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Misc GNR Flashcards

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0
Q

Haemophilus gram reaction

A

Gram-negative, pleomorphic coccobacilli

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1
Q

Haemophilus family

A

Pasteurellaceae

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2
Q

Haemophilus normal flora

A

Mucous membranes and upper respiratory tract

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3
Q

General characteristics of Haemophilus

A

Oxidase and catalase positive
Reduce nitrates to nitrites
Ferment carbohydrates

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4
Q

Factor X

1) Other name
2) Heat stability
3) Porphyrin test results

A

1) Hemin
2) Heat stable
3) Negative

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5
Q

Factor V

1) Other name
2) Heat stability
3) Agars

A

1) NAD
2) Heat labile
3) BAP; Horse and rabbit blood; chocolate

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6
Q

Common sources for Haemophilus cultures

A

Blood, CSF, Ear, Joint fluids, upper and lower respiratory tract, swabs from eyes, vaginal swabs, abscess drainage

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7
Q

Main media to isolate Haemophilus

A

Chocolate (contains X and V)

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8
Q

Other media to isolate Haemophilus

A

Levinthal, Flide, Casman’s

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9
Q

Organism to help isolate Haemophilus

A

Staph streak (releases factor V)

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10
Q

What agars will Haemophilus not grow on?

A

MAC, BAP

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11
Q

Gram morphology of encapsulated strains of Haemophilus

A

Halo around organism

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12
Q

Colony morphology of Haemophilus

A

Flat, grey, round, mousy odor

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13
Q

Why must you be aware of the incubation conditions for Haemophilus?

A

They are facultative anaerobes so when they are grown anaerobically they do not need to have hemin

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14
Q

How does the staph streak work?

A

Staph hemolysin releases Factor X and the staph also provides factor V

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15
Q

Porphyrin test (ALA)

1) Reagents
2) Use
3) Results

A

1) Delta-aminolevulinic acid test
2) Check which organisms make their own X factor
3) ALA (+) will make their own X factor

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16
Q 
X (-)
V (-)
XV (+)
Beta (-)
ALA (-)
A

H. influenza

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17
Q 
X (+)
V (-)
XV (+)
Beta (-) 
ALA (-)
A

H. ducreyi

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18
Q

Haemophilus influenzae used to be known as..

A

“Pfeiffer’s bacillus”

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19
Q

Haemophilus influenzae normal flora

A

Upper respiratory tract

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20
Q

Haemophilus influenzae virulence factors

A

Capsule
IgA proteases
Outer membrane proteins and LOS
Adherence

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21
Q

Adherence indicates….

A

Localized infection

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22
Q

What causes nonadherence giving way to a systemic infection?

A

Capsule

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23
Q

Haemophilus influenzae lipoligosaccharide

A

paralyzes ciliated respiratory cells so they cannot excrete the organism

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24
Q

What type of serotype of Haemophilus influenzae causes larger and more mucoid colonies?

A

Serotype B

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25
Q

Haemophilus influenzae Serotype B

1) Virulence
2) Resistant to…
3) Methods of detection

A

1) Antiphagocytic (no adherence)
2) Penicillin
3) Side agglutination; Quelling reaction; Protein A coagglutination; PCR; ELISA

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26
Q

Haemophilus influenzae biotype I cultures

A

Blood, CSF, upper respiratory

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27
Q

Haemophilus influenzae biotype II cultures

A

Eye, sputum, genital infections

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28
Q

Haemophilus influenzae biotype III cultures

A

Koch-Weeks bacillus (H. aegyptius), acute conjunctivitis, sputum

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29
Q

Haemophilus influenzae biotype I

1) Urease
2) Indole
3) ODC

A

1) +
2) +
3) +

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30
Q

Haemophilus influenzae biotype II

1) Urease
2) Indole
3) ODC

A

1) +
2) +
3) -

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31
Q

Haemophilus influenzae biotype III

1) Urease
2) Indole
3) ODC

A

1) +
2) -
3) -

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32
Q

Haemophilus influenzae clinical significance encapsulated strains

A 
Meningitis 
Epiglottitis 
Arthritis 
Cellulitis 
Acute pharyngitis
Pneumonia
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33
Q

Haemophilus influenzae clinical significance of nonencapsulated strains

A 
Otitis media
Bronchitis
Sinusitis 
Pneumonia in elderly patients
Genital tract
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34
Q

Haemophilus aegyptius diseases

A

Conjunctivitis

Brazillian purpuric fever

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35
Q

Patient presents with a severe fever, petechia rash, shock, and vascular crash…what is this indicative of?

