Gram Negative Flashcards

1
Q

Gram (-) Diplococci that is aeorbic and can utilize maltose positive

A

N. Meningitidis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Comma shaped rods that grows in alkaline media

A

Vibrio cholerae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Gram negative bacilli that ferment lactose faster

A

Klebsiella
E coli
Ebterobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Transmission of Neisseria meningitidis

A

Respiratory droplets
• in close quarters (camps, dormitories)
• carriage in the nasopharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Encapsulated, kidney-bean shaped diplococcus

A

Neisseria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Natural host of Neisseria

A

Only human

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Can form bactericidal and hemagglutinating antibodies

A

Neisseria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Most common cause among aged 2-18 years old

A

Meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Clinical manifestation includes fever, headache, stiif neck and increased level of PMNs in CSF

A

Miningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Most sever form of meningococcemia with high fever, shock, widespread purpura, disseminated intravascular coagulation, thrombocytopenia and adrenal insufficiency and bilateral hemorrhagic destruction of the adrenal glands

A

Waterhouse-Friderichen Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dissemination of meningococci into the bloodstream which causes from consumption coagulopathy into petechial or purpuric rash (purpura fulminans)

A

Mingococcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Positive in Meningococci but negative in gonococci

A

Polysaccharide capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Deficiencies in late acting complement components (C5-C9) predispose to illness that leads to cannot foem membrane attack complexes

A

Complement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Dark culture specimen on blood agar that has been heated to 80°C for 15 mins

A

Culture (Chocolate agar)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Prevents growth of bacteria using Thayer Martin Agar

A

Diagnosis of N meningitidis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ferment both maltose and glucose

A

N. Meningitidis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment of meningococcal meningitis and septicemia

A

Penicillin

Ceftriaxone/ cefotaxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Drugs for Prophylaxis of close contacts of infected persons

A

Rifampin/ Ciproflaxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Prevention for meningococcal which contains cqpsular polysaccharide of atrains A,C, Y, and W-135 coupled to a carrier protein (diptheria toxoid). The 1st meningococcal vaccine for serogroup B

A

Meningococcal polyvalent vaccine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

A chronic dibilitated home care Px presents with fever, cough, sputum culture, revealed gram (-) motile rods with blue pigmented colonies. What is the causative organism?

A

Pseudomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

A Px had diarrhea and eventially resolved, now he presents at the ER due to ascending paralysis which started 3 days ago. The physician diagnosed him eith Guillian-Barre syndrome. What is the most likely organism of the diarrhea?

A

Campylobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Most common anatomical site among carriers of N. miningitides.

A

Nasopharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which of the following opportunistic bacteria is non-motile and gram (-) bacilli?

  • Burkholderia
  • Pseudomonas
  • Acinetobacter
  • Aeromonas
A

Acinetobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which of the following opportunistic bacteria is non-motile and gram (-) bacilli?

  • Burkholderia
  • Pseudomonas
  • Acinetobacter
  • Aeromonas
A

Acinetobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

The virulence factor of Gonococci that enhances its ability to penetrate the mucosal lining and able to preven immunity from the previous infection.

A

IgA proteases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Thr hypovolemic shock in Pxs that is attributed to severe dehydration due to the massive watery diarrhea in cholera is due to?

A

Enterotoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

The hypovolemic shock in Pxs that is attributed to severe dehydration due to the massive watery diarrhea in cholera is due to?

A

Enterotoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

True for gonococcal infection.

  • Causes foul smelling and painful among females
  • Discharge is greenish and mucoid
  • Discharge is perfused and yellowish non-foul smelling
  • it causes non-purulent, non painful discharge to males
A

Discharge is perfused and yellowish non-foul smelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

The presence of purpura fulminans is an indication of what sequelae caused by the organism’s endotoxin.

A

Consumptive coagulopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Primary affects the human genital tract and transmitted thru sexual and birth canal (vertical transmission)

A

Neisseria gonorrhoeae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Prevention of Miningitidis infection which contains capsular polysaccharide of strains A, C, Y, and W-135 coupled to a carrier protein (diphtheria toxoid) to enhance immunogenicity

A

MENINGOCOCCAL POLYVALENT VACCINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

To appreciate the morphology of Legionella pneumophila, which method should be used?

