Haemophilus spp. and Other Fastidious Gram Negative Bacilli Flashcards
Which family do Haemophilus spp, Actinobacillus spp., Pasteurella spp., and Aggregatibacter belong?
Pasteurellaceae
The Pasteurellaceae family includes the following genera ______.
MNEMONIC: HAPA
* Haemophilus spp.
* Actinobacillus spp.
* Pasteurella spp.
* Aggregatibacter spp.
Gram stain reaction of Pasteurellaceae
Gram Negative (-)
Morphology of Pasteurellaceae
- Pleomorphic
- Coccoid to rod-shaped (generally bacilli)
Is Pasteurellaceae motile?
No
Aerotolerance of Pasteurellaceae
Facultative Anaerobes
Catalase reaction of Pasteurellaceae
Positive (+)
Nitrate to Nitrite reduction result of Pasteurellaceae
Positive (+)
Oxidase reaction of Pasteurellaceae
Negative (-)
Haemophilus is derived from the Greek word meaning ________.
“blood-lover”
What is the fastidious requirement of Haemophilus spp.?
Blood
Blood contains which factors?
X and V
What is the X factor in Haemophilus spp.?
Hemin or Hematin
The X factor can be found in ______.
Hemoglobin of RBCs
The “X” in X factor stands for _______.
Unknown
What is the V factor in Haemophilus spp.?
Nicotinamide Adenine Dinucleotide (NAD)
The “V” in V factor stands for _______.
Vitamin
It is a phenemenon which helps in the recognition of Haemophilus spp. requiring V factor.
Satellitism
What is the source of V factor in Satellitism?
Organisms
They could be from S. aureus, S. pneumoniae, or Neisseria spp.
What is the source of X factor in Satellitism?
BAP
Culture media for Haemophilus spp.
BAP and CAP
Which culture media is V factor dependent?
BAP
Which Culture Media?
RBC are still intact and contains NADase.
BAP
It hydrolyzes the V factor
NADase
Which Culture Media?
The blood is added when heat is tolerable
BAP
Which Culture Media?
Releases both X and V factors
CAP
Which Culture Media?
Inactivation of NADase
CAP
Which Culture Media?
The blood is added even if the mixture is still hot
CAP
Haemophilus influenzae is also known as ________.
Pfeiffer’s Bacillus
________ is also known as Pfeiffer’s Bacillus
Haemophilus influenzae
Virulence Factors of Haemophilus influenzae
- Capsule
- IgA Protease
- Adherence Mechanisms
A virulence factor of H. influenzae which plays the most significant role.
Capsule/Capsular Polysaccharide
How is the capsule of H. influenzae virulent?
Inhibits phagocytosis (antiphagocytic) and anticomplementary activity
The capsule of H. influenzae can be serologically grouped into ____.
Groups A,B,C,D,E,F
The most invasive serotype of H. influenzae
Serotype b (Hib)
Serotype b is composed of ________
ribose, ribitol, phosphate (polyribitol phosphate)
______ is composed of ribose, ribitol, phosphate (polyribitol phosphate).
H influenzae Serotype b
H. influenzae strains with capsule are ______.
Typable
H. influenzae strains without capsule are ______.
Non-typable
What do you call the strains of H. influenzae without a capsule?
Non-typable H. influenzae (NTHi)
The only genus that produces IgA protease is _______.
Haemophilus influenzae
H. influenzae is the only genus that produces _______.
IgA protease
How is IgA protease of H. influenzae virulent?
It cleaves secretory IgA
Adherence mechanisms of H. influenzae
- NTHi Strains
- Serotype b
Adherence Mechanisms
These are adherent to human epithelial cells.
NTHi Strains
Adherence Mechanisms
Which strain of H. influenzae produces a localized infection?
NTHi Strain
Adherence Mechanisms
It is not adherent to human epithelial cells.
Serotype b
Adherence Mechanisms
Which strain of H. influenzae produces a systemic infection?
Serotype b
Infections produced by encapsulated strains of H. influenzae
MNEMONIC: SepSepMOCeffyPePE
* Septicemia
* Septic arthritis
* Meningitis
* Osteomyelitis
* Cellulitis
* Pericarditis
* Pneumonia
* Epiglottis
Infections produced by non-encapsulated strains of H. influenzae
MNEMONIC: O Si Cindy Ba Pumatay?
