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AMT MT Exam > Review Cards - Microbiology > Flashcards

Review Cards - Microbiology Flashcards

1
Q

Biosafety levels - Level I - risk

A

minimal

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2
Q

Biosafety levels - Level I - types of agents

A

those not known to cause disease in healthy adults

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3
Q

Biosafety levels - Bacillus subtilis

A

Level I

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4
Q

Biosafety levels - Mycobacterium gordonae

A

Level I

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5
Q

Biosafety levels - soil microbes

A

Level I

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6
Q

Biosafety levels - Level I - precautions

A

-standard microbiological practices
-no special equipment

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7
Q

Biosafety levels - Level II - risk

A

moderate

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8
Q

Biosafety levels - Level II - types of agents

A

common human pathogens

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9
Q

Biosafety levels - Enterohemorrhagic E. coli

A

Level II

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10
Q

Biosafety levels - Salmonella

A

Level II

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11
Q

Biosafety levels - HIV

A

Level II

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12
Q

Biosafety levels - HBV

A

Level II

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13
Q

Biosafety levels - influenza

A

Level II

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14
Q

Biosafety levels - Level II - precautions

A

-biological safety cabinet (BSC) I or II
-PPE
-autoclave must be available
-limited access
-most micro labs fall in this category

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15
Q

Biosafety levels - Level III - risk

A

high

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16
Q

Biosafety levels - Level III - types of agents

A

those that may cause serious or lethal disease via inhalation.

-effective treatment available

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17
Q

Biosafety levels - Bacillus anthracis

A

Level III

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18
Q

Biosafety levels - Francisella

A

Level III

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19
Q

Biosafety levels - Brucella

A

Level III

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20
Q

Biosafety levels - Mycobacterium tuberculosis

A

Level III

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21
Q

Biosafety levels - Rickettsia rickettsii

A

Level III

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22
Q

Biosafety levels - Coxiella burnetii

A

Level III

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23
Q

Biosafety levels - mold stages of systemic fungi

A

Level III

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24
Q

Biosafety levels - Level III - precautions

A

-biological safety cabinet (BSC) I or II
-PPE
-autoclave must be available
-limited access
-negative air flow
-sealed windows

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25
Q

Biosafety levels - Level IV - risk

A

extreme

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26
Q

Biosafety levels - Level IV - types of agents

A

those that pose a high risk of life-threatening disease
-may be transmitted by aerosols
-no vaccine or therapy

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27
Q

Biosafety levels - Ebola virus

A

Level IV

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28
Q

Biosafety levels - Lassa virus

A

Level IV

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29
Q

Biosafety levels - hemorrhagic fevers

A

Level IV

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30
Q

Biosafety levels - Level IV - precautions

A

-class III BSC
-full-body, air-supplied positive pressure suit
-independent unit with specialized ventilation & waste management to prevent release into environment

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31
Q

CDC Classification of Biological Agents - Category A - priority

A

highest

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32
Q

CDC Classification of Biological Agents - Category A - spread

A

easily disseminated or transmitted from person to person

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33
Q

CDC Classification of Biological Agents - Category A - impact

A

high mortality, potential for major public health impact

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34
Q

CDC Classification of Biological Agents - Category B - priority

A

2nd highest

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35
Q

CDC Classification of Biological Agents - Category B - spread

A

moderately easy to disseminate

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36
Q

CDC Classification of Biological Agents - Category B - impact

A

moderate illness, low death rate

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37
Q

CDC Classification of Biological Agents - Category C - priority

A

3rd highest

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38
Q

CDC Classification of Biological Agents - Category C - spread

A

could be engineered for mass dissemination

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39
Q

CDC Classification of Biological Agents - Category C - impact

A

high morbidity/mortality, major public health impact

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40
Q

CDC Classification of Biological Agents - Bacillus anthracis

A

Category A

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41
Q

CDC Classification of Biological Agents - Yersinia pestis

A

Category A

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42
Q

CDC Classification of Biological Agents - Francisella tularensis

A

Category A

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43
Q

CDC Classification of Biological Agents - Clostridium botulinum toxin

A

Category A

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44
Q

CDC Classification of Biological Agents - smallpox

A

Category A

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45
Q

CDC Classification of Biological Agents - hemorrhagic fever viruses (Ebola, Marburg, Lassa, Machupo)

A

Category A

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46
Q

CDC Classification of Biological Agents - Brucella

A

Category B

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47
Q

CDC Classification of Biological Agents - Salmonella

A

Category B

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48
Q

CDC Classification of Biological Agents - Shigella

A

Category B

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49
Q

CDC Classification of Biological Agents - E.coli 0157:H7

A

Category B

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50
Q

CDC Classification of Biological Agents - Burkholderia mallei

A

Category B

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51
Q

CDC Classification of Biological Agents - Burkholderia pseudomallei

A

Category B

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52
Q

CDC Classification of Biological Agents - Chlamydia psittaci

A

Category B

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53
Q

CDC Classification of Biological Agents - Coxiella burnetii

A

Category B

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54
Q

CDC Classification of Biological Agents - Clostridium perfringens toxin

A

Category B

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55
Q

CDC Classification of Biological Agents - ricin toxin

A

Category B

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56
Q

CDC Classification of Biological Agents - staphylococcal enterotoxin B

A

Category B

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57
Q

CDC Classification of Biological Agents - Rickettsia prowazekii

A

Category B

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58
Q

CDC Classification of Biological Agents - viral encephalitis viruses

A

Category B

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59
Q

CDC Classification of Biological Agents - Vibrio cholerae

A

Category B

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60
Q

CDC Classification of Biological Agents - Cryptosporidium parvum

A

Category B

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61
Q

CDC Classification of Biological Agents - Nipah virus

A

Category C

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62
Q

CDC Classification of Biological Agents - hantavirus

A

Category C

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63
Q

Biological Safety Cabinets - open front; unsterilized room air enters; air passes through high efficiency particulate air (HEPA) filter before being exhausted - class of BSC?

A

Class I

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64
Q

Biological Safety Cabinets - laminar flow cabinets with variable sash opening; air passes through 1 HEPA filter before reaching work surface & 2nd one before being exhausted - class of BSC?

A

Class II

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65
Q

Biological Safety Cabinets - completely enclosed; negative pressure; air is filter sterilized comin in & going out; gloves are attached to front - class of BSC?

A

Class III

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66
Q

Which class of BSC is most commonly used in hospital micro labs?

A

Class II

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67
Q

Which class of BSC provides minimal personnel protect and doesn’t protect work surface?

A

Class I

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68
Q

Which class of BSC provides protection for the worker & work?

A

Class II

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69
Q

Which class of BSC provides maximum protection and is used in labs that work with extremely hazardous organisms?

A

Class III

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70
Q

Sterilization & Disinfection - Temperature - steam under pressure

A

-autoclave
-most widely utilized in clinical labs
-15 lb of pressure for 15 min (for media)
-121C/250F
-Kills spores
-may not kill prions

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71
Q

Sterilization & Disinfection - Temperature - boiling

A

-not reliable
-spores may not be killed

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72
Q

Sterilization & Disinfection - Temperature - pasteurization

A

-used in food industry to kill foodborne pathogens
-doesn’t sterilize
-liquid is heated to 71.7*C for 15 minutes

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73
Q

Sterilization & Disinfection - Temperature - hot air sterilization

A

-used when steam may damage or fail to penetrate
-2 hours at 170*C
-kills spores

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74
Q

Sterilization & Disinfection - Temperature - incineration

A

-used to sterilize inoculating loops & biomedical wastes

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75
Q

Sterilization & Disinfection - Filtration

A

-used to sterilize liquids that are thermolabile (e.g., urea broth)
-HEPA air filters are used in BSC

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76
Q

Sterilization & Disinfection - Radiation

A

UV light wavelengths in the 200-320 nm range are used for surface disinfection both in the lab and patient rooms

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77
Q

Sterilization & Disinfection - Chemicals - alcohols

A

-ethyl & isopropyl (70-80%) frequently used as antiseptics & disinfectant
-does NOT kill spores

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78
Q

Sterilization & Disinfection - Chemicals - chlorine compounds

A

-sodium hypochlorite (household bleach)
-one of the most effective agents against HIV & HBV
-10% solution
-CAN kill spores

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79
Q

Sterilization & Disinfection - Chemicals - Glutaraldehyde

A

-effective against most vegetative cells other than mycobacteria
-used for cold sterilization of items damaged by heat, e.g., inhalation therapy equipment, equipment with optical lenses such as endoscopes

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80
Q

Sterilization & Disinfection - Chemicals - Hydrogen peroxide

A

3%-6% solution used as disinfectant

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81
Q

Sterilization & Disinfection - Chemicals - iodine & iodophors

A

-iodophors (e.g., providone-iodine) release iodine slowly & are less irritating & nonstaining
-effective skin disinfectant
-used with alcohol on skin prior to collection of blood for blood culture

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82
Q

Sterilization & Disinfection - Chemicals - Phenolic compounds

A

0.5%-3% solution for disinfecting
-does NOT kill spores

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83
Q

Sterilization & Disinfection - Chemicals - Quaternary ammonium compounds

A

-effective against wide range of vegetative bacteria
-NOT effective against spores, mycobacteria, or non-enveloped viruses
-used to disinfect floors, walls, furniture

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84
Q

Sterilization & Disinfection - Gases - ethylene oxide

A

widely used in hospitals to sterilize materials that can’t withstand steam

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85
Q

Anaerobes - preservative or transport device

A

Aspirates preferred to swabs.
Anaerobic transport system to eliminate O2.

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86
Q

Anaerobes - storage temperature (unpreserved)

A

25*C

do not refrigerate

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87
Q

CSF - preservative or transport device

A

None

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88
Q

CSF - storage temperature (unpreserved)

A

Storage not recommended, process immediately

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89
Q

Neisseria gonorrhoeae - preservative or transport device

A

Amies transport medium with charcoal, JEMBEC plates, Gono-Pak, BioBag (best to inoculate medium directly)

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90
Q

Neisseria gonorrhoeae - storage temperature (unpreserved)

A

25*C

don’t refrigerate

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91
Q

Sputum - preservative or transport device

A

None

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92
Q

Sputum - storage temperature (unpreserved)

A

4*C

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93
Q

Stool for culture - preservative or transport device

A

Transport media - e.g., Cary-Blair transport medium (has high pH and sodium thioglycollate added) I’d specimen can’t be cultured within 2 hrs of collection

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94
Q

Stool for culture - storage temperature (unpreserved)

A

4*C

-best to process without delay
-refrigeration may kill Shigella

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95
Q

Stool for ova & parasites - preservative or transport device

A

Depending on procedures to be performed: polyvinyl alcohol (PVA), 10% formalin, sodium acetate-acetic acid-formalin (SAF), merthiolate-iodine-formalin (MIF), others without formaldehyde or mercury (e.g., Ecofix, Parasafe)

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96
Q

Stool for ova & parasites - storage temperature (unpreserved)

A

Can hold formed specimens at 4*C
-soft or liquid specimens should be examined immediately or preserved

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97
Q

Urine - preservative or transport device

A

Transport tubes with boric acid-glycerol if specimen can’t be processed within 2 hrs of collection

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98
Q

Urine - storage temperature (unpreserved)

A

4*C for not more than 24 hrs

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99
Q

Viruses - preservative or transport device

A

Collect during acute phase of infection (2-3 days)
-use viral transport medium (VTM)

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100
Q

Viruses - storage temperature (unpreserved)

A

4C
-for delay >24 hrs, freeze at -70C

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101
Q

Criteria for rejection of specimens in microbiology - unlabeled or improperly labeled specimen - reject?

A

reject

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102
Q

Criteria for rejection of specimens in microbiology - improper collection site - reject?

A

reject

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103
Q

Criteria for rejection of specimens in microbiology - prolonged transit time (over 2 hrs without preservation) - reject?

A

reject

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104
Q

Criteria for rejection of specimens in microbiology - improper temperature during transport or storage - reject?

A

reject

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105
Q

Criteria for rejection of specimens in microbiology - leaking specimens - reject?

A

reject

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106
Q

Criteria for rejection of specimens in microbiology - specimens in non-sterile containers - reject?

A

reject

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107
Q

Criteria for rejection of specimens in microbiology - dry swab - reject?

A

reject

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108
Q

Criteria for rejection of specimens in microbiology - improper swab, e.g., wood or calcium alginate for viruses or Chlamydia - reject?

A

reject

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109
Q

Criteria for rejection of specimens in microbiology - syringes with needles attached - reject?

A

reject

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110
Q

Criteria for rejection of specimens in microbiology - culture for anaerobes requested on inappropriate sources or not received in anaerobic transport tube - reject?

A

reject

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111
Q

Criteria for rejection of specimens in microbiology - specimens received in formalin - reject?

A

reject

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112
Q

Criteria for rejection of specimens in microbiology - saliva instead of sputum - reject?

A

reject

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113
Q

Criteria for rejection of specimens in microbiology - foley catheter tip - reject?

A

reject

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114
Q

Criteria for rejection of specimens in microbiology - insufficient quantity - reject?

A

reject

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115
Q

Criteria for rejection of specimens in microbiology - formed stool for C. difficile toxin testing - reject?

A

reject

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116
Q

Criteria for rejection of specimens in microbiology - swab for acid-fast bacilli (AFB) or fungal smear and culture - reject?

A

reject

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117
Q

List organisms that frequently require special collection and processing.

A
  1. Anaerobes
  2. Chlamydia
  3. Haemophilus influenzae
  4. Neisseria gonorrhoeae
  5. Neisseria meningitidis
  6. Salmonella
  7. Shigella
  8. Shigella
  9. Streptococcus pneumoniae
  10. Viruses
  11. Parasites
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118
Q

Gram stain - reagent - crystal violet:
-Function?
-Outcome?

A

Function: primary dye
Outcome: stains all bacteria purple

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119
Q

Gram stain - reagent - Iodine:
-Function?
-Outcome?

A

Function: mordant
Outcome: reacts with crystal violet to form a complex that incorporates into peptidoglycan

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120
Q

Gram stain - reagent - 95% ethyl alcohol or acetone or combination:
-Function?
-Outcome?

A

Function: decolorizer
Outcome: removes crystal violet from gram-negative (neg) bacterial cells

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121
Q

Gram stain - reagent - Safranin:
-Function?
-Outcome?

A

Function: counterstain
Outcome: stains gram-negative bacterial cells pink

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122
Q

Staining properties of gram-positive & gram negative bacteria - Gram Positive - cell wall

A

Thick peptidoglycan layer with teichoic acid & lipoteichoic acid.
-teichoic acid cross-links prevent decolorization in Gram stain

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123
Q

Staining properties of gram-positive & gram negative bacteria - Gram Positive:
Stained by?
Color in gram stain?

A

Stained by crystal violet.
Color in gram stain: purple

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124
Q

Staining properties of gram-positive & gram negative bacteria - Gram Negative - cell wall

A

Thin peptidoglycan layer covered with proteins, phospholipids, & lipopolysaccharides.
-decolorizing agent causes increased permeability of lipid-rich cell wall
-primary stain (crystal violet) washes out

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125
Q

Staining properties of gram-positive & gram negative bacteria - Gram Negative - cell wall

A

Thin peptidoglycan layer covered with proteins, phospholipids, & lipopolysaccharides.
-decolorizing agent causes increased permeability of lipid-rich cell wall
-primary stain (crystal violet) washes out

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126
Q

Staining properties of gram-positive & gram negative bacteria - Gram Negative:
Stained by?
Color in gram stain?

A

Stained by safranin.
Color in gram stain: pink

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127
Q

Types of culture media - nutritive

A

-supports growth of most non-fastidious bacteria

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128
Q

Types of culture media - nutrient agar

A

nutritive

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129
Q

Type of culture media - trypticase soy agar

A

nutritive

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130
Q

Type of culture media - sheep blood agar (SBA)

A

enrichment

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131
Q

Type of culture media - chocolate agar (CHOC)

A

enrichment

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132
Q

Type of culture media - brain-heart infusion

A

enrichment

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133
Q

Type of culture media - buffered charcoal-yeast extract (BCYE) agar

A

enrichment

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134
Q

Type of culture media - Columbia colistin-nalidixic acid (CNA) agar

A

selective

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135
Q

Type of culture media - eosin methylene blue (EMB)

A

selective and differential

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136
Q

Type of culture media - MacConkey (MAC)

A

selective and differential

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137
Q

Type of culture media - Hektoen enteric (HE)

A

selective and differential

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138
Q

Type of culture media - xylose lysine deoxychocolate (XLD)

A

selective and differential

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139
Q

Type of culture media - Thayer-Martin

A

selective

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140
Q

Type of culture media - enrichment

A

-contains added growth factors, e.g., blood, vitamins, yeast extract

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141
Q

Type of culture media - selective

A

-contains additives such as dyes, bile salts, alcohols, acids, or antibiotics to inhibit growth of certain bacteria (e.g., gram pos)

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142
Q

Type of culture media - differential

A

-contains compounds that allow certain bacteria (or even species) to be visually differentiated (e.g., lactose fermentation, hydrogen sulfide [H2S], production)

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143
Q

Routine media for aerobes and facultative anaerobes - sheep blood agar (SBA) - type?

A

-enrichment
-differential

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144
Q

Routine media for aerobes and facultative anaerobes - sheep blood agar (SBA) - for isolation of?

A

-most non-fastidious bacteria

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145
Q

Routine media for aerobes and facultative anaerobes - sheep blood agar (SBA):
Composed of?
Allow differentiation of?

A

tryptic soy agar with 5% sheep blood
-allows differentiation of hemolysis

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146
Q

Routine media for aerobes and facultative anaerobes - chocolate agar (CHOC) - type?

A

enrichment

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147
Q

Routine media for aerobes and facultative anaerobes - chocolate agar (CHOC) - for isolation of?

A

fastidious organisms including Haemophilus & Neisseria

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148
Q

Routine media for aerobes and facultative anaerobes - chocolate agar (CHOC):
Supplies what factors?
Incubated?

A

supplies X (hemin) & V (NAD) factors
-incubate in 5% CO2

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149
Q

Routine media for aerobes and facultative anaerobes - Columbia colistin-nalidixic acid (CNA) agar - type?

A

selective

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150
Q

Routine media for aerobes and facultative anaerobes - Columbia colistin-nalidixic acid (CNA) agar - for isolation of?

A

gram-positive cocci (GPC), especially from wound & stool culture

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151
Q

Routine media for aerobes and facultative anaerobes - Columbia colistin-nalidixic acid (CNA) agar - what does colistin & nalidixic acid do?

A

Colistin & nalidixic acid suppress most gram-negative (GN)
-contains 5% sheep blood but should not be used to observe hemolytic reactions.

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152
Q

Routine media for aerobes and facultative anaerobes - Phenylethyl alcohol agar (PEA) - type?

A

selective

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153
Q

Routine media for aerobes and facultative anaerobes - Phenylethyl alcohol agar (PEA) - for isolation of?

A

gram-positive cocci (GPC) & anaerobic gram-negative rods (GNR)

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154
Q

Routine media for aerobes and facultative anaerobes - Phenylethyl alcohol agar (PEA) - what does phenylethyl alcohol do?

A

Phenylethyl alcohol inhibits enteric GNR
-contains 5% sheep blood

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155
Q

Routine media for aerobes and facultative anaerobes - brain heart infusion agar - type?

A

enrichment & selective

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156
Q

Routine media for aerobes and facultative anaerobes - brain heart infusion agar - for isolation of?

A

fastidious and non-fastidious organisms (anaerobes included)

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157
Q

Routine media for aerobes and facultative anaerobes - brain heart infusion agar - useful for culturing?

A

useful for culturing streptococci, pneumococci, and meningococci

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158
Q

Routine media for aerobes and facultative anaerobes - brain heart infusion agar - what can be added to detect VRE?

A

vancomycin

VRE = vancomycin-resistant enterococci

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159
Q

Routine media for aerobes and facultative anaerobes - eosin methylene blue (EMB) - type?

A

selective & differential

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160
Q

Routine media for aerobes and facultative anaerobes - eosin methylene blue (EMB) - for isolation of?

A

enteric gram negative rods (GNR)

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161
Q

Routine media for aerobes and facultative anaerobes - eosin methylene blue (EMB):
Function of eosin and methylene blue?
Lactose fermenters?
E.coli?
Non-lactose fermenter?

A

-eosin & methylene blue inhibit gram positive (GP)
-LF = green-black or purple
-E.coli = green metallic sheen
-NLF = colorless or light purple

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162
Q

Routine media for aerobes and facultative anaerobes - MacConkey (MAC) agar - type?

A

selective & differential

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163
Q

Routine media for aerobes and facultative anaerobes - MacConkey (MAC) agar - for isolation of?

A

enteric gram negative rods (GNR)

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164
Q

Routine media for aerobes and facultative anaerobes - MacConkey (MAC) agar:
-Function of bile salts & crystal violet?
-Lactose fermenters?
-Non-lactose fermenters?

A

-bile salts & crystal violet inhibits most GP
-LF = pink
-NLF = colorless

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165
Q

Routine media for aerobes and facultative anaerobes - Sorbitol MacConkey (SMAC) agar - type?

A

selective

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166
Q

Routine media for aerobes and facultative anaerobes - Sorbitol MacConkey (SMAC) agar - for isolation of?

A

E. coli 0157:H7

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167
Q

Routine media for aerobes and facultative anaerobes - Sorbitol MacConkey (SMAC) agar:
-E. coli 0157:H7?

A

-Doesn’t ferment sorbitol = colorless colonies

-Some labs have stopped using because non-0157 serotypes can be pathogens

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168
Q

Routine media for aerobes and facultative anaerobes - Hektoen enteric (HE) - type?

A

selective & differential

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169
Q

Routine media for aerobes and facultative anaerobes - Hektoen enteric (HE) - for isolation of?

A

Salmonella & Shigella in stool

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170
Q

Routine media for aerobes and facultative anaerobes - Hektoen enteric (HE):
-Function of bile salts, bromothymol blue, & acid fusion?
-Nonpathogens?
-Non-lactose fermenters?
-H2S positive?

A

-Bile salts, bromothymol blue, & acid fuchsin inhibit normal GI flora

-Nonpathogens = orange to salmon pink

-NLF = green to blue-green

-H2S pos colonies = black precipitate

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171
Q

Routine media for aerobes and facultative anaerobes - xylose lysine deoxycholate (XLD) - type?

A

selective & differential

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172
Q

Routine media for aerobes and facultative anaerobes - xylose lysine deoxycholate (XLD) - for isolation of?

A

Salmonella & Shigella in stool

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173
Q

Routine media for aerobes and facultative anaerobes - xylose lysine deoxycholate (XLD):
-Function of deoxycholate?
-4 types of colonies?

A

-Deoxycholate inhibits many GNR & GP
-4 types of colonies:
1. yellow (e.g., E. coli)
2. yellow with black centers (e.g., some Proteus species)
3. colorless or red colonies (e.g., Shigella)
4. red colonies with black centers (e.g., Salmonella)

-Some shigellae may be inhibited.
-Some salmonellae may not produce H2S

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174
Q

Routine media for aerobes and facultative anaerobes - Salmonella-Shigella (SS) agar - type?

A

selective

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175
Q

Routine media for aerobes and facultative anaerobes - Salmonella-Shigella (SS) agar - for isolation of?

A

Salmonella & Shigella in stool

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176
Q

Routine media for aerobes and facultative anaerobes - Salmonella-Shigella (SS) agar:
-Function of brilliant green & bile salts?
-Ferment lactose?
-Produce H2S (black center)?

A

-brilliant green & bile salts inhibit other enterics.
-Salmonella & Shigella DO NOT ferment lactose - colorless colonies
-Salmonella produces H2S (black center)

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177
Q

Routine media for aerobes and facultative anaerobes - Deoxycholate-citrate agar - type?

A

selective

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178
Q

Routine media for aerobes and facultative anaerobes - Deoxycholate-citrate agar - for isolation of?

A

Salmonella & Shigella

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179
Q

Routine media for aerobes and facultative anaerobes - Deoxycholate-citrate agar - inhibits?

A

other non-pathogenic enterics

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180
Q

Routine media for aerobes and facultative anaerobes - Thioglycolate medium - type?

A

enrichment

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181
Q

Routine media for aerobes and facultative anaerobes - Thioglycolate medium - for isolation of?

A

Campylobacter from stool, wound cultures

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182
Q

Routine media for aerobes and facultative anaerobes - Thioglycolate medium - subculture to?

A

Campy-selective agar after overnight incubation at 4*C

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183
Q

Routine media for aerobes and facultative anaerobes - Campylobacter blood agar (Campy BAP) - type?

A

Enrichment & selective

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184
Q

Routine media for aerobes and facultative anaerobes - Campylobacter blood agar (Campy BAP) - for isolation of?

A

Campylobacter from stool

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185
Q

Routine media for aerobes and facultative anaerobes - Campylobacter blood agar (Campy BAP) - incubation?

A

Incubate plates in 5% CO2 at 42*C

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186
Q

Selective media for isolation of Neisseria gonorrhoeae and Neisseria meningitidis - Modified Thayer-Martin (MTM) - composed of?

A

Vancomycin
Colistin
Nystatin
Trimethoprim (TMP)

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187
Q

Selective media for isolation of Neisseria gonorrhoeae and Neisseria meningitidis - Modified Thayer-Martin (MTM) - function of Vancomycin, colistin, nystatin, and trimethoprim?

A

inhibit growth of normal genital flora

-some N. gonorrhoeae may be inhibited

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188
Q

Selective media for isolation of Neisseria gonorrhoeae and Neisseria meningitidis - Modified Thayer-Martin (MTM) - incubation?

A

incubate in increased CO2

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189
Q

Selective media for isolation of Neisseria gonorrhoeae and Neisseria meningitidis - Martin-Lewis - similar to?

A

similar to Thayer-Martin, but different antibiotics - inhibits YEAST better

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190
Q

Selective media for isolation of Neisseria gonorrhoeae and Neisseria meningitidis - Martin-Lewis - incubation?

A

incubate in increased CO2

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191
Q

Selective media for isolation of Neisseria gonorrhoeae and Neisseria meningitidis - New York City medium (NYC) - incubation?

A

incubate in increased CO2

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192
Q

Selective media for isolation of Neisseria gonorrhoeae and Neisseria meningitidis - New York City medium (NYC) - inhibited? Growth?

A

Some N. gonorrhoeae are inhibited by antibiotics.

Genital mycoplasmas will grow.

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193
Q

Selective media for isolation of Neisseria gonorrhoeae and Neisseria meningitidis - GC-LECT - antibiotics?

A

Contains antibiotics to inhibit gram positive & gram negative bacteria and yeast

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194
Q

Selective media for isolation of Neisseria gonorrhoeae and Neisseria meningitidis - JEMBEC plates - function?

A

For transportation & growth of N. gonorrhoeae

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195
Q

Selective media for isolation of Neisseria gonorrhoeae and Neisseria meningitidis - JEMBEC plates - contain?

A

Plates contain Neisseria-selective medium & come with resealable polyethylene bag & CO2-generating tablet.
–NO need to transfer to a culture plate.

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196
Q

List the selective media for isolation of Neisseria gonorrhoeae and Neisseria meningitidis.

A
  1. Modified Thayer-Martin (MTM)
  2. Martin-Lewis
  3. New York City medium (NYC)
  4. GC-LECT
  5. JEMBEC plates
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197
Q

Special bacteriologic media - Cystine-tellurite blood agar - use?

A

Differential medium for isolation of Corynebacterium diphtheriae

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198
Q

Special bacteriologic media - Cystine-tellurite blood agar - colonies on agar?

A

C. diphtheriae produces dark grey to black colonies.

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199
Q

Special bacteriologic media - Loeffler medium - use?

A

Enrichment medium for C. diphtheriae

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200
Q

Special bacteriologic media - Loeffler medium - function?

A

promotes development of metachromatic granules

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201
Q

Special bacteriologic media - Tindale agar - use?

A

selective differential medium for C. diphtheriae

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202
Q

Special bacteriologic media - Tindale agar - colonies?

A

Corynebacterium spp. produce gray to black colonies due to reduction of tellurite.

-C. diphtheriae colonies are surrounded by a brown halo.

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203
Q

Special bacteriologic media - Bismuth sulfite agar:
-selective for?
-function of bismuth sulfite & brilliant green?

A

-selective for Salmonella

-inhibits most others

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204
Q

Special bacteriologic media - Bismuth sulfite agar - S. typhi colonies?

A

S. typhi colonies are black, surrounded by metallic sheen.

-others are light green
-Some salmonellae may be inhibited

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205
Q

Special bacteriologic media - Cefsulodin-Irgasan-novobiocin (CIN) agar - use?

A

Selective medium for Yersinia enterocolitica, Aeromonas, & Plesiomonas shigelloides

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206
Q

Special bacteriologic media - Cefsulodin-Irgasan-novobiocin (CIN) agar:
-Function of crystal violet?
-Function of novobiocin?
-Function of Cefsulodin?

A

-Crystal violet inhibits most gram negatives.
-Novobiocin inhibits gram positive cocci
-Cefsulodin inhibits most gram positives & gram negatives

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207
Q

Special bacteriologic media - Cefsulodin-Irgasan-novobiocin (CIN) agar - Y. enterocolitica colonies?

