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CLINICAL BACTERIOLOGY > MIDTERM LEC: SPORE FORMING GRAM POSITIVE BACILLI > Flashcards

MIDTERM LEC: SPORE FORMING GRAM POSITIVE BACILLI Flashcards

1
Q

APPEARANCE: Gram positive (Purple)

A

SPORE FORMING GRAM POSITIVE BACILLI

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2
Q

TECHNIQUE: Hucker’s modification
o Crystal violet
o Grams iodine
o Acid Alcohol
o Safranin

A

SPORE FORMING GRAM POSITIVE BACILLI

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3
Q

Responsible for resistance to extreme conditions

A

SPORES (endospores)

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4
Q

Protect from harsh environment

A

SPORES (endospores)

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5
Q

process that bacteria forms
spores (protective appendages)

A

Sporalate

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6
Q

Tend to make their own spores to protect themselves.

A

SPORES (endospores)

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7
Q

THERMOPHILIC (can survive 55 degrees above).

A

SPORES (endospores)

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8
Q

O2 requirement

BACILLUS:

A

Aerobic

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9
Q

Catalase

BACILLUS:

A

POSITIVE

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10
Q

Gas production

BACILLUS:

A

NEGATIVE

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11
Q

O2 requirements

CLOSTRIDIUM:

A

ANAEROBIC

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12
Q

Catalase

CLOSTRIDIUM:

A

NEGATIVE

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13
Q

Gas production

CLOSTRIDIUM:

A

POSITIVE

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14
Q

catalase reagent used:

A

3% hydrogen peroxide

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15
Q

only observe in culture
media in tubes (plates seldom only)

A

Gas production

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16
Q

Appearance (culture if there is
gas production):

A

bubbles, culture media can form cracks (tube)

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17
Q

There are more than ____ species within the genus.

A

300

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18
Q

Members of the genus Bacillus are metabolically diverse, and some species are ____ that grow best at _______.

A

thermophiles; 55° C or higher

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19
Q

tend to live in a different temperature

A

Diverse

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20
Q

The survival of Bacillus spp. in nature is aided by the formation of ______.

A

spores

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21
Q

Largest pathogenic bacteria

A

Bacillus anthracis

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22
Q

Large single organism

A

Bacillus anthracis

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23
Q

Also known as “Anthrax Bacillus”

A

Bacillus anthracis

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24
Q

Produces 2 virulence factors produced by _____ (can be found in the structure of Bacillus anthracis).

A

PLASMID

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25
Q

Bacillus anthracis VIRULENCE FACTORS:

A
  1. D-glutamic acid capsule
  2. Anthrax toxin
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26
Q

This particular isomer of glutamic acid is resistant to hydrolysis (addition of H2O) by host proteolytic enzymes because it is the
“unnatural” (zymogen) form of the amino
acid

A

D-glutamic acid capsule

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27
Q

process introduce water
bond

A

Resistance to hydrolysis

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28
Q

– produced D-glutamic acid
 Although the capsule is necessary for
virulence, antibodies against the capsule do
not confer immunity

A

PLASMID PX02

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29
Q

produced by anthrax toxin

A

PLASMID PX01

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30
Q

PLASMID PX01 consist of three proteins:

A
  1. Protective antigen (PA)
  2. Edema factor (EF)
  3. Lethal factor (LF)
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31
Q

Each of which individually is nontoxic but
which together act synergistically to produce
damaging effects.

A

PLASMID PX01 three proteins

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32
Q

serves as a necessary binding molecule for EF and LF, permitting their attachment to specific
receptors on the host cell’s surface

A

PROTECTIVE ANTIGEN (PA)

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33
Q

is an adenylate cyclase, release of water and electrolytes

A

EDEMA FACTOR (EF)

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34
Q

is a protease the inhibit protein synthesis

A

LETHAL FACTOR (LF)

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35
Q

PA + LF =

A

DEATH

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36
Q

PA + EF =

A

EDEMA

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37
Q

Bacillus anthracis
CLINICAL MANIFESTATIONS

A
  1. Cutaneous Anthrax
  2. Inhalation Anthrax
  3. Gastrointestinal Anthrax
  4. Injectional Anthrax
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38
Q

 Direct contact; zoonotic contact
 Starts when there is an open wound.

