(M) Lesson 7.1: Gram Positive and Gram Negative Cocci Flashcards
Overview and Different Tests
Most commonly received test request in the lab
Culture and Sensitivity
Upon receiving this type, you are going to ____ and at the same time perform a ____ on the submitted sample
To culture and perform a sensitivity assay
- Genus and species
- What bacteria causes the infection
Culture
- The most effective or appropriate antimicrobial agent for the patient to avoid the possibility of having resistance
Sensitivity
- What is the correct dosage or amount
- Specific antibiotic if bacteria is the suspected case
Sensitivity
What is the first thing a lab should do when receiving a wound discharge?
Perform a G/S procedure even if not stated in the request
T or F: All samples received in the microbiology lab including stool should be gram-stained.
F (not including stool)
Most common G/S result under a microscope
Sample is from an infective suppurative suture
Gram-positive cocci in clusters
Wound discharges originating from suppurative lesions to result in ____ because the causative agent of the said infection is the most common cause of infection on a suppurative lesion area.
Gram-positive cocci
After seeing the G/S result, the next step should be based on what?
Results of the G/S
Upon seeing the G/S results, we should ____ the organism
Culture the organism
Inoculate on a plate or culture medium
What are the four routinely used media culture?
- Blood Agar Plate (BAP)
- Chocolate Agar Plate (CAP)
- MacConkey Medium
- TCBS Media
The selection of culture medium will be dependent on what?
G/S Result
- A general culture medium that is for both gram-positive and gram-negative organisms
- The best medium for gram-positive cocci
Blood Agar Plate (BAP)
- Used for gram-negative cocci or the physician suspects Haemophilus genus
- Also routinely used for CSF
Chocolate Agar Plate (CAP)
- Used if gram-negative bacilli is observed
- Also used for stool specimen
MacConkey Medium (MAC)
- For gram-negative bacilli
- Stool is suspected of vibrio
TCBS Media
____ and ____ are routinely used for fecal samples even if not stated on the test request.
MacConkey and TCBS
This is done to get isolated growth of the colony.
inoculation method
Overlapping Method
Give the optimal conditions for each category.
Temperature
35 to 37°C
Give the optimal conditions for each category.
Duration
- BAP: 24 hours
- Selective Medium: 48 hours
Give the optimal conditions for each category.
Environment
CO2 and ambient air
If general media is used, ____ is the routine incubation time.
24 hours
Selective media includes?
- CAP
- MAC
- TCBS
Why do we collect isolated colonies?
To determine the genus and species
Follow-up tests for biochemical testing will be based on what?
G/S results
- First test done on gram-positive cocci
- Determines the genus
- Differentiates the two most medically important gram-positive cocci genus in microbiology
Catalase Test
What are the two most medically important gram-positive cocci genus in microbiology?
Staphylococcus and Streptococcus
The characteristic arrangement of Staphylococcus?
In clusters
Catalase Test (Staphylococcus)
Releases ____ enzyme that reacts with ____ to produce free oxygen and water
Releases catalase enzyme that reacts with 3% H2O2 to produce free oxygen and water
Catalase Test (Staphylococcus)
Releases catalase enzyme that reacts with 3% H2O2 to produce ____ and ____
Free oxygen and water
Catalase Test
Positive result is?
Bubble formation (effervescence)
Catalase test
Negative result is?
No bubble formation
- There is no bubble formation in catalase test for this organism
- Requires more follow-up tests
Streptococcus
- This test determines the species
- Serves as a follow-up for catalase based on the importance of the species identified
Coagulase test
Coagulase Test
____ enzyme is released by a Staphylococcus specie that can clot plasma.
Coagulase
Coagulase Test
Uses Rabbit’s plasma either in a ____ or ____
Citrated or EDTA
- Arranged in clusters
- Most medically important specie of Staphylococcus
- Only one that can release coagulase hence provide a positive result
Staphylococcus aureus
Coagulase Test
Positive result is?
Clouding or solidification of plasma (clotting)
Coagulase Test
Other species besides Staphylococcus aureus result in what?
Negative result
- Confirmatory test to specifically identify Staphylococcus aureus
- Inoculate culture (from BAP) is subcultured using simple streak into Mannitol Salt Agar
- Further confirms Staphylococcus aureus
Mannitol Fermentation Test
Mannitol Fermentation Test
Inoculate culture (from BAP) is ____ using simple streak into ____
sub-cultured using simple streak into Mannitol Salt Agar (MSA)
Components of MSA?
- Mannitol (sugar)
- 10% NaCl
T or F: Most bacteria are able to grow at the salt concentration of MSA.
F (not grow)
Principle of Mannitol Fermentation Test?
Staphylococcus aureus is capable of being a mannitol fermentor and is halo-tolerant.
This means that S. aureus can grow in high salt concentration.
Mannitol Fermentation Test
Positive result indicators?
Note: These are results for Staphylococcus aureus only.
- Fermentation results in acid formation that turns the pH indicator yellow.
- Yellow halo or yellow growth of bacteria
Mannitol Fermentation Test
Negative result indicators?
Note: These results are for other Staph species.
- Retains its original red color from its pH indicator (phenol red)
- A serological test for Staphylococcus aureus since it is a very important organism (very expensive)
- Detects DNAse or deoxyribonucleases by Staphylococcus aureus
DNAse Test
What are the two methods for DNAse test?
- Dye Method
- HCl Precipitation
DNAse Test provides a positive result for what two species?
- Staphylococcus aureus
- Serracia marcescens (gram-negative)
Two Methods of DNAse Test
- Toluidine Blue - (+) pink zone
- Methyl Green - (+) clear zone
These are degraded by DNAse.
Dye Method
- Follow-up if initial results are negative (in coagulase and MSA)
- Susceptibility
- Similar to AST (inoculate then incubate)
Novobiocin Susceptibility Test
Principle of Novobiocin Susceptbility Test?
Staphylococcus is resistant
Novobiocin Susceptibility Test
Resistant results are?
Note: Only for Staphylococcus saprophyticus.
No ZOI or less than 14 mm
Novobiocin Susceptibility Test
Susceptible results are?
Note: Other species except Staphylococcus saphrophyticus.
Zone of Inhibition is greater than 14 mm
This species has a very visible ZOI under Novobiocin Susceptibility Test.
Staphylococcus epidermitis
- Uses tetramethyl para-phenylenediamine dihydrochloride in DMSO
- Used when G/s is gram positive cocci is positive with catalse with varying result in coagulase, MSA, and Novobiocin (no patterns)
- Further confirmed by other tests
Modified Oxidase Test
T or F: Oxidase test is important for gram-positive bacterium.
F (gram-negative)
Results for catalase, coagulase, and MSA.
Staphylococcus aureus
Positive for all three
Results for catalase, coagulase, and novobiocin.
Staphyloccus saphrophyticus
Positive for catalase
Negative for coagulase
Resistant for novobiocin
- One of the most common contaminant in the laboratory and is very common in the environment
- A pathogen if patient is very immunocompromised
- Otherwise, it is just a contaminant
Micrococus luteus
____ and ____ tests are common used to differentiate in the laboratory.
Modified Oxidase and Lysostaphin
Hi, please study the summary table for these following concepts:
- Micrococcus vs Staphylococcus
- Summary for the tests discussed in this deck
Go na, congrats on finishing the first deck! <3