A

Y. enterocolitica ferments mannitol, appears as red “bull’s-eye” colonies surrounded by colorless halo.

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208
Q

Special bacteriologic media - Alkaline peptone water (APW) - use?

A

Enrichment media for recovery of Vibrio from stool

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209
Q

Special bacteriologic media - Alkaline peptone water (APW):
-Function of alkaline pH?
-Subculture to?

A

-Alkaline pH suppresses commensals
-Subcultured to thiosulfate citrate bile salts sucrose (TCBS)

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210
Q

Special bacteriologic media - Thiosulfate Citrate Bile Salts Sucrose (TCBS) agar - use?

A

Selective for Vibrio

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211
Q

Special bacteriologic media - Thiosulfate Citrate Bile Salts Sucrose (TCBS) agar - function of high pH?

A

inhibits most bacteria

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212
Q

Special bacteriologic media - Thiosulfate Citrate Bile Salts Sucrose (TCBS) agar:
-V. cholerae colonies?
-V. parahaemolyticus and V. vulnificus colonies?

A

-V. cholerae ferments sucrose, produces yellow colonies

-V. parahaemolyticus & V. vulnificus DO NOT ferment sucrose; usually produce blue-green colonies

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213
Q

Special bacteriologic media - Bordet-Gengou agar - use?

A

Selective enrichment medium for isolation of Bordetella pertussis

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214
Q

Special bacteriologic media - Bordet-Gengou agar:
-composed of?
-function of methicillin?

A

-Potato-glycerol-based medium enriched with blood.
-Contaminants inhibited by methicillin.

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215
Q

Special bacteriologic media - Bordet-Gengou agar - Bordetella colonies?

A

Bordetella colonies resemble mercury droplets.

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216
Q

Special bacteriologic media - Bordet-Gengou agar - what is the plate also known as?

A

“Cough plate.”

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217
Q

Special bacteriologic media - Regan-Lowe agar - use?

A

Selective for B. pertussis

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218
Q

Special bacteriologic media - Regan-Lowe agar - composed of?

A

Charcoal agar supplemented with horse blood, cephalexin, & amphotericin B.

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219
Q

Special bacteriologic media - BYCE agar - use?

A

Enrichment medium for isolation of Legionella

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220
Q

Special bacteriologic media - BYCE agar:
-Function of yeast extract & L-cysteine?
-Function of charcoal?

A

-Yeast extract & L-cysteine enhance growth of Legionella.
-Charcoal absorbs toxic compounds.

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221
Q

Special bacteriologic media - V agar - use?

A

Selective & differential for G. vaginalis

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222
Q

Special bacteriologic media - V agar - incubation?

A

Incubate in increased CO2 for 48 hours.

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223
Q

Special bacteriologic media - V agar - G. vaginalis colonies?

A

G. vaginalis colonies are beta hemolytic.

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224
Q

Special bacteriologic media - CHROMagar or chromID - use?

A

Detect emerging antibiotic-resistant pathogens such as extended-spectrum beta-lactamase (ESBL) - producing E.coli, methicillin-resistant Staphylococcus aureus (MRSA), and carbapenemase-producing Enterobacteriaceae

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225
Q

Special bacteriologic media - CHROMagar or chromID - function of chromogens?

A

Chromogens are released if specific enzymes produced by target organism are present.

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226
Q

Aerotolerance test - Aerobe:
-blood agar incubated aerobically?
-blood agar incubated anaerobically?
-CHOC incubated in CO2 incubator?

A

-Growth
-No growth
-Growth

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227
Q

Aerotolerance test - Capnophilic aerobe:
-blood agar incubated aerobically?
-blood agar incubated anaerobically?
-CHOC incubated in CO2 incubator?

A

-No growth
-No growth
-Growth

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228
Q

Aerotolerance test - Facultative anaerobe:
-blood agar incubated aerobically?
-blood agar incubated anaerobically?
-CHOC incubated in CO2 incubator?

A

-Growth
-Growth
-Growth

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229
Q

Aerotolerance test - Obligate anaerobe:
-blood agar incubated aerobically?
-blood agar incubated anaerobically?
-CHOC incubated in CO2 incubator?

A

-No growth
-Growth
-No growth

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230
Q

Aerotolerance test - Aerotolerant anaerobe:
-blood agar incubated aerobically?
-blood agar incubated anaerobically?
-CHOC incubated in CO2 incubator?

A

-No growth
-Growth
-Growth

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231
Q

List the organisms requiring incubation in increased CO2.

A
  1. Campylobacter (10-15% CO2)
  2. Haemophilus (5-10% CO2)
  3. Helicobacter (5-10% CO2)
  4. Moraxella catarrhalis (5% CO2)
  5. Mycobacterium (5-10% CO2)
  6. Pathogenic Neisseria (5-10% CO2)
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232
Q

Hemolytic reactions on sheep blood agar - Alpha hemolysis:
-description
-explanation
-examples

A

-green zone around colony; may be narrow or wide
-partial lysis of RBCs
-Streptococcus pneumoniae & viridans streptococci

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233
Q

Hemolytic reactions on sheep blood agar - Beta hemolysis:
-description
-explanation
-examples

A

-clear zone around colony; may be narrow or wide
-complete lysis of RBCs
-Group A strep (GAS), group B strep (GBS), Listeria monocytogenes

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234
Q

Hemolytic reactions on sheep blood agar - Gamma (non-hemolytic):
-description
-explanation
-examples

A

-no zone of hemolysis
-no lysis of RBCs
-Enterococcus faecalis

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235
Q

Staphylococcaceae - Staphylococcus spp. - gram stain

A

gram positive cocci - usually in clusters

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236
Q

Staphylococcaceae - Staphylococcus spp. - colonies of SBA

A

1-3 mm
round
smooth
convex
glistening
opaque
entire edge
butyrous (butter-like)

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237
Q

Staphylococcaceae - Staphylococcus spp. - key characteristics

A

-catalase positive
-fermentative
-modified oxidase (microdase) negative
-resistant to bacitracin
-Matrix-assisted laser desorption ionization-time of flight (MALD-TOF) mass spectrometry routinely used for ID of isolates

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238
Q

Staphylococcaceae - Staphylococcus spp. - normal flora of?

A

skin
mouth
pharynx
vagina
urethra
GI tract

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239
Q

Staphylococcaceae - Staphylococcus spp. - aerotolerance

A

facultative anaerobe

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240
Q

Staphylococcaceae - Staphylococcus spp. - growth on media

A

Grows on most non-selective media

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241
Q

Staphylococcaceae - Staphylococcus spp. - salt tolerance

A

salt tolerant

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242
Q

Staphylococcaceae - S. aureus - pathogenicity

A

Causes suppurative cutaneous infections, toxic shock syndrome, food poisoning

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243
Q

Staphylococcaceae - S. aureus - gram stain

A

gram positive cocci - usually in clusters

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244
Q

Staphylococcaceae - S. aureus - colonies on SBA

A

-most are beta hemolytic (small zone)
-may be golden

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245
Q

Staphylococcaceae - S. aureus - key characteristics

A

-coagulase positive
-ferments mannitol (yellow color with mannitol salt agar (MSA))
-usually DNase positive

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246
Q

Staphylococcaceae - S. aureus - penicillin

A

85-90% resistant to penicillin

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247
Q

Staphylococcaceae - S. aureus - MRSA

A

-strains are common
-methicillin resistance is mediated by the mecA gene or its homologs and is the most important resistance mechanism

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248
Q

Which staphylococcaceae species is the second leading cause of health-care-associated infections, spread by direct contact with personnel and contaminated objects?

A. S. saprophyticus
B. S. aureus
C. S. epidermidis
D. Micrococcus

A

B. S. aureus

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249
Q

Staphylococcaceae - S. epidermidis - pathogenicity

A

-opportunistic pathogen
-causes nosocomial infections due to contamination of inserted or implanted medical devices

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250
Q

Staphylococcaceae - S. epidermidis - gram stain

A

gram positive cocci - usually in clusters

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251
Q

Staphylococcaceae - S. epidermidis - colonies on SBA

A

-white to slightly yellow
-usually non-hemolytic

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252
Q

Staphylococcaceae - S. epidermidis - key characteristics

A

-coagulase negative
-grows on MSA but does NOT ferment mannitol
-sensitive to novobiocin

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253
Q

Which staphylococcaceae is frequently recovered from blood cultures but not usually clinically significant in adults?

A. S. aureus
B. S. epidermidis
C. S. saprophyticus
D. Micrococcus

A

B. S. epidermidis

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254
Q

Staphylococcaceae - S. saprophyticus - pathogenicity

A

-UTI in young sexually active females
-Urethritis & prostatitis in males

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255
Q

Staphylococcaceae - S. saprophyticus - gram stain

A

gram positive cocci - usually in clusters

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256
Q

Staphylococcaceae - S. saprophyticus - colonies on SBA

A

-white to slightly yellow
-non-hemolytic

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257
Q

Staphylococcaceae - S. saprophyticus - key characteristics

A

-coagulase negative
-resistant to novobiocin
-may ferment mannitol

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258
Q

Which of the following characteristics can help differentiate between S. epidermidis and S. saprophyticus?

A. coagulase
B. mannitol fermentation
C. novobiocin sensitivity
D. none of the above

A

C. novobiocin sensitivity

-S. epidermidis is sensitive to novobiocin
-S. saprophyticus is resistant to novobiocin

-*S. saprophyticus may or may not ferment mannitol; S. epidermidis does NOT ferment mannitol.

-Both are coagulase negative

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259
Q

Staphylococcaceae - S. saprophyticus - when is novobiocin sensitivity performed?

A

Only when coagulase-negative staphylococci (CNS) are isolated from the urine of a female.

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260
Q

Staphylococcaceae - Micrococcus - pathogenicity

A

-usually non-pathogenic
-found in environment and on skin & mucous membranes

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261
Q

Staphylococcaceae - Micrococcus - gram stain

A

Large gram positive cocci in pairs or tetrads (predominant arrangement)

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262
Q

Staphylococcaceae - Micrococcus - colonies on SBA

A

-often pigmented (bright yellow, orange, pink, tan)
-high-domed colonies

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263
Q

Staphylococcaceae - Micrococcus - key characteristics

A

-catalase positive
-coagulase negative
-oxidative
-Modified oxidase (microdase) positive
-most urease positive
-resistant to furazolidone & lysostaphin (in contrast to most staphylococci)

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264
Q

How would you differentiate Micrococcus from staphylococci?

A. coagulase
B. modified oxidase (microdase)
C. All of the above
D. None of the above

A

B. modified oxidase (microdase)

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265
Q

Staphylococcaceae - Micrococcus - aerotolerance

A

usually grow aerobically

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266
Q

Staphylococcaceae - Micrococcus - species in this genus

A

Micrococcus luteus
Micrococcus lylae

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267
Q

List the tests used in the identification of staphylococci.

A
  1. Catalase
  2. Coagulase
  3. Slide agglutination tests for S. aureus
  4. MSA
  5. Rapid latex and hemagglutinin assays
  6. MALDI-TOF
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268
Q

Tests for identification of staphylococci - Catalase - principle

A

Enzyme catalase converts 3% hydrogen peroxide (H2O2) to oxygen & water. Immediate bubbling.

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269
Q

Tests for identification of staphylococci - Catalase - key reactions

A

Staphylococcus & micrococcus are catalase positive

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270
Q

Tests for identification of staphylococci - Catalase - bubbling

A

Bubbles after 20-30 seconds are NOT considered a positive reaction.

Catalase from RBCs in blood agar may produce weak bubbles.

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271
Q

Tests for identification of staphylococci - Coagulase - principle

A

Enzyme coagulase causes coagulation (tube test) or agglutination (slide test) in plasma.

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272
Q

Tests for identification of staphylococci - Coagulase - key reactions

A

S. aureus is coagulase positive.

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273
Q

Tests for identification of staphylococci - Coagulase - slide test vs. tube test

A

Slide test is a screening test - detects bound coagulase (clumping factor).
-If negative, a tube test should be performed - detects free coagulase.

Largely replaced by latex agglutination tests

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274
Q

Tests for identification of staphylococci - Slide agglutination tests for S. aureus - principle

A

Agglutination of latex beads coated with fibrinogen & antibodies to protein A (protein in cell wall of S. aureus).

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275
Q

Tests for identification of staphylococci - Slide agglutination tests for S. aureus - key reactions

A

S. aureus positive

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276
Q

Tests for identification of staphylococci - Slide agglutination tests for S. aureus - reporting by labs

A

Most labs report positive organisms as S. aureus.

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277
Q

Tests for identification of staphylococci - Mannitol Salt agar (MSA) - principle

A

Fermentation of mannitol results in color change from pink to yellow.

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278
Q

Tests for identification of staphylococci - Mannitol Salt agar (MSA) - key reactions

A

S. aureus positive

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279
Q

Tests for identification of staphylococci - Mannitol Salt agar (MSA) - what component inhibits most organisms other than staph?

A

7.5% salt

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280
Q

Tests for identification of staphylococci - Mannitol Salt agar (MSA) - do all staph grow on MSA?

A

They all can grow on MSA.

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281
Q

Tests for identification of staphylococci - Mannitol Salt agar (MSA) - why is it rarely used for ID of S. aureus today?

A

because other species ferment mannitol

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282
Q

Tests for identification of staphylococci - Rapid latex and hemagglutination assays - principle

A

Latex agglutination slide-card tests to detect coagulase and/or protein A associated with S. aureus & MRSA

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283
Q

Tests for identification of staphylococci - Rapid latex and hemagglutination assays - key reactions

A

S. aureus positive

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284
Q

Tests for identification of staphylococci - Rapid latex and hemagglutination assays - sensitivity & specificity

A

High sensitivity but relatively low specificity.

-May get false-positive with coagulase-negative staph.

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285
Q

Tests for identification of staphylococci - MALDI-TOF - principle

A

A type of mass spectrometry good for analyzing biomolecules like peptides, lipids, and saccharides.

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286
Q

Tests for identification of staphylococci - MALDI-TOF - key reactions

A

Rapid and specific ID of staphylococci and other catalase-positive cocci.

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287
Q

Tests for identification of staphylococci - MALDI-TOF - % of identification

A

ID of staphylococci at species levels is >97% but lower for coagulase-negative staph.

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288
Q

Streptococci - Streptococcus spp. - gram stain

A

Oval gram positive cocci in chains & pairs

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289
Q

Streptococci - Streptococcus spp. - colonies on SBA

A

-<1mm
-white to gray
-translucent or semi-opaque
-variable hemolysis

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290
Q

Streptococci - Streptococcus spp. - key characteristics

A

Catalase negative

-differentiates for staph

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291
Q

Streptococci - Streptococcus spp. - aerotolerance

A

Facultative anaerobes

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292
Q

Streptococci - Streptococcus spp. - growth media

A

-require enriched media
-chaining best in broth cultures

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293
Q

Streptococci - Group A Strep (GAS) - pathogenicity

A

-causes 90% of strep infections
-Strep sore throat
-rheumatic fever
-glomerulonephritis
-scarlet fever
-erysipelas
-puerperal sepsis
-impetigo

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294
Q

Streptococci - Group A Strep (GAS) - gram stain

A

oval gram positive cocci in chains

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295
Q

Streptococci - Group A Strep (GAS) - colonies on SBA

A

-pinpoint
-grayish white
-translucent
-usually beta hemolytic (wide zone)

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296
Q

Streptococci - Group A Strep (GAS) - key characteristics

A

-sensitive to bacitracin
-pyrrolidonyl aminopeptidase (PYR) positive

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297
Q

Streptococci - Group A Strep (GAS) - most common GAS?

A

S. pyogenes

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298
Q

Streptococci - Group A Strep (GAS) - hemolysis due to?

A

O2-stable streptolysin S & O2-labile streptolysin O.

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299
Q

Streptococci - Group A Strep (GAS) - definitive diagnosis

A

Immunoassay for Lancefield group A or MALDI-TOF

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300
Q

Streptococci - Group B Strep (GBS), S. agalactiae - pathogenicity

A

-normal flora of female genital tract
-most common cause of neonatal septicemia & meningitis

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301
Q

Streptococci - Group B Strep (GBS), S. agalactiae - gram stain

A

oval gram positive cocci in chains

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302
Q

Streptococci - Group B Strep (GBS), S. agalactiae - colonies on SBA

A

-slightly larger than GAS
-gray-white
-narrow zone of diffuse beta hemolysis
-may be non-hemolytic

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303
Q

Streptococci - Group B Strep (GBS), S. agalactiae - key characteristics

A

-resistant to bacitracin
-sodium hippurate positive
-CAMP positive

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304
Q

Streptococci - Group B Strep (GBS), S. agalactiae - pregnant women

A

Vaginal & rectal swabs collected from pregnant women at 35-37 weeks gestation

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305
Q

Streptococci - Group B Strep (GBS), S. agalactiae - growth media

A

Inoculated in selective broth, e.g., LIM, GBS broth

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306
Q

Streptococci - Group B Strep (GBS), S. agalactiae - test recommended for ID after culture enrichement?

A

Nucleic acid amplification tests (NAATs)

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307
Q

Streptococci - Streptococcus pneumoniae - pathogenicity

A

-colonizes upper respiratory tract of some children
-most common cause of community acquired pneumonia
-major cause of otitis media & meningitis in adults
-infects sinuses and eyes

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308
Q

Streptococci - Streptococcus pneumoniae - gram stain

A

-football-shaped (lancet-shaped) gram positive cocci
-usually in pairs
-may be single or in short chains
-frequently encapsulated

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309
Q

Streptococci - Streptococcus pneumoniae - colonies on SBA

A

-round
-translucent
-glistening
-dome-shaped when young
-central depression with age (umbilicate) due to autolysis
-Alpha hemolytic
-Encapsulated strains are mucoid

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310
Q

Streptococci - Streptococcus pneumoniae - key characteristics

A

-bile solubility positive
-sensitive to optochin

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311
Q

Streptococci - Streptococcus pneumoniae - Lancefield group

A

None

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312
Q

Streptococci - Streptococcus pneumoniae - tests used for ID

A

MALDI-TOF can be used

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313
Q

Streptococci - Group C/G streptococci - S. dysgalactiae subsp equisimilis - pathogenicity

A

-normal flora of upper respiratory tract but can cause pharyngitis (throat infection)

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314
Q

Streptococci - Group C/G streptococci - S. dysgalactiae subsp equisimilis - gram stain

A

oval gram positive cocci in clusters & pairs

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315
Q

Streptococci - Group C/G streptococci - S. dysgalactiae subsp equisimilis - colonies on SBA

A

beta-hemolytic

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316
Q

Streptococci - Group C/G streptococci - S. dysgalactiae subsp equisimilis - key characteristics

A

-resistant to bacitracin
-PYR positive

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317
Q

Streptococci - Group C/G streptococci - S. dysgalactiae subsp equisimilis - indistinguishable from?

A

Indistinguishable from pharyngitis caused by S. pyogenes.

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318
Q

Streptococci - Viridans streptococci (S. mitis group, S. mutans group, S. salivarius group, & S. bovis group) - pathogenicity

A

-normal in oral, respiratory, & GI mucosa
-opportunistic pathogens
-frequent cause of subacute bacterial endocarditis, bacteremia, sepsis, and abscesses.

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319
Q

Streptococci - Viridans streptococci (S. mitis group, S. mutans group, S. salivarius group, & S. bovis group) - gram stain

A

gram positive cocci in chains

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320
Q

Streptococci - Viridans streptococci (S. mitis group, S. anginosus group, S. mutans group, S. salivarius group, & S. bovis group) - colonies on SBA

A

-alpha hemolytic (S. mitis group)

-non-hemolytic (S. salivarius and S. bovis group)

-beta-hemolytic (S. anginosus group)

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321
Q

Streptococci - Viridans streptococci (S. mitis group, S. mutans group, S. salivarius group, & S. bovis group) - key characteristics

A

-S. mutans group - ferments sorbitol
-Bile solubility negative
-S. bovis is bile esculin positive

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322
Q

Enterococcus - E. faecium & E. faecalis - pathogenicity

A

-normal in mouth, GI tract, & male genital tract
-causes nosocomial UTI, wound infections, endocarditis, & bacteremia

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323
Q

Enterococcus - E. faecium & E. faecalis - gram stain

A

oval gram positive cocci in pairs, chains

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324
Q

Enterococcus - E. faecium & E. faecalis - colonies on SBA

A

E. faecium - alpha or non-hemolytic
-Some strains of E. faecalis may be beta-hemolytic

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325
Q

Enterococcus - E. faecium & E. faecalis - key characteristics

A

-catalase negative
-hydrolyzes esculin
-grows in 6.5% NaCl broth
-PYR positive

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326
Q

Enterococcus - E. faecium & E. faecalis - what antibiotic is E. faecalis resistant to?

A

Vancomycin

-VRE are a significant public health concern.
-VRE fecal surveillance culture is often done for early detection

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327
Q

Enterococcus - E. faecium & E. faecalis - media used for ID of VRE

A

chromogenic agar

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328
Q

Lists the test used for the identification of beta-hemolytic streptococci.

A
  1. Bacitracin disk
  2. MALDI-TOF
  3. PYR test
  4. CAMP test
  5. Hippurate hydrolysis
  6. Slide agglutination tests
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329
Q

Tests for identification of beta-hemolytic streptococci - Bacitracin disk - principle

A

Zone of inhibition after overnight incubation = susceptibility to bacitracin

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330
Q

Tests for identification of beta-hemolytic streptococci - Bacitracin disk - key reactions

A

-Group A strep susceptible
-Group B strep resistant

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331
Q

Tests for identification of beta-hemolytic streptococci - Bacitracin disk:
-also known as?
-media performed on?
-no longer recommended - why?
-replaced by?

A

-also known as A disk
-performed on SBA
-no longer recommended because some groups C & G are susceptible
-replaced by PYR & serogrouping by latex agglutination

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332
Q

Tests for identification of beta-hemolytic streptococci - MALDI-TOF - principle

A

A type of mass spectrometry good for identifying biomolecules like peptides, lipids, and saccharides.

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333
Q

Tests for identification of beta-hemolytic streptococci - MALDI-TOF - key reactions

A

Reliable for S. pyogenes, S. agalactiae, & S. pneumoniae

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334
Q

Tests for identification of beta-hemolytic streptococci - PYR test - principle

A

If PYR is hydrolyzed = red color after addition of color developer

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335
Q

Tests for identification of beta-hemolytic streptococci - PYR test - key reactions

A

group A strep are positive

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336
Q

Tests for identification of beta-hemolytic streptococci - PYR test - more specific than what other test for group A strep?

A

bacitracin disk test

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337
Q

True or False. Group A strep is the only beta-hemolytic strep that is PYR positive.

A

True

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338
Q

Tests for identification of beta-hemolytic streptococci - CAMP test - principle

A

Group B strep produces extracellular protein that enhances hemolysis of beta-hemolytic S. aureus on SBA

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339
Q

Tests for identification of beta-hemolytic streptococci - CAMP test - key reactions

A

group B strep is positive

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340
Q

Tests for identification of beta-hemolytic streptococci - CAMP test - classic method

A

-unknown is streaked perpendicular to a streak of beta-lysin producing S. aureus.
-incubated in ambient air overnight
-FALSE POSITVE in CO2
-Arrowhead hemolysis - where inoculum lines meet

-Disk containing beta-lysin can be used instead of S. aureus

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341
Q

Tests for identification of beta-hemolytic streptococci - CAMP test - rapid test

A

A drop of beta-lysin on colonies on SBA.
-only requires 20 minute incubation

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342
Q

List the tests used for identification of beta-hemolytic streptococci.

A
  1. Hippurate hydrolysis
  2. Slide agglutination tests
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343
Q

Tests for identification of beta-hemolytic streptococci - Hippurate hydrolysis - principle

A

Organisms that produce hippuricase (hippurate hydrolase) hydrolyze sodium hippurate to benzoate & glycine.

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344
Q

Tests for identification of beta-hemolytic streptococci - Hippurate hydrolysis - key reactions

A

group B strep positive

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345
Q

Tests for identification of beta-hemolytic streptococci - Hippurate hydrolysis - alternative to?

A

Alternative to CAMP.

-2 hr test available

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346
Q

Tests for identification of beta-hemolytic streptococci - Slide agglutination tests - principle

A

Latex particles coated with group-specific antibodies agglutinate in the presence of bacterial antigens.

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347
Q

Tests for identification of beta-hemolytic streptococci - Slide agglutination tests - key reactions

A

Organisms agglutinate in corresponding antisera

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348
Q

Tests for identification of beta-hemolytic streptococci - Slide agglutination tests - tests commercially available for rapid ID of?

A

groups A, B, C, D, F, G strep, & S. pneumoniae

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349
Q

List the tests used for identification of alpha-hemolytic streptococci.

A
  1. Optochin disk
  2. Bile solubility
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350
Q

Tests for identification of alpha-hemolytic streptococci - Optochin disk - principle

A

Zone of inhibition >=14 mm with 6-mm disk OR >=16 mm with 10-mm disk = susceptibility to optochin

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351
Q

Tests for identification of alpha-hemolytic streptococci - Optochin disk - key reactions

A

-S. pneumoniae susceptible
-Viridans strep resistant

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352
Q

Tests for identification of alpha-hemolytic streptococci - Optochin disk:
-also known as?
-contains?
-method?

A

-also known as P disk
-contains ethylhydrocupreine hydrochloride
-Method: Placed on lawn of inoculum on SBA. Plates incubated overnight in CO2. If zone of inhibin is <14 mm, ID organisms as S. pneumoniae only if bile soluble.

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353
Q

Tests for identification of alpha-hemolytic streptococci - Bile solubility - principle

A

Bile salts (e.g., sodium deoxycholate) causes lysis of some organisms

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354
Q

Tests for identification of alpha-hemolytic streptococci - Bile solubility - key reactions

A

S. pneumoniae positive

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355
Q

Tests for identification of alpha-hemolytic streptococci - Bile solubility - performed on? positive?

A

-can be performed in broth or on colony
-POS = clearing of broth or disappearance of colony
-results in 30 seconds or less

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356
Q

Antibiograms of gram-positive cocci - Methicillin-sensitive Staphylococcus aureus - susceptibility

A

-resistant to penicillin
-susceptible to cephalosporin & vancomycin

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357
Q

Antibiograms of gram-positive cocci - Methicillin-sensitive Staphylococcus aureus - routine susceptibility testing?

A

yes

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358
Q

Antibiograms of gram-positive cocci - Methicillin-resistant Staphylococcus aureus (MRSA) - susceptibility

A

-resistant to all beta-lactams (penicillin, ampicillin, and cephalosporin)

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359
Q

Antibiograms of gram-positive cocci - Methicillin-resistant Staphylococcus aureus (MRSA) - routine susceptibility testing?

A

yes

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360
Q

Antibiograms of gram-positive cocci - Group A Strep (GAS) - susceptibility

A

-universally susceptible to penicillin, cephalosporins, vancomycin

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361
Q

Antibiograms of gram-positive cocci - Group A Strep (GAS) - routine susceptibility testing?

A

no

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362
Q

Antibiograms of gram-positive cocci - Group B Strep (GBS) - susceptibility

A

Susceptible to penicillin, cephalosporins, vancomycin

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363
Q

Antibiograms of gram-positive cocci - Group B Strep (GBS) - routine susceptibility testing?

A

variable - may be done when isolated from baby

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364
Q

Antibiograms of gram-positive cocci - Streptococcus pneumoniae - susceptibility

A

-increasingly resistant to penicillin
-Susceptible to vancomycin

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365
Q

Antibiograms of gram-positive cocci - Streptococcus pneumoniae - routine susceptibility testing?

A

yes

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366
Q

Antibiograms of gram-positive cocci - Enterococcus - susceptibility

A

E. faecium
-usually resistant to penicillin & several other commonly used antibiotics
-most are susceptible to vancomycin

*E. faecium
-vancomycin resistant (VRE)

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367
Q

Antibiograms of gram-positive cocci - Enterococcus - routine susceptibility testing?

A

yes

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368
Q

Aerobic spore-forming gram-positive rods - Bacillus spp. - pathogenicity

A

usually contaminants

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369
Q

Aerobic spore-forming gram-positive rods - Bacillus spp. - gram stain

A

-large with square ends
-may be in chains
-oval, central to subterminal spores that aren’t swollen
-looks like bamboo
-spores may not be seen in direct smear

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370
Q

Aerobic spore-forming gram-positive rods - Bacillus spp. - culture

A

-large spreading beta-hemolytic colonies with irregular edges (MEDUSA HEAD)
-whitish gray
-may be pigmented

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371
Q

Aerobic spore-forming gram-positive rods - Bacillus spp. - key characteristics

A

-catalase positive
-most are motile

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372
Q

Aerobic spore-forming gram-positive rods - Bacillus spp. - what must be ruled out? how?