  • cultured with Buffered Carchoal Extract Agar
  • silver staining technique
  • serologic test
  • gram staining technique
A

silver staining technique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Drug/s of choice in treating N. miningitidis

A

Penicillin

Ceftriaxone (cefotaxime)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Culture used for N miningitidis and the selcecrive media.

A

Chocolate agar

Thayer Martin Agar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Inhibits gram (+) Colistin

A

Vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Inhibits gram (-) excrpt Neisseria

A

Trimethoprim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Inhibits fungi

A

Nystatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Human host only with no immunity to repeated infections

A

N. gonorrhoeaa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Kidney bean-shaped with concave sides facing each other forming the appearance of doughnut Gram-negative diplococci.

A

N. gonorrhoeae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Most common sites of inoculation of N gonorrhoeae

A
  • Cervix (cervicitis) or vagina in the female

* Urethra (urethritis) or penis in the male

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

A most common cause of urethritis

A

Gonococcal urethritis

Urethritis and epididymitis in men (“ Tulo” in Men)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

A most common cause of urethritis

A

Gonococcal urethritis

Urethritis and epididymitis in men (“ Tulo” in Men)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

A most common cause of urethritis

A

Gonococcal urethritis

Urethritis and epididymitis in men (“ Tulo” in Men)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

the most common cause of septic arthritis in sexually active individuals

A

Gonococcal arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

N. gonorrhoeae is the most common, the most severe form of conjunctivitis.

A

Hyperactive bacterial conjunctivitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

purulent conjunctivitis in newborns

A

Ophthalmia neonaturum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Discharge is usually mucoid/mucopurulent and the only manifestation may be crusting in the morning

A

Non- gonococcal urethritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Promote adherence and invasion into epithelial cells; expression results in opaque colonies

A

Opa proteins

49
Q

Have unique proteins that can extract iron from transferrin, lactoferrin and hemoglobin

A

N gonorrhoeae

50
Q

Kidney bean-shaped with concave sides facing each other forming the appearance of doughnut Gram-negative diplococci

A

N gonorrhoeae

51
Q

Treatment of N gonorrhoeae

A

Ceftriaxone

>plus Doxycycline (to cover for Chlamydia trachomatis – usual coinfection)

52
Q

Treatment to prevent ophthalmia neonatorum.

A

Erythromycin ointment or Silver nitrate

Silver nitrate is no longer used because it can cause chemical conjunctivitis

53
Q

Gram Negative cocci which can be naturally found in the Upper Respiratory tract

A

Moraxella (Branhamella catarrhalis)

54
Q
Clinical manifestation:
OTITIS MEDIA in children
SINUSITIS
BRONCHITIS
PNEUMONIA
COPD EXACERBATION
A

Moraxella (Branhamella catarrhalis)

55
Q

Treatment of Moraxella infection

A
  • Azithromycin or clarithromycin
  • Amoxicillin with clavulanate
  • Oral second or third generation cephalosporin
  • Trimethoprim- sulfamethoxazole
56
Q

Direct contact with droplets and discharges from nose and throat of an infected person.

A

Moraxella (Branhamella catarrhalis)

57
Q

Facultative anaerobes, short, curved Gram negative bacilli which are usually motile with monotrichous (polar) flagella, Oxidase positive

A

Vibrio

58
Q

Facultative anaerobes, short, curved Gram negative bacilli which are usually motile with monotrichous (polar) flagella, Oxidase positive

A

Vibrio

59
Q

Comma shaped gram-negative, motile rods with a single polar flagellum. Pandemics caused by O1 biotype El tor (cholera El Tor)

A

V. cholerae

60
Q

Producing Vibrio cholerae O1 is a well-known cause of epidemic cholera, which manifests itself by massive intestinal fluid loss and dehydration.

A

Cholera toxin

61
Q

Producing Vibrio cholerae O1 is a well-known cause of epidemic cholera, which manifests itself by massive intestinal fluid loss and dehydration.