A

Brazilian purpuric fever caused by Haemophilus aegyptius

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36
Q

What is Haemophilus influenzae biotype III known as?

A

Haemophilus aegyptius

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37
Q

Haemophilus ducreyi main disease

A

Chancroid (highly communicable STD)
Mimics syphilis except that ulcers are very painful
Lymph node enlargement in inguinal area called buboes

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38
Q

What organism has a “school of fish” gram stain?

A

Haemophilus ducreyi

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39
Q

What is Haemophilus aphrophilus now known as?

A

Aggregatibacter aphrophilus

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40
Q

Which organism causes endocarditis and septicemia?

A

Haemophilus aphrophilus

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41
Q

What is very unique about Haemophilus aphrophilus?

A

Will grow on BAP and is non hemolytic

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42
Q

Haemophilus aphrophilus normal flora

A

Oral cavity

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43
Q

Which organism is known as a HACEK organism?

A

Haemophilus aphrophilus

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44
Q

Haemophilus aphrophilus porphyrin test result

A

positive

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45
Q

Haemophilus heamolyticus

1) Normal flora
2) Requires
3) Colony morphology on BAP

A

1) Upper respiratory tract
2) X and V
3) Wide zone of hemolysis

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46
Q

Haemophilus parahemolyticus

1) Normal flora
2) Requires
3) Colony morphology on BAP

A

1) Upper respiratory tract
2) Factor V
3) Hemolytic on BAP

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47
Q

Haemophilus parainfluenza

1) Normal flora
2) Requires
3) Hemolysis on BAP

A

1) Upper respiratory tract
2) Factor V
3) Nonhemolytic

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48
Q

What type of testing must be done for all Haemophilus isolates?

A

Beta lactamase

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49
Q

Beta-lactamase

1) Reagent
2) Method

A

1) Cefinase disc

2) Acidometric

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50
Q

Neisseria normal flora

A

Nasopharynx, pharynx, mucous membranes of the respiratory and urogenital tract

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51
Q

Neisseria gram reaction

A

Diplococci, “kidney bean”

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52
Q

Neisseria general characteristics

A

Oxidase positive
Catalase positive
Nitrate negative
Aerobic with increased CO2

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53
Q

Neisseria gonorrhoeae disease

A

STD; gonorrhea (acute pyogenic infection mainly of the mucous membranes of the endocervix in females and the urethra in males

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54
Q

Neisseria gonorrhoeae disease in males

A

Acute urethritis

Asymptomatic gonococcal infections

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55
Q

Neisseria gonorrhoeae disease in females

A

Pelvic inflammatory disease

Asymptomatic gonococcal infection

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56
Q

Neisseria gonorrhea infections

A

Disseminated gonococcal infections
Opthalmia neonatorum
Pharyngitis and rectal gonorrhea

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57
Q

Neisseria gonorrhea virulence factors

A

Capsule
Pili
Cell-wall proteins
Lipopolysaccharide

58
Q

Neisseria gonorrhea capsule

A

Prevents phagocytosis of organism

59
Q

Neisseria gonorrhea

1) T1 and T2
2) T3, T4, T5

A

1) Possess pili and are virulent, colonies are small and raised
2) No pili and are avirulent, colonies are large and flatter

60
Q

Neisseria gonorrhea pili

A

Inhibit phagocytosis

61
Q

Neisseria gonorrhea cell-wall proteins purpose

A

Prevent phagocytosis

62
Q

Neisseria gonorrhea protein I

A
  • Allows for the organism to insert into host cell

* ELISA, coagglutination and gonococcal serotyping

63
Q

Neisseria gonorrhea protein II

A

Associated with virulence which allows attachment to neutrophils, epithelial cells and resist effects of antibiotics

64
Q

Neisseria gonorrhea protein III

A

Major binding site for IgG-blocking antibody

65
Q

Neisseria gonorrhea lipopolysaccharide

A

Prevent phagocytosis

Endotoxin (mediates damage to body tissues)

66
Q

Neisseria gonorrhea choice for genital cultures

1) Females
2) Males

A

1) Endocervix

2) Urethra

67
Q

What are non-culture ways to identify Neisseria gonorrhea?

A

Urine for PCR/LCR

68
Q

Why is Neisseria gonorrhea important to immediately culture to media or transport agar?

A

Gonococcus is susceptible to drying and chilling

69
Q

Neisseria gonorrhea gram stain

A

Gram negative intracellular diplococci

70
Q

A gram stain of a urethral exudate showing gram negative intracellular diplococci can be a presumptive ID of what organism?