A

Must rule out B. anthracis
-often done via PCR

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373
Q

Aerobic spore-forming gram-positive rods - Bacillus anthracis - pathogenicity

A

-one of the most highly pathogenic microorganisms
-causes anthrax
-contracted from contaminated hides, wool, meat

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374
Q

Aerobic spore-forming gram-positive rods - Bacillus anthracis - gram stain

A

-large with square ends
-may be in chains
-oval, central to subterminal spores that aren’t swollen
-looks like bamboo
-spores may not be seen in direct smear

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375
Q

Aerobic spore-forming gram-positive rods - Bacillus anthracis - culture

A

-large
-adherent
-NON-HEMOLYTIC
-flat to slightly convex
-irregular border
-GROUND GLASS appearance
-comma shaped projections
-stands up like BEATEN EGG WHITE when touched with loop

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376
Q

Aerobic spore-forming gram-positive rods - Bacillus anthracis - key characteristics

A

-NON-HEMOLYTIC (beta-hydrolysis rules out)
-catalase positive
-NON-MOTILE
-capsules are seen in CSF & blood smears

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377
Q

Aerobic spore-forming gram-positive rods - Bacillus anthracis - antibotic susceptibility

A

Most strains are susceptible to penicillin.

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378
Q

Aerobic spore-forming gram-positive rods - Bacillus cereus - pathogenicity

A

-often environmental contaminant
-can cause focal & systemic infections, food poisoning

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379
Q

Aerobic spore-forming gram-positive rods - Bacillus cereus - gram stain

A

-large with square ends
-may be in chains
-oval, central to subterminal spores that aren’t swollen
-looks like bamboo
-spores may not be seen in direct smear

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380
Q

Aerobic spore-forming gram-positive rods - Bacillus cereus - culture

A

-large
-adherent
-HEMOLYTIC
-flat to slightly convex
-irregular border
-GROUND GLASS appearance
-comma shaped projections
-stands up like BEATEN EGG WHITE when touched with loop

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381
Q

Aerobic spore-forming gram-positive rods - Bacillus cereus - key characteristics

A

-hemolytic
-motile

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382
Q

Aerobic NON-spore-forming gram-positive rods - Corynebacterium spp. - pathogenicity

A

-normal on skin & mucous membranes
-opportunistic pathogen

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383
Q

Aerobic NON-spore-forming gram-positive rods - Corynebacterium spp. - gram stain

A

-irregular
-slightly curved
-non-paralleled sides
-CLUB-SHAPED ends
-if taken from fluid, they can arrange in PALLISADES or clusters with angular V-shaped forms

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384
Q

Aerobic NON-spore-forming gram-positive rods - Corynebacterium spp. - culture

A

-facultative anaerobes
-grow on most media

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385
Q

Aerobic NON-spore-forming gram-positive rods - Corynebacterium spp. - also known as?

A

DIPTHEROIDS - because they resemble C. diphtheriae

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386
Q

Aerobic NON-spore-forming gram-positive rods - Corynebacterium spp. - key characteristics

A

-catalase positive
-non-motile

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387
Q

Aerobic NON-spore-forming gram-positive rods - Corynebacterium diphtheriae - pathogenicity

A

Diphtheria

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388
Q

Aerobic NON-spore-forming gram-positive rods - Corynebacterium diphtheriae - gram stain

A

-irregular
-slightly curved
-non-paralleled sides
-CLUB-SHAPED ends
-if taken from fluid, they can arrange in PALLISADES or clusters with angular V-shaped forms

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389
Q

Aerobic NON-spore-forming gram-positive rods - Corynebacterium diphtheriae- culture

A

-Tindale agar: gray-black colonies with brown halos
-Cystine tellurite agar: black colonies

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390
Q

Aerobic NON-spore-forming gram-positive rods - Corynebacterium diphtheriae - key characteristics

A

-catalase positive
-non-motile
-toxin producing

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391
Q

Aerobic NON-spore-forming gram-positive rods - Corynebacterium diphtheriae - requirements for ID

A

-demonstration of toxin production

PCR or MALDI-TOFF are used for ID but must be followed up with ELEK immunoprecipitation test to confrim toxin production

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392
Q

Aerobic NON-spore-forming gram-positive rods - Corynebacterium diphtheriae - Corynebacterium ulcerans

A

-closely releated to C. diphtheriae
-also contains the TOX gene and can cause diphtheriae

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393
Q

Aerobic NON-spore-forming gram-positive rods - Corynebacterium jeikeium - pathogenicity

A

hospital-acquired pathogen

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394
Q

Aerobic NON-spore-forming gram-positive rods - Corynebacterium jeikeium - gram stain

A

-irregular
-slightly curved
-non-paralleled sides
-CLUB-SHAPED ends
-if taken from fluid, they can arrange in PALLISADES or clusters with angular V-shaped forms

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395
Q

Aerobic NON-spore-forming gram-positive rods - Corynebacterium jeikeium - culture

A

Same as other commensal corynebacteria

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396
Q

Aerobic NON-spore-forming gram-positive rods - Corynebacterium jeikeium - key characteristics

A

-catalase positive
-rapid sucrose urea (RSU) negative

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397
Q

Aerobic NON-spore-forming gram-positive rods - Corynebacterium jeikeium - antibiotic susceptibility

A

multidrug resistant (MDR)

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398
Q

Which diphtheroid is the most commonly isolated?

A. C. diphtheriae
B. C. ulcerans
C. C. jeikeium
D. None of the above

A

C. C. jeikeium

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399
Q

Aerobic NON-spore-forming gram-positive rods - Listeria monocytogenes - pathogenicity

A

-able to cross the placenta and can infect the fetus causing preterm labor and other complications resulting in fetal loss up to 24%
-meningitis & septicemia in newborns & immunocompromised
-food poisoning with mortality ranges up to 50%

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400
Q

Aerobic NON-spore-forming gram-positive rods - Listeria monocytogenes - gram stain

A

-parallel sides
-rounded ends
-coccobacillary
-singles or short chain arrangement

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401
Q

Aerobic NON-spore-forming gram-positive rods - Listeria monocytogenes - culture

A

-tiny colonies with narrow zone of indistinct beta hemolysis
-translucent, gray

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402
Q

Aerobic NON-spore-forming gram-positive rods - Listeria monocytogenes - key characteristics

A

-catalase positive
-hippurate hydrolysis positive
-esculin positive
-CAMP positive (hemolysis looks like SHOVEL, not arrowhead)
-TUMBLING motility on wet mount
-UMBRELLA growth in motility agar at room temperature but not at 35*C.

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403
Q

Aerobic NON-spore-forming gram-positive rods - Listeria monocytogenes:
-growth temp?
-enrichment?
-differentiation from group B strep?
-differentiation from diphtheroids?
-MALDI-TOF?

A

-grows from 0.5C-45C
-cold enrichment may be used
-catalase differentiates from group B strep
-motility (tumbling) differentiates from diphtheroids (non-motile)
-MALDI-TOF can be used for ID

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404
Q

Aerobic NON-spore-forming gram-positive rods - Nocardia - pathogenicity

A

-immunocompetent: skin infection
-immunocompromised: invasive pulmonary & disseminated infections

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405
Q

Aerobic NON-spore-forming gram-positive rods - Nocardia - gram stain

A

-aerobic actinomycetes
-fine branching filaments with fragmentation
-often beaded

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406
Q

Aerobic NON-spore-forming gram-positive rods - Nocardia - culture

A

-slow growing

-SBA:
–wrinkled
–dry
–crumbly
–chalky white to orange-tan
–beta hemolytic

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407
Q

Aerobic NON-spore-forming gram-positive rods - Nocardia - key characteristics

A

-catalase positive
-partially ACID FAST
-SULFUR granules

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408
Q

Aerobic NON-spore-forming gram-positive rods - Nocardia - frequently isolated species

A

N. brasiliensis
N. pseudobrasiliensis
N. abscessus

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409
Q

Aerobic NON-spore-forming gram-positive rods - Nocardia - reporting

A

Nocardia isolates may be identified and reported at “complex” or “group” level.

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410
Q

Neisseria & Moraxella - Neisseria spp. - gram stain

A

-gram negative DIPLOCOCCI (GNDC) OR single COFFEE-BEAN shaped

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411
Q

Neisseria & Moraxella - Neisseria spp. - culture

A

-aerobic OR facultative
-pathogens are CAPNOPHILIC

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412
Q

Neisseria & Moraxella - Neisseria spp. - key characteristics

A

-catalase positive
-oxidase positive

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413
Q

Neisseria & Moraxella - Neisseria gonorrhoeae - pathogenicity

A

-gonorrhea
-salpingitis
-ophthalmia of newborn

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414
Q

Neisseria & Moraxella - Neisseria gonorrhoeae - gram stain

A

-intracellular & extracellular GNDC

–diagnostic in urethral discharge from symptomatic males
–culture confirmation required for females

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415
Q

Neisseria & Moraxella - Neisseria gonorrhoeae - culture

A

-requires increased CO2
-usually does NOT grow on SBA
-grows on CHOC & Neisseria-selective media
-colonies are small, grayish white or tan
-may look like mixed culture

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416
Q

Neisseria & Moraxella - Neisseria gonorrhoeae - key characteristics

A

-oxidase positive
-carbohydrate utilization: GLUCOSE only

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417
Q

Neisseria & Moraxella - Neisseria gonorrhoeae:
-susceptible to what conditions?
-culture used for?
-definitive ID?
-NAATs?

A

-susceptible to drying & cold
-culture used for presumptive ID
-definitive ID: monoclonal antibodies
-NAATs can be used on male urine specimens with high sensitivity but should NOT be used with oropharyngeal, rectal, ocular, or pediatric patients

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418
Q

Neisseria & Moraxella - Neisseria meningitidis - pathogenicity

A

-normal flora in upper respiratory tract
-always pathogenic when recovered from usually sterile body fluids such as blood or CSF
-common cause of meningitis in young adults

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419
Q

Neisseria & Moraxella - Neisseria meningitidis - gram stain

A

-intracellular & extracellular GNDC

-a gram stain of CSF is required for all cases of suspected bacterial meningitis sent to the lab

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420
Q

Neisseria & Moraxella - Neisseria meningitidis - culture

A

-grows on SBA, CHOC, & Neisseria-selective media
-colonies are grey, convex, glistening, & occasionally mucoid

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421
Q

Neisseria & Moraxella - Neisseria meningitidis - key characteristics

A

-carbohydrate utilization: GLUCOSE & MALTOSE
-O-nitrophenyl-beta-D-galactopyranoside (ONPG) NEGATIVE

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422
Q

Neisseria & Moraxella - Commensal Neisseria spp. - pathogenicity

A

-normal in upper respiratory tract
-rarely cause disease

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423
Q

Neisseria & Moraxella - Commensal Neisseria spp. - gram stain

A

GNDC

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424
Q

Neisseria & Moraxella - Commensal Neisseria spp. - culture

A

-grow on SBA & CHOC at RT
-grow on nutrient agar at 35*C
-some grow on Neisseria-selective media
-DO NOT require increased CO2
-may be pigmented

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425
Q

Neisseria & Moraxella - Commensal Neisseria spp. - key characteristics

A

varies with species

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426
Q

Neisseria & Moraxella - Commensal Neisseria spp.:
-speciation?
-must differentiate from?
-N. lactamica?

A

-not speciated if from respiratory tract
-must differentiate from pathogenic Neisseria when isolated on selective media or from normally sterile body site
-N. lactamica is easily confused with N. meningitidis but N. lactamica acidifies lactose in addition to glucose

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427
Q

Neisseria & Moraxella - Moraxella catarrhalis - pathogenicity

A

-normal in upper respiratory tract
-causes respiratory infections in young, old, & immunocompromised
-causes otitis media & sinusitis in children

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428
Q

Neisseria & Moraxella - Moraxella catarrhalis - gram stain

A

GNDC

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429
Q

Neisseria & Moraxella - Moraxella catarrhalis - culture

A

-grows on SBA & CHOC
-some may grow at RT &/or on Neisseria-selective media
-“HOCKEY PUCK colonies” - colonies can be pushed over agar surface with a loop

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430
Q

Neisseria & Moraxella - Moraxella catarrhalis - key characteristics

A

-catalase positive
-oxidase positive
-carbohydrate utilization: NEG for all sugars
-ONPG negative
-DNase positive
-butyrate esterase positive

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431
Q

Neisseria & Moraxella - Moraxella catarrhalis - differentiation from Neisseria spp.

A

DNase & butyrate esterase differentiate from Neisseria spp.

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432
Q

Characteristics of Enterobacterales - gram stain

A

Non-spore-forming GNRs

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433
Q

Characteristics of Enterobacterales - gram stain

A

Non-spore-forming GNRs

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434
Q

Characteristics of Enterobacterales - growth characteristics

A

facultative anaerobes

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435
Q

Characteristics of Enterobacterales - colonies on SBA

A

most are large, dull, gray, non-hemolytic

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436
Q

Characteristics of Enterobacterales - colonies on MAC

A

-lactose fermenters = pink
-non-lactose fermenters = colorless

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437
Q

Characteristics of Enterobacterales - Biochemicals

A

-ferment GLUCOSE
-oxidase negative
-most reduce nitrates to nitrites
-most are catalase positive

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438
Q

List the biochemical tests used for identification of Enterobacterales. (14)

A
  1. Oxidase
  2. nitrate reduction
  3. carbohydrate fermentation
  4. ONPG
  5. H2S production
  6. Triple sugar iron (TSI) agar
  7. Indole
  8. Methyl red (MR)
  9. Voges-Proskauer (VP)
  10. Citrate
  11. Urease
  12. Phenylalanine deaminase (PD)
  13. Decarboxylase reactions
  14. motility
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439
Q

Biochemical tests for identification of Enterobacterales - oxidase - principle

A

tetramethyl-para-phenylenediamine dihydrochloride reacts with cytochrome C to produce a blue or purple color

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440
Q

Biochemical tests for identification of Enterobacterales - oxidase - interpretation

A

Positive = blue or purple color

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441
Q

Biochemical tests for identification of Enterobacterales - oxidase:
-test used to differentiate?
-false pos?

A

-good test to differentiate Enterobacterales from non-fermenters
-false positive from iron-containing wire - use platinum or wooden stick

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442
Q

Biochemical tests for identification of Enterobacterales - nitrate reduction - principle

A

If organism reduces nitrates to nitrites, a RED color develops when sulfanic aicd & N,N-dimethyl-L-naphthylamine added

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443
Q

Biochemical tests for identification of Enterobacterales - nitrate reduction - interpretation

A

Positive = red, OR no color after addition of zinc dust

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444
Q

Biochemical tests for identification of Enterobacterales - nitrate reduction - zinc dust

A

If no color develops (red = pos), zinc dust is added. It reduces nitrates.
-RED color AFTER zinc dust = presence of nitrates (NEG REACTION)
-NO COLOR after zinc dust means nitrates reduces to N2 or NO2 (POS REACTION)

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445
Q

Biochemical tests for identification of Enterobacterales - carbohydrate fermentation - principle

A

when carbohydrate is fermented, acidic end products cause color change in pH indicator

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446
Q

Biochemical tests for identification of Enterobacterales - carbohydrate fermentation - interpretation

A

with phenol red indicator = change from red to yellow

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447
Q

Biochemical tests for identification of Enterobacterales - carbohydrate fermentation:
-frequently tested carbohydrates?
-all Enterobacterales ferment?

A

-frequently tested carbohydrates are glucose, lactose, sucrose, mannose, sorbitol, mannitol, xylose, adonitol, cellobiose, dulcitol, trehalose
-All Enterobacterales ferment GLUCOSE

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448
Q

Biochemical tests for identification of Enterobacterales - ONPG - principle

A

ONPG is changed to orthonitrophenol by beta-galactosidase

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449
Q

Biochemical tests for identification of Enterobacterales - ONPG - interpretation

A

positive = yellow

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450
Q

Biochemical tests for identification of Enterobacterales - ONPG:
-test for?
-differentiation of?

A

-test for slow lactose fermentation
-helpful in differentiating Citrobacter (positive) from most Salmonella (negative).

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451
Q

Biochemical tests for identification of Enterobacterales - H2S production - principle

A

-organisms that possess H2S-producing enzymes produce colorless H2S gas from sulfur containing compounds
-H2S reacts with iron salt in medium to form black ferrous sulfide

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452
Q

Biochemical tests for identification of Enterobacterales - H2S production - interpretation

A

black precipitate

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453
Q

Biochemical tests for identification of Enterobacterales - H2S production:
-sulfur-containing compounds?
-differentiates?

A

-sulfur-containing compounds = sodium thiosulfate, cystine, methionine
-good test to differentiate Salmonella (H2S positive) from Shigella (H2S negative).

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454
Q

Biochemical tests for identification of Enterobacterales - Triple sugar iron (TSI) agar - principle

A

sugar fermentation produces acid = changes color of pH indicator

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455
Q

Biochemical tests for identification of Enterobacterales - Triple sugar iron (TSI) agar - interpretation

A

Yellow = acid (A)
Pink = alkaline (K)

Pink butt = glucose NOT fermented
Yellow butt = glucose fermented

Pink slant = lactose/sucrose NOT fermented
Yellow slant = lactose and/or sucrose fermented

Black precipitate = H2S produced
Bubbles = gas production

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456
Q

Biochemical tests for identification of Enterobacterales - Triple sugar iron (TSI) agar:
-contains?
-how to leave cap to tube?
-record as?
-Kligler iron agar (KIA)?

A

-contains 0.1% glucose, 1% lactose, 1% sucrose, phenol red, sodium thiosulfate, iron salt
-leave cap slightly loose
-record as slant/butt, e.g., K/A [some record NC = no change (for pink butt]
-Kligler iron agar (KIA) is same except NO sucrose

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457
Q

Biochemical tests for identification of Enterobacterales - Indole - principle

A

-tryptophanase deaminates tryptophan = indole produced
-Kovacs reagent (paradimethylaminobenzaldehyde) forms pink-colored complex with indole

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458
Q

Biochemical tests for identification of Enterobacterales - Indole - interpretation

A

positive = pink

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459
Q

Biochemical tests for identification of Enterobacterales - Indole - spot indole test

A

-commercially available
-need source of tryptophan
-use colonies from SBA or CHOC agar, not MAC
-positive = blue

-E. coli & Proteus vulgaris are positive

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460
Q

Biochemical tests for identification of Enterobacterales - methyl red (MR) - principle

A

-acid products formed when glucose is metabolized by mixed acid fermentation pathway
-color changes pH indicator

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461
Q

Biochemical tests for identification of Enterobacterales - methyl red (MR) - interpretation

A

positive = red color after addition of MR (pH indicator)

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462
Q

Biochemical tests for identification of Enterobacterales - methyl red (MR) - pH at which test becomes positive?

A

4.5

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463
Q

Biochemical tests for identification of Enterobacterales - Voges-Proskauer (VP) - principle

A

acetoin is produced from alternate pathway for glucose metabolism

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464
Q

Biochemical tests for identification of Enterobacterales - Voges-Proskauer (VP) - interpretation

A

positive = red color when alphanaphthol & KOH added

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465
Q

Biochemical tests for identification of Enterobacterales - Voges-Proskauer (VP) - VP vs. MR

A

organisms that are VP positive are usually MR negative & vice versa

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466
Q

Biochemical tests for identification of Enterobacterales - Citrate - principle

A

if organism can use citrate as sole source of carbon, pH increases, and pH indicator changes color

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467
Q

Biochemical tests for identification of Enterobacterales - Citrate - interpretation

A

positive = green to blue, or growth

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468
Q

Biochemical tests for identification of Enterobacterales - Citrate - false negatives

A

false negative if cap is NOT loose

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469
Q

Biochemical tests for identification of Enterobacterales - Citrate - positive bacteria

A

Klebsiella & Enterobacter are positive

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470
Q

Biochemical tests for identification of Enterobacterales - Urease - principle

A

-urease breaks down to urea
-ammonia released, pH increased, pH indicator changes color

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471
Q

Biochemical tests for identification of Enterobacterales - Urease - interpretation

A

positive = yellow to pink

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472
Q

Biochemical tests for identification of Enterobacterales - Urease - rapid urease producers

A

Proteus & Morganella

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473
Q

Biochemical tests for identification of Enterobacterales - Phenylalanine deaminase (PD) - principle

A

PD deaminates phenylalanine to phenylpyruvic acid, which reacts with ferric chloride to produce a green color.

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474
Q

Biochemical tests for identification of Enterobacterales - Phenylalanine deaminase (PD) - interpretation

A

positive = green color after addition of ferric chloride

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475
Q

Biochemical tests for identification of Enterobacterales - Phenylalanine deaminase (PD) - positive organisms

A

-Proteus
-Providencia
-Morganella

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476
Q

Biochemical tests for identification of Enterobacterales - Decarboxylase reactions - principle

A

if organism has enzyme to decarboxylate amino acid (e.g., ornithine, lysine, arginine), pH increases, pH indicator changes color

-Ornithine decarboxylase (ODC)

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477
Q

Biochemical tests for identification of Enterobacterales - Decarboxylase reactions - interpretation

A

positive = yellow to purple

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478
Q

Biochemical tests for identification of Enterobacterales - Motility - interpretation

A

motile organisms grow away from stab line in motility medium

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479
Q

Biochemical tests for identification of Enterobacterales - Motility - interpretation

A

positive:
-movement away from stab line OR
-hazy appearance throughout medium after overnight incubation

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480
Q

Biochemical tests for identification of Enterobacterales - Motility - positive organisms

A

most Enterobacterales are positive, EXCEPT Klebsiella & Shigella

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481
Q

Biochemical tests for identification of Enterobacterales - Motility - differentiates?

A

Differentiates:
-Klebsiella (neg) from Enterobacter (pos)
AND
-Shigella (neg) from Salmonella (pos)

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482
Q

Antigens of Enterobacterales - O antigen:
-alternate name
-location
-characteristics
-used for serological grouping of?

A

-somatic antigen
-cell wall
-lipopolysaccharide, heat stable
-used for serological grouping of Salmonella & Shigella

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483
Q

Antigens of Enterobacterales - H antigen:
-alternate name
-location
-characteristics
-used to serotype?

A

-flagellar antigen
-flagella
-proteins, heat labile
-used to serotype Salmonella

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484
Q

Antigens of Enterobacterales - K antigen:
-alternate name
-location
-characteristics
-role in preventing what?
-Vi antigen

A

-capsular antigen
-capsule
-polysaccharide, heat labile, may mask O antigen; removed by heating
-role in preventing phagocytosis = increased virulence
-Vi antigen is K antigen produced by S. typhi

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485
Q

Escherichia, Shigella, and Salmonella Enterobacterales - E. coli - pathogenicity

A

-UTI
-septicemia
-neonatal sepsis
-meningitis
-diarrhea (some)

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486
Q

Escherichia, Shigella, and Salmonella Enterobacterales - E. coli - key reactions - POSITIVE

A

-lactose
-gas
-indole
-MR
-motility

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487
Q

Escherichia, Shigella, and Salmonella Enterobacterales - E. coli - key reactions - NEGATIVE

A

-H2S
-VP
-citrate
-PD
-urease

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488
Q

Which of the following is the predominant aerobe in the GI tract?

A. Shigella
B. Salmonella
C. E. coli
D. None of the above

A

C. E. coli

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489
Q

Which of the following is the most common cause of UTI?

A. E. coli
B. Salmonella
C. Shigella
D. None of the above

A

A. E. coli

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490
Q

Escherichia, Shigella, and Salmonella Enterobacterales - E. coli - EMB media

A

green metallic sheen

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491
Q

Escherichia, Shigella, and Salmonella Enterobacterales - E. coli - presumptive ID

A

-lactose positive
-dry colony on MAC
-oxidase negative
-indole positive

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492
Q

Escherichia, Shigella, and Salmonella Enterobacterales - E. coli - E. coli 0157:H7

A

-does NOT ferment sorbitol
-colorless colonies on SMAC

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493
Q

Escherichia, Shigella, and Salmonella Enterobacterales - Shigella - pathogenicity

A

-dysentery (shigellosis)
-most communicable of bacterial diarrheas
-found primarily in crowded or substandard conditions, e.g., day-care centers, jails, prisons

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494
Q

Escherichia, Shigella, and Salmonella Enterobacterales - Shigella - key reactions - POSITIVE

A

MR

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495
Q

Escherichia, Shigella, and Salmonella Enterobacterales - Shigella - key reactions - NEGATIVE

A

-lactose
-gas
-H2S
-citrate
-PD
-urease
-motility

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496
Q

Escherichia, Shigella, and Salmonella Enterobacterales - Shigella - what is found in the stool of patients positive for Shigella

A

-blood
-mucus
-neutrophils

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497
Q

Escherichia, Shigella, and Salmonella Enterobacterales - Shigella - most severe species?

A

S. dysenteriae

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498
Q

Escherichia, Shigella, and Salmonella Enterobacterales - Shigella - most common species in the US?

A

S. sonnei

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499
Q

Escherichia, Shigella, and Salmonella Enterobacterales - Shigella - serogrouped by what antigens?

A

O antigens

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500
Q

Escherichia, Shigella, and Salmonella Enterobacterales - Shigella - serogroups?

A

A, B, C, D

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501
Q

Escherichia, Shigella, and Salmonella Enterobacterales - Shigella - closely related to what organism on a molecular basis?

A

Escherichia

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502
Q

Escherichia, Shigella, and Salmonella Enterobacterales - Salmonella - pathogenicity

A

-Typhoid (enteric) fever
-bacteremia
-enterocolitis

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503
Q

Escherichia, Shigella, and Salmonella Enterobacterales - Salmonella - key reactions - POSITIVE

A

-H2S
-MR
-motility
-lysine decarboxylase (LDC)

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504
Q

Escherichia, Shigella, and Salmonella Enterobacterales - Salmonella - key reactions - NEGATIVE

A

-lactose
-indole
-VP
-PD
-urease
-ONPG

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505
Q

Escherichia, Shigella, and Salmonella Enterobacterales - Salmonella - what type of meat is it found in?

A

poultry

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506
Q

Escherichia, Shigella, and Salmonella Enterobacterales - Salmonella - may be transmitted by what type of animal?

A

reptiles

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507
Q

Escherichia, Shigella, and Salmonella Enterobacterales - Salmonella - S. typhi

A

-Vi antigen
-only trace H2S
-citrate negative

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508
Q

Escherichia, Shigella, and Salmonella Enterobacterales - Salmonella - grouped by? serotyped by?

A

-grouped by O antigens (e.g., A, B, C)
-serotyped by H antigens (e.g., 1, 2)

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509
Q

Diarrheagenic Escherichia coli - Enterohemorrhagic (EHEC) - pathogenicity

*also known as Shiga toxin-producing (STEC) OR verotoxin-producing (VTEC)

A

-diarrhea
-hemorrhagic colitis
-hemolytic uremic syndrome (HUS)
-most common cause of renal failure in children in the US
-may be fatal, especially in young or elderly

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510
Q

Diarrheagenic Escherichia coli - Enterohemorrhagic (EHEC) - transmission

A

-undercooked meat
-raw milk
-apple cider

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511
Q

Diarrheagenic Escherichia coli - Enterohemorrhagic (EHEC) - disease mechanism

A

toxins (verotoxins or Shiga toxins)

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512
Q

Diarrheagenic Escherichia coli - Enterohemorrhagic (EHEC) - gram stain of stool

A

RBCs but usually no segmented neutrophils

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513
Q

Diarrheagenic Escherichia coli - Enterohemorrhagic (EHEC) - E. coli 0157:H7

A

-most common isolate of group
-pathogen most often isolated from bloody stools

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514
Q

Diarrheagenic Escherichia coli - Enterohemorrhagic (EHEC) - DNA probes

A

ID genes that code for toxins

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515
Q

Diarrheagenic Escherichia coli - Enterotoxigenic (ETEC) - pathogenicity

A

-traveler diarrhea
-diarrhea in infants

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516
Q

Diarrheagenic Escherichia coli - Enterotoxigenic (ETEC) - transmission

A

contaminated food or water

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517
Q

Diarrheagenic Escherichia coli - Enterotoxigenic (ETEC) - disease mechanism

A

toxins

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518
Q

Diarrheagenic Escherichia coli - Enterotoxigenic (ETEC) - gram stain of stool

A

no segmented neutrophils or RBCs

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519
Q

Diarrheagenic Escherichia coli - Enterotoxigenic (ETEC) - type of stool

A

profuse, watery stool

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520
Q

Diarrheagenic Escherichia coli - Enterotoxigenic (ETEC) - DNA probes

A

detect toxins or toxin genes

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521
Q

Diarrheagenic Escherichia coli - Enteroinvasive (EIEC) - pathogenicity

A

-bloody diarrhea
-dysentery-like
-usually in young children in areas of poor sanitation

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522
Q

Diarrheagenic Escherichia coli - Enteroinvasive (EIEC) - transmission

A

contaminated food or water

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523
Q

Diarrheagenic Escherichia coli - Enteroinvasive (EIEC) - disease mechanism

A

invasiveness

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524
Q

Diarrheagenic Escherichia coli - Enteroinvasive (EIEC) - gram stain of stool

A

-segmented neutrophils
-RBCs
-mucus

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525
Q

Diarrheagenic Escherichia coli - Enteropathogenic (EPEC) - pathogenicity

A

-diarrhea in infants
-major pathogen in infants in developing countries

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526
Q

Diarrheagenic Escherichia coli - Enteropathogenic (EPEC) - transmission

A

formula & food contaminated with fecal material

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527
Q

Diarrheagenic Escherichia coli - Enteropathogenic (EPEC) - disease mechanism

A

adherence-attachment

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528
Q

Diarrheagenic Escherichia coli - Enteropathogenic (EPEC) - gram stain of stool

A

no segmented neutrophils or RBCs

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529
Q

Diarrheagenic Escherichia coli - Enteropathogenic (EPEC) - type of stool

A

watery diarrhea with mucus

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530
Q

Diarrheagenic Escherichia coli - Enteroaggregative (EAEC) - pathogenicity

A

-diarrhea in developing countries
-chronic diarrhea in HIV-infected patients

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531
Q

Diarrheagenic Escherichia coli - Enteroaggregative (EAEC) - transmission

A

nosocomial & community acquired

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532
Q

Diarrheagenic Escherichia coli - Enteroaggregative (EAEC) - disease transmission

A

adherence-attachment

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533
Q

Diarrheagenic Escherichia coli - Diffusely adherent (DAEC) - pathogenicity

A

-diarrhea & UTI
-most common in children in developing countries

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534
Q

Diarrheagenic Escherichia coli - Diffusely adherent (DAEC) - transmission

A

little known about epidemiology

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535
Q

Diarrheagenic Escherichia coli - Diffusely adherent (DAEC) - disease mechanism

A

adherence-attachment

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536
Q

Klebsiella and other commonly isolated Enterobacterales - Klebsiella pneumoniae - pathogenicity

A

-pneumonia
-UTI
-septicemia
-Carbapenem-resistant
-significant pathogen in both community and hospital settings

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537
Q

Klebsiella and other commonly isolated Enterobacterales - Klebsiella pneumoniae - key reactions - POSITIVE

A

-lactose
-gas
-VP
-citrate
-urease (slow)

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538
Q

Klebsiella and other commonly isolated Enterobacterales - Klebsiella pneumoniae - key reactions - NEGATIVE

A

-H2S
-indole
-MR
-PD
-motility
-ODC

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539
Q

Klebsiella and other commonly isolated Enterobacterales - Klebsiella pneumoniae - encapsulated?