A

Cholera toxin

62
Q

Match the following

V. parahemolyticus and V. vulnificus:
V. cholerae:
V. parahemolyticus:
V. vulnificus:

  • saltwater
  • Fecal-oral route
  • Contaminated raw seafood
  • Trauma to skin, especially in shellfish handlers, or by ingestion of raw shellfish
A

V. parahemolyticus and V. vulnificus: saltwater
V. cholerae: Fecal-oral route
V. parahemolyticus: Contaminated raw seafood
V. vulnificus: Trauma to skin, especially in shellfish handlers, or by ingestion of raw shellfish

63
Q

severe diarrhea with rice water stools (no pus in stools). Washer woman’s hands sign wrinkled skin due to loss of skin turgor due to dehydration.
Complications: cardiac and renal failure, non-gap acidosis, hypokalemia

A

CHOLERA

64
Q

Generally self-limited with an explosive onset of watery diarrhea and nausea, vomiting, abdominal cramps, headache, low-grade fever

A

GASTROENTERITIS caused by. V. parahemolyticus and V. vulnificus

65
Q

Associated with exposure to contaminated water

A

WOUND INFECTIONS caused by. V. vulnificus

66
Q

Associated with exposure to contaminated water

A

WOUND INFECTIONS caused by. V. vulnificus

67
Q

digest mucous layer so V. cholerae can attach to cells

A

Mucinase

68
Q

like LT of E. coli, acts by ADP ribosylation  Increase cAMP, secretion of electrolytes and water from the intestinal epithelium Secretory diarrhea

A

Choleragen (enterotoxin)

69
Q

The flagella has (H-antigen) that has the motility

A

Shooting star / fast darting motility

70
Q

Grows as flat yellow colonies on selective media: Thiosulfatecitrate- bile-salts-sucrose (TCBS) agar

A

Vibrio

71
Q

Grows as flat yellow colonies on selective media: Thiosulfatecitrate- bile-salts-sucrose (TCBS) agar

A

Vibrio

72
Q

Treatment for Cholera

A

Fluid and electrolyte replacement
Doxycycline, Tetracycline or Azithromycin shortens duration

73
Q

Prevention of Cholera

A

Short term immunity using cholera vaccine may cause herd immunity
Only improvements in sanitation can lead to effective control of the disease

74
Q

V. Parahemolyticus and V. vulnificus infection treatment

A

Minocycline plus Fluoroquinolone or Cefotaxime

75
Q

Curved, comma- or S shaped, Seagull wing shape gram-negative, motile rod with a single polar, flagellum
Microaerophilic, Oxidase-positive, Catalase-positive

A

Campylobacter jejuni

76
Q

Zoonotic of Campylobacter jejuni

A

wild and domestic animal and poultry; undercooked chicken

77
Q

Mode of transmission of Campylobacter jejuni

A
(fecal-oral route)
Uncooked meat (especially poultry)
Unpasteurized milk
78
Q

Most common cause of bacterial gastroenteritis.
Watery, foul-smelling diarrhea followed by bloody stools accompanied by fever and severe abdominal pain
May mimic ulcerative colitis

A

GASTROENTERITIS

79
Q

Antigenic cross-reactivity between oligosaccharides in bacterial capsule and glycosphingolipidson surface of neural tissues

A

GUILLAIN-BARRE SYNDROME

80
Q

Triad of: Urethritis, Uveitis, Arthritis

A

REACTIVE ARTHRITIS (REITER’S SYNDROME)

81
Q

Endocarditis, Pericarditis, Pneumonia, Thrombophlebitis, Peritonitis, Meningoencephalitis

A

Campylobacter fetus

82
Q

Gram staining of stool specimen reveals curved/comma- or Sshaped gram-negative rods with a single polar flagellum

A

Campylobacter jejuni

83
Q

Selective media used with antibiotic at 42 C

A

Skirrow’s agar and Campy’s agar

84
Q

Drug of choice for Campylobacter jejuni

A

Erythromycin - for severe disease
Fluoroquinolone

85
Q

Transmission: via water aerosols, aspiration, and fecal contamination on Medical devices, Hands of healthcare workers and Healthcare giver
Major pathogen for nosocomial infections because of its ubiquitous presence in the hospital environment

A

Pseudomonas aeruginosa

86
Q

It is the most common pathogen isolated from patients who have been hospitalized longer than 1 week, and it is a frequent cause of nosocomial infections

A

Pseudomonas aeruginosa

87
Q

Inhabits the skin, upper respiratory tract, and colon of about 10% of people Soil, Water, Plants, Animals, Intestinal Flora, Skin

A

Pseudomonas aeruginosa

88
Q

SKIN AND SOFT TISSUE INFECTIONS
Burn wound infections
Hot tub folliculitis: spa pools, whirl pools, or inadequately chlorinated swimming pools and hot tubs
Skin graft loss due to infection
Green nail syndrome

