpha toxin)
A

Clostridium perfringens

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113
Q
  • gram positive bacilli, anaerobic
  • spore forming, heavily swarming
  • terminal spores
A

Clostridium tetani

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114
Q
  • gram positive bacilli, anaerobic
  • spore forming, heavily swarming
  • subterminal spores
A

Clostridium septicum

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115
Q

Clostridium botulinum infection

A
  • causes botulism
  • botulism toxins
  • due to ingestion of toxin, ingestion of spores in infants
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116
Q
  • antibiotic-associated diarrhea
  • causes pseudomembranous colitis (blood, necrosis)
  • nosocomial infection, CCFA agar
  • fluoresces chartreuse
A

Clostridium difficile

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117
Q
  • gram positive bacilli, anaerobic
  • normal skin flora
  • causes granulomatous disease (“sulfur granules”)
  • molar tooth colonies, infected IUD’s, lumpy jaw
A

Actinomyces

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118
Q
  • gram negative bacilli, anaerobic
  • # 1 flora in colon
  • grows on KVLB and BBE
  • bile tolerant
  • pilonidal cysts
A

Bacteroides fragilis

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119
Q
  • gram negative bacilli, anaerobic
  • # 1 gingiva flora
  • brick-red fluorescence on KVLB (then turn black)
A

Prevotella melaninogenica

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120
Q
  • gram negative bacilli, anaerobic
  • slow grower
  • brick-red fluorescence on KVLB (then turn black)
A

Porphyromonas

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121
Q
  • gram negative bacilli, anaerobic
  • long, thin rods with pointed ends
  • fluoresces chartreuse
  • nonhemolytic, indole +, lipase -
A

Fusobacterium nucleatum

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122
Q
  • gram negative bacilli, anaerobic
  • pleomorphic with rounded ends
  • fluoresces chartreuse
  • beta hemolytic, indole +, lipase +
A

Fusobacterium necrophorum

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123
Q
  • gram positive cocci, anaerobic
  • common contaminant, skin flora
  • catalase -, indole -, urease -, nitrate -, SPS S
A

Peptostreptococcus anaerobius

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124
Q
  • gram positive cocci, anaerobic
  • common contaminant, skin flora
  • catalase -, indole -, urease -, nitrate -, SPS R
A

Peptostreptococcus asaccharolyticus

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125
Q

Anaerobic specimen collection

A
  • aspirates collected and transported on PRAS media

- use methanol as fixative for gram staining instead of heat

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126
Q

Vancomycin disk susceptibility

A
  • S: Porphyromonas, Clostridium

- R: Bacteroides, Prevotella, Fusobacterium

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127
Q

Kanamycin disk susceptibility

A
  • S: Bacteroides, Fusobacterium

- R: B. fragilis, Prevotella, Porphyromonas

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128
Q

Colistin disk susceptibility

A
  • S: Prevotella, Fusobacterium, Bacteroides

- R: B. fragilis, Porphyromonas, Clostridium

129
Q
  • helical shapted
  • Borrelia, Treponema, Leptospira
  • mostly identified by serology
  • Fletcher’s media, Stuart’s media, Kelly medium
A

Spirochetes

130
Q
  • obligate aerobic helical rods
  • tightly coiled, thin, flexible
  • 20 serovars
  • reduced phagocytosis, hemolysis and endotoxins
  • disease associated with contact with infected urine
  • zoonotic disease
A

Leptospires

131
Q
  • loosely coiled
  • arthropod borne (tick)
  • microaerophilic
  • causes relapsing fever
  • can get Jarisch-Herxheimer reaction (death of spirochetes can cause sudden endotoxin release)
A

Borrelia recurrentis

132
Q
  • Lyme disease
  • transmitted via tick bite (Ixodes)
  • complement evasion (binds factor H)
A

Borrelia burgdorferi

133
Q

Treponema virulence

A
  • penetrate intact mucous membranes
  • crosses placenta
  • dissemination
  • antigenic variation
134
Q

Syphilis infection

A
  • Primary: PAINLESS chancre at site of infection
  • Secondary: widespread macular rash
  • Latent: non-infectious, detect with serology
  • Late: CNS disease, congenital syphilis
135
Q

Congenital syphilis (symptoms)

A
  • non-immune hydrops (placental disease causing fetal death)
  • bone lesions, hepatosplenomegaly
  • visible deformities (tibias, Hutchinson’s teeth)
136
Q
  • obligate intracellular parasite
  • EB and RB stages of life cycle
  • most common STI in the US
  • can cause Reiter syndrome, Lymphogranuloma venereum
A

Chlamydia trachomatis

137
Q

Chlamydia infection in men

A
  • Nongonococcal urethritis (NGU), Prostatitis, Epididymitis
  • urethral discharge, dysuria, hemospermia, conjunctivitis
  • usually asymptomatic
138
Q