A

yes

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540
Q

Klebsiella and other commonly isolated Enterobacterales - Klebsiella pneumoniae - colonies on agar

A

colonies are usually mucoid

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541
Q

Klebsiella and other commonly isolated Enterobacterales - Klebsiella pneumoniae - K. oxytoca

A

similar to K. pneumoniae EXCEPT indole positive

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542
Q

Klebsiella and other commonly isolated Enterobacterales - Klebsiella pneumoniae - differentiation from Enterobacter

A

-motility
-ODC

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543
Q

Klebsiella and other commonly isolated Enterobacterales - Citrobacter - pathogenicity

A

-nosocomial infections
-UTI is most common site of infection

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544
Q

Klebsiella and other commonly isolated Enterobacterales - Citrobacter - key reactions - POSITIVE

A

-gas
-H2S
-MR
-citrate
-motility
-ONPG

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545
Q

Klebsiella and other commonly isolated Enterobacterales - Citrobacter - key reactions - NEGATIVE

A

-VP
-PD
-LDC

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546
Q

Klebsiella and other commonly isolated Enterobacterales - Citrobacter - lactose?

A

lactose variable

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547
Q

Klebsiella and other commonly isolated Enterobacterales - Citrobacter - differentiation from Salmonella?

A

-ONPG
-LDC

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548
Q

Klebsiella and other commonly isolated Enterobacterales - Edwardsiella tarda - pathogenicity

A

-opportunistic
-can cause bacteremia, wound, and GI infections
-environmental risk factors include exposure to brackish water or undercooked fish

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549
Q

Klebsiella and other commonly isolated Enterobacterales - Edwardsiella tarda - key reactions - POSITIVE

A

-gas
-H2S
-indole
-MR
-motility

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550
Q

Klebsiella and other commonly isolated Enterobacterales - Edwardsiella tarda - key reactions - NEGATIVE

A

-lactose
-VP
-citrate
-PD
-urease

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551
Q

Klebsiella and other commonly isolated Enterobacterales - Edwardsiella tarda - primarily what type of pathogen?

A

fish

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552
Q

Klebsiella and other commonly isolated Enterobacterales - Edwardsiella tarda - differentiation from Salmonella

A

positive indole

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553
Q

Klebsiella and other commonly isolated Enterobacterales - Klebsiella aerogenes - pathogenicity

A

-opportunistic & nosocomial infections
-UTI
-respiratory tract infection (RTI)
-wound infections

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554
Q

Klebsiella and other commonly isolated Enterobacterales - Klebsiella aerogenes - key reactions - POSITIVE

A

-VP
-ONPG
-ODC
-citrate
-motility
-gas

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555
Q

Klebsiella and other commonly isolated Enterobacterales - Klebsiella aerogenes - key reactions - NEGATIVE

A

-H2S
-indole
-MR
-PD

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556
Q

Klebsiella and other commonly isolated Enterobacterales - Klebsiella aerogenes - colonies on agar

A

colonies may be mucoid

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557
Q

Klebsiella and other commonly isolated Enterobacterales - Enterobacter cloacae - pathogenicity

A

-nosocomial infections from contaminated medical devices and instruments

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558
Q

Klebsiella and other commonly isolated Enterobacterales - Enterobacter cloacae - key reactions - POSITIVE

A

-ODC
-VP
-sucrose

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559
Q

Klebsiella and other commonly isolated Enterobacterales - Enterobacter cloacae - key reactions - NEGATIVE

A

-oxidase
-H2S
-indole

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560
Q

Klebsiella and other commonly isolated Enterobacterales - Enterobacter cloacae - antibiotic susceptibility

A

frequently antibiotic resistant (intrinsic and plasma-based)

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561
Q

Other commonly isolated Enterobacterales - Serratia marcescens - pathogenicity

A

-opportunistic pathogen
-UTI (indwelling catheters)
-ocular
-GI tract in children

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562
Q

Other commonly isolated Enterobacterales - Serratia marcescens - key reactions - POSITIVE

A

-VP
-citrate
-motility

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563
Q

Other commonly isolated Enterobacterales - Serratia marcescens - key reactions - NEGATIVE

A

-lactose
-H2S
-indole
-PD
-urease

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564
Q

Other commonly isolated Enterobacterales - Serratia marcescens - pigment produced when incubated at RT

A

red pigment

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565
Q

Other commonly isolated Enterobacterales - Proteus vulgaris & Proteus mirabilis - pathogenicity

A

-UTI
-wound infections
-septicemia

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566
Q

Other commonly isolated Enterobacterales - Proteus vulgaris & Proteus mirabilis - key reactions - POSITIVE

A

-H2S
-MR
-PD
-urease
-motility

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567
Q

Other commonly isolated Enterobacterales - Proteus vulgaris & Proteus mirabilis - key reactions - NEGATIVE

A

-lactose

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568
Q

Other commonly isolated Enterobacterales - Proteus vulgaris & Proteus mirabilis - colonies on agar

A

-swarming
-burned chocolate odor

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569
Q

Other commonly isolated Enterobacterales - Proteus vulgaris & Proteus mirabilis - indole

A

P. mirabilis - indole negative

P. vulgaris - indole positive

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570
Q

Other commonly isolated Enterobacterales - Proteus vulgaris & Proteus mirabilis - P. vulgaris on TSI

A

A/A - because of sucrose fermentation

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571
Q

Other commonly isolated Enterobacterales - Morganella morganii - pathogenicity

A

-mainly nosocomial infections
-UTI
-wound infections

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572
Q

Other commonly isolated Enterobacterales - Morganella morganii - key reactions - POSITIVE

A

-indole
-MR
-PD
-urease (weak)
-motility
-ODC

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573
Q

Other commonly isolated Enterobacterales - Morganella morganii - key reactions - NEGATIVE

A

-lactose
-H2S
-VP
-citrate

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574
Q

Other commonly isolated Enterobacterales - Providencia - pathogenicity

A

-UTI
-diarrhea

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575
Q

Other commonly isolated Enterobacterales - Providencia - key reactions - POSITIVE

A

-indole
-MR
-citrate
-PD
-motility

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576
Q

Other commonly isolated Enterobacterales - Providencia - key reactions - NEGATIVE

A

-lactose
-H2S
-VP

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577
Q

Other commonly isolated Enterobacterales - Providencia - urease

A

P. rettgeri is urease positive

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578
Q

Other commonly isolated Enterobacterales - Providencia - which species is most commonly isolated?

A

P. stuartii

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579
Q

Other commonly isolated Enterobacterales - Yersinia enterocolitica - pathogenicity

A

diarrhea

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580
Q

Other commonly isolated Enterobacterales - Yersinia enterocolitica - key reactions - POSITIVE

A

-MR
-urease
-ONDC

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581
Q

Other commonly isolated Enterobacterales - Yersinia enterocolitica - key reactions - NEGATIVE

A

-lactose
-H2S
-VP (variable)
-citrate
-PD

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582
Q

Other commonly isolated Enterobacterales - Yersinia enterocolitica - gram stain

A

-gram negative coccobacilli
-bipolar staining

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583
Q

Other commonly isolated Enterobacterales - Yersinia enterocolitica - optimal temp for growth

A

25-30*C

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584
Q

Other commonly isolated Enterobacterales - Yersinia enterocolitica - motility

A

motile at 25C but NOT 35C

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585
Q

Other commonly isolated Enterobacterales - Yersinia enterocolitica - agar

A

-CIN agar is selective
-incubate 48 hours
-red “BULL’S EYE” colonies surrounded by colorless halo

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586
Q

What species of Yersinia causes plague?

A

Y. pestis

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587
Q

Summary of key reactions for Enterobacterales - lactose negative

A

-Shigella
-Edwardsiella
-Salmonella
-Citrobacter (some)
-Serratia
-Proteus
-Morganella
-Providencia
-Yersinia

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588
Q

Summary of key reactions for Enterobacterales - H2S positive

A

-Edwardsiella
-Salmonella
-Citrobacter
-Proteus

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589
Q

Summary of key reactions for Enterobacterales - VP positive

A

-Klebsiella
-Enterobacter
-Serratia

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590
Q

Summary of key reactions for Enterobacterales - PD positive

A

-Proteus
-Morganella
-Providencia
-Klebsiella (slow)

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591
Q

Summary of key reactions for Enterobacterales - Urease positive

A

-Proteus
-Morganella
-Providencia rettgeri
-some species of Citrobacter

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592
Q

Summary of key reactions for Enterobacterales - nonmotile at 35*C

A

-Shigella
-Klebsiella
-Yersinia (motile at 22*C)

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593
Q

Appearance of Enterobacterales on selected media - Escherichia coli - TSI

A

A/A, gas

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594
Q

Appearance of Enterobacterales on selected media - Escherichia coli - MAC

A

flat, dry pink colony with darker pink halo

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595
Q

Appearance of Enterobacterales on selected media - Escherichia coli - HE

A

yellow

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596
Q

Appearance of Enterobacterales on selected media - Escherichia coli - XLD

A

yellow

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597
Q

Appearance of Enterobacterales on selected media - Shigella - TSI

A

K/A

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598
Q

Appearance of Enterobacterales on selected media - Shigella - MAC

A

colorless

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599
Q

Appearance of Enterobacterales on selected media - Shigella - HE

A

green

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600
Q

Appearance of Enterobacterales on selected media - Shigella - XLD

A

colorless

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601
Q

Appearance of Enterobacterales on selected media - Edwardsiella - TSI

A

K/A, gas, H2S

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602
Q

Appearance of Enterobacterales on selected media - Edwardsiella - MAC

A

colorless

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603
Q

Appearance of Enterobacterales on selected media - Edwardsiella - HE

A

colorless

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604
Q

Appearance of Enterobacterales on selected media - Edwardsiella - XLD

A

red, yellow, or colorless with or without black centers

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605
Q

Appearance of Enterobacterales on selected media - Citrobacter - TSI

A

A/A or K/A, gas, with or without H2S

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606
Q

Appearance of Enterobacterales on selected media - Citrobacter - MAC

A

-colorless at 24 hrs
-may become pink at 48 hrs

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607
Q

Appearance of Enterobacterales on selected media - Citrobacter - HE

A

colorless

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608
Q

Appearance of Enterobacterales on selected media - Citrobacter - XLD

A

red, yellow, or colorless with or without black centers

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609
Q

Appearance of Enterobacterales on selected media - Salmonella - TSI

A

K/A, gas, H2S

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610
Q

Appearance of Enterobacterales on selected media - Salmonella - MAC

A

colorless

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611
Q

Appearance of Enterobacterales on selected media - Salmonella - HE

A

green

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612
Q

Appearance of Enterobacterales on selected media - Salmonella - XLD

A

red with black center

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613
Q

Appearance of Enterobacterales on selected media - Klebsiella - TSI

A

A/A, gas

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614
Q

Appearance of Enterobacterales on selected media - Klebsiella - MAC

A

pink, mucoid

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615
Q

Appearance of Enterobacterales on selected media - Klebsiella - HE

A

yellow

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616
Q

Appearance of Enterobacterales on selected media - Klebsiella - XLD

A

yellow

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617
Q

Appearance of Enterobacterales on selected media - Enterobacter - TSI

A

A/A, gas

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618
Q

Appearance of Enterobacterales on selected media - Enterobacter - MAC

A

pink, may be mucoid

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619
Q

Appearance of Enterobacterales on selected media - Enterobacter - HE

A

yellow

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620
Q

Appearance of Enterobacterales on selected media - Enterobacter - XLD

A

yellow

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621
Q

Appearance of Enterobacterales on selected media - Serratia - TSI

A

K/A

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622
Q

Appearance of Enterobacterales on selected media - Serratia - MAC

A

-colorless at first, turning pink
-S. marcescens may have red pigment at RT

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623
Q

Appearance of Enterobacterales on selected media - Serratia - HE

A

colorless

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624
Q

Appearance of Enterobacterales on selected media - Serratia - XLD

A

yellow or colorless

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625
Q

Appearance of Enterobacterales on selected media - Proteus - TSI

A

-K/A (P. mirabilis)
-A/A (P. vulgaris)
-gas, H2S

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626
Q

Appearance of Enterobacterales on selected media - Proteus - MAC

A

colorless, may swarm

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627
Q

Appearance of Enterobacterales on selected media - Proteus - HE

A

colorless

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628
Q

Appearance of Enterobacterales on selected media - Proteus - XLD

A

yellow or colorless, with or without black centers

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629
Q

Appearance of Enterobacterales on selected media - Morganella - TSI

A

K/A, gas

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630
Q

Appearance of Enterobacterales on selected media - Morganella - MAC

A

colorless

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631
Q

Appearance of Enterobacterales on selected media - Morganella - HE

A

colorless

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632
Q

Appearance of Enterobacterales on selected media - Morganella - XLD

A

red or colorless

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633
Q

Appearance of Enterobacterales on selected media - Providencia - TSI

A

K/A

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634
Q

Appearance of Enterobacterales on selected media - Providencia - MAC

A

colorless

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635
Q

Appearance of Enterobacterales on selected media - Providencia - HE

A

colorless

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636
Q

Appearance of Enterobacterales on selected media - Providencia - XLD

A

yellow or colorless

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637
Q

Appearance of Enterobacterales on selected media - Yersinia - TSI

A

Yellow/orange

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638
Q

Appearance of Enterobacterales on selected media - Yersinia - MAC

A

colorless to peach

639
Q

Appearance of Enterobacterales on selected media - Yersinia - HE

A

salmon

640
Q

Appearance of Enterobacterales on selected media - Yersinia - XLD

A

yellow or colorless

641
Q

Characteristics of non-fermenting gram-negative rods - aerotolerance

A

obligate aerobes

642
Q

Characteristics of non-fermenting gram-negative rods - TSI

A

K/K - they do NOT ferment carbohydrates

643
Q

Characteristics of non-fermenting gram-negative rods - oxidizer/non-oxidizer

A

may be oxidizers or non-oxidizers (asaccharolytic)

644
Q

Characteristics of non-fermenting gram-negative rods - oxidation-fermentation (OF) medium

A

either open tube pos/closed tube neg (oxidizer) OR open tube neg/closed tube neg (non-oxidizer)

645
Q

Characteristics of non-fermenting gram-negative rods - SBA & CHOC

A

grow in 24-48 hours

646
Q

Characteristics of non-fermenting gram-negative rods - MAC

A

appear as non-lactose-fermenters

647
Q

Characteristics of non-fermenting gram-negative rods - oxidase

A

-most are oxidase positive
-differentiates from Enterobacterales

648
Q

Characteristics of non-fermenting gram-negative rods - antibiotic susceptibility

A

resistant to a variety of antibiotics

649
Q

Commonly isolated non-fermenting gram-negative rods - Pseudomonas aeruginosa - pathogenicity

A

-usually not normal flora-important cause of nosocomial infections, e.g., burn, wound, RTI, UTI, bacteremia
-causes SWIMMER’S EAR & contact lens KERATITIS
-predominant respiratory pathogen in patients with CYSTIC FIBROSIS

650
Q

Commonly isolated non-fermenting gram-negative rods - Pseudomonas aeruginosa - gram stain

A

-long, thin, pale-staining GNR
-slightly pointed or rounded ends

651
Q

Commonly isolated non-fermenting gram-negative rods - Pseudomonas aeruginosa - culture

A

SBA:
-flat spreading colonies
-usually beta hemolytic
-dull gray or blue-green
-METALLIC SHEEN

Grows on MAC & EMB (lactose neg)

652
Q

Commonly isolated non-fermenting gram-negative rods - Pseudomonas aeruginosa - key characteristics

A

-oxidase positive
-catalase positive
-motile
-grows at 42*C
-GRAPE-LIKE odor
-only non-fermenter to produce PYOCYANIN (4% don’t)
-also produces pyoverdin (fluorescent pigment)
-resistant to many antibiotics

653
Q

Commonly isolated non-fermenting gram-negative rods - Acinetobacter spp. - pathogenicity

A

-part of normal flora of skin, pharynx in some
-opportunistic pathogen
-nosocomial infections, e.g., UTI, pneumonia, septicemia, meningitis
-2nd to P. aeruginosa in frequency
-most common = A. baumannii

654
Q

Commonly isolated non-fermenting gram-negative rods - Acinetobacter spp. - gram stain

A

-pleomorphic gram-negative coccobacilli (GNCB) in singles, pairs, short chains
-can be confused with N. gonorrhoeae, Moraxella
-may retain crystal violet in broths & direct smears & be confused with GPC

655
Q

Commonly isolated non-fermenting gram-negative rods - Acinetobacter spp. - culture

A

-can grow on most media, including MAC
-some produce purplish colonies (might be mistaken for lactose fermenter)

656
Q

Commonly isolated non-fermenting gram-negative rods - Acinetobacter spp. - key characteristics

A

-oxidase negative (differentiates from N. gonorrhoeae)
-catalase positive
-non-motile
-resistant to many antibiotics

657
Q

Commonly isolated non-fermenting gram-negative rods - Stenotrophomonas maltophilia - pathogenicity

A

-NOT part of normal flora
-common cause of wound infections from agricultural machinery
-colonizes immunocompromised patients
-common in hospital
-nosocomial infections, e.g., pneumonia

658
Q

Commonly isolated non-fermenting gram-negative rods - Stenotrophomonas maltophilia - gram stain

A

straight or slightly curved slender GNR in singles or pairs

659
Q

Commonly isolated non-fermenting gram-negative rods - Stenotrophomonas maltophilia - culture

A

SBA:
-large, non-hemolytic
-may be light yellow
-agar may have lavender-green discoloration in areas of heavy growth

Grows on MAC

660
Q

Commonly isolated non-fermenting gram-negative rods - Stenotrophomonas maltophilia - key characteristics

A

-most often oxidase negative
-catalase positive
-motile
-rapid oxidation of maltose
-weaker oxidation of glucose
-AMMONIA odor
-resistant to many antibiotics
-disk diffusion can give false results
-broth dilution recommended

661
Q

Campylobacter & Helicobacter - Campylobacter jenuni - pathogenicity

A

-most common cause of bacterial diarrhea
-sources of infection: chickens, raw milk, pets

662
Q

Campylobacter & Helicobacter - Campylobacter jenuni - gram stain

A

-curved, slender, gram negative rods
-“GULL WING-shaped”
-loose spirals
-S shaped
-stain faintly

663
Q

Campylobacter & Helicobacter - Campylobacter jenuni - culture

A

-microaerophilic & capnophilic
-grow on CAMPY-BAP at 42C in increased CO2 (can grow at 37C; normal enteric flora inhibited by 42*C incubation)
-slow growing - hold plate 3 days
-NAATs can be used for faster ID

664
Q

Campylobacter & Helicobacter - Campylobacter jenuni - key characteristics

A

-DARTING CORKSCREW motility
-oxidase positive
-catalase positive
-hippurate hydrolysis positive

665
Q

Campylobacter & Helicobacter - Campylobacter coli - pathogenicity

A

-similar to C. jejuni, but less severe
-usually foodborne

666
Q

Campylobacter & Helicobacter - Campylobacter coli - gram stain

A

-curved, slender GNR
-“GULL WING-shaped”
-loose spirals
-S shaped
-stain faintly

667
Q

Campylobacter & Helicobacter - Campylobacter coli - culture

A

-microaerophilic & capnophilic
-grow on CAMPY-BAP at 42C in increased CO2 (can grow at 37C; normal enteric flora inhibited by 42*C incubation)
-slow growing - hold plate 3 days
-NAATs can be used for faster ID

668
Q

Campylobacter & Helicobacter - Campylobacter coli - key characteristics

A

-hippurate hydrolysis NEGATIVE
-a MALDI-TOF can be used to differentiate from C.jejunu

669
Q

Campylobacter & Helicobacter - Campylobacter fetus - pathogenicity

A

-causes bacteremia in immunocompromised & elderly
-uncommon stool isolate

670
Q

Campylobacter & Helicobacter - Campylobacter fetus- gram stain

A

-curved, slender, gram negative rods
-“GULL WING-shaped”
-loose spirals
-S shaped
-stain faintly

671
Q

Campylobacter & Helicobacter - Campylobacter fetus- culture

A

-most often isolated in blood cultures
-hold for 2 weeks
-inhibited on Campy agar
-grows on routine media at 37C but NOT at 42C

672
Q

Campylobacter & Helicobacter - Campylobacter fetus - key characteristics

A

-oxidase positive
-catalase positive
-hippurate hydrolysis NEGATIVE

673
Q

Campylobacter & Helicobacter - Helicobacter pylori - pathogenicity

A

-gastritis
-duodenal & peptic ulcers
-possible risk factor for gastric carcinoma

674
Q

Campylobacter & Helicobacter - Helicobacter pylori - gram stain

A

-curved, slender, GNR

675
Q

Campylobacter & Helicobacter - Helicobacter pylori - culture

A

-grows on non-selective media incubated at 37C in same atmosphere as Campy
-does NOT grow at 42C
-slow growing

676
Q

Campylobacter & Helicobacter - Helicobacter pylori - key characteristics

A

-rarely cultured
-rapid urease tests on gastric biopsy, urea breath test, histology, PCR, serology, and ELISA all can be used for ID

677
Q

Vibrio and related organisms - Vibrio cholerae - pathogenicity

A

-Cholera (acute diarrhea, dehydration, electrolyte imbalance)
-transmitted by contaminated water, seafood
-uncommon in the US, but may be seen in coastal areas

678
Q

Vibrio and related organisms - Vibrio cholerae - gram stain

A

-small, COMMA-shaped GNR in direct smears
-straight pleomorphic GNR in culture

679
Q

Vibrio and related organisms - Vibrio cholerae - culture

A

-non-halophilic (doesn’t require NaCl for growth)
-grows on SBA, CHOC, MAC (NLF)
-large yellow colonies on TCBS (ferments sucrose)
-alkaline peptone water can be used for enrichment

680
Q

Vibrio and related organisms - Vibrio cholerae - key characteristics

A

-“RICE WATER” stools
-oxidase positive
-serological ID with anti sera to O ag.
-01 & 0139 strains cause epidemics
-01 strains are divided into 2 serotypes (Inaba and Ogawa) and 2 biotypes (El Tor and classical)

681
Q

Vibrio and related organisms - Vibrio vulnificus - pathogenicity

A

-2nd most serious type of vibrio infection
-causes primary septicemia and wound infections most often following consumption of raw oysters
-patients usually have preexisting conditions such as liver disease or immunosuppression
-seen in the US

682
Q

Vibrio and related organisms - Vibrio vulnificus - gram stain

A

Straight or curved GNR

683
Q

Vibrio and related organisms - Vibrio vulnificus - culture

A

-HALOPHILIC (salt-loving, requires addition of sodium)
-most are green on TCBS; some are yellow
-May look like enteric on MAC because some are lactose positive

684
Q

Vibrio and related organisms - Vibrio vulnificus - key characteristics

A

-oxidase positive
-motile

685
Q

Vibrio and related organisms - Vibrio parahaemolyticus - pathogenicity

A

-most common cause of bacterial foodborne intestinal infection in Asia
-contaminated seafood
-water-associated wound infections
-seen in US

686
Q

Vibrio and related organisms - Vibrio parahaemolyticus - gram stain

A

straight or curved GNR

687
Q

Vibrio and related organisms - Vibrio parahaemolyticus - culture

A

-requires 1% NaCl for growth
-grows on SBA, MAC (NLF)
-blue-green colonies on TCBS (doesn’t ferment sucrose)

688
Q

Vibrio and related organisms - Vibrio parahaemolyticus - key characteristics

A

-oxidase positive
-motile

689
Q

Vibrio and related organisms - Aeromonas spp. - pathogenicity

A

-gastroenteritis & wound infections, often related to aquatic exposure
-septicemia
-meningitis

690
Q

Vibrio and related organisms - Aeromonas spp. - gram stain

A

straight or curved GNR with rounded ends

691
Q

Vibrio and related organisms - Aeromonas spp. - culture

A

-grows on routine media
-most are beta-hemolytic on SBA
-NLF on MAC
-does NOT grow on TCBS
-CIN agar & APW can be used for selective isolation

692
Q

Vibrio and related organisms - Aeromonas spp. - key characteristics

A

-oxidase positive
-motile
-NAATs and MALDI-TOF can be used for ID

693
Q

Vibrio and related organisms - Plesiomonas shigelloides - pathogenicity

A

-gastroenteritis from contaminated water or seafood
-bacteremia & meningitis in immunocompromised & neonates

694
Q

Vibrio and related organisms - Plesiomonas shigelloides - gram stain

A

pleomorphic GNR in singles, pairs, short chains, or long filaments

695
Q

Vibrio and related organisms - Plesiomonas shigelloides - culture

A

-grows on SBA, CHOC
-most grow on MAC, appear as NLF
-does NOT arrow on TCBS

696
Q

Vibrio and related organisms - Plesiomonas shigelloides - key characteristics

A

-biochemical & antigenic similarities to Shigella
-oxidase positive
-motile

697
Q

Haemophilus - H. influenzae - pathogenicity

A

-normal flora of upper respiratory tract
-causes: sinusitis, otitis media, pneumonia, bronchitis, often in elderly & immunocompromised
-type b - common cause of pneumonia & meningitis in children where Hib vaccine not available

698
Q

Haemophilus - H. influenzae - gram stain

A

-small, pleomorphic GNCB to long filaments
-capsules may be seen

699
Q

Haemophilus - H. influenzae - culture

A

-grows on CHOC in 5-10% CO2
-medium for optimum recovery should contain at least 10 mcg/mL of free X and V factors
-translucent, moist, tannish colonies
-encapsulated strains form larger & more mucoid colonies
-MOUSY or BLEACH-like odor
-may demonstrate SATELLITISM with staph on SBA

700
Q

Haemophilus - H. influenzae:
-porphyrin & porphobilinogen
-NAATs

A

-porphyrin & porphobilinogen negative
-NAATs can be used to detect from CSF, plasma, serum, and whole blood

701
Q

Haemophilus - H. influenzae biotype aegyptius & H. aegyptius - pathogenicity

A

-both cause conjunctivitis (pink eye)
-H. influenzae biotype aegyptius also causes Brazilian purpuric fever

702
Q

Haemophilus - H. influenzae biotype aegyptius & H. aegyptius - gram stain

A

-small, pleomorphic GNCB to long filaments
-capsules may be seen

703
Q

Haemophilus - H. influenzae biotype aegyptius & H. aegyptius - culture

A

-grows on CHOC in 5-10% CO2
-medium for optimum recovery should contain at least 10 mcg/mL of free X and V factors
-translucent, moist, tannish colonies
-encapsulated strains form larger & more mucoid colonies
-MOUSY or BLEACH-like odor
-may demonstrate SATELLITISM with staph on SBA

704
Q

Haemophilus - H. influenzae biotype aegyptius & H. aegyptius:
-characteristics are similar to?