A

Cutaneous Anthrax

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39
Q

 A small pimple (2 to 3 days after exposure)
 eventually ulcerates and dries, forming a
depressed black necrotic central area known
as an** eschar or black eschar**

A

Cutaneous Anthrax

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40
Q

Cutaneous Anthrax Malignant postule;

A

90%

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41
Q

Respiratory anthrax
 Also known as Woolsorter’s disease, is acquired when spores are inhaled into the
pulmonary parenchyma.
Bioterrorism agent

A

Inhalation Anthrax

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42
Q

most fatal form – paspas mukalat ; 2%
 Ingestion of the spores
 The symptoms include abdominal pain, nausea, anorexia, and vomiting. Bloody diarrhea can also occur.
 Difficult to diagnose

A

Gastrointestinal Anthrax

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43
Q

 Not common; mostly common in person
using drugs
 Injection anthrax is characterized by soft
tissue infection associated with “skin
popping”
Lack of eschar, severity of disease, and increased mortality rate make this form
clinically distinct from the cutaneous form.

A

Injectional Anthrax

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44
Q

Bacillus anthracis TREATMENT

  • The CDC recommends that ________be used for initial intravenous therapy until antimicrobial susceptibility results are known.
A

ciprofloxacin or doxycycline

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44
Q

Bacillus anthracis TREATMENT
- Most isolates of B. anthracis are susceptible to penicillin, but resistance can occur in the absence of ______.

A

B-lactamase production

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45
Q

Bacillus anthracis TREATMENT
- Standard form culture agar:

A

MHA (muellerhinton agar)

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46
Q

Bacillus anthracis TREATMENT
- what biosafety cabinet should used?

A

Biosafety Level 3

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47
Q

a large, square-ended, grampositive rod found singly or in chains.

A

B. anthracis LABORATORY DIAGNOSIS: MICROSCOPY

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48
Q

Gives the appearance of bamboo pole arrangement.

A

B. anthracis LABORATORY DIAGNOSIS: MICROSCOPY

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49
Q

Centrally located endospores

A

B. anthracis LABORATORY DIAGNOSIS: MICROSCOPY

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50
Q

B. anthracis LABORATORY DIAGNOSIS: STAIN

A

Schaeffer Fulton

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51
Q

The spores are generally not present in clinical samples.

A

B. anthracis LABORATORY DIAGNOSIS: MICROSCOPY

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52
Q

Spores can be observed with a spore stain.
With this technique, vegetative cells stain
red, and the spores stain green.

A

B. anthracis LABORATORY DIAGNOSIS: MICROSCOPY

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53
Q

SPORES STAIN GREEN

A

Malachite Green

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54
Q

VEGETATIVE CELLS STAIN RED

A

Safranin

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55
Q

Bacillus anthracis
LABORATORY DIAGNOSIS: CULTURE The term _______has been used to describe the colony morphology of B. anthracis on BAP

A

medusa/head/beaten egg whites

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56
Q

medusa/head/beaten egg whites Observe directly bacteria:

A

Inverted microscope

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57
Q

Culture medium of B. anthracis

A

String of pearls of MHA with penicillin

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58
Q

culture medium in terms of performing
antimicrobial susceptibility testing; standard culture medium

A

Mueller Hinton Agar (MHA)

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59
Q

Fried rice Bacillus

A

Bacillus cereus

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60
Q

is a relatively common cause of fried rice poisoning and opportunistic

A

Bacillus cereus

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61
Q

Food poisoning caused by B. cereus takes two forms:

A

diarrheal and emetic

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62
Q

causes food poisoning

A

Staphylococcus aureus

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63
Q

 Meat and poultry
 8-16 hours (long)
 Heat labile enterotoxin – upon
introducing heat, the toxin will be dead.