A

Neisseria gonorrhea

71
Q

Can Neisseria gonorrhea be ID’d from a gram stain in female specimens?

A

No due to the fact that diplococci is normal flora for a female

72
Q

What is indicated by a gram stain with more than 5 PMNs per field but no bacteria?

A

Nongonococcal urethritis

73
Q

What is the normal flora in females that look like gram negative diplococci?

A

Actinobacter and Moraxella

74
Q

Neisseria gonorrhea colony characteristics

A

Small, gray, translucent, and raised

75
Q

How can Neisseria gonorrhea be presumptively ID’d?

A

Pili typing, AHU, Oxidase positive, catalase positive

76
Q

Neisseria gonorrhea definitive ID

A

Carbohydrate utilization (glucose positive); FA; ELISA; Genital probe; LCR

77
Q

Neisseria gonorrhea auxotypes

1) Stands for…

A

Arginine, hypoxanthine; uracil

78
Q

Neisseria meningitidis disease

A

Bacterial meningitis and septicemia

79
Q

Neisseria meningitidis normal flora

A

Upper respiratory tract

80
Q

Neisseria meningitidis group A

A

Worldwide epidemics

81
Q

Neisseria meningitidis group B & C

A

Most common in US

82
Q

Neisseria meningitidis group B

A

Community-acquired disease usually sporadic outbreaks

83
Q

Neisseria meningitidis virulence factors

A 
Pili 
Polysaccharide capsule (resist phagocytosis)
Endotoxin production
IgA protease (enzyme that aids invasiveness)
84
Q

Neisseria meningitidis primary source

A

Oral secretions, respiratory droplets from asymptomatic carriers

85
Q

Neisseria meningitidis risk groups

A

College dorms, military barracks

86
Q

Neisseria meningitidis diseases

A

Meningococcemia (enters bloodstream)

Meningitis (spreads to meninges, CNS)

87
Q

Patient presents with severe headache, stiff neck, nausea, vomiting, delirium, and rigid spine?

A

Neisseria meningitidis

88
Q

What other diseases are caused by Neisseria meningitidis?

A

Petechial (hemorrhagic skin lesions, release of endotoxin)
DIC (uncontrolled clotting within bloodstream)
Waterhouse-Frederiksen syndrome (severe, shock, large petechial lesions, internal bleeding, hemorrhage into adrenal glands)

89
Q

Chronic Neisseria meningitidis disease

A

Symptomatic, fever, rash, arthritis

90
Q

Acute Neisseria meningitidis disease

A

Slight fever and symptoms of respiratory tract infection, positive blood cultures, patient usually clinically well

91
Q

Direct detection tests for Neisseria meningitidis

A

Latex agglutination, Coagglutination; Serogrouping; gram stain (CSF and petechial)

92
Q

Neisseria meningitidis carbohydrate fermentation

A

Glucose and maltose positive

93
Q

Neisseria meningitidis colony morphology

A

Gray on chocolate, sometimes mucoid, round, smooth, glistening
Bluish on BAP

94
Q

Moraxella catarrhalis normal flora

A

Respiratory tract

95
Q

Moraxella catarrhalis opportunistic pathogen causing…

A

Pneumoniae

96
Q

Moraxella catarrhalis colony morphology

A

Smooth, gray to white, develop salmon-pink, “hockey puck”

97
Q

What are Moraxella catarrhalis intrinsically resistant to?

A

Ampicillin (beta-lactamase)

98
Q

Moraxella catarrhalis DNase

A

Positive

99
Q

Moraxella catarrhalis diseases

A

Acute and chronic bronchitis

Sinusitis, meningitis, endocarditis, pneumoniae, otitis media

100
Q

Nonpathogenic Neisseria sp: main reason to be familiar with these?

A

Accurately separate them from pathogenic species

101
Q

Nonpathogenic Neisseria spp. colony morphology

A

yellow, dry, crunchy

102
Q

Neisseria cinerea

1) Disease
2) Normal flora
3) Colony pigment
4) Carbohydrate fermentation
5) DNase

A

1) Bacteremia, conjunctivitis, nosocomial pneumoniae, proctitis
2) Oropharyngeal and genital flora
3) Yellow
4) Glucose (+)
5) (-)

103
Q

Neisseria lactamica

1) Normal flora
2) Carbohydrate
3) ONPG

A

1) Nasopharynx of infants and children
2) Glucose, maltose, lactose
3) (+)

104
Q

Kingella denitrificans

1) Normal flora
2) Main disease
3) Carbohydrate
4) Catalase

A

1) Upper respiratory tract
2) Endocarditis (HACEK)
3) Glucose
4) Negative

105
Q

Bordetella epidemiology

A
  • *Acquired through respiratory tract via aerosols
  • *Replicate on ciliated respiratory epithelial cells
  • *Toxins and other virulence factors are produced and have system effect
106
Q

What is one of the most highly communicable disease of childhood?