BONE AND CARTILAGE INFECTIONS
Puncture wound osteomyelitis
Osteomyelitis in IV drug users

EAR INFECTIONS

Most common cause of:

Otitis externa -> swimmer’s ear

Malignant otitis externa in diabetics
Chronic suppurative otitis media

(SECONDARY) PNEUMONIA
Ventilator-associated pneumonia
Necrotizing pneumonia (fleur-de-lis pattern)

High-risk CAP:
Immunocompromised
Broad-spectrum antibiotics
Steroid therapy
Structural lung lesions
• Bronchiectasis
• Cystic fibrosis

A

Pseudomonas aeruginosa

89
Q

SKIN AND SOFT TISSUE INFECTIONS
Burn wound infections
Hot tub folliculitis: spa pools, whirl pools, or inadequately chlorinated swimming pools and hot tubs
Skin graft loss due to infection
Green nail syndrome

BONE AND CARTILAGE INFECTIONS
Puncture wound osteomyelitis
Osteomyelitis in IV drug users

EAR INFECTIONS

Most common cause of:

Otitis externa -> swimmer’s ear

Malignant otitis externa in diabetics
Chronic suppurative otitis media

(SECONDARY) PNEUMONIA
Ventilator-associated pneumonia
Necrotizing pneumonia (fleur-de-lis pattern)

High-risk CAP:
Immunocompromised
Broad-spectrum antibiotics
Steroid therapy
Structural lung lesions
• Bronchiectasis
• Cystic fibrosis

A

Pseudomonas aeruginosa

90
Q

GASTROINTESTINAL INFECTIONS
Typhilitis (necrotizing enterocolitis)
Shanghai fever (mild form of typhoid)
Peritonitis in peritoneal dialysis patients

URINARY TRACT INFECTONS
3rd MCC of nosocomial UTIs
SEPSIS
Ecthyma gangrenosum (hemorrhagic lesions)
Febrile neutropenia

Leukemia or lymphoma post chemoradiation therapy
Severe burns

A

Pseudomonas aeruginosa

91
Q

GASTROINTESTINAL INFECTIONS
Typhilitis (necrotizing enterocolitis)
Shanghai fever (mild form of typhoid)
Peritonitis in peritoneal dialysis patients

URINARY TRACT INFECTONS
3rd MCC of nosocomial UTIs
SEPSIS
Ecthyma gangrenosum (hemorrhagic lesions)
Febrile neutropenia

Leukemia or lymphoma post chemoradiation therapy
Severe burns

A

Pseudomonas aeruginosa

92
Q

facilitates exotoxin transfer

A

Type III secretion system

93
Q

lethal toxin similar to diphtheria toxin
inhibits protein synthesis by blocking EF2 causes tissue necrosis

A

Exotoxin A

94
Q

Grown on Cetrimide agar (selective media) smooth,large,translucent,low convex, 2-4mm in diameter

Blood agar= Greenish metallic colonies
with sweet, fruity grape-like odor
produces pigments:
Pyocyanin (blue)

Pyoverdin (green fluorescent)
A

Pseudomonas aeruginosa

95
Q

Combination of active antibiotics required because of resistance to multiple antibiotics

Antipseudomonal penicillins= (ticarcillin, piperacillin)

Penicillin + Betalactamase inhibitor= ticarcillin- clavulanate, piperacillintazobactam

3rd gen cephalosporins: ceftazidime
4th gen cephalosporins: cefepime

Monobactam: aztreonam
Carbapenems: imipenem, meropenem, doripenem, ertapenem
Fluoroquinolones: ciprofloxacin

Examples of suitable combinations:
Ceftazidime + Amikacin
Piperacillin + Amikacin
Azlocillin + Ciprofloxacin
Rifampicin is added for refractory cases

A

Pseudomonas aeruginosa

96
Q

are aerobic, non–spore-forming, gram-negative rods
All are motile because they have polar flagella.
These organisms are catalase positive, and most are oxidase positive.
On MacConkey’s agar, they produce lactose-negative colonies

A

Burkholderia

97
Q

Match

Burkholderia mallei-
Burkholderia pseudomallei-
Burkholderia cepacia complex-

Causes Glander’s disease
Causes Maliodosis
It is an important pathogen in patients with cystic fibrosis (CF) and in those with chronic granulomatous disease

A

Burkholderia mallei- Causes Glander’s disease
Burkholderia pseudomallei- causes Maliodosis
Burkholderia cepacia complex-It is an important pathogen in patients with cystic fibrosis (CF) and in those with chronic granulomatous disease

98
Q

Treatment for Stenotrophomonas maltophilia

A

Trimethoprim-sulfamethoxazole is the antibiotic of choice, although some strains are resistant.