A

-characteristics are similar to H. influenzae
-difficult to differentiate unless molecular methods are employed

705
Q

Haemophilus - H. parainfluenzae, H. haemolyticus, & H. parahaemolyticus - pathogenicity

A

-normal flora of upper respiratory tract
-low incidence of pathogenicity

706
Q

Haemophilus - H. parainfluenzae, H. haemolyticus, & H. parahaemolyticus - gram stain

A

small, pleomorphic GNCB to long filaments

707
Q

Haemophilus - H. parainfluenzae, H. haemolyticus, & H. parahaemolyticus - culture

A

colonies are larger, dry, & tannish

708
Q

Haemophilus - H. parainfluenzae, H. haemolyticus, & H. parahaemolyticus - which species is porphyrin positive?

A

H. parainfluenzae

709
Q

Haemophilus - H. ducreyi - pathogenicity

A

-NEVER normal flora
-causes chancroid (STD)
-rare

710
Q

Haemophilus - H. ducreyi - gram stain

A

-small GNCB
-bipolar staining
-may resemble SCHOOL OF FISH or RAILROAD TRACKS

711
Q

Haemophilus - H. ducreyi - culture

A

difficult to culture without the use of many growth factors in the media

(can identify by PCR)

712
Q

Speciation of Haemophilus - H. influenzae & H. aegyptius:
-requires X factor (hemin)?
-requires V factor (NAD)?
-hemolysis on rabbit or horse blood agar/
-porphyrin/delta-aminolevulinic acid (ALA)?

A

-X factor? YES
-V factor? YES
-hemolysis? NO
-porphyrin/delta-ALA? NO

713
Q

Speciation of Haemophilus - H. parainfluenzae:
-requires X factor (hemin)?
-requires V factor (NAD)?
-hemolysis on rabbit or horse blood agar/
-porphyrin/delta-aminolevulinic acid (ALA)?

A

-X factor? NO
-V factor? YES
-hemolysis? NO
-porphyrin/delta-ALA? YES

714
Q

Speciation of Haemophilus - H. haemolyticus:
-requires X factor (hemin)?
-requires V factor (NAD)?
-hemolysis on rabbit or horse blood agar/
-porphyrin/delta-aminolevulinic acid (ALA)?

A

-X factor? YES
-V factor? YES
-hemolysis? YES
-porphyrin/delta-ALA? NO

715
Q

Speciation of Haemophilus - H. parahaemolyticus:
-requires X factor (hemin)?
-requires V factor (NAD)?
-hemolysis on rabbit or horse blood agar/
-porphyrin/delta-aminolevulinic acid (ALA)?

A

-X factor? NO
-V factor? YES
-hemolysis? YES
-porphyrin/delta-ALA? YES

716
Q

Speciation of Haemophilus - H. parahaemolyticus:
-requires X factor (hemin)?
-requires V factor (NAD)?
-hemolysis on rabbit or horse blood agar/
-porphyrin/delta-aminolevulinic acid (ALA)?

A

-X factor? YES
-V factor? NO
-hemolysis? NO
-porphyrin/delta-ALA? NO

717
Q

Misc. gram-negative rods - Bartonella - pathogenicity

A

-trench fever
-relapsing fever
-bacteremia
-endocarditis
-CAT-SCRATCH disease

718
Q

Misc. gram-negative rods - Bartonella - gram stain

A

gram-negative pleomorphic rods

719
Q

Misc. gram-negative rods - Bartonella - culture

A

-not practical
-takes 9-40 days to grow
-requires heme for growth

720
Q

Misc. gram-negative rods - Bartonella - key characteristics

A

-identify by nucleic acid technique

721
Q

Misc. gram-negative rods - Bordetella pertussis - pathogenicity

A

-whooping cough in children and adults
-DTaP vaccine is available

722
Q

Misc. gram-negative rods - Bordetella pertussis - gram stain

A

small GNCB

723
Q

Misc. gram-negative rods - Bordetella pertussis - culture

A

grows on Bordet-Gengou & Regan-Lowe (charcoal, horse’s blood) after 3-7 days

724
Q

Misc. gram-negative rods - Bordetella pertussis - key characteristics

A

MALDI-TOF or agglutination with specific antibodies for ID

725
Q

Misc. gram-negative rods - Brucella - pathogenicity

A

-Brucellosis (undulent fever)
-from unpasteurized milk or contact with infected goats, cows, hogs, dogs

726
Q

Misc. gram-negative rods - Brucella - gram stain

A

tiny, faintly staining GNCB

727
Q

Misc. gram-negative rods - Brucella - culture

A

-most often isolated from blood cultures or biopsies of reticuloendothelial (RE) tissue
-blood cultures incubated in increased CO2 for 3 weeks
-culture is not sensitive

728
Q

Misc. gram-negative rods - Brucella - key characteristics

A

-oxidase positive
-catalase positive
-urease positive
-potential bioterrorism agent
-reportable disease
-slide agglutination test with specific antibodies used for ID

729
Q

Misc. gram-negative rods - Francisella - pathogenicity

A

-Tularemia (rabbit fever)
-human infected by tick or handling infected animal

730
Q

Misc. gram-negative rods - Francisella - gram stain

A

-pale staining, small, pleomorphic, INTRACELLULAR GNCB with bipolar staining

731
Q

Misc. gram-negative rods - Francisella - culture

A

-grows on special media enriched with glucose & cystine (e.g., blood cystine glucose agar), Thayer-Martin (TM), & BCYE
-small, transparent colonies after 3 days

732
Q

Misc. gram-negative rods - Francisella - key characteristics

A

-level 3 pathogen
-direct fluorescent antibody methods for ID
-send to public health lab for confirmation

733
Q

Misc. gram-negative rods - Gardnerella - pathogenicity

A

-normal flora of female genital tract
-associated with bacterial vaginosis (BV) when it & anaerobic GNR are predominant & Lactobacillus is absent
-linked to maternal & neonatal infections, bacteremia, rarely UTI

734
Q

Misc. gram-negative rods - Gardnerella - gram stain

A

small, pleomorphic gram-variable rods

735
Q

Misc. gram-negative rods - Gardnerella - culture

A

-not recommended for diagnosis of BV
-grows on SBA, PEA, CNA, human blood Tween (HBT) agar, V agar
-produces diffuse beta hemolysis only on media containing human blood
-requires increased CO2 & 48-72 hour incubation

736
Q

Misc. gram-negative rods - Gardnerella - key characteristics

A

-catalase negative
-oxidase negative
-tests for Dx of BV: CLUE CELLS (vaginal epithelial cells covered with gram-variable rods), whiff test (10% KOH added to vaginal secretion => fish-like odor)

737
Q

Misc. gram-negative rods - Legionella - pathogenicity

A

-Legionnaire disease
-Pontiac fever
-found in water (e.g., air conditioners, shower-heads, whirlpools)
-contracted by inhalation of aerosol

738
Q

Misc. gram-negative rods - Legionella - gram stain

A

small, pleomorphic, weakly staining GNR (sometimes filamentous)

739
Q

Misc. gram-negative rods - Legionella - culture

A

-grows on BCYE in 3-4 days
-pale yellow-green fluorescence with WOOL LAMP

740
Q

Misc. gram-negative rods - Legionella - key characteristics

A

-oxidase positive
-ID by immunofluorescent stain or agglutination methods
-MALDI-TOF can also be used

741
Q

Misc. gram-negative rods - Pasteurella multicoda - pathogenicity

A

-contracted by bite or scratch of cat or dog or contact with infected carcass
-wound & soft tissue infection

742
Q

Misc. gram-negative rods - Pasteurella multicoda - gram stain

A

pleomorphic GNCB with bipolar staining

743
Q

Misc. gram-negative rods - Pasteurella multicoda - culture

A

-grows on SBA & CHOC, but NOT MAC
-MUSTY odor

744
Q

Misc. gram-negative rods - Pasteurella multicoda - key characteristics

A

-oxidase positive
-catalase positive
-indole positive
-weak oxidase reaction after 30 minutes of being characteristic of Pasteurella
-MALDI-TOF can also be used for ID

745
Q

Specimens for anaerobic culture - bile - acceptable or unacceptable?

A

Acceptable

746
Q

Specimens for anaerobic culture - blood - acceptable or unacceptable?

A

Acceptable

747
Q

Specimens for anaerobic culture - body fluids - acceptable or unacceptable?

A

Acceptable

748
Q

Specimens for anaerobic culture - bone marrow - acceptable or unacceptable?

A

Acceptable

749
Q

Specimens for anaerobic culture - percutaneous lung aspirate or biopsy - acceptable or unacceptable?

A

Acceptable

750
Q

Specimens for anaerobic culture - suprapubic bladder aspirates - acceptable or unacceptable?

A

Acceptable

751
Q

Specimens for anaerobic culture - tissue - acceptable or unacceptable?

A

Acceptable

752
Q

Specimens for anaerobic culture - transtracheal aspirate - acceptable or unacceptable?

A

Acceptable

753
Q

Specimens for anaerobic culture - wound - acceptable or unacceptable?

A

Acceptable

754
Q

Specimens for anaerobic culture - expectorated sputum - acceptable or unacceptable?

A

Unacceptable

755
Q

Specimens for anaerobic culture - feces - acceptable or unacceptable?

A

Unacceptable

756
Q

Specimens for anaerobic culture - gastric juice - acceptable or unacceptable?

A

Unacceptable

757
Q

Specimens for anaerobic culture - swabs - acceptable or unacceptable?

A

Unacceptable

758
Q

Specimens for anaerobic culture - voided or catheterized urine - acceptable or unacceptable?

A

Unacceptable

759
Q

Specimens for anaerobic culture - bronchial washings (unless obtained with double lumen plugged catheter) - acceptable or unacceptable?

A

Unacceptable

760
Q

Media for culture of anaerobes - Anaerobic blood agar-CDC - use? contains?

A

-non-selective enrichment medium that grows obligate & facultative anaerobes
-contains yeast extract, L-cysteine, hemin, & vitamin K

761
Q

Media for culture of anaerobes - Bacteroides bile-esculin (BBE) agar - use? contains? function? B. fragilis colonies?

A

-selective differential medium for Baceteroides fragilis
-bile salts & gentamicin act as inhibitors
-B. fragilis colonies are black with dark halos due to esculin hydrolysis

762
Q

Media for culture of anaerobes - Brucella blood agar - use?

A

enrichment medium that grows obligate & facultative anaerobes

763
Q

Media for culture of anaerobes - CNA blood agar - use?

A

selective medium that grows obligate anaerobes & GP facultative anaerobes

764
Q

Media for culture of anaerobes - Cycloserine cefoxitin fructose egg yolk (CCFA) agar - use? colonies? fluorescence?

A

-selective & differential for Clostridium difficile
-C. diff colonies are yellow due to fermentation of fructose
-Chartreuse fluorescence

765
Q

Media for culture of anaerobes - Egg-yolk agar (EYA) - use?

A

-for determination of lecithinase & lipase production by clostridia & fusobacteria

766
Q

Media for culture of anaerobes - Kanamycin-vancomycin laked blood (KVLB) agar - use? also known as?

A

-selective medium for isolation of anaerobic GNRs, especially Bacteroides & Prevotella
-also known as laked blood kanamycin-vancomycin (LKV) agar

767
Q

Media for culture of anaerobes - PEA agar - use?

A

-selective medium:
—inhibits enteric GNRs
—grows obligate anaerobes & GP facultative anaerobes

768
Q

Media for culture of anaerobes - Thioglycolate (THIO) broth - use? function? growth? storage? requirements before use?

A

-all-purpose medium that supports growth of most aerobes & anaerobes; can be used as backup broth to detect organisms present in small numbers or anaerobes
-THIO acts as a reducing agent
-Growth:
—aerobes grow at the top
—strict anaerobes grow at the bottom
—facultative anaerobes grow throughout
-store at RT
-boil & cool before use

769
Q

Methods to identify anaerobes - gram stain - how does it help ID? GN anaerobes & safranin? GP anaerobes?

A

-gram reaction; morphology; presence, location, & shape of spores
-some GN anaerobes stain faintly with safranin; extend time of counter staining to 3-5 minutes or use 0.1% basic fuchsin
-some GP anaerobes, e.g., Clostridium, May stain pink

770
Q

Methods to identify anaerobes - growth on media - how it helps ID

A

-which media organism grows on
-pigmentation
-hemolysis
-colony morphology

771
Q

Methods to identify anaerobes - special-potency antimicrobial disks - how does it help ID

A

-kanamycin, vancomycin, & colistin disks help differentiate anaerobes & ensure that over-decolorized Clostridium is not misidentified as GNR
-the disk is placed on the first quadrant of the plate; after incubation , observe if organism is susceptible or resistant

772
Q

Methods to identify anaerobes - rapid tests - how do they help ID

A

-presumptive ID, e.g., fluorescence; catalase; spot indole; urease; motility; sodium polyanethanol sulfonate (SPS), nitrate, & bile disks; lecithinase, lipase, & proteolytic reaction on EYA

773
Q

Methods to identify anaerobes - conventional tubes biochemicals

A

-test tubes containing variety of media inoculated & incubated in anaerobic environment
-reaction leads to change in pH
-expensive & time consuming
-largely replaced by multitest systems

774
Q

Methods to identify anaerobes - preformed enzyme-based systems

A

-detect preexisting enzymes
-panels or cards are inoculated & incubated in room air
-color changes are read in 4 hours
-code number obtained & ID determined from code book
-only contains codes for most commonly isolated anaerobes

775
Q

Methods to identify anaerobes - gas-liquid chromatography (GLC)

A

-analysis of metabolic end products or cellular fatty acids
-not frequently used

776
Q

Methods to identify anaerobes - 16S ribosomal RNA gene sequencing

A

-DNA extracted from organism, amplified by PCR, sequenced on automated sequencer
-nucleotide sequence compared with known sequences in database

777
Q

Methods to identify anaerobes - MALDI-TOF

A

-extremely sensitive method requiring little sample volume for ID
-the mass spectra generated are compared to known databases

778
Q

Anaerobic gram-positive cocci - Finegoldia magna (formerly Peptostreptococcus magnus) - pathogenicity

A

-normal flora on skin & in mouth, intestines, female genital tract
-most commonly isolated & most pathogenic anaerobic GPC
-associated with skin infections, decubitus ulcers, septic arthritis, bone infection following orthopedic surgery, oral & female genital tract infections, bacteremia

779
Q

Anaerobic gram-positive cocci - Finegoldia magna (formerly Peptostreptococcus magnus) - gram stain

A

-GPC in singles, pairs, retreads, clusters
-resembles staph

780
Q

Anaerobic gram-positive cocci - Finegoldia magna (formerly Peptostreptococcus magnus) - characteristics

A

-small colonies
-May take 48 hours to grow
-catalase negative
-indole negative
-resistant to SPS

781
Q

Anaerobic gram-positive cocci - Peptostreptococcus anaerobius - pathogenicity

A

-normal flora on skin& mouth, GI, & genitourinary (GU) tracts
-mixed infections of skin, soft tissues, GI tract, female genital tract, bones, joints, lungs, brain

782
Q

Anaerobic gram-positive cocci - Peptostreptococcus anaerobius - gram stain

A

-tiny GPC in chains
-resembles strep

783
Q

Anaerobic gram-positive cocci - Peptostreptococcus anaerobius - characteristics

A

-small gray-white colonies in 24-48 hours
-SWEET odor
-sensitive to SPS

784
Q

Anaerobic gram-positive cocci - Peptoniphilus asaccharolyticus (formerly *Peptostreptococcus assaccharolyticus) - pathogenicity

A

-normal on skin & in GI & GU tracts
-associated with obstetric & gynecological infections

785
Q

Anaerobic gram-positive cocci - Peptoniphilus asaccharolyticus (formerly *Peptostreptococcus assaccharolyticus) - characteristics

A

-yellow colonies
-MUSTY odor
-resistant to SPS
-indole positive

786
Q

Anaerobic gram-positive cocci - Peptoniphilus asaccharolyticus (formerly *Peptostreptococcus assaccharolyticus) - gram stain

A

-GPC in pairs, short chains, tetrads, clusters
-some strains decolorize easily and can be confused with gram-negative anaerobes

787
Q

Anaerobic gram-positive rods - Actinomyces - pathogenicity

A

-normal inhabitants of mucosal surfaces throughout the body
-infects brain, face, lungs, genitals

788
Q

Anaerobic gram-positive rods - Actinomyces - gram stain

A

-short or long gram-positive rods (GPR)
-branched or unbranched
-BANDED appearance
-can break into club-shaped rods resembling diphtheroids

789
Q

Anaerobic gram-positive rods - Actinomyces - characteristics

A

-sulfur granules may be seen in discharge
-crush & stain to reveal characteristic gram-stain morphology
-“MOLAR TOOTH” colonies

790
Q

Anaerobic gram-positive rods - *Clostridium botulinum * - pathogenicity

A

-botulism due to ingestion of toxin in inadequately cooked or improperly canned foods
-infant botulism due to ingestion of spores in honey
-wound botulism from injection drug use

791
Q

Anaerobic gram-positive rods - *Clostridium botulinum * - gram stain

A

-GPR with oval subterminal spores

792
Q

Anaerobic gram-positive rods - *Clostridium botulinum * - characteristics

A

-reportable disease
-toxin testing at public health labs

793
Q

Anaerobic gram-positive rods - Clostridioides difficile - pathogenicity

A

-antibiotic-associated diarrhea
-pseudomembranous colitis

794
Q

Anaerobic gram-positive rods - Clostridioides difficile - gram stain

A

-thin GPR
-May form chains
-rare oval subterminal spores

795
Q

Anaerobic gram-positive rods - Clostridioides difficile - characteristics

A

-yellow GROUND GLASS colonies on CCFA
-usually not cultured
-must demonstrate toxin production
-toxins A & B
-tissue culture molecular methods or enzyme immunoassay (EIA) to confirm

796
Q

Anaerobic gram-positive rods - Clostridium perfringens - pathogenicity

A

-normal in GI tract
-causes gas gangrene
-most common bacterial cause in US
-can produce more than 16 different toxins and is classified by toxinotype

797
Q

Anaerobic gram-positive rods - Clostridium perfringens - gram stain

A

-large GPR with BLUNT ends in chains
-“BOX CARS”
-tendency to stain gram negative
-usually no spores seen

798
Q

Anaerobic gram-positive rods - Clostridium perfringens - characteristics

A

-most commonly isolated Clostridium
-double zone of beta hemolysis on SBA

799
Q

Anaerobic gram-positive rods - Clostridium tetani - pathogenicity

A

-causes tetanus
-deep wounds infected with soil

800
Q

Anaerobic gram-positive rods - Clostridium tetani - gram stain

A

-GPR with swollen terminal spores
-“DRUMSTICK”
-“TENNIS RACQUET”
-becomes gram-negative after 24 hours

801
Q

Anaerobic gram-positive rods - Clostridium tetani - characteristics

A

-rare in US because of DTap vaccine but common worldwide
-lab confirmation rarely required

802
Q

Anaerobic gram-positive rods - Cutibacterium (formerly Propionibacterium) - pathogenicity

A

-normal skin flora
-common contaminant of blood cultures
-causes acne
-infections associated with artificial joints, cathethers, shunts, artificial heart valves
-keratitis
-bacteremia
-endocarditis

803
Q

Anaerobic gram-positive rods - Cutibacterium (formerly Propionibacterium) - gram stain

A

-CLUB-shaped, pleomorphic GPR
-diphtheroid-like

804
Q

Anaerobic gram-positive rods - Cutibacterium (formerly Propionibacterium) - characteristics

A

-most common anaerobic GPR
-catalase positive
-indole positive

805
Q

Anaerobic gram-positive rods - Lactobacillus - pathogenicity

A

-normal in mouth, GI tract
-predominant & beneficial flora of vagina during reproductive years
-produces lactic acid, maintains vaginal pH
-absence in vagina predisposes to BV & yeast infections
-rare cause of endocarditis, septicemia in immunocompromised
-

806
Q

Anaerobic gram-positive rods - Lactobacillus - gram stain

A

-pleomorphic, long, thin, non-spore-forming GPR, often in chains
-chains of rods in THIO

807
Q

Anaerobic gram-positive rods - Lactobacillus - characteristics

A

-aerotolerant anaerobes
-grow better under anaerobic conditions
-colonies vary greatly
-may resemble S. viridans
-catalase negative

808
Q

Gram-negative anaerobes - GNC - Veillonella - pathogenicity

A

-normal flora of upper respiratory tract, GI & GU tracts
-usually in mixed culture
-can cause infections in immunocompromised

809
Q

Gram-negative anaerobes - GNC - Veillonella - gram stain

A

-tiny GNDC in pairs, clusters, short chains
-can resemble Neisseria

810
Q

Gram-negative anaerobes - GNC - Veillonella - characteristics

A

-may show weak red fluorescence under UV light
-does NOT grow on KVLB
-usually doesn’t reduce nitrates

811
Q

Gram-negative anaerobes - GNR - Bacteroides fragilis - pathogenicity

A

-main anaerobic organism recovered from intraabdominal infections
-also causes endocarditis
-more virulent and antibiotic resistant than most other anaerobes

812
Q

Gram-negative anaerobes - GNR - Bacteroides fragilis - gram stain

A

pleomorphic, pale, irregularly staining GNR

813
Q

Gram-negative anaerobes - GNR - Bacteroides fragilis - characteristics

A

-resistant to bile
-hydrolyzes esculin
-turns BBE brown

814
Q

Gram-negative anaerobes - GNR - Fusobacterium - pathogenicity

A

-pulmonary infections
-brain abscesses
-oral lesions

815
Q

Gram-negative anaerobes - GNR - Fusobacterium - gram stain

A

-GNR
-F. nucleatum is long & thin with tapered ends (SPINDLE-shaped)

816
Q

Gram-negative anaerobes - GNR - Fusobacterium - characteristics

A

-indole positive
-most fluoresce CHARTREUSE (green-yellow) under UV light

817
Q

Gram-negative anaerobes - GNR - Porphyromonas - pathogenicity

A

head, neck, & pleuropulmonary infections

818
Q

Gram-negative anaerobes - GNR - Porphyromonas - gram stain

A

GNCB

819
Q

Gram-negative anaerobes - GNR - Porphyromonas - characteristics

A

-slow growing
-brown to black on SBA
-some fluoresce brick-red to orange under UV light
-doesn’t grow on KVLB

820
Q

Gram-negative anaerobes - GNR - Prevotella - pathogenicity

A

head, neck, & pleuropulmonary infections

821
Q

Gram-negative anaerobes - GNR - Prevotella - gram stain

A

GNCB

822
Q

Gram-negative anaerobes - GNR - Prevotella - characteristics

A

-slow growing
-some are pigmented
-brown to black on SBA & KVLB
-some fluoresce brick-red to orange under UV light
-doesn’t grow on BBE

823
Q

Laboratory ID of Mycobacteria - lab safety

A

-non-recirculating ventilation system
-negative air pressure
-BS-2 for non-aerosol-producing activities
-BS-3 for manipulation of cultures and susceptibility testing
-electric incinerators instead of flames to sterilize wire loops
-slide-warming trays instead of flames to fix slides
-tuberculocidal disinfectants to clean equipment & BSC (1:10 dilution of household bleach)
-UV light in BSC (only when not in use)
-annual testing of employees for exposure

824
Q

Laboratory ID of Mycobacteria - specimens requiring digestion/decontamination

A

Sputum & other specimens with normal flora such as gastric lavage, urine, feces

825
Q

Laboratory ID of Mycobacteria - specimens NOT requiring digestion/decontamination

A

Tissue or body fluids collected aseptically

826
Q

Laboratory ID of Mycobacteria - digestion/decontamination methods

A

-sodium hydroxide (NaOH) - digestant and decontaminant
-N-acetyl-L-cysteine/NaOH - NALC is a liquefying agent
-benzalkonium chloride
-oxalic acid

827
Q

Laboratory ID of Mycobacteria - staining

A

-cell walls have a high lipid content (mycolic acids)
-difficult to stain
-resist decolorization by acid alcohol (acid-fast)
-gram stain poorly
-use carbolfuchsin or fluorochrome acid-fast stains

828
Q

Laboratory ID of Mycobacteria - media

A

-agar-based (Middlebrook 7H10 & 7H11)
-egg-based (Löwenstein-Jensen, Petragnani, American Thoracic Society)
-liquid (Middlebrook 7H9)
-combination of a solid-based medium & a liquid-based medium recommended for primary isolation

829
Q

Laboratory ID of Mycobacteria - incubation

A

35*C in 5-10% CO2

(EXCEPTION: if M. marinum, M. ulcerans, or M. haemophilum suspected, incubate at 25-30*C)

830
Q

Laboratory ID of Mycobacteria - rate of growth

A

-slow
-on solid media, most require 2-6 weeks incubation
-rapid growers = 2-3 days
-more rapid growth in liquid media

831
Q

Laboratory ID of Mycobacteria - automated systems for recovery

A

-liquid broth inoculated
-placed in blood culture instrument for automatic or continuous monitoring
-growth indicated by consumption of O2 or production of CO2
-Vitek MS is FDA approved & provides fast turnaround time

832
Q

Laboratory ID of Mycobacteria - methods of identification

A

-colony morphology
-growth rate
-optimum temp for growth
-photoreactivity
-biochemical tests
-smear microscopy
-nucleus acid hybridization
-PCR
-automated DNA sequencing
-MALDI-TOF

833
Q

Acid-fast stains - Ziehl-Neelsen:
-primary stain?
-decolorizer?
-counterstain?

A

-Primary stain: Carbolfuchsin
-Decolorizer: acid alcohol
-Counterstain: methylene blue

834
Q

Acid-fast stains - Kinyoun:
-primary stain?
-decolorizer?
-counterstain?

A

-Primary stain: carbolfuchsin
-Decolorizer: acid alcohol
-Counterstain: methylene blue

835
Q

Acid-fast stains - Fluorochrome:
-primary stain?
-decolorizer?
-counterstain?

A

-Primary stain: auramine-rhodamine
-Decolorizer: acid alcohol
-Counterstain: potassium permanganate OR acridine orange

836
Q

Acid-fast stains - Ziehl-Neelsen - appearance of AFB

A

-red, slightly curved, beaded rods (2-8 um)
-blue background

837
Q

Acid-fast stains - Kinyoun - appearance of AFB

A

-red, slightly curved, beaded rods (2-8 um)
-blue background

838
Q

Acid-fast stains - Fluorochrome - appearance of AFB

A

yellow-orange rods against a dark background

839
Q

Acid-fast stains - Ziehl-Neelsen - technique? modification?