A

Diarrheal Type

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64
Q

 Fried rice
 1-6 hours (short)
 Heat stable enterotoxin
 CLINICAL MANIFESTATIONS: vomiting

A

Emetic Type

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65
Q

____ from a food poisoning incident may be done to quantify and isolate B. cereus

A

Culture of suspected food

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66
Q

can also be use as a specimen

A

FRIED RICE

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67
Q

________ food poisoning by this organism is confirmed.

A

> 105 B. cereus/gram

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68
Q

Most food poisoning cases caused by B. cereus do not require ______ treatment.

A

antimicrobial

68
Q

To confirm the organism as the cause of the
disease, viable counts from the stool should
also be ________.

A

at least 105 cells per gram

69
Q

In contrast to B. anthracis, B. cereus is
resistant to penicillin and all of the other Blactam antibiotic for the _______

A

carbapenems

70
Q

B. cereus Treatment with vancomycin or clindamycin with our without an aminoglycoside has been successful.

A

TRUE

71
Q

Bacillus cereus bacteria stained with _____ to display their flagella.

A

Leifson dye

72
Q

B. cereus Arrangement of flagella:

A

Peritrichous

73
Q

CATALASE +

A

B. anthracis, B. cereus

74
Q

Lecithinase +

A

B. anthracis, B. cereus

75
Q

NON-MOTILE

A

B. anthracis

76
Q

MOTILE

A

B. cereus

77
Q

BAP Hemolysis

Gamma hemolysis

A

B. anthracis

78
Q

BAP Hemolysis

Beta hemolysis

A

B. cereus

79
Q

differentiate B. antracis and B. cereus

A

Motility and Hemolysis

80
Q

ANAEROBIC SPORE FORMING GRAM (+) BACILLI:

A
  • Clostridium tetani
  • Clostridium perfringens
  • Clostridium botulinum
  • Clostridium difficile
81
Q

Clostridium causing Tetanus (Spasmic Paralysis)

A

Clostridium tetani

82
Q

Also known as Racquet Bacillus

A

Clostridium tetani

83
Q

Endospore are round and terminal
(drumstick//tennis racquet appearance) –
due to locations of endospres

A

Clostridium tetani

84
Q

Spores are highly resistant to adverse conditions

A

Clostridium tetani

84
Q

Motile by peritrichous flagella

A

Clostridium tetani

85
Q

Iodine (1%) in water is able to kill the spore within a few hours

A

Clostridium tetani

86
Q

Neurotoxin and an essential pathogenic product

A

Tetanospasmin

87
Q

Clostridium tetani VIRULENCE FACTORS:

A

Tetanospasmin

88
Q

Toxic to humans and various animals when
injected parenterally, but it is not toxic by the
oral route

A

Tetanospasmin

89
Q

Causes increasing excitability of spinal cord neurons and muscle spasm.

A

Tetanospasmin

90
Q

This neonate is displaying a bodily rigidity
orduced by C. tetani exotoxin, called

A

neonatal tetanus

91
Q

Sir Charles Bell’s portrait of a soldier dying of
tetanus. The characteristic rigidity of the
body is referred to as .

A

opisthotonos and risus sardonicus

92
Q

Clostridium tetani
LABORATORY DIAGNOSIS
 Specimen:

A

Wound exudates using capillary tube
o Red ring (anticoagulant; HEPARIN)

93
Q

is a good method for identifying
Clostridium.

A

Gram stain

94
Q

Cl. tetani is a Gram positive rod, motile with a round terminal spore giving a ____ appearance.