CLSI recommends reporting only levofloxacin, trimethoprim-sulfamethoxazole, and minocycline.

99
Q

Distinguishing biochemical reactions of S. maltophilia are its negative oxidase reaction and positive DNase activity.
Colonies grow on blood agar (lavender green colonies) and MacConkey’s agar; the bacteria are nonmotile and non-fermentative.

A

Stenotrophomonas maltophilia

100
Q

A significant nosocomial pathogen.
Risk factors for colonization or infection with this organism are mechanical ventilation, use of broad-spectrum antibiotics, catheterization, and neutropenia.

A

Stenotrophomonas maltophilia

101
Q

Trwatment that may be susceptible to doxycycline, trimethoprim-sulfamethoxazole, quinolones, ureidopenicillins, imipenem, ampicillin-sulbactam, and ceftazidime

A

Acinetobacter

102
Q

Acinetobacter spp. can be distinguished readily from _______ on the basis of their lack of motility, inability to reduce nitrates, and negative oxidase reaction.

A

pseudomonads

103
Q

Nonhemolytic clinical strains of Acinetobacter

A

A. baumanii

104
Q

Nonsaccharolytic strains (non–glucose oxidizers), Non-hemolytic Acinetobacter

A

Acinetobacter lwoffi

105
Q

if hemolytic Acinetobacter

A

Acinetobacter haemolyticus

106
Q

The most clinically relevant species is Acinetobacter

A

A. baumanii.

107
Q

Gram-negative rods, non-spore forming, and facultative anaerobes

A

Aeromonas

108
Q

They are susceptible to piperacillin, azlocillin, second and third generation cephalosporins, and carbapenems

A

Aeromonas

109
Q

They have been associated with diarrheal disease ranging from acute diarrhea in immunocompetent adults (healthy adults) to chronic diarrhea in children, elderly, and immunocompromised individuals
Two distinct types of gastroenteritis have been associated with A. hydrophila: a cholera-like illness with a watery (rice and water) diarrhea and a dysenteric illness characterized by loose stools containing blood and mucus

A

Aeromonas

110
Q

Clinical Manifestation includes
PONTIAC FEVER (Legionellosis)
mild flu-like illness. headache, fever, muscle aches and fatigue
self-limiting: recovery in a week is common

ATYPICAL PNEUMONIA
Accompanied by confusion, nonbloody diarrhea, hyponatremia, proteinuria, hematuria

A

Legionella

111
Q

PREDISPOSING FACTORS: Old age; Smoking; High alcohol intake; Immunosuppression

A

Legionella

112
Q

is a thin, aerobic, pleomorphic flagellated (Bipolar) non-spore forming bacteria, catalase (+), constitute 90% of pneumonia cases caused by legionella

A

Legionella pneumophila

113
Q

the only virulence factor of Legionella

A

Endotoxin

114
Q

Amoebae (AcanthamoebaandHartmannella) appear to be the natural reservoir for the organisms.

A

Legionella

115
Q

Non-encapsulated facultative intracellular organism
Ubiquitous in man and natural water, environments
> air conditioning systems; cooling towers; Freshwater
Amoebae (AcanthamoebaandHartmannella) appear to be the natural reservoir for the organisms.

A

Legionella

116
Q

Aerobic, motile, and nutritionally fastidious pleomorphic poorly gram-negative rods
visualized with silver stain

Serology (IFA and ELISA) Urinary antigen can be detected by radioimmunoassay with high sensitivity and specify and will remain positive for months after infection.

Urine antigen test only detects L. pneumophilia serogroup 1, but this accounts for 90% of cases

A

Legionella

117
Q

protects bacteria from macrophage superoxide
and hydro peroxide oxidative burst

A

Cu-Zn superoxide dismutase and catalase-peroxidase

118
Q

Can start patients with Azithromycin, Levofloxacin, Doxycycline

A

Legionella

119
Q

Prevention of Legionella

A

Reducing cigarette and alcohol
Eliminating aerosols from water sources
High temperatures and hyper chlorination in hospital water supply
Legionellae can resist low levels of chlorine used in water distribution systems