Chlamydia infection in women

A
  • Cervicitis, endometritis, salpingitis, PID, perihepatitis, conjunctivitis
  • vaginal discharge, dysuria, pain bleeding
  • usually asymptomatic
  • infertility and sterility
139
Q

Chlamydia infection in neonates

A
  • conjunctivitis, nasopharyngeal infection, pneumonia
  • otitis media (less common)
  • erythromycin eyedrops at birth to take care of infections
140
Q
  • bird chlamydia
  • parakeets, turkey
  • PARROT FEVER (psittacosis)
  • pneumonia in humans
  • survive in macrophages or epithelial cells
  • bird-to-bird transmission
A

Chlamydia psittaci

141
Q
  • ROCKY MOUNTAIN SPOTTED FEVER
  • transmitted via ticks
  • flulike symptoms
  • rash spread over ankles, wrists, hands and soles of feet
  • NO RASH ON THE FACE
A

Rickettsia rickettsii

142
Q
  • ticks and dogs
  • rash over palms, soles of feet, body and ON THE FACE
  • taches noires (black spots at primary site of infection)
A

Mediterranean spotted fever (Boutonneuse Fever)

143
Q
  • endemic typhus (murine typhus)
  • oriental rat flea, cat flea
  • infection when flea defecates on skin and scratching infects the bite
A

Rickettsia typhi

144
Q
  • epidemic louse-borne typhus
  • known as BRILL-ZINSSER DISEASE
  • areas of sanitation disruption
  • defecates in bite wound via scratching
  • rash over the body and FACE
A

Rickettsia prowazekii

145
Q
  • transmitted via mouse mite

- rash on face, trunk and extremities, but NOT ON PALMS OR SOLES

A

Rickettsia akari

146
Q
  • scrub typhus
  • transmitted via chigger, reservoir is rat
  • tache noire at site of infection
  • rash not on palms, soles of feet or the face
A

Orientia tsutsugamushi

147
Q
  • dogs infected with brown dog ticks
  • rickettsial-like inclusions IN MONOCYTES (HME)
  • Lone star tick (A. americanum)
A

Ehrlichia chaffeensis

148
Q
  • Q FEVER (Query fever)
  • potential bioterror agent
  • goats, cattle, sheep
  • influenza-like illness
A

Coxiella burnetii

149
Q
  • don’t have cells walls (CWD)
  • slow growing, fastidious
  • Fried Egg appearance
A

Mycoplasma

150
Q
  • adhere to epithelium of mucosal surfaces in oropharynx
  • bronchitis, pharyngitis
  • WALKING PNEUMONIA
  • isolation indicates pathogenicity
  • spread via close contact (dorms, military, prison)
  • epidemics can occur
A

Mycoplasma pneumoniae

151
Q
  • adhere to epithelium of urogenital tract
  • normal flora, opportunistic
  • salpingitis, pyelonephritis, PID, postpartum fevers
  • requires arginine (pink)
  • plate to A8 agar
A

Mycoplasma hominis

152
Q
  • urogenital tract infection
  • normal flora of lower urinary tract in women
  • upper urinary tract infection
  • significant infection to fetus: chorioamnionitis (infection of placental membrane), congenital pneumonia, chronic lung disease, meningitis
  • 10% NGU in men
  • requires urea (pink)
A

Ureaplasma urealyticum

153
Q
  • slender, slightly curved or straight rods
  • non-motile, non-spore-forming
  • cell wall has high lipid content (mycolic acid)
  • acid-fast (resist gram stain), SPUTUM SPECIMEN IS BEST
  • aerobic
  • require complex media
  • slow growers (2-6 weeks)
A

Mycobacteria

154
Q

Two major Mycobacteria groups

A
  • M. tuberculosis complex

- Nontuberculous mycobacteria (NTMs)

155
Q
  • transmitted by airborne droplet
  • bacteria phagocytosed and multiply intracellularly
  • slow growing
  • raised, dry, rough colonies
  • nonpigmented, non-chromogen
  • cord factor (inhibits PMN migration)
  • grow best at 35-37C
  • positive niacin accumulation, reduces nitrate
A

Mycobacterium tuberculosis

156
Q

TB treatment

A
  • 9 month course of therapy
  • isoniazid and rifampin
  • maybe streptomycin or ethambutol
  • drug combo if resistant
157
Q
  • most common NTM causing TB in the US
  • slow growing, nonpigmented, non-chromogen
  • soil and water sources
  • disease in swine and poultry
  • large increase in number of isolates due to HIV patients developing AIDS (most common systemic disease)
  • produces heat-stable catalase
A