* Otitis media
* Sinusitis
* Conjunctivitis
* Bacteremia
* Pneumonia
The common name of Haemophilus aegyptius is _________.
Koch-Weeks Bacillus
Koch Weeks Bacillus is the common name of _______.
Haemophilus aegyptius
The causative agent of acute conjuctivitis is ________.
Haemophilus aegyptius
H. aegyptius is the causative agent of ________.
Acute Conjunctivitis
Acute conjunctivitis is also known as ________.
Pink eye
The counterpart of H. aegyptius in Virology is _______.
Adenovirus
______ in Virology, also causes pink eye.
Adenovirus
The causative agent of conjunctivitis in pediatric patients.
Haemophilus influenzae biogroup aegyptius
Haemophilus influenzae biogroup aegyptius is the causative agent of ________.
Conjunctivitis in pediatric patients
Is Haemophilus influenzae biogroup aegyptius capsulated?
No
It causes Brazilian Purpuric Fever (BPF)
Haemophilus influenzae biogroup aegyptius
Brazilian Purpuric Fever (BPF) is a ________ disease.
Systemic
Haemophilus influenzae biogroup aegyptius causes the systemic disease called _________.
Brazillian Purpuric Fever (BPF)
Which Haemophilus sp. is not a part of the human microbiota?
Haemophilus ducreyi
It is a strict pathogen, which is known to be the smallest pathogenic bacteria.
Haemophilus ducreyi
It is the causative agent of Chancroid
Haemophilus ducreyi
Haemophilus ducreyi is the causative agent of ________.
Chancroid
It is a highly communicable sexually transmitted genital ulcer disease.
Chancroid
Two kinds of Chancroid
- Soft chancre
- Hard chancre
Soft chancre is caused by _______.
Haemophilus ducreyi
Hard chancre is caused by ______.
Syphilis
Which Haemophilus sp. causes endocarditis?
Haemophilus parainfluenzae
Haemophilus parainfluenzae causes _____.
Endocarditis
The primary site of infection for Haemophilus parainfluenzae is ________.
Mitral Valve
Specimen Collection and Transport for Haemophilus spp.
Lower RT
Bronchial Washing
Specimen Collection and Transport for Haemophilus spp.
Genital sites are cleaned with ______.
sterile gauze
Specimen Collection and Transport for Haemophilus spp.
Genital sites are cleaned with sterile gauze moistened with ______.
sterile saline
Specimen Collection and Transport for Haemophilus spp.
________ are cleaned with sterile gauze with sterile saline.
Genital sites
Specimen Collection and Transport for Haemophilus spp.
Swab pre-moistened with ______ at the base of the ulcer.
sterile phosphate buffered saline
Specimen Collection and Transport for Haemophilus spp.
Swab pre-moistened with sterile phosphate buffered saline at the ________.
base of the ulcer
Specimen Collection and Transport for Haemophilus spp.
For genital sites, aspirate from _____.
buboes
Specimen Collection and Transport for Haemophilus spp.
For Haemophilus spp., ___________ instead of transport medium.
Direct Plating Bedside
Direct Microscopic Examination of H. influenzae
Intracellular and extracellular gram negative coccobacilli
An excellent medium for the isolation of Haemophilus spp. for RT specimens.
CAP
Culture media for H. influenzae
CAP incubated between 33 to 37 C with 5-10% CO2 at 18-24 hours of incubation w/ 300 ml/L of bacitracin
Why is bacitracin added to CAP in isolating H. influenzae?
To inhibit other normal flora in the RT
A synthetic supplement in a vial, which is a source of X and V factor.
IsoVitaleX or Vitox
Culture media for H. ducreyi and H. aegyptius
CAP with 1% IsoVitaleX or Vitox
Which Haemophilus sp. grows best at 33 C?
Haemophilus ducreyi
Culture media for H. ducreyi
Nairobi Biplate
Nairobi Biplate contains ______.