A

Pertussis

107
Q

Bordetella pertussis virulence factors

A 
Adherence
Pertussis toxin (PT)
Overcome host defenses
108
Q

Bordetella pertussis clinical stages

A

1) Catarrhal stage
2) Paroxysmal phase
3) Convalescent phase

109
Q

Bordetella pertussis catarrhal stage

A
  • Cold or flu-like
  • Highly communicable
  • Treatment in this stage
110
Q

Bordetella pertussis paroxysmal phase

A

*Severe repetitive cough; “whoop”

111
Q

Bordetella pertussis convalescent phase

A

Begins at 4 weeks, lasts 6 months

112
Q

What are the best specimens to culture for Bordetella pertussis?

A

NP aspirates or NP swabs

113
Q

Direct detection of Bordetella pertussis

A

DFA

Nucleic acid detection

114
Q

Culture media for Bordetella pertussis

A

Bordet-Gengou
Modified Jones-Kendrick
Regan-Lowe

115
Q

Incubation for Bordetella pertussis

A

7 days minimum

35 C

116
Q

Bordetella pertussis gram stain

A

Minute, faintly staining coccobacilli singly or in pairs

117
Q

Oxidase (+)
Urease (-)
Motility (-)
Nitrate (-)

A

Bordetella pertussis

118
Q

Bordetella parapertussis direct detection

A

DFA

119
Q

Bordetella parapertussis incubation

A

5-7 days

120
Q

Bordetella parapertussis AMS

A

Erythromycin

121
Q

Oxidase (-)
Urea (+)
Motility (-)
Citrate (+)

A

Bordetella parapertussis

122
Q

Bordetella bronchiseptica

1) Normal flora
2) Associated with…

A

1) Mouth of animals, dogs, cats, and rabbits

2) Animal bites

123
Q

Bordetella bronchiseptica gram reaction

A

Medium sized straight rod

124
Q

Which Bordetella grows quickly within 1-2 days?

A

Bordetella bronchiseptica

125
Q

Which Bordetella will show a non lactose fermentation reaction on MAC?

A

Bordetella bronchiseptica

126
Q

Oxidase (+)
Urea (+)
Motile
Citrate (+)

A

Bordetella bronchiseptica

127
Q

Which organism will show urea positive in 4 hours?

A

Bordetella bronchiseptica

128
Q

Legionella clinical disease

A

Pneumonia (Legionnaire’s disease)

Pontiac Fever

129
Q

Legionella incubation

A

2-10 days

130
Q

Patient presents with a nonproductive cough, fever, headache, myalgia. Later, the patient presents with bloody sputum, rales, dyspnea, chills.

A

Legionella

131
Q

What is the Legionella organism taken up by during phagocytosis?

A

Alveolar macrophages

132
Q

Pontiac Fever

A

Nonpneumonic form; flulike symptoms for 2-5 days; milder form of infection

133
Q

Legionella specimen collection

A

Sputum, BAL, BW, lung tissue, wound and abscess material, pleural and pericardial fluids, blood, environmental water samples

134
Q

Legionella direct detection

A

DFA
Gram stain (difficult faintly staining)
Tissue; silver or Giemsa stain

135
Q

Legionella culture

A

BYCE

136
Q

Legionella colony morphology

A

“ground-glass” appearance, developing a blue color

137
Q

How long does it take for Legionella take to grow?

A

3-4 days

138
Q

Legionella gram morphology

A

Long thin gram negative rod

139
Q

IFA will show a four fold rise in titer when infected with what organism?

A

Legionella

140
Q

Legionella ID

A

Urine antigen test; EIA; IFA

141
Q

Gardnerella vaginalis epidemiology

A

Normal vaginal flora of humans; may also colonize distal urethra of males

142
Q

Gardnerella vaginalis transmission

A

Endogenous strains

143
Q

Gardnerella vaginalis

1) Clinical disease
2) Culture
3) Colony appearance
4) ID
5) Direct detection

A

1) Bacterial vaginosis
2) V agar; human blood
3) Small pinpoint colonies on chocolate with beta hemolysis
4) Appearance on V agar and gram stain
5) Clue cells

Microbiology (3 decks)

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