M. avium complex (MAC complex)

M. avium and M. intracellulare

158
Q
  • Johne’s disease

- niacin -, nitrate -, tween 80 -

A

M. paratuberculosis

159
Q
  • 2nd most common NTM causing lung disease in US
  • CHRONIC PULMONARY DISEASE
  • photochromogenic, slow grower
  • catalase +, Tween 80 +
  • reduces nitrate
  • pyrazinamidase production
A

M. kansasii

160
Q
  • photoreactivity

- carotene pigment upon exposure to light

A

photochromogens

161
Q
  • photoreactivity

- produce a pale yellow to orange color in dark or light

A

scotochromogens

162
Q
  • photoreactivity

- buff or lack of color

A

non-chromogens

163
Q
  • disseminated AIDS infection
  • enteritis, genital, soft tissue
  • SQ and heat-stable catalase +
  • pyrazinamidase +, urease +
  • slow grower, non-chromogen
A

M. genavense

164
Q
  • cutaneous infections
  • due to contact with saltwater or inadequately chlorinated freshwater
  • “swimming pool granuloma”
  • slow grower, photochromogen
A

M. marinum

165
Q
  • cervical lymphadenitis in kids
  • smooth colonies with dense centers
  • light yellow to deep orange pigment
  • Tween 80 -, don’t reduce nitrate
  • urease +, high SQ catalase
  • slow grower, scotochromogen
A

M. scrofulaceum

166
Q
  • pulmonary disease
  • phochromogenic, slow grower
  • niacin +
167
Q
  • pulmonary disease
  • similar to TB
  • slow grower, scotochromogen
  • Tween 80 +, reduces nitrate
  • inhibited by NaCl
A

M. szulgai

168
Q
  • nodule developing into a severe shallow ulcer
  • nonchromogenic buff colonies, slow grower
  • heat-stable catalase
A

M. ulcerans

169
Q
  • hot and cold-water taps, birds
  • pulmonary infection in patients with predisposing condition
  • scotochromogenic, slow grower
  • niacin - , reduce nitrate
170
Q
  • tap water and soil sources
  • “tap water” bacillus
  • slow grower, scotochromogen
A

M. gordonae

171
Q
  • rapid growing, non-chromogen
  • M. abscessus group
  • opportunistic
  • more drug resistance than M. fortuitum
  • positive 3-day arylsulfatase test
  • growth on Mac without crystal violet
  • doesn’t reduce nitrate
A

M. chelonae

172
Q
  • rapid growing, non-chromogen
  • localized infections of skin and soft tissues
  • positive 3-day arylsulfatase test
  • reduces nitrate
A

M. fortuitum

173
Q
  • rapid growing, scotochromogen
  • rare cases of pulmonary, skin, soft tissue and bone infections
  • nonpigmented colonies
  • negative arylsulfatase test
  • reduces nitrate
  • grows on Mac w/o crystal violet
A

M. smegmatis

174
Q
  • Hansen’s disease
  • person-to-person transmission
  • low infection rate
  • can’t be cultured in vitro
  • armadillos and foot pads of white mice
175
Q

Digestion/decontamination of specimens

A
  • liquefy sample through digestion of proteinaceous material
  • allow chemical decontaminating agent to contact and kill the non-mycobacterial organisms (sodium hydroxide and N-acetyl-L-cysteine)
  • mycobacteria survive chemical treatment because of high lipid content in cell walls
  • liquefying mucin allows mycobacteria to utilize nutrients
176
Q

Specimens that need digestion and decontamination

A

sputum, gastric washing, BAL, bronchial washings, transtracheal aspirate

177
Q

Specimens that only need decontamination

A

urine, autopsy tissue, fluids

178
Q

Specimens that don’t need digestion and decontamination

A

CSF, pleural fluid, joint fluid

179
Q

Acid-fast staining

A
  • Ziehl-Neelsen (uses heat)
  • KINYOUN***(no heating)
  • red organism with blue background
180
Q

Mycobacteria culture media

A
  • Lowenstein-Jensen (LJ) media: eggs, salts, glycerol, potato flour, MALACHITE GREEN
  • Middlebrook media
  • all media contain malachite green (suppress gram-positive)
181
Q

BACTEC system principle

A

amount of labeled CO2 liberated is detected by instrument and is interpreted as “growth index”

182
Q

Mycobacteria ID

A
  • acid fast organism
  • colony morphology (smooth and soft or rough)
  • growth rates: rapid growers (7 days)
  • photoreactivity
  • niacin accumulation (most +)
  • nitrate test (M. kansasii and tuberculosis +)
  • catalase (M. tb, bovis are -)
  • Tween 80 hydrolysis
  • arylsulfatase test
  • pyrazinamidase (distinguishes M. marinum (+) from kansasii (-) and M. bovis (-) from tb (+))
  • Tellurite reduction (MAC +)
  • urease (M. scrofulaceum (+) and gordonae (-))
183
Q

MTB ID

A

MTB is only non-pigmented producer that is nitrate + and niacin + in culture media

