Nonfermenters/Unusual Neg Rods/Haemophilus Flashcards by Tanner Hovland

List the nonfermenters.

Burkholderia
Baleatrix
Brevundimonas
Shingomonas
Shewanella
Stenotrophomonas
Methylobacterium
Moraxella+Oligella
Chromobacterium
Comanomas
Alcaligenes+Achromobacter
AcinetobacteR
Pseudomonas
Flavobacteriaceae

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What are three clues that would lead you to suspect a nonfermenter:

Clear colonies on the MAC plate
Poor growth in automated systems in 24 hrs
Oxidase pos reactions (some are neg)
Coccobacilli or very long gram neg bacilli

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What is the typical TSI reaction for a nonfermenter and what two things were ignored on the initial evaluation?

K/K

Clear colonies on the MAC plate or neg on MAC and the oxidase

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Define (OF test) fermentative, oxidative, nonsaccharolytic:

There are two different tubes, Anaerobic and Aerobic. Anaerobic is overlayed with oil while the aerobe is left alone.

Aerobe: grows in aerobic tube
Anaerobe: grows in anaerobic tube
Facultative: grows in both
Nonsaccharolytic/asaccharalitic: grows in none of them

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Define pyocyanin and pyoverdin:

Pyocyanin-a water soluble pigment produced by P. aeruginosa that gives it a blue-green appearance with a slightly metallic surface

Pyoverdin-a water soluble fluorescent pigment that is produced by P. fluorescent and P. putida and P. aeruginosa

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Pseudomonas aeruginosa

Pathogenicity:
Features:
Requirements:

Wound infections, nosocomial, swimmers ear, pulmonary disease, increased in CF pts.

Very resistant to antibiotics, green sheen, ox pos, grape like odor caused by 2-aminoacetophenone, large flat spread colony

Will tolerate 42°C

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Pseudomonas fluorescens & putida

Pathogenicity:
Features:
Requirements:

Low virulence

Produce pyoverdin, Ox pos

37°C

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Stenotrophomonas maltophilia

Pathogenicity:
Features:
Requirements:

Nosocomial infections in contaminated equip (venous cath #1)

Ox neg, nonfermentor
Cat, DNase, Esculin, Lysine decarb pos

37C

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Acinetobacter baumannii & lwoffi

Pathogenicity:
Features:
Requirements:

Opportunistic

Ox neg, coccobacilli, Cat pos, nonmotile

Purple colony on MAC (looks like lactose fermentor then)

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Burkholderia cepacia

Pathogenicity:
Features:
Requirements:

Nosocomial infections, increased in CF patients (pneumonia)

Slow Ox, glucose, maltose, lactose, mannitol, LOA positive

Can grow on MAC and Blood but is inhibited by other NF, grows best on OFPBL

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Flacobacteriaceae

Pathogenicity:
Features:
Requirements:

Nosocomial

Weak fermenters so appear as nonfermenters, Ox pos

Yellow pigment

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Moraxella

Pathogenicity:
Features:

Opportunistic

Ox pos, nonmotile, coccobacilli, do not utilize common carbs.

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Oligella

Pathogenicity:
Features:
Requirements:

Opportunistic

Coccobacilli

No growth on MAC

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What is the colony morphology of Pseudomonas stutzeri:

wrinkled, leathery colony with a light yellow to brown pigment

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Discuss the significant characteristics of Burkholderia cepacia:

Nosocomial pathogen but attacks CF patients frequently

Prefers 30°C, oxidase neg

Yellow pigment and non wrinkled colony

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Discuss the pathogenicity and distinguishing characteristics of Burkholderia pseudomallei and Burkholderia mallei:

Burkholderia pseudomallei-

Burkholderia mallei-

Burkholderia pseudomallei- causes meliondosis granulomatous pulmonary disease, has bipolar staining on gram stains, is a nonfermentor with a wrinkled colony (earthy odor)

Burkholderia mallei- only nonmotile, gram neg coccobacilli that may branch and look filamentous, CDC considers this a bioterroristic organisms due to glanders

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List the common phenotypic characteristics of gram neg rods and discuss why the “other gram negative rods” don’t belong in these categories.

Hemophilus - require X and/or V factors (tiny gram neg rods)

Enterobacteriaceae - all are oxidase neg, change nitrates to nitrites and ferment glucose

Nonfermentors - do not ferment glucose

Unusual gram neg rods don’t fall into any of these groups

Define the similar characteristics the HACEK group shares, and name each organism:

H =

A =

C =

E =

K =

H = Haemophilus sp. (Aggregatibacter Aphrophilus)

A = Actinobacillus actinomycetemcomitans

C = Cardiobacterium hominis

E = Eikenella carrodens

K = Kingella

They all need increased CO₂ and their love of heart valves, all NF except for Aphrophilus

Actinobacillus

Pathogenicity:
Special ID Features:
Special Isolation/Growth:

Zoonotic, isolated from blood

Nonmotile, coccobacilli, 48 hr star like colonies

Increased CO₂, MAC neg

Cardiobacterium

Pathogenicity:
Special ID Features:
Special Isolation/Growth:

Respiratory and GI NF, may cause endocarditis following dental visits

Pleomorphic rods, gram variable, hemolytic, pit agar, nonmotile

Increased CO₂, MAC neg

Eikenella

Pathogenicity:
Special ID Features:
Special Isolation/Growth:

Flora of oral and bowel cavities, bite and fight wounds

Coccobacilli, Ox pos, Yello pigment, Pits agar/bleach odor

Increased CO₂, Poor on MAC

Kingella

Pathogenicity:
Special ID Features:
Special Isolation/Growth:

Rare pathogen

Pairs of short chained coccobacilli, Ox pos

Increased CO₂, 42C

What are the general characteristics of Haemophilus:

Gram neg coccobacillus, Ox and Cat pos, like increased CO₂

List the three most pathogenic Haemophilus and their primary location for growth on the body:

H. influenzae
H. aegyptius
H. ducreyi

H. influenza - upper resp.
H. aegyptius - eye
H. ducreyi - genital

Discuss the X and V requirements for the three microbes listed above, and the term hemophilic: H. influenzae H. aegyptius H. ducreyi hemophilic

H. influenza - requires both X and V H. aegyptius - requires both X and V H. ducreyi - requires X only, Ox neg hemophilic = blood loving

Define X and V factors and the porphyrin test

``` X = hemin V = NADC nicotinamide-adenine dinucleotide ``` Porphyrin test looks for the organisms ability to convert ALA to porphyrins. This takes the place of the X test. If the organism requires X to be provided for them it is porphyrin neg

Define satellitism:

If a Haemophilus requires both X and V factor, on a BAP the X would be available from the media but the V would be donated from one of these (Strep pneumoniae, Staph aureus, or Neisseria) The Haemophilus grows only around these colonies on a BAP as tiny, shiny gray colonies

Discuss these virulence factors associated with H. influenzae: Capsule IgA Adherence LPS

Capsule - which is where the antigens are from for the 6 serotypes (A, B, C, D, E, and F) B being the most invasive) IgA - Protease lyses IgAs so weakens defenses in mucous membranes Adherence - the lack adherence may play a role in the orgs ability to become systemic LPS - paralyzing effects of the ciliated respiratory epithelium

Discuss the pathogenicity of H. influenzae serotype b:

Serotype B affects children between the ages of 3 months to 6 years, as the causative agent of meningitis, cellulitis, and epiglottitis Since the advent of the Hib vaccine there has been a decrease in invasive disease

What are the primary antibiotics used against H. influenzae type b for life threatening and non life threatening infections: Obj 10

Life threatening - cefotaxime or ceftriaxone alternates include trimethoprim, SXT, imipenam, ciprofloxacin Non life threatening - amoxicillin or 2 or 3rd gen cephalosporins H. ducreyi - erythromycin

Resistance to ampicillin is probable due to B-lactamase. Discuss a mechanism for this test

A disk containing Cefinase is rehydrated with water. Several colonies are placed on the disk. If the org has the enzyme it breaks the B-lactam ring of the Cefinase and color change occurs

Pasteurella multocida Pathogenicity: Special ID features: Special Isolation/Growth:

Cellulitis from cat scratch or bites Pleomorphic gram neg rod Will grow on BAP, ox pos, cat pos

Brucella Pathogenicity: Special ID features: Special Isolation/Growth:

Zoonotic, infects through contact with infected animals and animal products Multiple blood cultures held for 30 days serologic testing, most beneficial

Legionella Pathogenicity: Special ID features: Special Isolation/Growth:

Pneumonia, Legionnaires disease, Pontiac fever Urine antigen test, fluorescent test, DNA probe 20-43C, BCYE isolation with ground glass appearance

Francisella Pathogenicity: Special ID features: Special Isolation/Growth:

Tularemia, zoonotic, usually infected by rabbits or ticks Ulcer specimens or biopsy of lymph nodes Serologic studies

Bordetella pertussis Pathogenicity: Special ID features: Special Isolation/Growth:

Whooping cough or pertussis direct fl. testing, DNA probes Regan-Lowe, Bordet-Gengou media

Gardnerella Pathogenicity: Special ID features: Special Isolation/Growth:

Bacterial vaginosis epithelial cell with borders obscured by tiny gram neg rods/clue cells B hemolytic on V agar

Campylobacter Pathogenicity: Special ID features: Special Isolation/Growth:

Most common cause of bacterial gastroenteritis Darting motility, nonfermentor, curved gram stain Ox and Cat pos Campy BAP, 42°C 85%N₂ (microaerophilic)

Helicobacter Pathogenicity: Special ID features: Special Isolation/Growth:

Gastric and duodenal ulcers Rapidly reacting urease Serological testing available

Compare and contrast Vibrio, Aeromonas, and Plesiomonas: Vibrio - Aeromonas - Plesiomonas-

Vibrio - Vibrio cholerae is causative agent of a severe life threatening diarrheal disease, curved gram neg rods but straight in lab growth, Ox pos, nitrates to nitrites, halophilic, pos string test, susceptible to O129, require addition of Na+, TCBS media Aeromonas - Ox pos on BAP, glucose fermenting, causes gastroenteritis, wound infections, septicemia, distributed worldwide Plesiomonas - Ox pos, glucose fermenting, found in soil/water, cannot grow at less than 8°C, looks like E.coli on regular enteric media has been moved to the Enterobacteriaceae family, Causes gastroenteritis

Capnocytophage can cause life threatening infections after which of the following?

Dog or cat bite

How to differentiate between Campylobactor jejuni and Helicobactor pylori

Urease, nitrate, and hippurate hydrolysis