A

drumstick

95
Q

Clostridium tetani
LABORATORY DIAGNOSIS
Culture:

A

o On blood agar and incubated anaerobically
o Growth appears as a fine spreading film

96
Q

Causative agent of gas gangrene

A

Clostridium perfringens

97
Q

Also known as GAS GANGRENE
BACILLUS

A

Clostridium perfringens

98
Q

Can also cause food poisoning

A

Clostridium perfringens

99
Q

Non-motile, capsulated with Subterminal spores

A

Clostridium perfringens

100
Q

centrally located sprores

A

Bacillus anthracis

101
Q

terminal spores

A

Clostridium tetani

102
Q

subterminal spores

A

Clostridium perfringens

103
Q

Clostridium perfringens VIRULENCE FACTORS: TOXINS

A
  • a toxin (phospholipase C, lecithinase)
  • B toxin
  • Enterotoxin
104
Q

Clostridium perfringens MOST IMPORTANT TOXIN

A

a toxin (phospholipase C, lecithinase)

105
Q

Lyses RBCs, platelets, leukocytes
and endothelial cells

A

a toxin (phospholipase C, lecithinase)

106
Q

Increased vascular permeability with massive hemolysis and bleeding tissue destruction.

A

a toxin (phospholipase C, lecithinase)

107
Q

Responsible for necrotic lesions in
necrotizing enterocolitis

A

B toxin

107
Q

Hepatic toxicity and myocardial
dysfunction

A

a toxin (phospholipase C, lecithinase)

108
Q

Clostridium perfringens
LABORATORY DIAGNOSIS
 Specimen:

A

Histological specimen (tissues)
or wound exudates

108
Q

o heat labile (can be destroyed by heat) toxin produced in colon
o for food poisoning