184
Q

Colony count using 0.001 loop

75 colonies seen =

A

75,000 CFU/mL

100,000 is significant; ID and perform sensitivity

185
Q

Common causes of UTI’s

A
  • S. saprophyticus (young, sexually active females)

- Enterococcus, Enterobacteriaceae, S. aureus, S. epidermidis

186
Q

Upper vs. Lower UTI’s

A
  • Upper: infection of renal parenchyma or ureters

- Lower: infection of bladder, urethra or prostate (males)

187
Q

Complicated vs. Uncomplicated UTI’s

A
  • Complicated: UTI’s due to one or more structural or functional abnormalities
  • Uncomplicated: UTI’s in sexually active women with normal GU tracts; no procedures
188
Q

UTI Risk factors

A
  • AGE (kids with long-term medical problems, adults with GU abnormalities, elderly because of catheterization, prostate problems, bladder prolapse)
  • INSTITUTIONALIZE CARE (catheters, asymptomatic bacteruria)
  • PREGNANCY (increased ASB)
  • RENAL TRANSPLANT (leads to septicemia)
  • BLADDER CATHETERIZATION
189
Q

UTI Routes of Infection

A
  • Ascending route: most common route, migration from bladder, acquired UTI’s
  • Descending route: infection via blood, < 5% of UTI’s
190
Q

Infections in urine cultures that aren’t UTI’s

A
  • Herpes simplex (HSV)
  • Chlamydia trachomatis
  • Neisseria gonorrhoeae
191
Q

Specimen type/collection and processing

A
  • Voided midstream specimen collection (CCMS)
  • Catheterized specimen collection (best for kids)
  • Suprapubic aspiration (for anaerobes)
  • 24hr old specimen is unacceptable
  • first morning urine is best
  • processed within 2 hours
  • REFRIGERATE if not processed immediately
192
Q

Culture with 3 or more uropathogens

A

contamination

193
Q

Reportable results

A
  • a pure culture of S. aureus is significant
  • yeast in any culture is significant
  • unusual organisms are reportable
  • only report significant UTI antibiotics
194
Q

Acceptable sputum smear

A

< 10 epithelial cells

> 25 PMN’s

195
Q

Pharyngitis pathogens

A
  • LOOK FOR GROUP A STREP
  • viral with rhinorrhea
  • C. diphtheriae
196
Q

Otitis media pathogens

A

Streptococcus pneumoniae, Haemophilus influenzae

197
Q

Epiglottitis pathogens

A

Streptococcus, Staphylococcus, Hib***

198
Q

Pertussis pathogens

A

Bordetella

199
Q

Health-care-acquired pneumonia pathogens

A

Pseudomonas, Kleb. pneumoniae, Acinetobacter, MRSA GNR’s, S.pneumo, H. influenzae, Legionella

200
Q

Causes of pneumonia in CF patients

A

Pseudomonas aeruginosa, Burkholderia cepacia

201
Q

Main Respiratory Tract Pathogens

A

Pseudomonas aeruginosa, Burkholderia cepacia, S. pneumoniae, Klebsiella pneumoniae, S. pyogenes, H. influenzae

202
Q

Bronchitis pathogens

A

viruses, H. influenzae

203
Q

Community-acquired pneumonia pathogens

A
  • Kids: viruses, H. parainfluenzae, Mycoplasma pneumoniae

- Adults: S. pneumoniae, Hib, M. pneumoniae

204
Q

Lower Respiratory Tract pathogens

A
  • neonates: Chlamydia trachomatis
  • infants: viruses
  • 5-18 months: S. pneumo, H. influenzae
  • 3-19 years: viruses, S. aureus, M. pneumoniae
  • 18-45 years: M. pneumoniae
  • older: S. pneumoniae, Legionella
  • hospitalized: GNR’s, S. pneumoniae, S. aureus
205
Q

Respiratory Tract pathogens with capsules

A

S. pneumoniae, H. influenzae, Pseudomonas aeruginosa, Klebsiella pneumoniae

206
Q

Sinusitis pathogens

A
  • complication of URT infection
  • viruses (> 90%)
  • S. pneumo, H. flu, S. pyogenes, M. catarrhalis, S. aureus
207
Q

Empyema

A
  • collection of purulent fluid in pleural cavity

- S. aureus, S. pneumo, S. pyogenes

208
Q
  • rapid onset, lack of fever
  • absence of blood or pus
  • large number of watery stools (> 20/day)
  • Enterotoxigenic E. coli, cholera, S. aureus, C. perfringens, Bacillus cereus, viral or parasitic
A