A

-requires heat
-examine at least 300 OI fields
-wipe lens after positive smears to avoid cross-contamination & false positives

-can be modified for improved detection by adding cytospin and Triton processing

840
Q

Acid-fast stains - Kinyoun - technique

A

-cold stain
-examine at least 300 OI fields
-wipe lens after positive smears to avoid cross-contamination & false positives

841
Q

Acid-fast stains - Fluorochrome - technique

A

-more sensitive & faster than carbolfuchsin
-can examine at 250X
-read immediately or store at 2-8*C in dark to avoid fading
-examine at least 300 fields
-POSITIVE should be confirmed with carbolfuchsin stain
-rapid 2 minute stain now available

842
Q

Classification of Mycobacteria based on pathogenicity - Mycobacterium tuberculosis complex (“tubercle bacilli”) - pathogenicity

A

cause human tuberculosis

843
Q

Classification of Mycobacteria based on pathogenicity - Mycobacterium tuberculosis complex (“tubercle bacilli”) - species

A

Most predominant:
-M. tuberculosis
-M. bovis
-M. africanum
-M. microti

Others:
-M. canetti
-M. pinnipedii

844
Q

Classification of Mycobacteria based on pathogenicity - Atypical mycobacteria, nontuberculous mycobacteria (NTM), or mycobacteria other than tubercle (MOTT) bacilli - pathogenicity

A

-some cause pulmonary infection similar to TB but not transmitted person to person
-usually in immunocompromised
-contracted from environment (soil, water)

845
Q

Classification of Mycobacteria based on pathogenicity - Atypical mycobacteria, nontuberculous mycobacteria (NTM), or mycobacteria other than tubercle (MOTT) bacilli - species

A

-M. avium
-M. intracellulare
-M. kansaii
-M. malmoense
-M. chelonae
-M. xenopi
-M. gordonae

846
Q

Medically important Mycobacteria - M. tuberculosis - pathogenicity

A

TB

847
Q

Medically important Mycobacteria - M. tuberculosis - characteristics

A

-slow growth
-average recovery time by conventional methods is 21 days
-rough, dry, buff-colored (no pigmentation) colonies
-serpentine cording on smear from culture
-niacin & nitrate positive
-68*C catalase negative

848
Q

Medically important Mycobacteria - M. bovis - pathogenicity

A

causes disease similar to M. tuberculosis and is treated accordingly

849
Q

Medically important Mycobacteria - M. bovis - characteristics

A

-resistant to pyrazinamide
-Bacille Calmette-Guerin (BCG) is attenuated strain used in vaccine in some parts of the world
-causes false-pos purified protein derivative (PPD) test

850
Q

Medically important Mycobacteria - M. africanum - pathogenicity

A

-causes lung infection
-disseminated disease in immunocompromised

851
Q

Medically important Mycobacteria - M. africanum - characteristics

A

-spread by respiratory droplets
-endemic in equatorial Africa
-rare in the US

852
Q

Medically important Mycobacteria - M. avium complex - pathogenicity

A

-most common NTM to cause lung disease in US
-most common systemic bacterial infection in AIDS patients
-cervical lymphadenitis in children

853
Q

Medically important Mycobacteria - M. avium complex - characteristics

A

-M. avium and M. intracellulare most commonly cause lung disease
-contracted from environment

854
Q

Medically important Mycobacteria - M. haemophilum - pathogenicity

A

-skin, joint, bone, lung infections in immunocompromised
-lymphadenitis in children

855
Q

Medically important Mycobacteria - M. haemophilum - characteristics

A

-requires hemin for growth
-grows Best at 28-30*C

856
Q

Medically important Mycobacteria - M. ulcerans - pathogenicity

A

-chronic infection of skin& subcutaneous tissue
-Buruli ulcers

857
Q

Medically important Mycobacteria - M. ulcerans - characteristics

A

-endemic in tropics
-3rd most common mycobacterial disease after TB & leprosy
-grows best at 30*C
-molecular techniques aid ID

858
Q

Medically important Mycobacteria - M. kansaii - pathogenicity

A

-2nd common NTM to cause lung disease
-causes skin& soft tissue infections, lymphadenitis
-can disseminate in immunocompromised

859
Q

Medically important Mycobacteria - M. kansaii - characteristics

A

-often found in tap water
-photochromogen
-can ID by 16sRNA probe

860
Q

Medically important Mycobacteria - M. marinum - pathogenicity

A

skin infections

861
Q

Medically important Mycobacteria - M. marinum - characteristics

A

-contracted from swimming pools, aquariums
-grows best at 28-30*C
-photochromogen

862
Q

Medically important Mycobacteria - M. simiae - pathogenicity

A

-rare but associated with chronic respiratory infection

863
Q

Medically important Mycobacteria - M. simiae - characteristics

A

-difficult to treat due to multi drug resistance (MDR)
-high mortality & morbidity

864
Q

Medically important Mycobacteria - M. gordonae - pathogenicity

A

rarely causes infection (lab contaminant)

865
Q

Medically important Mycobacteria - M. gordonae - characteristics

A

-“tap-water bacillus”
-scotochromogen (does not require light to produce pigment)

866
Q

Medically important Mycobacteria - M. abscessus - pathogenicity

A

-in water, soil, dust
-contaminant of medical devices
-skin & soft tissue infections
-lung infections in those with chronic lung disease, e.g., cystic fibrosis
-disseminated infection in immunocompromised

867
Q

Medically important Mycobacteria - M. abscessus - characteristics

A

-rapid grower
-tap water reservoir

868
Q

Medically important Mycobacteria - M. chelonae - pathogenicity

A

-disseminated cutaneous infections in immunocompromised
-infections of lungs, bone, CNS, prosthetic heart valves

869
Q

Medically important Mycobacteria - M. chelonae - characteristics

A

Rapid grower

870
Q

Medically important Mycobacteria - M. fortuitum - characteristics

A

-rapid grower
-common in environment
-weakly gram positive
-stains with carbolfuchsin, but may not with fluorescent stain

871
Q

Medically important Mycobacteria - M. fortuitum - pathogenicity

A

infection of skin, soft tissues, IV & injection sites, surgical wounds

872
Q

Medically important Mycobacteria - M. leprae - pathogenicity

A

Leprosy (Hansen disease)

873
Q

Medically important Mycobacteria - M. leprae - characteristics

A

-endemic in Southern hemisphere
-<100 cases per year in US
-most cases in Texas, California, Louisiana, Hawaii, Puerto Rico
-armadillos may be reservoir
-doesn’t grow on artificial media
-can be grown in footpads of mice & armadillos
-Dx by acid-fast stain of tissue
-less acid fast than M. tuberculosis

874
Q

Chlamydia and Chlamydophila - Chlamydia trachomatis - pathogenicity

A

-most common STD bacterial infection in US
-trachoma
-lymphogranuloma venereum
-non-gonococcal urethritis
-pelvic inflammatory disease
-pneumonia & conjunctivitis in newborns

875
Q

Chlamydia and Chlamydophila - Chlamydia trachomatis - laboratory diagnosis

A

-Giemsa stain
-direct fluorescent antibody stain
-NAATs (most common)

876
Q

Chlamydia and Chlamydophila - Chlamydia trachomatis - characteristics

A

-obligate intracellular parasite
-need epithelial cells for culture
-wooden swabs are toxic
-NAAT preferred for genital and first-catch urine specimens
-commercial systems available for simultaneous detection of M. gonorrhoeae

877
Q

Chlamydia and Chlamydophila - Chlamydia pneumoniae - pathogenicity

A

3rd most common cause of acute RTI

878
Q

Chlamydia and Chlamydophila - Chlamydia pneumoniae - laboratory diagnosis

A

serological or molecular tests are method of choice

879
Q

Chlamydia and Chlamydophila - Chlamydia pneumoniae - characteristics

A

-obligate intracellular parasite
-risk factor for Guillain-Barre syndrome

880
Q

Chlamydia and Chlamydophila - Chlamydia psittaci - pathogenicity

A

-Psittacosis (“PARROT FEVER”)
-rare in the US

881
Q

Chlamydia and Chlamydophila - Chlamydia psittaci - laboratory diagnosis

A

serological or molecular tests

882
Q

Chlamydia and Chlamydophila - Chlamydia psittaci - characteristics

A

-obligate intracellular parasite
-spread by BIRDS

883
Q

Spirochetes - Borrelia recurrentis - pathogenicity

A

Relapsing fever

884
Q

Spirochetes - Borrelia recurrentis - laboratory diagnosis

A

-Giemsa-or Wright-stained blood smears
-thrombocytopenia is common

885
Q

Spirochetes - Borrelia recurrentis - characteristics

A

-transmitted by ticks & lice
-there are over 20 species in the relapsing fever Borrelia group but B. recurrentis causes the most cases

886
Q

Spirochetes - Borrelia burgdorferi sensu lato - pathogenicity

A

-Lyme disease (erythema chronicum migrans, neurological & cardiac abnormalities, arthritis)

887
Q

Spirochetes - Borrelia burgdorferi sensu lato - laboratory diagnosis

A

-grows on modified Kelly medium
-ELISA is most common method

888
Q

Spirochetes - Borrelia burgdorferi sensu lato - vector

A

Ixodes tick

889
Q

What is the most commonly reported tick-borne infection in the United State?

A

Borrelia burgdorferi (Lyme disease)

890
Q

Spirochetes - Treponema pallidum subspecies pallidum - pathogenicity

A

Syphilis

891
Q

Spirochetes - Treponema pallidum subspecies pallidum -laboratory diagnosis

A

-doesn’t grow on artificial media
-darkfield microscopy, fluorescent stain
-serology (EIA) is most common method

892
Q

Spirochetes - Leptospira interrogans - pathogenicity

A

Weil disease (infectious jaundice, leptospirosis)

893
Q

Spirochetes - Leptospira interrogans - laboratory diagnosis

A

-PCR or serological tests
-can culture: growth = turbidity below surface of semisolid media such as Ellinghausen-McCullough-Johnson-Harris (EMJH)
-hold cultures for 13 weeks

894
Q

Spirochetes - Leptospira interrogans - characteristics

A

-zoonotic disease
-transmitted by urine of infected animal
-organism in blood & CSF during first week, then urine
-common in tropical regions

895
Q

Mycoplasma/Ureaplasma - Mycoplasma pneumoniae - pathogenicity

A

primary atypical pneumonia (walking pneumonia)

896
Q

Mycoplasma/Ureaplasma - Mycoplasma pneumoniae - characteristics

A

-smallest free-living cells
-LACK CELL WALL
-pleomorphic
-not visible by Gram staining
-difficult to grow
-culture rarely performed
-may take 21 days or more
-usually Dx by serology

897
Q

Mycoplasma/Ureaplasma - Mycoplasma hominis - pathogenicity

A

urogenital tract disease

898
Q

Mycoplasma/Ureaplasma - Mycoplasma hominis - characteristics

A

-only species that will grow on SBA & CHOC but may require 4 days
-PINPOINT translucent colonies easily overlooked
-“FRIED-EGG” colonies seen with stereomicroscope after staining with methylene blue
-serological methods available

899
Q

Mycoplasma/Ureaplasma - Ureaplasma urealyticum - pathogenicity

A

urogenital tract disease

900
Q

Mycoplasma/Ureaplasma - Ureaplasma urealyticum - characteristics

A

-granular brown appearance on A8 agar because of urease production
-serological methods available

901
Q

Rickettsia, Ehrlichia, and Coxiella - Rickettsia - pathogenicity

A

-Rocky mountain spotted fever
-rickettsial pox
-epidemic typhus
-murine typhus
-scrub typhus

902
Q

Rickettsia, Ehrlichia, and Coxiella - Rickettsia - laboratory diagnosis

A

-don’t grow on artificial media
-grow in lice, ticks, tissue culture, eggs
-usually Dx by serology
-immunohistologic & molecular methods available

903
Q

Rickettsia, Ehrlichia, and Coxiella - Rickettsia - characteristics

A

-obligate intracellular parasite
-transmitted by ticks, mites, lice, fleas
-Rocky mountain spotted fever is most common rickettsial infection in the US - caused by R. rickettsii
-BSL-3 biohazard

904
Q

Rickettsia, Ehrlichia, and Coxiella - Coxiella - pathogenicity

A

Q fever

905
Q

Rickettsia, Ehrlichia, and Coxiella - Coxiella - laboratory diagnosis

A

-usual Dx by NAATs and serology
-IFA and imaging available

906
Q

Rickettsia, Ehrlichia, and Coxiella - Coxiella - characteristics

A

-obligate intracellular parasite
-zoonotic disease
-found in cattle, sheep, goats
-highly contagious
-BSL-3 biohazard
-reportable disease
-potential bioterrorism agent

907
Q

Rickettsia, Ehrlichia, and Coxiella - Ehrlichia - pathogenicity

A

Ehrlichiosis

908
Q

Rickettsia, Ehrlichia, and Coxiella - Ehrlichia - laboratory diagnosis

A

-morulae (clusters of organisms that resemble blackberry) in WBCs
-usual Dx by serology, molecular amplification, and blood smear examination

909
Q

Rickettsia, Ehrlichia, and Coxiella - Ehrlichia - characteristics

A

-obligate intracellular parasites
-infects WBCs
-transmitted by ticks
-disease similar to Rocky Mountain spotted fever

910
Q

Routine culture setup and interpretation - Throat/nasopharynx - media

A

-SBA
-CHOC
-Streptococcus-selective agar may be used

911
Q

Routine culture setup and interpretation - Throat/nasopharynx - normal flora

A

-alpha & gamma strep
-commensal Neisseria
-CNS
-diphtheroids
-S. pneumoniae
-Candida

912
Q

Routine culture setup and interpretation - Throat/nasopharynx - common pathogens

A

-GAS (S. pyogenes)

913
Q

Routine culture setup and interpretation - Throat/nasopharynx - diagnosis

A

-stab streaking to detect beta strep that only produce streptolysin-O
-direct antigen tests for GAS
-negative result should be cultured

914
Q

Routine culture setup and interpretation - Sputum, bronchial washings/aspirates, transtracheal aspirates - media

A

-SBA
-CHOC
-MAC

915
Q

Routine culture setup and interpretation - Sputum, bronchial washings/aspirates, transtracheal aspirates - normal flora

A

-CNS
-non-beta hemolytic strep
-diphtheroids
-commensal Neisseria
-Haemophilus
-yeast

-ASPIRATES: none

916
Q

Routine culture setup and interpretation - Sputum, bronchial washings/aspirates, transtracheal aspirates - common pathogens

A

-S. pneumoniae
-H. influenzae
-S. aureus
-Enterobacterales
-Pseudomonas
-M. catarrhalis
-C. albicans

917
Q

Routine culture setup and interpretation - Sputum, bronchial washings/aspirates, transtracheal aspirates - diagnosis

A

-gram stain
-acceptable sputum:
–<10 epi cells/LPF
–>25 seg. neutrophils/LFP

-NOTE: neutropenic patients may not produce seg. neutrophils

918
Q

Routine culture setup and interpretation - Urines - media

A

-SBA
-MAC

Use 0.01 mL or 0.001 mL calibrated loop

919
Q

Routine culture setup and interpretation - Urines - normal flora

A

-clean catch: few skin flora
-catheterized or aspirate: NONE

920
Q

Routine culture setup and interpretation - Urines - common pathogens

A

-E. coli
-Klebsiella
-Enterobacter
-Proteus
-Pseudomonas
-S. aureus
-S. saprophyticus
-CNS
-GBS

921
Q

Routine culture setup and interpretation - Urines - diagnosis

A

-rapid screen for UTI: 1 or more bacteria/OI field on Gram stain of uncentrifuged urine
-low counts are significant in catheterized urines & aspirates
-3 or more organisms with none predominant = probable contamination

922
Q

Routine culture setup and interpretation - Stool - media

A

-SBA
-MAC
-EMB
-XLD or HE
-Campy blood
-possible CIN and/or TCBS

923
Q

Routine culture setup and interpretation - Stool - normal flora

A

-anaerobes
-Enterobacterales
-enterococci
-strep
-yeast

924
Q

Routine culture setup and interpretation - Stool - common pathogens

A

-Salmonella
-Shigella
-Campylobacter
-diarrheagenic E. coli
-Aeromonas
-Plesiomonas
-Y. enterocolitica
Vibrio

925
Q

Routine culture setup and interpretation - Stool - diagnosis

A

-seg. neutrophils = invasive diarrhea; e.g., Salmonella, Shigella, Campylobacter, EIEC, C. difficile

-no seg. neutrophils = enterotoxin-mediated diarrhea; e.g., ETEC, Vibrio

-RBCs with EHEC

926
Q

Routine culture setup and interpretation - Genital - media

A

-SBA
-CHOC
-MAC
-Thayer-Martin
-add THIO & anaerobic media for tissue & aspirates

927
Q

Routine culture setup and interpretation - Genital - normal flora

A

-Urethra: CNS, diphtheroids
-Vagina, pre-pubescent/postmenopausal: yeast, GNR, GPC
-Vagina, reproductive years: Lactobacillus, PGC
-Surgical/aspirates: NONE

928
Q

Routine culture setup and interpretation - Genital - common pathogens

A

-N. gonorrhoeae
-C. albicans
-GBS
-S. aureus

-Surgical/aspirates: also anaerobes

929
Q

Routine culture setup and interpretation - Genital - diagnosis

A

Gram stain

930
Q

Routine culture setup and interpretation - CSF - media

A

-SBA
-CHOC
-MAC
-some add THIO

931
Q

Routine culture setup and interpretation - CSF - normal flora

A

NONE

932
Q

Routine culture setup and interpretation - CSF - common pathogens

A

-GBS (infants)
-Listeria (infants, elderly)
-H. influenzae (unimmunized children)
-N. meningitidis
-*S. pneumoniae
-GNR

Any isolate is significant.

933
Q

Routine culture setup and interpretation - CSF - diagnosis

A

-use tube 2
-handle STAT
-DO NOT refrigerate
-use of cytocentrifuge to concentrate specimen increases sensitivity of Gram stain
-ID all isolates

934
Q

Routine culture setup and interpretation - Blood - media

A

-most labs inoculate an aerobic & anaerobic bottle
-some use 2 aerobic bottles, no anaerobic

935
Q

Routine culture setup and interpretation - Blood - normal flora

A

NONE

-common contaminants: CNS, Micrococcus, alpha strep, diphtheroids, Cutibacterium

936
Q

Routine culture setup and interpretation - Blood - common pathogens

A

any isolate potentially significant
-GPC are most common

937
Q

Routine culture setup and interpretation - Blood - diagnosis

A

-skin prep: 80-95% ethanol or isopropyl alcohol followed by povidone-iodine or tincture of iodine
-optimum volume: adult, 20 mL; child, 1 mL per year of life
-blood-to-broth ratio: 1:5 to 1:10
-usually draw 2 sets in 24 hours
-automated systems used for monitoring
-growth indicated by consumption of O2 or production of CO2
-Gram stain & subculture required for ID

938
Q

Routine culture setup and interpretation - Wound - media

A

-SBA
-CHOC
-MAC

-surgical, aspirate, or tissue: add anerobic blood, KVLB, THIO

939
Q

Routine culture setup and interpretation - Wound - normal flora

A

-CNS
-diphtheroids
-Cutibacterium

-surgical, aspirate, or tissue: NONE

940
Q

Routine culture setup and interpretation - Wound - common pathogens

A

-S. aureus
-beta-hemolytic strep
-Enterobacterales
-P. aeruginosa

-surgical, aspirate, or tissue: also anaerobes

-human bite: alpha-hemolytic strep, S. aureus, S. pyogenes, Eikenella corrodens, anaerobes

941
Q

Routine culture setup and interpretation - Wound - diagnosis

A

Gram stain

942
Q

Routine culture setup and interpretation - Eye - media

A

-SBA
-CHOC

943
Q

Routine culture setup and interpretation - Eye - normal flora

A

-CNS
-diphtheroids
-Cutibacterium

944
Q

Routine culture setup and interpretation - Eye - common pathogens

A

-H. influenzae
-S. pneumoniae
-S. aureus
-Enterobacterales
-Pseudomonas

945
Q

Routine culture setup and interpretation - Eye - diagnosis

A

-Gram stain - if POS, call
-Keratitis = EMERGENCY - loss of eye can occur

946
Q

Routine culture setup and interpretation - Ear - media

A

-SBA
-CHOC
-MAC

947
Q

Routine culture setup and interpretation - Ear - normal flora

A

normal skin flora

948
Q

Routine culture setup and interpretation - Ear - common pathogens

A

-S. pneumoniae
-H. influenzae
-GAS
-M. catarrhalis
-S. aureus
-Pseudomonas

949
Q

Routine culture setup and interpretation - Ear - diagnosis

A

Gram stain

950
Q

Fecal pathogens - OXIDASE positive

A

-Campylobacter
-Vibrio
-Aeromonas
-Plesiomonas

951
Q

Fecal pathogens - OXIDASE negative

A

-Escherichia coli
-Salmonella
-Shigella
-Yersinia

952
Q

Major classes of antibiotics - Natural penicillins - representative antibiotics

A

-Penicillin V
-Penicillin G

953
Q

Major classes of antibiotics - Natural penicillins - mode of action

A

inhibit cell wall synthesis

954
Q

Major classes of antibiotics - Natural penicillins - spectrum of activity

A

-narrow
-GPs other than staph
-some GN

955
Q

Major classes of antibiotics - Natural penicillins - characteristics

A

-beta-lactam
-bactericidal
-allergic reaction common side effect

956
Q

Major classes of antibiotics - Synthetic penicillins - representative antibiotics

A

-methicillin
-oxacillin
-ampicillin
-carbenicillin
-piperacillin

957
Q

Major classes of antibiotics - Synthetic penicillins - mode of action

A

inhibit cell wall synthesis

958
Q

Major classes of antibiotics - Synthetic penicillins - spectrum of activity

A

-broader spectrum of activity than natural penicillins
-GPs (not MRSA) & GNs

959
Q

Major classes of antibiotics - Synthetic penicillins - characteristics

A

-beta-lactam
-bactericidal
-penicillinase-resistant penicillins = oxacillin, methicillin, nafcillin, cloxacillin, dicloxacillin
-drug class of choice for STAPH infections

960
Q

Major classes of antibiotics - Cephalosporins - representative antibiotics

A

-cephalexin
-cefotoxin
-ceftriaxone
-cefepime

961
Q

Major classes of antibiotics - Cephalosporins - mode of action

A

inhibit cell wall synthesis

962
Q

Major classes of antibiotics - Cephalosporins - spectrum of activity

A

-GPs & GNs
-each generation has broader spectrum of activity than previous

963
Q

Major classes of antibiotics - Cephalosporins - characteristics

A

-beta-lactam
-bactericidal

964
Q

Major classes of antibiotics - Carbapenems - representative antibiotics

A

Imipenem

965
Q

Major classes of antibiotics - Carbapenems - mode of action

A

inhibit cell wall synthesis

966
Q

Major classes of antibiotics - Carbapenems - spectrum of activity

A

-widest spectrum
-GPs & GNs, including P. aeruginosa & anaerobes, but NOT MRSA or VRE

967
Q

Major classes of antibiotics - Carbapenems - characteristics

A

-beta-lactam
-bactericidal
-reserved for IV use in serious infections

968
Q

Major classes of antibiotics - Monobactams - representative antibiotics

A

Aztreonam

969
Q

Major classes of antibiotics - Monobactams - mode of action

A

inhibit cell wall synthesis

970
Q

Major classes of antibiotics - Monobactams - spectrum of activity

A

-P. aeruginosa & other GNR
-low activity against GPs & anaerobes

971
Q

Major classes of antibiotics - Monobactams - characteristics

A

-beta-lactam
-bactericidal

972
Q

Major classes of antibiotics - Glycopeptides - representative antibiotics

A

Vancomycin

973
Q

Major classes of antibiotics - Glycopeptides - mode of action

A

inhibit cell wall synthesis

974
Q

Major classes of antibiotics - Glycopeptides - spectrum of activity

A

-GPs
-drug of choice for MRSA
-some strain of Enterococcus are now resistant (VRE)

975
Q

Major classes of antibiotics - Glycopeptides - characteristics

A

-bactericidal
-used for serious infections

976
Q

Major classes of antibiotics - Macrolides - representative antibiotics

A

-erythromycin
-clarithromycin
-azithromycin

977
Q

Major classes of antibiotics - Macrolides - mode of action

A

inhibit RNA-dependent protein synthesis

978
Q

Major classes of antibiotics - Macrolides - spectrum of activity

A

-GPs & some GNs
-intracellular organisms
-atypical mycobacteria

979
Q

Major classes of antibiotics - Macrolides - characteristics

A

bacteriostatic

980
Q

Major classes of antibiotics - Tetracyclines - representative antibiotics

A

-tetracycline
-doxycycline

981
Q

Major classes of antibiotics - Tetracyclines - representative antibiotics

A

-tetracycline
-doxycycline

982
Q

Major classes of antibiotics - Tetracyclines - mode of action

A

inhibit protein synthesis

983
Q

Major classes of antibiotics - Tetracyclines - spectrum of activity

A

-GPs & GNs
-intracellular organisms
-spirochetes
-MRSA
-VRE

984
Q

Major classes of antibiotics - Tetracyclines - characteristics

A

-bacteriostatic
-used less often than B-lactams
-NOT given to children or pregnant women due to staining of teeth, abnormal bone growth

985
Q

Major classes of antibiotics - Aminoglycosides - representative antibiotics

A

-gentamycin
-tobramycin
-amikacin

986
Q

Major classes of antibiotics - Aminoglycosides - mode of action

A

inhibit protein synthesis by binding irreversibly to 30S ribosomal subunit

987
Q

Major classes of antibiotics - Aminoglycosides - spectrum of activity

A

-used primarily for GNs (including P. aeruginosa)
-ineffective against anaerobes

988
Q

Major classes of antibiotics - Aminoglycosides - characteristics

A

-bactericidal
-toxic to kidneys & ears
-only used to treat serious GN infections

989
Q

Major classes of antibiotics - Sulfonamides - representative antibiotics

A

-Sulfamethoxazole (SMZ)
-Trimethoprim (TMP)

990
Q

Major classes of antibiotics - Sulfonamides - mode of action

A

inhibit folic acid synthesis

991
Q

Major classes of antibiotics - Sulfonamides - spectrum of activity

A

broad spectrum of activity against Enterobacterales

992
Q

Major classes of antibiotics - Sulfonamides - characteristics

A

-bacteriostatic
-used primarily for UTI

993
Q

Major classes of antibiotics - Quinolones - representative antibiotics

A

-ciprofloxacin
-levofloxacin
-ofloxacin

994
Q

Major classes of antibiotics - Quinolones - mode of action

A

inhibit DNA synthesis

995
Q

Major classes of antibiotics - Quinolones - spectrum of activity

A

broad spectrum

996
Q

Major classes of antibiotics - Quinolones - characteristics

A

-bactericidal
-used to treat serious infections
-ciprofloxacin used for anthrax

997
Q

What antibiotic is used to treat anthrax?

A

anthrax

998
Q

Major classes of antibiotics - Lincosamides - representative antibiotics

A

clindamycin

999
Q

Major classes of antibiotics - Lincosamides - mode of action

A

inhibit protein synthesis

1000
Q

Major classes of antibiotics - Lincosamides - spectrum of activity

A

-GPC (including MRSA)
-anaerobes

1001
Q

Major classes of antibiotics - Lincosamides - spectrum of activity

A

-GPC (including MRSA)
-anaerobes

1002
Q

Major classes of antibiotics - Lincosamides - characteristics

A

one of the most effective antibiotics against ANAEROBES but resistance is increasing

1003
Q

Disk diffusion susceptibility method (Kirby Bauer) - organisms

A

-rapidly grow aerobes & facultative anaerobes
-NOT for slow growers, anaerobes, or fastidious organisms (except with modifications)

1004
Q

Disk diffusion susceptibility method (Kirby Bauer) - inoculum

A

-18-24 hour pure culture
-1.5 x 10^8 CFU/mL
-compare to 0.5 McFarland standard
-too heavy = smaller zones/false resistant
-too light = larger zones/false susceptible

1005
Q

Disk diffusion susceptibility method (Kirby Bauer) - medium

A

-Mueller-Hinton (MH) agar
-swab entire surface evenly to achieve solid lawn of growth

1006
Q

Disk diffusion susceptibility method (Kirby Bauer) - disks

A

-store in refrigerator or freezer in sealed, desiccated container
-warm to RT before use
-check expiration dates
-place within 15 minutes of inoculation
-no more than 12 per 150-mm plate

1007
Q

Disk diffusion susceptibility method (Kirby Bauer) - incubation

A

-within 15 minutes of disk placement
-inverted
-ambient air
-35*C for 16-18 hours
-<16 hours = increased zone, false susceptible
->18 hours = decreased zone, false resistant

EXCEPTION: MRSA may require 24 hours

1008
Q

Disk diffusion susceptibility method (Kirby Bauer) - modifications for fastidious bacteria

A

-Streptococcus: use MH supplemented with 5% sheep blood; incubate in 5-7% CO2
-Haemophilus: use Haemophilus test medium (HTM); incubate in 5-7% CO2

1009
Q

Disk diffusion susceptibility method (Kirby Bauer) - reading

A

-routine: measure zones from back side of plate using ruler or calipers
-media containing blood: read from top with lid removed

1010
Q

Disk diffusion susceptibility method (Kirby Bauer) - situations/actions

A

-sparse growth: repeat with standardized inoculum
-mixed culture: repeat with pure inoculum
-colonies within zone: subculture & retest
-slight growth in zone for TMP & sulfonamides: disregard
-swarming of Proteus into zone: ignore

1011
Q

Disk diffusion susceptibility method (Kirby Bauer) - reporting

A

resistant, intermediate, or susceptible based on zone of inhibition in mm

1012
Q

Disk diffusion susceptibility method (Kirby Bauer) - quality control (QC)

A

-test QC strains of E.coli, S.aureus, P.aeruginosa, Enterococcus faecalis for 20-30 consecutive days
-if results are acceptable, frequency may be reduced to weekly if all other guidelines are followed

1013
Q

Other susceptibility tests - Minimal inhibitory concentration (MIC)

A

-standard inoculum added to serial dilutions of antibiotics & incubated
-MIC = least amount of antibiotic (highest dilution) that prevents visible growth
-can be done in tubes, microtiter trays, or automated systems

1014
Q

Other susceptibility tests - Minimal bacterial concentration

A

-clear tubes from MIC are subcultured to agar
-MBC = concentration of antibiotic that results in 99.9% decrease in CFU per mL

1015
Q

Other susceptibility tests - Beta-Lactamase

A

-detects enzyme that cleaves beta-lactam ring, rendering penicillin & cephalosporins ineffective
-test Haemophilus, N.gonorrhoeae, Moraxella
-bacteria applied to moistened disk impregnated with cephalosporin nitrocefin (Cefinase disk)
-RED color if beta-lactam ring is broken, i.e., organism produces beta-lactamase

1016
Q

Other susceptibility tests - screen for penicillin susceptibility in S. pneumoniae

A

-test with oxacillin disk instead of penicillin disk
-more sensitive in detecting resistance
-Mueller-Hinton with 5% sheep blood inoculated with organism
-oxacillin sick (1 mcg) placed
-incubated overnight in 5-7% CO2
-zone of inhibition >=20 mm = susceptible to penicillin
-zone of inhibition <20 mm = perform MIC

1017
Q

Other susceptibility tests - tests for oxacillin- (methicillin-) resistant S.aureus (MRSA)

A

-oxacillin used as class representative for penicillinase-resistant penicillins
-organism resistant to it is resistant to all
-oxacillin screen plate: Mueller-Hinton with 4% NaCl & oxacillin (6 mcg/mL) inoculated & incubated overnight
-any growth = resistant
-not suitable for testing CNS
-CLSI recommends cefoxitin disk diffusion method for both S.aureus & CNS

1018
Q

Other susceptibility tests - vancomycin screen

A

-for detection of VRE
-brain-heart infusion agar plus 6 mcg vancomycin/mL inoculated & incubated overnight
-growth = resistance
-can also be used for * S.aureus*

1019
Q

Other susceptibility tests - E test

A

-plastic strip containing concentration gradient placed on inoculum lawn on Mueller-Hinton plate & incubated overnight
-MIC = point where border or growth inhibition intersects strip
-useful for testing fastidious organisms such as S.pneumoniae, other strep, H. influenzae, & anaerobes

1020
Q

Other susceptibility tests - D test (inducible clindamycin resistance)

A

-to detect inducible clindamycin resistance in MRSA isolated that are resistant to erythromycin & susceptible to clindamycin on initial testing
-erythromycin & clindamycin disks placed 15-26 mm apart on Mueller-Hinton agar inoculated with organism
-after overnight incubation, flattened zone between disks (D-shaped zone of inhibition aground clindamycin disk) means erythromycin induces clindamycin resistance = clindamycin reported as resistant
-similar procedure for beta-hemolytic strep except Mueller-Hinton with sheep blood used & disks placed 12 mm apart

1021
Q

Automated susceptibility testing - susceptibility

A

-broth with various dilutions of antibiotics are inoculated & incubated
-growth is determined by photometry, turbidity, or fluorescence, depending on system

1022
Q

Automated susceptibility testing - features

A

-walk-away capability
-LIS interface
-generation of institutional antibiograms
-epidemiology reportz

1023
Q

Automated susceptibility testing - advantages

A

-accuracy
-short TAT
-frees tech for other duties

1024
Q

Automated susceptibility testing - limitations

A

-only for rapidly growing organisms
-not all microorganisms are in databases

1025
Q

Examples of quality control in microbiology labs - autoclave - requirements

A

-spore test weekly (B. stearothermophilus
-must reach 121*C/15 psi

1026
Q

Examples of quality control in microbiology labs - balances - requirements

A

check for accuracy annually

1027
Q

Examples of quality control in microbiology labs - biosafety cabinet - requirements

A

check airflow annually

1028
Q

Examples of quality control in microbiology labs - centrifuges - requirements

A

check rpm every 6 months

1029
Q

Examples of quality control in microbiology labs - CO2 incubator - requirements

A

check CO2 & temperature daily

1030
Q

Examples of quality control in microbiology labs - gas pack - requirements

A

check for anaerobiosis with methylene blue strip each use (white = no O2; blue = O2)

1031
Q

Examples of quality control in microbiology labs - microscopes - requirements

A

clean & adjust 4 times per year

1032
Q

Examples of quality control in microbiology labs - temperatures - requirements

A

daily checks of incubators, heating blocks, water baths, refrigerators, freezers

1033
Q

Examples of quality control in microbiology labs - thermometers - requirements

A

must be checked against reference thermometer from National Bureau of Standards

1034
Q

Examples of quality control in microbiology labs - instrument logs - requirements

A

document routine function checks, preventive maintenance service
-maintain for life of instrument

1035
Q

Examples of quality control in microbiology labs - Gram stain - requirements

A

control slide weekly (E. coli & S.aureus)

1036
Q

Examples of quality control in microbiology labs - reagents - requirements

A

most are tested each day of use with positive & negative controls

1037
Q

Examples of quality control in microbiology labs - media - requirements

A

-most are exempt from retesting if purchased from manufacturer who follows CLSI guidelines
-obtain & retain statement of QC
-retesting required for CHOC, selective media for Neisseria & Campylobacter

1038
Q

Examples of quality control in microbiology labs - procedure manual - requirements

A

-must be reviewed & signed annually by lab director
-changes must be approved & signed by lab director
-obsolete procedures must be removed & retained for 2 years

1039
Q

Examples of quality control in microbiology labs - employee competency - requirements

A

verification on hiring & annually

1040
Q

Examples of quality control in microbiology labs - proficiency testing - requirements

A

-test unknowns exactly as patient specimens
-must maintain an average score of 80%
-document corrective action

1041
Q

Stool specimens for Ova & Parasites - consistency - liquid:
-max time between collection & examination?
-parasites recovered?