A

Enterotoxin

109
Q

```

Clostridium perfringens
Histological specimen transferred aseptically
into a _________ & used immediately for microscopic examination & culture

A

sterile screw-capped bottle

110
Q

Clostridium perfringens
Specimens of exudates should be taken
from the deeper areas of the wound where
the infection seems to be most pronounced.

A

TRUE

111
Q

Clostridium perfringens
LABORATORY DIAGNOSIS
 CULTURE:

A

Anaerobically at 37 C

111
Q

Exhibit Double zone of hemolysis (two zone beta hemolysis)

A

Clostridium perfringens LABORATORY DIAGNOSIS

112
Q

Clostridium perfringens
blackening of meat will observed with the
production of H2S and NH3

A

Robertson’s cooked meat medium

113
Q

It ferments many carbohydrates with acid & gas

A

Clostridium perfringens LABORATORY DIAGNOSIS

114
Q

Nagler reaction (+)

A

Clostridium perfringens LABORATORY DIAGNOSIS

115
Q

It acidified litmus milk with stormy clot production

A

Clostridium perfringens LABORATORY DIAGNOSIS

116
Q

This test is done to detect the
LECITHINASE ACTIVITY

A

NAGLER REACTION

116
Q

Clostridium perfringens
LABORATORY DIAGNOSIS:

A
  • NAGLER REACTION
  • LITMUS MILK
  • Reverse CAMP Test
117
Q

alpha-toxin

A

NAGLER REACTION

118
Q

Inoculated on the medium containing human
serum or egg yolk (contains lecithin)

A

NAGLER REACTION

119
Q

NAGLER REACTION The plate is incubated anaerobically at

A

37° C for 24 hrs

120
Q

Colonies of Cl. perfringens are surrounded
by zones of turbidity due to lecithinase
activity and the effect is specifically inhibited
if Cl. perfringens antiserum containing alpha
antitoxin is present on the medium.

A

NAGLER REACTION

121
Q

LITMUS MILK ACIDIC REACTION =

A

Pink Color

122
Q

LITMUS MILK BASIC REACTION =

A

Blue Color

123
Q

POSITIVE LITMUS MILK:

A

acid with stormy clot fermentation

124
Q

CAMP Positive S. agalactiae (Group B
Streptococcus) is streaked in SBA and C.
perfringens is streaked perpendicular to it.

A

Reverse CAMP Test

125
Q

(+) “arrowhead” (enhanced) hemolysis is seen in between = C. perfringens

A

Reverse CAMP Test

126
Q

CAUSES BOTULISM (Flaccid Paralysis)

A

Clostridium botulinum

127
Q

Seven neurotoxic subtypes, labeled A-G

A

Clostridium botulinum

128
Q

First recognized and isolated in 1896 by Van Ermenhem

A

Clostridium botulinum

129
Q

Botulism is a neuroparalytic disease

A

Clostridium botulinum

130
Q

Once released into the bloodstream it
irreversibly binds to the acetylcholine
receptors in the neuromuscular junction

A

Clostridium botulinum

131
Q

It alters the mechanism for acetylcholine
release, making the neuron unresponsive to
action potentials

A

Clostridium botulinum

132
Q

 Most common form
 Afflicts babies from 1 week – to 1 year
 Antigenic variation types A/B

A

Floppy Baby Syndrome

133
Q

Infant Botulism:

A

Floppy Baby Syndrome

134
Q

Floppy Baby Syndrome Caused by:

A

 Ingesting contaminated foodstuff
 Untreated natural honey and corn syrup
 Household dust containing C. botulinum
spores

135
Q

Clostridium botulinum MANAGEMENT:
must be administered intravenously (recovery takes several weeks)

A

Trivalent (A,B,E) antitoxin

136
Q

Clostridium botulinum MANAGEMENT:
is administered if necessary.

A

Mechanical respirator

137
Q

Clostridium botulinum
LABORATORY DIAGNOSIS:

A

 Toxins found in serum, leftover food
 In infants, found in stool
 Mice injected with toxin die rapidly
 Spores are oval, subterminal
 Lipase positive

138
Q

A common cause of nosocomial antibioticassociated diarrhea (AAD) & antibiotic (Clindamycin) -associated
pseudomembranous colitis

A

Clostridium difficile

139
Q

The only nosocomial organism that is
anaerobic and forms spores (survive >5
months and hard to destroy)

A

Clostridium difficile

140
Q

Clostridium difficile
Pathogenesis is mainly due to toxin production:

A

Infective dose is <10 spores

141
Q

Cyclocidin-Cefoxitin Fructose
Agar POSITIVE

A

(+) colonies with Yellow Halo

141
Q

Clostridium difficile
LABORATORY DIAGNOSIS
 Specimen:

A

Stool

142
Q

Clostridium difficile
LABORATORY DIAGNOSIS
Cultured on:

A

Cyclocidin-Cefoxitin Fructose
Agar

143
Q

a selective culture media

A

Cyclocidin-Cefoxitin Fructose
Agar

144
Q

sweet or fruity odor

A

Pseudomanas aeruginosa

144
Q

Horse manure odor

A

Clostridium difficile

145
Q

Old sock

A

Staphylococcus aereus

145
Q

Freshly lawn grass odor

A

Nocardia spp.

146
Q

C. difficile toxin testing: ______if not used/tested for longer than 48 hours. No preservatives added because it will inhibit the toxins.

A

Should be freezed (78C)

147
Q

Best strategy for C. difficile testing
 For clinical use:

A

two-step testing uses initially EIA detection screening followed by cytotoxicity assay or toxigenic culture for confirmation

148
Q

C. difficile testing Gold standard:

A

stool culture followed by
toxigenic culture assay

149
Q

NON-MOTILE

A

C. perfringens

150
Q

MOTILE

A
  • C. botulinum
  • C. tetani
  • C. difficile
151
Q

POSITIVE LECITHINASE

A

C. perfringens

152
Q

NEGATIVE LECITHINASE

A
  • C. botulinum
  • C. tetani
  • C. difficile
153
Q

NEGATIVE LIPASE

A

C. perfringens

154
Q

POSITIVE LIPASE

A

C. botulinum

155
Q

NEGATIVE LIPASE

A

C. tetani
C. difficile

156
Q

POSITIVE LACTOSE

A

C. perfringens

157
Q

NEGATIVE LACTOSE

A
  • C. botulinum
  • C. tetani
  • C. difficile
158
Q

POSITIVE GLUCOSE

A

C. perfringens

159
Q

POSITIVE GLUCOSE

A
  • C. botulinum
  • C. difficile
160
Q

NEGATIVE GLUCOSE

A

C. tetani

CLINICAL BACTERIOLOGY (7 decks)

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