Enterotoxin-mediated diarrhea

209
Q
  • fecal leukocytes, RBC’s, fever

- Salmonella, Campy, Shigella, E. coli, Entamoeba

A

Diarrhea mediated by invasion of bowel mucosal surface

210
Q
  • S. typhi, Y. enterocolitica
  • presents with constipation
  • fecal leukocytes and RBC’s
A

Diarrhea mediated by invasion of full thickness of bowel with lymphatic spread

211
Q
  • presence of viable bacteria in the blood

- one of the most serious infections

A

Bacteremia

212
Q

bacteremia present with the absence of physical signs/symptoms

A

Occult Bacteremia

213
Q

Bacteremia plus clinical presentation of signs/symptoms of bacterial invasion and toxin production

A

Septicemia

214
Q

Systemic response to infection sometimes accompanied by organ involvement

215
Q

Sepsis accompanied by hypotension

A

Septic shock

216
Q

Primary vs. Secondary Bacteremia

A
  • Primary: arises from endovascular source

- Secondary: arises from exovascular source

217
Q

Common blood culture contaminants

A

Propionibacterium, S. epidermidis, Corynebacterium

218
Q

Transient vs. Intermittent vs. Continuous Bacteremia

A
  • Transient: result of procedure, caused by flora
  • Intermittent: result of abscess (meningococcemia, gonococcemia)
  • Continuous: intravascular source, continuously present, i.e., prosthetic heart valve
219
Q

Common Bacteremia causes

A

Candida albicans, Malassesia furfur, E. coli, P. aeruginosa, S. aureus, CoNS, Enterococcus, S. pyogenes, Aeromonas hydrophila, Acinetobacter baumanii, Kleb pneumoniae

220
Q
  • anticoagulant in blood culture bottles
  • neutralizes bactericidal activity (complement)
  • prevention of phagocytosis
  • inactivation of certain antimicrobial agents (streptomycin, gentamycin)
  • may inhibit Peptostreptoccus, N. gonorrhoeae, N. meningitidis, Gardnerella)
A

Sodium polyanethol sulfonate (SPS)

221
Q

BacT/ALERT principle

A

measures CO2 derived pH changes by colorimetric sensor

222
Q

Contamination vs. Pathogen

A
  • S. aureus, E. coli, Enterics, S. pneumo, P. aeruginosa, Candida are almost always true pathogens
  • CoNS, diptheroids, skin flora should be questioned
  • more than one bottle growing the same thing usually indicates significance
  • growth of skin biota in single bottle usually indicates contaminant
223
Q
  • infection in/around hair follicles
  • S. aureus is most common
  • Enterobacteriaceae
  • Pseudomonas aeruginosa associated with hot tubs
A

folliculitis, furuncolosis, carbuncles

224
Q
  • dermatophyte fungi, Trichophyton, Epidermophyton, Microsporum
  • ringworm
  • tinea pedis: athlete’s foot
  • tinea versicolor: Malassezia furfur
  • erythrasma (chronic infection)
A

Infection of keratinized layer

225
Q

Hidradentis suppurativa

A
  • obstructed apocrine gland (sweat gland)

- S. aureus, anaerobic strep, Bacteroides

226
Q

Cellulitis

A
  • usually in extremities, usually staph or strep
  • anaerobic and aerobic mixed
  • E. coli, Enterics, S. aureus, Strep, Anaerobes
227
Q

Necrotizing fasciitis pathogens

A
  • Group A Strep, S. aureus, Bacteroides, Clostridium

- Gas gangrene: C. perfringens

228
Q

Myositis pathogens

A
  • extensive muscle involvement
  • S. aureus, Clostridium, Group A and B strep
  • Virbio vulnificus, Aeromonas, other wound-associated bacteria
229
Q

Wound infection pathogens

A
  • human bite wounds: mouth flora, strep, S. aureus, Eikenella, Anaerobes
  • animal bite wounds: pasteurella, strep, staph, anaerobes
  • burns: Pseudomonas, S. aureus, Enterobacter, E. coli
230
Q

Lymphadenitis pathogens

A

M. scrofulaceum, Group A strep, S. aureus, Y. pestis

231
Q

Skin infections associated with Bacteremia

A
  • Petechiae with meningococcemia
  • Cutaneous ulcers and Vibrio vulnificus sepsis
  • S. aureus, P. aeruginosa, M. leprae, T. pallidum, Rickettsia
232
Q

CSF functions

A
  • cushions brain
  • reduces effective weight by factor of 30
  • supplies metabolites
  • removes wastes
233
Q

Routes of CSF Infection

A
  • Hematogenous spread (most common)
  • Direct spread from infected site (close to or contiguous with CNS - sinusitis, etc.)
  • Anatomic defects in CNS (surgery, trauma, abnormalities)
  • Direct intraneural (along nerves to brain): least common
234
Q

CSF Infections

A
  • Meningitis: infection within subarachnoid space or leptomeninges
  • Encephalitis: inflammation of brain parenchyma
  • Meningoencephalitis: meningitis and encephalitis
235
Q