A

-30 minutes
-trophozoites (trophs), helminth eggs, larvae

1042
Q

Stool specimens for Ova & Parasites - consistency - semisolid:
-max time between collection & examination?
-parasites recovered?

A

-1 hour
-trophs, helminth eggs, larvae

1043
Q

Stool specimens for Ova & Parasites - consistency - formed:
-max time between collection & examination?
-parasites recovered?

A

-24 hours
-cysts, helminth eggs, larvae

1044
Q

Ova and parasite fresh stool examination - number of specimens

A

-1-3 for routine workup
-patients should submit 3 stool specimens, one every other day

1045
Q

Ova and parasite fresh stool examination - interfering substances

A

-antibiotics
-antiseptics
-barium
-laxatives
-mineral oil
-soap
-water
-urine

1046
Q

Ova and parasite fresh stool examination - preservation

A

-PVA
-5-10% formalin
-MIF
-SAF

Formed stools may be refrigerated for 1-2 days

1047
Q

Ova and parasite fresh stool examination - direct smear, saline

A

-on fresh liquid stools
-to observe motility of trophs

1048
Q

Ova and parasite fresh stool examination - direct smear, iodine

A

-1% D’Antoni or Lugol iodine
-to observe nuclei of cysts
-trophs will be killed

1049
Q

Ova and parasite fresh stool examination - concentration

A

to concentrate parasites & separate from fecal debris

1050
Q

Ova and parasite fresh stool examination - concentration - sedimentation method

A

-Formalin-ethyl acetate
-recovers eggs, larvae, cysts

1051
Q

Ova and parasite fresh stool examination - concentration - flotation method

A

-33% zinc sulfate
-specific gravity 1.18
-parasites float to top
-may miss operculated eggs, unfertilized Ascaris

1052
Q

Ova and parasite fresh stool examination - permanent stained slides

A

-for Dx of protozoa
-PVA fixed or fresh specimen
-iron hematoxylin or trichrome stain

1053
Q

Intestinal amebae - Entamoeba histolytica - nucleus

A

-round
-fine, even peripheral chromatin
-small, delicate, central karyosome

1054
Q

Intestinal amebae - Entamoeba histolytica - troph

A

-10-60 um, average 20 um
-1 nucleus
-delicate, finely granular cytoplasm
-ingested RBCs
-seldom contains bacteria
-single, long, finger-like pseudopod
-directional motility

1055
Q

Intestinal amebae - Entamoeba histolytica - cyst

A

-round
-10-20 um
-2-4 nuclei
-10% have cigar-shaped chromatoid bodies
-may have glycogen vacuoles

1056
Q

Intestinal amebae - Entamoeba histolytica - pathogenicity

A

-causes acute amebic dysentery
-can cause extraintestinal amebiasis

1057
Q

What intestinal ameba is the only ameba that ingests RBCs?

A

Entamoeba histolytica

1058
Q

Intestinal amebae - Entamoeba histolytica - diagnosis

A

-EIA for antigen detection
-molecular testing available

1059
Q

Intestinal amebae - Entamoeba hartmanni - nucleus

A

-round
-fine, even peripheral chromatin
-small, delicate, central karyosome

1060
Q

Intestinal amebae - Entamoeba hartmanni - troph

A

-5-12 um
-1 nucleus
-delicate, finely granular cytoplasm
-ingests bacteria
-single, long, finger-like pseudopod
-directional motility

1061
Q

Intestinal amebae - Entamoeba hartmanni - cyst

A

-round
-5-9 um
-2-4 nuclei
-10% have cigar-shaped chromatoid bodies
-may have glycogen vacuoles

1062
Q

Intestinal amebae - Entamoeba hartmanni - pathogenicity

A

non-pathogenic

1063
Q

Intestinal amebae - Entamoeba coli - nucleus

A

-coarse, irregular peripheral chromatin
-eccentric karyosome

1064
Q

Intestinal amebae - Entamoeba coli - troph

A

-15-50 um
-coarse cytoplasm with many vacuoles & ingested bacteria
-short, blunt, multiple pseudopods
-sluggish non-directional motility

1065
Q

Intestinal amebae - Entamoeba coli - cyst

A

-round
-10-35 um
-2-8 nuclei
-occasional chromatoid bodies with splintered ends
-may have glycogen vacuoles

1066
Q

Intestinal amebae - Entamoeba coli - pathogenicity

A

non-pathogenic

1067
Q

Intestinal amebae - Endolimax nana - nucleus

A

-no peripheral chromatin
-large, irregular karyosome

1068
Q

Intestinal amebae - Endolimax nana - troph

A

-2-12 um
-single nucleus
-finely granular vacuolated cytoplasm
-blunt pseudopods
-sluggish, non-progressive motility

1069
Q

Intestinal amebae - Endolimax nana - cyst

A

-5-10 um
-round to oval
-usually 4 nuclei
-no chromatoid bodies
-may have poorly defined glycogen mass

1070
Q

Intestinal amebae - Endolimax nana - pathogenicity

A

non-pathogenic

1071
Q

What intestinal ameba is on eof the smallest amoeba?

A

Endolimax nana

1072
Q

Intestinal amebae - Iodamoeba butschlii - nucleus

A

-no peripheral chromatin
-large karyosome surrounded by layer of small granules

1073
Q

Intestinal amebae - Iodamoeba butschlii - troph

A

-8-20 um
-coarsely granular cytoplasm with vacuoles & bacteria
-blunt pseudopod
-sluggishly progressive motility

1074
Q

Intestinal amebae - Iodamoeba butschlii - cyst

A

-5-20 um
-ovoid
-1 nucleus
-prominent glycogen vacuole
-“Iodine cyst”

1075
Q

Intestinal amebae - Iodamoeba butschlii - pathogenicity

A

non-pathogenic

1076
Q

What intestinal ameba is the only ameba with just one nucleus in cyst?

A

Iodamoeba butschlii

1077
Q

Intestinal amebae - Blastocystis hominis - nucleus

A

up to 4, pushed to the side

1078
Q

Intestinal amebae - Blastocystis hominis - troph

A

-round
-6-40 um
-large central body

1079
Q

Intestinal amebae - Blastocystis hominis - cyst

A

NONE

1080
Q

Intestinal amebae - Blastocystis hominis - pathogenicity

A

-uncertain
-does cause diarrhea, fever, abdominal pain, & vomiting

1081
Q

True or False. Blastocystis hominis should be quantitated.

A

True

1082
Q

What intestinal ameba was formerly classified as a yeast?

A

Blastocystis hominis

1083
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Dientamoeba fragilis - troph

A

-5-15 um
-80% have 2 nuclei
-no peripheral chromatin
-karyosome is mass of 4-8 granules

1084
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Dientamoeba fragilis - cyst

A

-rarely observed
-contains 2 nuclei, each with a large karyosome, in the center of the cell

1085
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Dientamoeba fragilis - transmission

A

-fecal-oral
-oral-anal

1086
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Dientamoeba fragilis - pathogenic?

A

Yes

1087
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Dientamoeba fragilis - flagella

A

only visible with an electron microscope

1088
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Giardia intestinalis (also known as G. lamblia or G. duodenalis) - troph

A

-pear-shaped
-10-20 um
-2 nuclei with large central karyosomes
-4 pairs of flagella
-anterior & ventral sucking disks
-2 axostyles
-2 median bodies
-“Old man in glasses”
-FALLING LEAF motility

1089
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Giardia intestinalis (also known as G. lamblia or G. duodenalis) - cyst

A

-ovoid
-8-19 um
-thick double wall
-cytoplasm shrinks away from cell wall
-2-4 nuclei at anterior end
-median bodies & axostyles

1090
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Giardia intestinalis (also known as G. lamblia or G. duodenalis) - transmission

A

ingestion of cyst in contaminated water, oral-anal, pets

1091
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Giardia intestinalis (also known as G. lamblia or G. duodenalis) - pathogenic?

A

Yes

1092
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Giardia intestinalis (also known as G. lamblia or G. duodenalis) - Enterotest

A

-patient swallows capsule attached to string
-string withdrawn after 4 hours and mucus is examined
-antigen detected

1093
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Chilomastix mesnili - troph

A

-6-24 um
-broad anterior, tapering posterior
-3 flagella at anterior
-1 flagella posterior
-spiral groove running length of body
-prominent cytostome bordered by fibrils
-single nucleus at anterior
-stiff rotary motility

1094
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Chilomastix mesnili - cyst

A

-6-10 um
-round with bulge at anterior
-single large nucleus
-hourglass-shaped cytostome & prominent fibrils
-“Lemon cyst”

1095
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Chilomastix mesnili - transmission

A

ingestion of cyst

1096
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Chilomastix mesnili - pathogenic?

A

No

1097
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Pentatrichomonas hominis - troph

A

-6-14 um
-prominent axostyle extending through posterior
-4 anterior flagella
-undulating membrane entire length of body along costa
-1 oval nucleus with small karyosome
-rotary motion

1098
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Pentatrichomonas hominis - cyst

A

NONE

1099
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Pentatrichomonas hominis - transmission

A

ingestion of fecally contaminated material

1100
Q

Flagellates of the intestinal and urogenital tracts - GI tract - Pentatrichomonas hominis - pathogenic?

A

No

1101
Q

Flagellates of the intestinal and urogenital tracts - Urogenital tract - Trichomonas vaginalis - troph

A

-5-18 um
-4 anterior flagella
-undulating membrane that extends half the body

1102
Q

Flagellates of the intestinal and urogenital tracts - Urogenital tract - Trichomonas vaginalis - cyst

A

NONE

1103
Q

Flagellates of the intestinal and urogenital tracts - Urogenital tract - Trichomonas vaginalis - transmission

A

sexual

1104
Q

Flagellates of the intestinal and urogenital tracts - Urogenital tract - Trichomonas vaginalis - pathogenic?

A

Yes

1105
Q

What flagellate is the only flagellate in the urogenital tract?

A

Trichomonas vaginalis

1106
Q

Flagellates of the intestinal and urogenital tracts - Urogenital tract - Trichomonas vaginalis - diagnosis

A

-wet mount (jerky motility)
-culture
-rapid antigen tests
-PCR

1107
Q

Intestinal ciliates - Balantidium coli (Neobalantidium coli) - troph

A

-ovoid
-usually 40-50 um, but can reach 200 um
-covered with cilia
-funnel-shaped cytostome
-macronucleus & micronucleus
-vacuoles
-rapid rotary motion

1108
Q

Intestinal ciliates - Balantidium coli (Neobalantidium coli) - cyst

A

-round
-45-65 um
-thick refractile cell wall
-no cilia

1109
Q

Intestinal ciliates - Balantidium coli (Neobalantidium coli) - transmission

A

ingestion of cyst

1110
Q

Intestinal ciliates - Balantidium coli (Neobalantidium coli) - pathogenic?

A

Yes

1111
Q

What ciliate is the only ciliate that is pathogenic to humans?

A

Balantidium coli (Neobalantidium coli)

1112
Q

What is the largest protozoan of humans?

A

Balantidium coli (Neobalantidium coli)

1113
Q

Which intestinal ciliate is common in pigs?

A

Balantidium coli (Neobalantidium coli)

1114
Q

Intestinal sporozoans - Cystoisospora (Isospora) belli - transmission

A

ingestion of oocysts in fecally contaminated food or water

1115
Q

Intestinal sporozoans - Cystoisospora (Isospora) belli - diagnosis

A

-oocysts in feces
-30 x 12 um
-transparent
-stain well with iodine
-1-2 sporoblasts

1116
Q

Intestinal sporozoans - Cystoisospora (Isospora) belli - definitive host

A

human

1117
Q

Intestinal sporozoans - Cystoisospora (Isospora) belli - symptoms

A

-anorexia
-nausea
-abdominal pain
-diarrhea
-possible malabsorption

1118
Q

Intestinal sporozoans - Cryptosporidium parvum and Cryptosporidium hominis - transmission

A

-ingestion of oocysts from food or water contamination with animal feces
-oral/anal route
-direct contact with infected individual or animal

1119
Q

Intestinal sporozoans - Cryptosporidium parvum and Cryptosporidium hominis - diagnosis

A

-modified acid-fast stain of feces
-red spherical bodies 3-6 um
-4 sporozoites
-immunoassay kits

1120
Q

Intestinal sporozoans - Cryptosporidium parvum and Cryptosporidium hominis - fecal oocysts of both species

A

indistinguishable by routine microscopy

1121
Q

Intestinal sporozoans - Cryptosporidium parvum and Cryptosporidium hominis - symptoms

A

-chronic diarrhea in immunocompromised or those with AIDS
-acute self-limited diarrhea in immunocompetent

1122
Q

Intestinal sporozoans - Cyclospora cayetanensis - transmission

A

contaminated food & water

1123
Q

Intestinal sporozoans - Cyclospora cayetanensis - diagnosis

A

-oocysts in direct wet mount
-8-10 um
-variable staining with modified acid-fast stain
-autofluorescence under UV light
-bright blue at 365 nm
-mint green at 450-490 nm
-antigen-based immunoassay kits during outbreaks
-PCR

1124
Q

Intestinal sporozoans - Cyclospora cayetanensis - symptoms

A

prolonged diarrhea

1125
Q

Intestinal sporozoans - Microsporidia - transmission

A

ingestion of spores

1126
Q

Intestinal sporozoans - Microsporidia - diagnosis

A

-histology on tissue using acid-fast and periodic acid-schiff (PAS) stains
-chromotrophic stains also

1127
Q

True or False. Microsporidia are small obligate intracellular parasites.

A

True

1128
Q

Intestinal sporozoans - Microsporidia - symptoms

A

-causes prolonged diarrhea
-can disseminate

Opportunistic pathogen, mainly in AIDS patients.

1129
Q

Intestinal sporozoans - Microsporidia - molecular studies indicate?

A

related to fungi

1130
Q

Intestinal nematodes - Trichuris trichiura - route of infection

A

ingestion of infective egg

1131
Q

Intestinal nematodes - Trichuris trichiura - diagnostic stage

A

-undeveloped eggs in feces
-barrel-shaped ovum
-50 x 23 um
-brown or yellow
-clear plug at either end

1132
Q

Intestinal nematodes - Trichuris trichiura - also called?

A

Whip worm

1133
Q

Intestinal nematodes - Trichuris trichiura - what is required before the eggs become infective?

A

eggs require a developmental period in warm soil before infective

1134
Q

Intestinal nematodes - Trichuris trichiura - causes?

A

eosinophilia

1135
Q

Intestinal nematodes - Enterobius vermicularis - route of infection

A

ingestion of infective egg

1136
Q

Intestinal nematodes - Enterobius vermicularis - diagnostic stage

A

-ovoid ovum
-50 x 20 um
-1 side flattened
-colorless
-larva inside

1137
Q

Intestinal nematodes - Enterobius vermicularis - also called?

A

Pinworm

1138
Q

Intestinal nematodes - Enterobius vermicularis - causes?

A

itching when adult female migrates out of anus at night to deposit eggs

1139
Q

Intestinal nematodes - Enterobius vermicularis - diagnosis (tape)

A

cellophane tape prep taken early in the morning when the patient first wakes

1140
Q

Intestinal nematodes - Necator americanus - route of infection

A

skin penetration or ingestion of filariform larva

1141
Q

Intestinal nematodes - Necator americanus - diagnostic stage

A

-ovoid ovum
-40 x 60 um
-colorless
-contains segmented embryo 2- to 8-cell stage surrounded by clear outer zone

1142
Q

Intestinal nematodes - Necator americanus - also called?

A

New World hookworm

1143
Q

Intestinal nematodes - Necator americanus - causes?

A

-severe allergic itching can develop - “Ground itch”
-eosinophilia
-can lead to anemia

1144
Q

Intestinal nematodes - Necator americanus - larval migration

A

through lungs

1145
Q

Intestinal nematodes - Ancylostoma duodenale - route of infection

A

skin penetration or ingestion of filariform larva

1146
Q

Intestinal nematodes - Ancylostoma duodenale - diagnostic stage

A

-ovoid ovum
-40 x 60 um
-colorless
-contains segmented embryo 2- to 8-cell stage surrounded by clear outer zone

1147
Q

Intestinal nematodes - Ancylostoma duodenale - also called?

A

Old World hookworm

1148
Q

Intestinal nematodes - Strongyloides stercoralis - route of infection

A

-skin penetration by filariform larva
-sexual transmission
-autoreinfection

1149
Q

Intestinal nematodes - Strongyloides stercoralis - diagnostic stage

A

-rhabditiform larvae
-200-250 um long x 16 um in diameter
-short buccal cavity
-large bulb in esophagus
-prominent genital primordium

1150
Q

Intestinal nematodes - Strongyloides stercoralis - also called?

A

Threadworm

1151
Q

Intestinal nematodes - Strongyloides stercoralis - larval migration

A

through lungs

1152
Q

Intestinal nematodes - Strongyloides stercoralis - diagnosis (tests)

A

-duodenal aspirates and/or Enterotest
-serology (EIA)

1153
Q

Intestinal nematodes - Strongyloides stercoralis - must differentiate from?

A

hookworm larvae

1154
Q

Intestinal nematodes - Strongyloides stercoralis - immunocompromised patients

A

can disseminate & be fatal

1155
Q

Intestinal nematodes - Strongyloides stercoralis - causes?

A

eosinophilia

1156
Q

True or False. Strongyloides stercoralis is not infectious to laboratorians.

A

False

1157
Q

Intestinal nematodes - Ascaris lumbricoides - route of infection

A

ingestion of infective ovum

1158
Q

Intestinal nematodes - Ascaris lumbricoides - diagnostic stage

A

Fertilized ovum:
-ovoid
-50-75 um x 40-60 um
-yellow to brown
-granular yolk
-clear zones at either end
-may have mammillated covering or be decorticated

Nonfertilized ovum:
-larger & more elongated
-thinner shell
-no concentric clear zones
-can be mammillated or decorticated

1159
Q

Intestinal nematodes - Ascaris lumbricoides - also called?

A

Roundworm

1160
Q

What is the most common helminth worldwide?

A

Ascaris lumbricoides

1161
Q

Intestinal nematodes - Ascaris lumbricoides - often seen with?

A

Trichuris

1162
Q

Intestinal nematodes - Ascaris lumbricoides - requirements for egg to become infective

A

eggs require several weeks in soil to become infective

1163
Q

Intestinal nematodes - Ascaris lumbricoides - larval migration

A

through lungs

1164
Q

Intestinal nematodes - Ascaris lumbricoides - the adult resembles?

A

earthworms

1165
Q

Intestinal nematodes - Ascaris lumbricoides - may pass from?

A

-anus
-mouth
-nose

1166
Q

Intestinal nematodes - Ascaris lumbricoides - causes?

A

eosinophilia

1167
Q

Intestinal nematodes - Ascaris lumbricoides - diagnosis (test)

A

ELISA

1168
Q

Intestinal cestodes - Taenia saginata - scolex

A

-tetragonal
-4 cup-shaped suckers
-no hooklets

1169
Q

Intestinal cestodes - Taenia saginata - gravid proglottid

A

-longer than wide
-15-30 uterine branches per side
-irregularly alternating genital pores

1170
Q

Intestinal cestodes - Taenia saginata - ovum

A

-spherical
-35-45 um
-yellow or brown
-thick radially striated shell

1171
Q

Intestinal cestodes - Taenia saginata - intermediate host

A

cow

1172
Q

Intestinal cestodes - Taenia saginata - transmission

A

ingestion of larva in undercooked beef

1173
Q

Intestinal cestodes - Taenia saginata - diagnostic stage

A

ova in feces

1174
Q

Intestinal cestodes - Taenia saginata - also called?

A

beef tapeworm

1175
Q

True or False. Taenia saginata ova are infective to cattle, but not humnas.

A

True

1176
Q

Intestinal cestodes - Taenia solium - scolex

A

-4 cup-shaped suckers
-2 rows of hooklets around rounded rostellum

1177
Q

Intestinal cestodes - Taenia solium - gravid proglottid

A

-longer than wide
-7-13 uterine branches per side
-regularly alternating genital pores

1178
Q

Intestinal cestodes - Taenia solium - ovum

A

-spherical
-35-45 um
-yellow or brown
-thick radially striated shell

1179
Q

Intestinal cestodes - Taenia solium - intermediate host

A

pig

1180
Q

Intestinal cestodes - Taenia solium - transmission

A

ingestion of larva in undercooked pork

1181
Q

Intestinal cestodes - Taenia solium - diagnostic stage

A

ova in feces

1182
Q

Intestinal cestodes - Taenia solium - also called?

A

pork tapeworm

1183
Q

The ova of which intestinal cestode is infective to humans?

A. Taenia saginata
B. Diphyllobothrium latum
C. Taenia solium
D. Echinococcus granulosus

A

C. Taenia solium

1184
Q

Intestinal cestodes - Taenia solium - causes?

A

cysticercosis

1185
Q

Intestinal cestodes - Diphyllobothrium latum - scolex

A

-almond shaped
-lateral groove on each side
-no hooklets

1186
Q

Intestinal cestodes - Diphyllobothrium latum - gravid proglottid

A

-wider than long
-central rosette-shaped uterus

1187
Q

Intestinal cestodes - Diphyllobothrium latum - ovum

A

-ovoid
-45-70 um
-yellow-brown
-operculum
-small knob at posterior

1188
Q

Intestinal cestodes - Diphyllobothrium latum - intermediate host

A

1st: crustacean
2nd: fish

1189
Q

Intestinal cestodes - Diphyllobothrium latum - transmission

A

ingestion of larva in undercooked freshwater fish

1190
Q

Intestinal cestodes - Diphyllobothrium latum - diagnostic stage

A

ova in feces

1191
Q

Intestinal cestodes - Diphyllobothrium latum - also called?

A

Broad fish tapeworm

1192
Q

Intestinal cestodes - Diphyllobothrium latum - can cause?

A

vitamin B12 deficiency

1193
Q

Intestinal cestodes - Echinococcus granulosus - transmission

A

ingestion of fecal material from infected dog or cat

1194
Q

Intestinal cestodes - Echinococcus granulosus - diagnostic stage

A

radiologic ID of cysts in organs (liver/lungs)

-can also ID with serology

1195
Q

Intestinal cestodes - Echinococcus granulosus - accidental host?

A

humans

1196
Q

Intestinal cestodes - Hymenolepis nana - scolex

A

-diamond-shaped
-4 suckers
-single row of hooklets around short rostellum

1197
Q

Intestinal cestodes - Hymenolepis nana - gravid proglottid

A

-wider than long
-uterine branches obliterated by eggs
-3 ovoid irregularly spaced testes

1198
Q

Intestinal cestodes - Hymenolepis nana - ovum

A

-round
-40 um
-colorless
-2 distinct walls
-slight bulge at each pole of inner wall with 4-8 hair-like polar filaments

1199
Q

Intestinal cestodes - Hymenolepis nana - intermediate host

A

NONE

1200
Q

Intestinal cestodes - Hymenolepis nana - transmission

A

ingestion of eggs in feces of infected mice/rats

1201
Q

Intestinal cestodes - Hymenolepis nana - diagnostic stage

A

ova in feces

1202
Q

Intestinal cestodes - Hymenolepis nana - also called?

A

Dwarf tapeworm

1203
Q

Intestinal cestodes - Hymenolepis nana - adult

A

2.5-4 cm long

1204
Q

What is the most common tapeworm?

A

Hymenolepis nana

1205
Q

What is the only tapeworm without an intermediate host?

A

Hymenolepis nana

1206
Q

Trematodes - Fasciolopsis buski - route of infection

A

ingestion of metacercariae on aquatic plants

1207
Q

Trematodes - Fasciolopsis buski - location of adult

A

duodenum

1208
Q

Trematodes - Fasciolopsis buski - diagnostic stage

A

-ova in feces
-135 x 80 um
-yellow-brown
-thin shell
-small operculum
-granular contents evenly distributed
-clear zone between shell & yolk

1209
Q

Trematodes - Fasciolopsis buski - also called?

A

large intestinal fluke

1210
Q

Trematodes - Fasciolopsis buski - symptoms of infection

A

bowel mucosal ulcers

1211
Q

Trematodes - Fasciola hepatica - route of infection

A

ingestion of metacercariae on aquatic plants

1212
Q

Trematodes - Fasciola hepatica -location of adult

A

bile duct

1213
Q

Trematodes - Fasciola hepatica -diagnostic stage

A

Similar to F. buski:
-ova in feces
-135 x 80 um
-yellow-brown
-thin shell
-small operculum
-granular contents evenly distributed
-clear zone between shell & yolk

1214
Q

Trematodes - Fasciola hepatica -also called?

A

Sheep liver fluke

1215
Q

Trematodes - Clonorchis sinensis - route of infection

A

ingestion of metacercariae in raw, undercooked, dried, salted, or pickled fish

1216
Q

Trematodes - Clonorchis sinensis - location of adult

A

-bile ducts
-gallbladder
-pancreatic ducts

1217
Q

Trematodes - Clonorchis sinensis - diagnostic stage

A

-ova in feces
-29 x 16 um
-bulbous
-opercular shoulders
-small comma-shaped protuberance at posterior
-thick shell with tiny spines
-ciliated miracidium inside

1218
Q

Trematodes - Clonorchis sinensis - also called?