- GC agar base with 2% bovine hemoglobin and 5% fetal calf serum with vancomycin
- Mueller Hinton Agar with 5% chocolatized horse blood with vancomycin
GC agar base components
2% bovine hemoglobin and 5% fetal calf serum with vancomycin
Mueller Hinton Broth Agar components __________.
5% chocolatized horse blood with vancomycin
Macroscopic Examination
Haemophilus influenzae
CAP: Transluscent, tannish, moist colonies with a distinct “mousy” or bleach-like odor
Which Haemophilus sp. has a distinct “mousy” or bleach-like odor?
Haemophilus influenzae
Why can’t Haemophilus spp. grow on MAC agar?
Because the agar does not contain X and V factors
Macroscopic Examination
Haemophilus parainfluenzae
CAP: Tannish, drier, medium to large size compared to H. influenzae
Macroscopic Examination
Haemophilus haemolyticus and Haemophilus parahaemolyticus
β-hemolysis on BAP
Macroscopic Examination
Haemophilus ducreyi
CAP: Small, flat, smooth, non-mucoid, transparent to opaque colonies
Which organism is it?
Colonies can be pushed intact using a loop and difficult to pick up
Haemophilus ducreyi
Which organism is it?
It produces a “clumpy” non-homogenous appearance when suspended in saline.
Haemophilus ducreyi
H. ducreyi produces a ________ non-homogenous appearance when suspended in saline.
“clumpy”
H. ducreyi produces a “clumpy” non-homogenous appearance when suspended in ________.
saline
Microscopic Examination
Haemophilus spp.
Small, gram negative (-), coccobacilli to long filaments
Microscopic Examination
Haemophilus ducreyi
- Pale-staining, gram negative (-), coccobacilli arranged in singly or in groups
- “School of fish”, “railroad tracks”, “fingerprint”
H. ducreyi is commonly referred as _________.
- “School of fish”
- “Railroad tracks”
- “Fingerprints”
Which organism is commonly referred to as:
* “School of fish”
* “Railroad tracks”
* “Fingerprints”
Haemophilus ducreyi
An alternative method for differentiating the heme-producing species of Haemophilus.
Porphyrin Test
Explain the principle of Porphyrin Test
To determine the ability of an organism to convert δ-aminolevulinic acid (ALA) into porphyrins or porphobilinogen.
What is the substrate in Porphyrin Test?
δ-aminolevulinic acid (ALA)
What is the reagent in Porphyrin Test?
p-dimethylaminobenzaldehyde
p-dimethylaminobenzaldehyde is also known as ________.
Kovac’s Reagent
What are the intermediates in the synthesis of X factor?
- Porphyrins
- Porphobilinogen
(+) Result in Tubed Porphyrin Test
Red color in lower aqueous solution
The (+) result in the tubed porphyrin test indicates the presence of _______.
Porphobilinogen
(+) Result in Plated Porphyrin Test
Reddish-orange fluorescence in UVL detection at 360 nm
The (+) result in the plated porphyrin test indicates the presence of _______.
Porphyrin
Which organisms are (+) for D-ALA/Porphyrin Test?
Organisms who do not require X factor:
* H. parainfluenzae
* H. parahaemolyticus
* H. aphrophilus
* H. paraphrophilus
Determine if the species have X factor, V factor or both
H. influenzae
Both
Determine if the species have X factor, V factor or both
H. parainfluenzae
V Factor
Determine if the species have X factor, V factor or both
H. haemolyticus
Both
Determine if the species have X factor, V factor or both
H. parahaemolyticus
V Factor
Determine if the species have X factor, V factor or both
H. aegyptius
Both
Determine if the species have X factor, V factor or both
H. aphrophilus
None
Determine if the species have X factor, V factor or both
H. paraphrophilus
V Factor
Determine if the species have X factor, V factor or both
H. ducreyi
X Factor
Which Haemophilus spp. are the only ones who produce β-hemolysis?
- H. haemolyticus
- H. parahaemolyticus
Gram stain reaction and morphology of HACEK group
Gram negative (-) bacilli
Is HACEK group fastidious?
Yes
Fastidious requirement for HACEK group
Increased CO2
Infection caused by HACEK group
Endocarditis
HACEK group is a normal microbiota of the ________.
Oral cavity