Acute Bacterial Meningitis Pathogens

A

S. pneumoniae, N. meningitidis, H. influenzae, S. agalactiae, E. coli, Elizabethkingia meningosepticum, Listeria monocytogenes, GNR’s

236
Q

Newborn meningitis

A

GNR’s, Group B Strep, Listeria monocytogenes

237
Q

Infant meningitis

A

Group B Strep, H. influenzae, S. pneumoniae, N. meningitidis, E. coli

238
Q

Kids/Young Adult meningitis

A

S. pneumoniae, N. meningitidis, Group B strep, S. aureus, Enterobacter

239
Q

Adult meningitis

A

S. pneumoniae, N. meningitidis, Listeria, GNR’s

240
Q

CSF Shunt Infections

A
  • 2/3 of infections are Staph
  • rest are gram negatives (E. coli, Kleb, Proteus, Propionibacterium)
  • Candida
241
Q

Meningoencephalitis pathogens

A
  • most commonly caused by viruses

- involvement of cerebral cortex

242
Q

Brain abscess pathogens

A
  • commonly bacterial

- Streptococcus

243
Q

CSF Fluid Collection and Processing

A
  • 3-4 tubes collected
  • first tube is most contaminated
  • tubes 2 and 3 go for cell count and differential
  • other tubes go to micro and chemistry
  • CSF must be hand-delivered immediately
  • NEVER refrigerate CSF
244
Q

Pleural fluid (location and organisms)

A
  • between lungs and chest wall
  • organisms isolated here are pneumonia associated
  • S. pneumoniae, S. aureus, H. influenzae, Enterobacteriaceae, Pseudomonas, TB
245
Q

Transudate vs. Exudate

A
  • Transudate: fluid passed through membrane or extracted from tissues (renal, hepatic or cardiac disease)
  • Exudate: fluid from blood vessels in adjacent spaces; associated with infection (contains WBC’s); bloody fluid associated with malignancy
246
Q

Peritoneal fluid

A
  • between abdominal wall and organs
  • small amount of fluid is normal
  • ascites: increased fluid in cavity due to infection or inflammation containing WBC’s and proteins
247
Q

Peritoneal fluid organisms

A
  • gain entry via bowel perforation, surgery, trauma
  • kids: S. pneumoniae, Group A strep, Enterics, Staph
  • adults: E. coli, S. pneumoniae, Group A strep, N. gonorrhoeae, Chlaymdia (sexually active women)
248
Q

Intra-abdominal abscess pathogens

A
  • Anaerobes (B. frag, Clostridium)
  • Enterobacteriaceae
  • Strep, Enterococcus
249
Q

Peritoneal dialysis fluid pathogens

A
  • S. epidermidis and S. aureus (most common)

- Strep, GNR’s, etc.

250
Q

Pericardial fluid

A
  • between epicardium and pericardium
  • normally clear fluid
  • organisms: Viruses (usually), parasites, bacteria, fungi, non-infectious fluid buildup
251
Q

Synovial fluid

A
  • joint fluid
  • secondary to hematogenous spread of bacteria
  • bone infection, PROSTHETIC DEVICES
252
Q

Synovial fluid pathogens

A
  • S. aureus (70%)
  • N. gonorrhoeae in young adults
  • H. influenzae in kids < 2
  • Group A and B strep, S. pneumoniae, B. fragilis, Fusobacterium
253
Q

Pathogens of prosthetic devices

A
  • gain entry during surgery

- S. epidermidis, CoNS, Corynebacterium, Propionibacterium, S. aureus

254
Q

Osteomyelitis

A
  • # 1 cause is S. aureus secondary to bacteremia
  • Salmonella, Haemophilus
  • hematogenous spread: S. AUREUS, Salmonella, Haemophilus, Pseudomonas, Enterics
  • Bites: Eikenella, Pasteurella
255
Q

VP + Enterobacteriaceae

A

Klebsiella, Enterobacter, Hafnia, Serratia

256
Q

H2S + Enterobacteriaceae

A

Salmonella, Proteus, Edwardsiella, Citrobacter

257
Q

PAD + Enterobacteriaceae

A

Proteus, Providencia, Morganella

258
Q

Primary Genital Pathogens

A
  • Chlamydia trachomatis
  • Neisseria gonorrhoeae
  • Treponema pallidum
  • Human papilloma virus
  • Gardnerella vaginalis
  • Trichomonas vaginalis
  • Haemophilus ducreyi
  • Klebseilla granulomatis
  • Mycoplasma hominis
  • Ureaplasma urealyticum
259
Q
  • cervicitis with mucus
  • PID leading to infertility
  • Preterm births
A

Chlamydica trachomatis

260
Q
  • may be #1 STI
  • penile malignancy, cervical carcinoma
  • genital warts
A

Human Papilloma virus (HPV)

261
Q
  • bacterial vaginosis, premature labor, low birth rates
  • CLUE CELLS (epi’s surrounded by bacteria)
  • KOH + (Whiff test)
A

Gardnerella vaginalis

262
Q
  • questionable role in genital infection
  • PID, pyelonephritis
  • postpartum fever with morbidity and still births
A

Mycoplasma hominis

263
Q
  • acute non-gonococcal urethritis

- acute urethral syndrome in females with reproductive failure

A

Ureaplasma urealyticum

264
Q

Cervicitis

A
  • inflammation of cervix
  • increased number of PMN’s
  • N. gonorrhoeae, C. trachomatis
265
Q

Anorectal lesions

A
  • HPV, HSV, viruses, parasites, N. gonorrhoeae, C. trachomatis
  • itching, discharge, anal pain
  • proctitis: N. gonorrhoeae and C. trachomatis
  • due to HIV in ICP’s
266
Q

Pelvic Inflammatory Disease (PID)

A
  • cervical microorganisms travel to endometrium, fallopian tubes and other pelvic structures
  • N. gonorrhoeae and C. trachomatis
  • associated with IUD’s (Actinomyces)***
267
Q

Chorioamnionitis

A
  • infection of uterus and contents during pregnancy

- anaerobes, genital mycoplasmas, Group B strep, E. coli

268
Q

Gonococci media

A

Modified Thayer Martin, New York City agar, JEMBEC

269
Q

Herpes Simplex Virus (HSV)

A
  • genital herpes
  • extensive PAINFUL vesicles
  • culture and look for cytopathogenic effect
  • DFA, EIA, PCR
270
Q

Gram positive cell wall

A
  • thick peptidoglycan layer

- penicillin and vancomycin effective

271
Q

Gram negative cell wall

A
  • thin peptidoglycan layer surrounded by membrane
  • substances cannot diffuse into cell wall (Vanco’s too large)
  • substances must be actively transported into cell
272
Q

Antibiotic target sites

A
  • cell wall integrity
  • cell membrane structure and functions
  • inhibition of protein synthesis
  • inhibition of nucleic acid mechanisms
  • inhibition of essential metabolites
273
Q

Intrinsic resistance

A
  • natural resistance
  • all gram negatives resistant to vancomycin
  • anaerobes resistant to aminoglycosides
274
Q

Acquired resistance

A
  • low affinity target sites (drugs bind poorly)
  • reduced permeability
  • efflux pumps
  • bypass mechanisms
  • enzymatic inactivation
275
Q

Resistance expression

A
  • constitutive: constantly expressing resistance
  • inducible: only when exposed to agent
  • constitutive-inducible: constantly expressed at low levels
  • homogeneous: entire population is resistant
  • heterogeneous: some of population is resistant (i.e. MRSA)
276
Q

Full susceptibility testing required for

A
  • Staphylococci
  • S. pneumoniae
  • Viridans strep (if from normally sterile site)
  • Enterococci
  • Enterobacteriaceae
  • Pseudomonas aeruginosa
277
Q

Beta lactamase testing required for

A
  • H. influenzae
  • N. gonorrhoeae
  • Moraxella catarrhalis
  • Anaerobes
278
Q

Penicillins mechanism of action

A

Inhibits cell wall synthesis by binding PBP

279
Q

Penicillin (resistance mechanisms)

A
  • Beta lactamase
  • low-affinity PBP (MRSA mecA gene)
  • ESBL’s (Extended Spectrum Beta Lactamases)
280
Q

Glycopeptides: drugs and mechanism of action

A
  • Vancomycin
  • Inhibits cell wall synthesis
  • gram negatives intrinsically resistant
  • treats MRSA, C. difficle
281
Q

Aminoglycosides: drugs and mechanism of action

A
  • Gentamycin, Tobramycin, Amikacin
  • protein synthesis inhibitor acts on 30S ribosome component
  • has toxic side effects (only for serious GN infections)
282
Q

Tetracyclines: drugs and mechanism of action

A
  • tetracycline, doxycycline
  • protein synthesis inhibitor acts on 30S ribosome component
  • broad spectrum
  • leads to discolored teeth, yeast infection
283
Q

Chloramphenicol mechanism of action

A
  • protein synthesis inhibitor acts on 50S subunit

- can cause aplastic anemia

284
Q

Macrolides: drugs and mechanism of action

A
  • erythromycin, clindamycin
  • protein synthesis inhibitor acts on 50S subunit
  • D zone test for inducible resistance
285
Q

Quinolones: drugs and mechanism of action

A
  • Ciprofloxacin, Norfloxacin
  • inhibits DNA synthesis
  • broad spectrum for P. aeruginosa and aerobes
286
Q

Sulfonamides: drugs and mechanism of action

A
  • Sulfamethoxazole

- inhibits folic acid synthesis (DNA synthesis)

287
Q

Mycobacterial Chemotherapy: drugs and mechanism of action

A
  • Isoniazid

- inhibits synthesis of mycolic acid

288
Q

Susceptibility testing

A
  • disk diffusion or dilution
  • no susceptibility on organisms from normal site
  • gram-positive battery, gram negative battery, sometimes UTI battery
289
Q

lowest concentration of antibiotic that visibly inhibits growth of an organism

A

Minimum inhibitory concentration (MIC)

290
Q

lowest concentration that results in the death or killing of > 99.9% of test organism

A

Minimum bactericidal concentration (MBC)

291
Q

An interpretive category that indicates an organism that is inhibited based on the amount of drug safely achieved in patient

A

Susceptible or Sensitive

292
Q

represents an organism that may require a higher dose of antibiotic for a longer period of time to be inhibited

A

Intermediate

293
Q

indicates an organism that is not inhibited by the recommended dose or achievable level

294
Q

Preparation of Inoculum

A

Mcfarland standards used

295
Q

Standardized methods

A
  • Micro dilution method (automated)
  • Disk diffusion method (antibiotic disks, Kirby Bauer)
  • Broth dilution method (antibiotic in broth)
  • Agar dilution method (antibiotic in agar)
  • Special methods (beta lactamase)
296
Q

Breakpoint MIC panels

A
  • point where effective tissue concentration can be achieved for bacterial inhibition
  • results based on two wells (both turbid = R, one = I, none = S)
297
Q

Meuller-Hinton Agar (QC and troubleshooting) – Kirby Bauer method

A
  • QC weekly with E. coli, S. aureus, P. aeruginosa
  • too thin agar = increased zones for disks
  • too thick agar = decreased zones for disks
  • decreased pH of agar = decreased activity
  • increased cation concentration = decreased aminoglycoside and tetracycline activity
298
Q

Disk Diffusion Test Interpretaion

A
  • Susceptible: large zone and low MIC

- Resistant: small zone and high MIC

299
Q

Broth Dilution Test

A

tests for bactericidal activity

300
Q

E Test

A
  • used for testing uncommon drugs for an organism or new drugs
  • used for S. pneumo and fastidious organisms
301
Q

Normal eye flora

A

S. epidermidis, Lactobacillus

302
Q

Blepharitis

A
  • infection of the eyelid margins
  • redness, burning, irritation, itching
  • Chlamydia trachomatis (leading cause of blindness)
  • S. aureus, S. epidermidis, viruses
303
Q

Conjunctivitis

A
  • most common eye infection
  • inflammation, swelling
  • H. aegyptius, Chlamydia trachomatis, gonococcal, Moraxella, M. TB, F. tularensis, T. pallidum, Y. enterocolitica, viruses
  • adults: S. pneumoniae, S. aureus, S. epidermidis
  • kids: H. influenzae, S. pneumoniae, S. aureus
304
Q

Keratitis

A
  • inflammation of the cornea

- S. aureus, S. pneumoniae, P. aeruginosa, Acinetobacter, T. pallidum, fungi (Fusarium, Acanthamoeba)

305
Q

Keratoconjunctivitis

A

N. gonorrhoeae, Chlamydia trachomatis

306
Q

Endophthalmitis

A
  • infection of ocular cavities
  • S. aureus, S. epidermidis
  • C. albicans
307
Q

Dacryocystitis

A
  • inflammation of lacrimal sac

- S. pneumoniae, S. aureus, S. pyogenes, H. influenzae

308
Q

Dacryoadenitis

A
  • acute inflammation of the lacrimal gland

- S. pneumoniae, S. aureus, S. pyogenes

309
Q

Periocular infections

A
  • acute infection of orbital contents
  • S. aureus
  • H. influenzae in kids
  • Mucormycosis in diabetics
310
Q

Eye Infection Specimen

A
  • sterile swab from BOTH EYES
  • gram stain
  • inoculate plates
311
Q

Normal ear flora

A

Pneumococci, Propionibacterium acnes, S. aureus, Enterobacteriaceae, P. aeruginosa, Candida

312
Q

External Ear Infections

A
  • S. aureus causes pustules
  • Group A strep causes erysipelas
  • swimmers ear caused by P. aeruginosa**
313
Q

Middle Ear Infections

A
  • kids: Pneumococci, H. influenzae, Group A Strep

- M. catarrhalis, viruses

314
Q

Sinusitis

A
  • maxillary sinusitis is most common

- H. influenzae, S. pneumoniae, Group A Strep, Moraxella

315
Q

Neck infections

A

normally oral flora is responsible

316
Q

Stomatitis

A
  • inflammation of mucus membranes of oral cavity

- herpes simplex virus

317
Q

Thrush

318
Q

Parotitis

319
Q

Dental infections

A

usually anaerobes

Microbiology (26 decks)

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