A

Chinese liver fluke

1219
Q

True or False. Clonorchis sinensis eggs are one of the smallest passed by humans.

A

True

1220
Q

True or False. Clonorchis sinensis eggs are one of the smallest passed by humans.

A

True

1221
Q

Trematodes - Paragonimus westermani - route of infection

A

ingestion of undercooked crabs or crayfish

1222
Q

Trematodes - Paragonimus westermani - location of adult

A

lungs

1223
Q

Trematodes - Paragonimus westermani - diagnostic stage

A

-ova in feces or bloody sputum
-80-120 um x 48-60 um
-yellow-brown
-thick shelled
-flattened operculum

1224
Q

Trematodes - Paragonimus westermani - also called?

A

Oriental lung fluke

1225
Q

Trematodes - Schistosoma mansoni - route of infection

A

skin penetration

1226
Q

Trematodes - Schistosoma mansoni - location of adults

A

intestinal venules

1227
Q

Trematodes - Schistosoma mansoni - diagnostic stage

A

-ova in feces
-elongated
-155 x 65 um
-pronounced lateral spine

1228
Q

Trematodes - Schistosoma mansoni - also called?

A

Blood fluke

1229
Q

Trematodes - Schistosoma japonicum - route of infection

A

skin penetration

1230
Q

Trematodes - Schistosoma japonicum - location of adult

A

intestinal venules

1231
Q

Trematodes - Schistosoma japonicum - diagnostic stage

A

-ova in feces or rectal biopsy
-ovoid
-90 x 70 um
-minute lateral spine

1232
Q

Trematodes - Schistosoma japonicum - also called?

A

Blood fluke

1233
Q

Trematodes - Schistosoma japonicum - diagnosis (test)

A

serology

1234
Q

Trematodes - Schistosoma haematobium - route of infection

A

skin penetration

1235
Q

Trematodes - Schistosoma haematobium - location of adult

A

bladder venules

1236
Q

Trematodes - Schistosoma haematobium - diagnostic stage

A

-ova in concentrated urine
-elongated
-140 x 60 um
-terminal spine

1237
Q

Trematodes - Schistosoma haematobium - also called?

A

Blood fluke

1238
Q

What is the only parasite of urinary system?

A

Schistosoma haematobium

1239
Q

Differentiation of Plasmodium - P. falciparum - name of disease

A

malignant malaria

1240
Q

Differentiation of Plasmodium - P. falciparum - paroxysm cycle

A

36-48 hours

1241
Q

Differentiation of Plasmodium - P. falciparum - infected RBCs

A

not enlarged

1242
Q

Differentiation of Plasmodium - P. falciparum - stages seen

A

-ring forms (trophs)
-gametocytes

1243
Q

Differentiation of Plasmodium - P. malariae - name of disease

A

quartan malaria

1244
Q

Differentiation of Plasmodium - P. malariae - paroxysm cycle

A

72 hours

1245
Q

Differentiation of Plasmodium - P. malariae - infected RBCs

A

not enlarged

1246
Q

Differentiation of Plasmodium - P. malariae - stages seen

A

all

1247
Q

Differentiation of Plasmodium - P. ovale - name of disease

A

ovale malaria

1248
Q

Differentiation of Plasmodium - P. ovale - paroxysm cycle

A

48 hours

1249
Q

Differentiation of Plasmodium - P. ovale - infected RBCs

A

-sometimes enlarged
-frequently oval with ragged margins
-Schuffner dots

1250
Q

Differentiation of Plasmodium - P. ovale - stages seen

A

all

1251
Q

Differentiation of Plasmodium - P. vivax - name of disease

A

tertian malaria

1252
Q

Differentiation of Plasmodium - P. vivax - paroxysm cycle

A

44-48 hours

1253
Q

Differentiation of Plasmodium - P. vivax - infected RBCs

A

-enlarged
-Schuffner dots

1254
Q

Differentiation of Plasmodium - P. vivax - stages seen

A

all

1255
Q

Differentiation of Plasmodium - P. falciparum - merozoites per mature schizont

A

not seen in peripheral blood

1256
Q

Differentiation of Plasmodium - P. malariae - merozoites per mature schizont

A

6-12

1257
Q

Differentiation of Plasmodium - P. ovale - merozoites per mature schizont

A

8-12

1258
Q

Differentiation of Plasmodium - P. vivax - merozoites per mature schizont

A

12-24

1259
Q

Differentiation of Plasmodium - P. falciparum - shape of gametocytes

A

sausage- or crescent-shaped

1260
Q

Differentiation of Plasmodium - P. malariae - shape of gametocytes

A

ovoid

1261
Q

Differentiation of Plasmodium - P. ovale - shape of gametocytes

A

round

1262
Q

Differentiation of Plasmodium - P. vivax - shape of gametocytes

A

round

1263
Q

Differentiation of Plasmodium - P. falciparum - multiple parasites per cell?

A

YES

1264
Q

Differentiation of Plasmodium - P. malariae - multiple parasites per cell?

A

NO

1265
Q

Differentiation of Plasmodium - P. ovale - multiple parasites per cell?

A

NO

1266
Q

Differentiation of Plasmodium - P. vivax - multiple parasites per cell?

A

rare

1267
Q

Differentiation of Plasmodium - P. falciparum - double chromatin dots?

A

YES

1268
Q

Differentiation of Plasmodium - P. falciparum - double chromatin dots?

A

YES

1269
Q

Differentiation of Plasmodium - P. malariae - double chromatin dots?

A

NO

1270
Q

Differentiation of Plasmodium - P. ovale - double chromatin dots?

A

NO

1271
Q

Differentiation of Plasmodium - P. vivax - double chromatin dots?

A

rare

1272
Q

Differentiation of Plasmodium - P. falciparum - other characteristics

A

-high mortality
-medical emergency

1273
Q

Differentiation of Plasmodium - P. malariae - other characteristics

A

-rarely fatal
-band-shaped trophs
-similar morphology to newly emerging P. knowlesi species - differentiate by symptoms and PCR

1274
Q

Differentiation of Plasmodium - P. ovale - other characteristics

A

-least common
-rarely fatal
-may cause relapses

1275
Q

Which Plasmodium species is the least common?

A

P. ovale

1276
Q

Differentiation of Plasmodium - P. vivax - other characteristics

A

-most common
-rarely fatal
-may cause relapses

1277
Q

Which Plasmodium species is the most common?

A

P. vivax

1278
Q

Blood and tissue protozoa - Acanthamoeba spp. - classification

A

ameba

1279
Q

Blood and tissue protozoa - Acanthamoeba spp. - transmission

A

-swimming in contaminated water
-inadequately disinfected contact lenses

1280
Q

Blood and tissue protozoa - Acanthamoeba spp. - diagnosis

A

trophozoites and cysts from brain or skin biopsy or corneal scraping

1281
Q

Blood and tissue protozoa - Acanthamoeba spp. - causes?

A

-granulomatous amebic encephalitis (GAE)
-ulcerative acanthamoeba keratitis in contact lens wearers

Usually in immunocompromised or debilitated

1282
Q

Blood and tissue protozoa - Naegleria fowleri - classification

A

ameba

1283
Q

Blood and tissue protozoa - Naegleria fowleri - transmission

A

swimming in contaminated ponds or streams

1284
Q

Blood and tissue protozoa - Naegleria fowleri - diagnosis

A

-stained smears of culture material
-trophs in CSF

1285
Q

Blood and tissue protozoa - Naegleria fowleri - causes?

A

primary amebic meningoencephalitis (PAM)

1286
Q

Blood and tissue protozoa - Plasmodium - classification

A

sporozoan

1287
Q

Blood and tissue protozoa - Plasmodium - transmission

A

Anopheles mosquito

1288
Q

Blood and tissue protozoa - Plasmodium - diagnosis

A

-Wright-stained thick & thin blood smears
-draw blood just before paroxysm
-rapid immunochromatographic dipsticks for antigen detection and fluorescent DNA/RNA stained films also used

1289
Q

Blood and tissue protozoa - Plasmodium - causes?

A

malaria

1290
Q

Blood and tissue protozoa - Babesia - classification

A

sporozoan

1291
Q

Blood and tissue protozoa - Babesia - transmission

A

-tick bite
-blood transfusion

1292
Q

Blood and tissue protozoa - Babesia - diagnosis

A

-Wright-stained thick & thin blood smears
-parasites in RBCs
-2-4 um
-trophozoites are usually pear-shaped, usually in pairs (most common) or tetrads

1293
Q

Blood and tissue protozoa - Babesia - symptoms resemble?

A

malaria

1294
Q

Blood and tissue protozoa - Toxoplasma gondii - classification

A

coccidian

1295
Q

Blood and tissue protozoa - Toxoplasma gondii - transmission

A

-ingestion of undercooked meat or oocysts from cat feces
-transplacental
-organ transplants

1296
Q

Blood and tissue protozoa - Toxoplasma gondii - diagnosis

A

-serological tests
-ELISA
-PCR

1297
Q

Blood and tissue protozoa - Toxoplasma gondii - definitive host

A

cat

1298
Q

Blood and tissue protozoa - Toxoplasma gondii - congenital infection

A

causes birth defects

1299
Q

Blood and tissue protozoa - Toxoplasma gondii - AIDS patients

A

major cause of encephalitis

1300
Q

Blood and tissue protozoa - Leishmania spp. complexes L. tropica (Old World), L. mexicana (New World), L. braziliensis, and L. donovani - classification

A

flagellate

1301
Q

Blood and tissue protozoa - Leishmania spp. complexes L. tropica (Old World), L. mexicana (New World), L. braziliensis, and L. donovani - transmission

A

sand flies

1302
Q

Blood and tissue protozoa - Leishmania spp. complexes L. tropica (Old World), L. mexicana (New World), L. braziliensis, and L. donovani - diagnosis

A

amastigote forms in WBCs & cells of the RE system

1303
Q

Blood and tissue protozoa - Leishmania spp. complexes L. tropica (Old World), L. mexicana (New World), L. braziliensis, and L. donovani - what type of parasite?

A

obligate intracellular parasite

1304
Q

Blood and tissue protozoa - Leishmania spp. complexes L. tropica (Old World), L. mexicana (New World), L. braziliensis, and L. donovani - causes?

A

Kalaazar, cutaneous & mucocutaneous leishmaniasis

1305
Q

Blood and tissue protozoa - Trypanosoma - classification

A

flagellate

1306
Q

Blood and tissue protozoa - Trypanosoma - transmission

A

-T. brucei gambiense & T. brucei rhodesiense: tsetse fly

-T. cruzi: reduviid or kissing bug

1307
Q

Blood and tissue protozoa - Trypanosoma - diagnosis

A

-T. brucei gambiense & T. brucei rhodesiense: trypomastigote in blood, lymph nodes, CSF

-T. cruzi: trypomastigote in blood; amastigote in RE cells, myocardium, CNS

1308
Q

Blood and tissue protozoa - Trypanosoma - T. brucei rhodesiense - causes?

A

East African sleeping sickness

1309
Q

Blood and tissue protozoa - Trypanosoma - T. brucei gambiense - causes?

A

West African sleeping sickness

1310
Q

Blood and tissue protozoa - Trypanosoma - T. cruzi - causes?

A

Chagas disease

-found in Southern US

1311
Q

Blood and tissue helminths - Toxocara - classification

A

nematode (in dogs/cats)

1312
Q

Blood and tissue helminths - Toxocara - transmission

A

ingestion of eggs from dog/cat feces

1313
Q

Blood and tissue helminths - Toxocara - diagnosis

A

serological tests

1314
Q

Blood and tissue helminths - Toxocara - accidental hosts

A

humans

1315
Q

Blood and tissue helminths - Toxocara - larvae location

A

tissues

1316
Q

Blood and tissue helminths - Toxocara - causes?

A

visceral & ocular larva migrams (toxocariasis)

1317
Q

Blood and tissue helminths - Trichinella spiralis - classification

A

nematode

1318
Q

Blood and tissue helminths - Trichinella spiralis - transmission

A

undercooked pork
-bear

1319
Q

Blood and tissue helminths - Trichinella spiralis - diagnosis

A

-larvae encysted in muscle
-serological tests (ELISA)

1320
Q

Blood and tissue helminths - Trichinella spiralis - symptoms

A

-eosinophilia
-edema of upper eyelids
-fever
-myalgia

1321
Q

Blood and tissue helminths - Wuchereria bancrofti - classification

A

nematode

1322
Q

Blood and tissue helminths - Wuchereria bancrofti - transmisson

A

mosquitos

1323
Q

Blood and tissue helminths - Wuchereria bancrofti - diagnosis

A

-microfilariae in blood
-Giemsa-stained thick & thin smears

1324
Q

Blood and tissue helminths - Wuchereria bancrofti - causes?

A

chronic infection causes elephantiasis (lymphatic filariasis)

1325
Q

Blood and tissue helminths - Brugia malayi - classification

A

nematode

1326
Q

Blood and tissue helminths - Brugia malayi - transmission

A

mosquitos

1327
Q

Blood and tissue helminths - Brugia malayi - diagnosis

A

-microfilariae in blood
-Giemsa-stained thick & thin smears

1328
Q

Blood and tissue helminths - Brugia malayi - causes?

A

elephantiasis

1329
Q

Blood and tissue helminths - Brugia malayi - periodicity

A

nocturnal

1330
Q

Blood and tissue helminths - Loa loa - classification

A

nematode

1331
Q

Blood and tissue helminths - Loa loa - transmission

A

Mango fly (Chrysops)

1332
Q

Blood and tissue helminths - Loa loa - diagnosis

A

-microfilariae in blood
-Giemsa-stained thick & thin smears

1333
Q

Blood and tissue helminths - Loa loa - also called?

A

African eye worm

1334
Q

Blood and tissue helminths - Loa loa - periodicity

A

nocturnal

1335
Q

Blood and tissue helminths - Onchocerca volvulus - classification

A

nematode

1336
Q

Blood and tissue helminths - Onchocerca volvulus - transmission

A

Black fly

1337
Q

Blood and tissue helminths - Onchocerca volvulus - diagnosis

A

-microfilariae from skin snips or aspirates of fibrous nodules on body

1338
Q

Blood and tissue helminths - Onchocerca volvulus - causes?

A

River blindness

1339
Q

Stains used in mycology - KOH - used for?

A

-skin
-hair
-nails

1340
Q

Stains used in mycology - KOH - dissolves?

A

keratin

1341
Q

Stains used in mycology - KOH - function

A

makes fungal elements more visible

1342
Q

Stains used in mycology - Calcofluor white - used for

A

-tissues
-sputum
-body fluids
-skin scrapings
-corneal scrapings

1343
Q

Stains used in mycology - Calcofluor white - type of stain

A

fluorescent stain, optimal fluorescence occurs with UV excitation

1344
Q

Stains used in mycology - Lactophenol cotton blue - used for

A

microscopic exam of fungal culture

1345
Q

Stains used in mycology - Lactophenol cotton blue - function

A

-lactic acid = preserves
-phenol = kills
-cotton blue = stains

1346
Q

Stains used in mycology - Gram stain - used for

A

yeast

1347
Q

Stains used in mycology - Gram stain - does fungi stain gram positive or gram negative?

A

gram positive

1348
Q

Stains used in mycology - Acid-fast - used for

A

Nocardia

(partially acid-fast)

1349
Q

Stains used in mycology - Colloidal carbon wet mount (India ink) - used for

A

CSF sediment if Cryptococcus is suspected

1350
Q

Stains used in mycology - Colloidal carbon wet mount (India ink) - diagnosis

A

halos around yeast due to wide capsule

-insensitive
-direct antigen test preferred

1351
Q

Stains used in mycology - Giemsa - used for

A

blood & bone marrow

1352
Q

Stains used in mycology - Giemsa -useful for?

A

Histoplasma

1353
Q

List the fungal culture media used for isolation.

A
  1. Sabouraud dextrose agar (SDA)
  2. SDA with antibiotics
  3. Brain-heart infusion agar
  4. Inhibitory mold agar
  5. Dermatophyte test medium
1354
Q

List the fungal culture media used for identification.

A
  1. Potato dextrose agar
  2. Cornmeal agar with Tween 80
  3. Urea agar
  4. Birdseed agar (niger seed or caffeic agar)
  5. Chromogenic agar
1355
Q

Fungal culture media - for isolation - Sabouraud dextrose agar (SDA) - use

A

-general medium
-pH 5.6 inhibits bacteria
-grows most molds & yeasts
-can also be made with glucose (SGA)

1356
Q

Fungal culture media - for isolation - Sabouraud dextrose agar (SDA) with antibiotics- use

A

-antibiotics inhibit fungal contaminants & bacteria
-dermatophytes & most fungal pathogens grow

1357
Q

Fungal culture media - for isolation - Brain-heart infusion agar - use

A

-used for the isolation of all fungi including fastidious dimorphic fungi
-10% sheep blood is added for enrichment
-antibiotics can be added to make the medium selective by inhibiting bacteria

1358
Q

Fungal culture media - for isolation - Inhibitory mold agar - use

A

-for recovery of fungi from specimens contaminated with bacteria
-contains chloramphenicol & gentamicin to inhibit bacteria
-more sensitive than SDA

1359
Q

Fungal culture media - for isolation - Dermatophyte test medium - use

A

-for recovery of dermatophytes from skin, hair, and nails
-turn agar from yellow to red
-antibiotics added to inhibit bacteria

1360
Q

Fungal culture media - for identification - Potato dextrose agar - use

A

-stimulates sporulation of molds
-good for slide cultures

1361
Q

Fungal culture media - for identification - Cornmeal agar with Tween 80 - use

A

-allows for enhanced formation of hyphae, blastospores, & chlamydoconidia, to differentiate Candida species
-C. albicans produces chlamydospores

1362
Q

Fungal culture media - for identification - Urea agar - use

A

detects urease for presumptive ID of Cryptococcus and Trichophyton

1363
Q

Fungal culture media - for identification - Birdseed agar (niger seed or caffeic agar) - use

A

-isolation of Cryptococcus species
-black-brown colonies in 4-7 days

1364
Q

Fungal culture media - for identification - Chromogenic agar - use

A

-allows rapid ID and detection
-contains chromogenic substrates hydrolyzed by species-specific enzymes

1365
Q

Dermatophytes - Microsporum - infects

A

-skin
-hair
-rarely nails

1366
Q

Dermatophytes - Microsporum -macroconidia

A

-large
-spindle or cylinder shaped
-thick walled
-multi-septate
-rough
-spiny
-borne singly on short conidiophores

1367
Q

Dermatophytes - Microsporum -microconidia

A

-few or absent
-small, club shaped

1368
Q

Dermatophytes - Microsporum -hair

A

-ectothrix hair invasion
-some species cause hair to fluoresce under UV light

1369
Q

Dermatophytes - Microsporum -lab ID

A

direct microscopic examination

1370
Q

Dermatophytes - Microsporum -most common species

A

-M. canis
-Nannizzia gypsea
-M. audouinii

1371
Q

Dermatophytes - Trichophyton -infects

A

-hair
-skin
-nails

1372
Q

Dermatophytes - Trichophyton -macroconidia

A

-rare
-pencil shaped
-multiseptate
-thin walled
-smooth
-borne singly on conidiophore

1373
Q

Dermatophytes - Trichophyton -microconidia

A

-predominant
-spherical, tear shaped, or clavate

1374
Q

Dermatophytes - Trichophyton -hair

A

-hair infections endothrix or ectothrix
-hair usually doesn’t fluoresce

1375
Q

Dermatophytes - Trichophyton -other characteristics

A

may have spirals, nodular bodies, chlamydospores, faviform mycelia

1376
Q

Dermatophytes - Trichophyton -T. rubrum colonies on agar

A

red on reverse side

1377
Q

Dermatophytes - Trichophyton -most common species

A

-T. mentagrophytes
-T. rubrum
-T. tonsurans

1378
Q

Which dermatophytes cause epidemic tinea capitis in children?

A

*T. tonsurans and M. audouinii

1379
Q

Dermatophytes - Epidermophyton - infects

A

-skin
-sometimes nails
-rarely hair

1380
Q

Dermatophytes - Epidermophyton - macroconidia

A

-club shaped
-septate
-thin walled
-smooth
-borne in singles or clusters of 2-3 per conidiophore

1381
Q

Dermatophytes - Epidermophyton - microconidia

A

absent

1382
Q

Dermatophytes - Epidermophyton - chlamydospores

A

numerous

1383
Q

Dermatophytes - Epidermophyton - most common species

A

E. floccosum is the only species

1384
Q

Dermatophytes - identification

A

-colony characteristics on SGA and microscopic morphology
-MALDI-TOF

1385
Q

Dimorphic fungi - Blastomyces spp. (i.e., dermatitidis) - infection

A

blastomycosis

1386
Q

Dimorphic fungi - Blastomyces spp. (i.e., dermatitidis) - mold phase

A

-white to gray-brown colony
-hyaline, septate hyphae with small oval conidia borne singly at tips of conidiophores
-“Lollipops”

1387
Q

Dimorphic fungi - Blastomyces spp. (i.e., dermatitidis) - yeast phase

A

-8-15 um
-round, thick walled
-single bud connected by wide neck

1388
Q

Dimorphic fungi - Blastomyces spp. (i.e., dermatitidis) - endemic

A

Ohio & Mississippi River valleys

1389
Q

Dimorphic fungi - Blastomyces spp. (i.e., dermatitidis) - most commonly infected

A

farmers - contract from soil

1390
Q

Dimorphic fungi - Blastomyces spp. (i.e., dermatitidis) - infection location

A

-begins in lungs
-may become systemic

1391
Q

Dimorphic fungi - Paracoccidioides spp. (i.e., brasiliensis) - infection

A

paracoccidioidomycosis

1392
Q

Dimorphic fungi - Paracoccidioides spp. (i.e., brasiliensis) - mold phase

A

resembles Blastomyces:
-white to gray-brown colony
-hyaline, septate hyphae with small oval conidia borne singly at tips of conidiophores
-“Lollipops”

1393
Q

Dimorphic fungi - Paracoccidioides spp. (i.e., brasiliensis) - yeast phase

A

-10-30 um
-round, double walled
-multiple buds pinched at attachment
-“Mariner’s wheel”

1394
Q

Dimorphic fungi - Paracoccidioides spp. (i.e., brasiliensis) - mainly found

A

-Brazil
-Argentina
-S. Mexico

1395
Q

Dimorphic fungi - Paracoccidioides spp. (i.e., brasiliensis) - infection location

A

-begins in lungs
-can become systemic

1396
Q

Dimorphic fungi - Coccidioides spp. (C. immitis and C. posadasii*) - infection

A

Valley fever

1397
Q

Dimorphic fungi - Coccidioides spp. (C. immitis and C. posadasii*) - mold phase

A

-fluffy or powdery white to gray-tan colonies
-barrel-shaped arthrospores

1398
Q

Dimorphic fungi - Coccidioides spp. (C. immitis and C. posadasii*) - yeast phase

A

-spherule
-20-80 um
-contains numerous endospores

1399
Q

Dimorphic fungi - Coccidioides spp. (C. immitis and C. posadasii*) - where is it found

A

California and fixed desert of Southwest US

1400
Q

Dimorphic fungi - Coccidioides spp. (C. immitis and C. posadasii*) - primarily infects

A

diagnosed more in males than females (15:1 ratio)

1401
Q

Dimorphic fungi - Coccidioides spp. (C. immitis and C. posadasii*) - how does it infect

A

-spores are inhaled or contaminate injured skin
-affects respiratory tract 1st
-can spread to other organs

1402
Q

Dimorphic fungi - Coccidioides spp. (C. immitis and C. posadasii*) - highly infectious

A

arthrospores

1403
Q

Dimorphic fungi - Coccidioides spp. (C. immitis and C. posadasii*) - diagnosis

A

serological tests

1404
Q

Dimorphic fungi - Histoplasma capsulatum - infection

A

Histoplasmosis

1405
Q

Dimorphic fungi - Histoplasma capsulatum - mold phase

A

-silky, white to gray-tan colonies
-thick-walled spherical macroconidia, 7-16 um, surrounded by finger-like projections
-“Tuberculate chlamydospores”

1406
Q

Dimorphic fungi - Histoplasma capsulatum - yeast phase

A

-1-4 um
-round to oval
-intracellular in phagocytes of blood or bone marrow

1407
Q

Dimorphic fungi - Histoplasma capsulatum - endemic

A

Ohio & mississippi River valleys

1408
Q

Dimorphic fungi - Histoplasma capsulatum - where does it grow

A

(Soil saprophyte)
-grows best in soils enriched with bird or bat droppings

1409
Q

Dimorphic fungi - Histoplasma capsulatum - infection location

A

acute pulmonary disease (esp. dangerous to immunocompromised)
-predilection for RE system

1410
Q

Dimorphic fungi - Sporothrix schenckii - infection

A

Sporotrichosis (rose gardener’s disease)

1411
Q

Dimorphic fungi - Sporothrix schenckii - mold phase

A

-white to yellow colonies
-clusters of pear-shaped conidia at tips of conidiophores
-“flowers”

1412
Q

Dimorphic fungi - Sporothrix schenckii - yeast phase

A

-gram positive
-cigar-shaped cells
-usually not seen in direct smears unless by immunofluorescence

1413
Q

Dimorphic fungi - Sporothrix schenckii - endemic

A

Mississippi & Missouri River valleys

1414
Q

Dimorphic fungi - Sporothrix schenckii - where does it grow

A

-rose bushes
-barberry bushes
-sphagnum moss
-mulch

1415
Q

Dimorphic fungi - Sporothrix schenckii - usually infects

A

farmers or florists

-introduced by trauma, usually to the hand

1416
Q

Dimorphic fungi - Sporothrix schenckii - cutaneous lesions

A

spread along lymphatics

1417
Q

Yeast - Candida albicans - infections

A

-thrush (mouth)
-vulvovaginitis
-diaper rash
-onychomycosis (nails)
-paronychomycosis (cuticles)
-endocarditis
-meningitis
-UTI
-pulmonary infections
-candidemia

1418
Q

Yeast - Candida albicans - important characteristics - agar type

A

grows on SBA, EMB (spider-like projections), SDA

1419
Q

Yeast - Candida albicans - important characteristics - gram stain

A

gram positive cells, 2-4 um

1420
Q

Yeast - Candida albicans - important characteristics - conidia

A

blastoconidia or pseudohyphae (no constrictions)

1421
Q

Yeast - Candida albicans - important characteristics - serum

A

produces germ tubes

1422
Q

Yeast - Candida albicans - important characteristics - cornmeal agar

A

produces round terminal chlamydospores

1423
Q

Yeast - Candida albicans - important characteristics - agar used for ID

A

chromogenic agar

1424
Q

Yeast - Candida albicans - normal flora of

A

-GI tract
-mucocutaneous areas

1425
Q

Yeast - Candida albicans - AIDS

A

-onychomycosis (nails)
-esophagitis

1426
Q

Yeast - Candida albicans - tests available for ID

A

-serological (antigen & antibody)
-nucleic acid tests

1427
Q

Yeast - Candida tropicalis - infections

A

-vaginitis
-UTI
-GI
-pulmonary
-systemic infections

1428
Q

Yeast - Candida tropicalis - cornmeal agar

A

blastoconidia produced randomly along pseudohyphae

1429
Q

Yeast - Candida tropicalis - germ tubes

A

may produce constricted germ tubes (true germ tubes lack constrictions)

1430
Q

Yeast - Candida tropicalis - usually infects

A

immunosuppressed

1431
Q

Yeast - Candida glabrata - infections

A

-UTI
-systemic infections

1432
Q

Yeast - Candida glabrata - important characteristics

A

-no true- or pseudomycelium
-small budding cells only

1433
Q

Yeast - Candida glabrata - often resistant to?

A

fluconazole

1434
Q

Which yeast is the predominant non-C. albicans cause of candidemia?

A

C. glabrata

1435
Q

Yeast - Candida krusei - infections

A

-endocarditis
-ocular

1436
Q

Yeast - Candida krusei - important characteristics

A

-forms true/pseudophyphae
-does not produce germ tube

1437
Q

Yeast - Candida krusei - resistant to?

A

fluconazole

1438
Q

Yeast - Geotrichum candidum - infections

A

uncommon cause of wound infections & oral thrush

1439
Q

Yeast - Geotrichum candidum - cornmeal agar

A

forms hockey stick-shaped arthroconidia

1440
Q

Yeast - Geotrichum candidum - blastoconidia

A

none

1441
Q

True or False. Geotrichum candidum is not actually a yeast, but rather a yeast-like organism.

A

True

1442
Q

Yeast - Cryptococcus neoformans - infections

A

lung infections that can disseminate to brain

1443
Q

Yeast - Cryptococcus neoformans - cells

A

-irregularly sized
-spherical
-surrounded by a capsule

1444
Q

Yeast - Cryptococcus neoformans - niger seed agar

A

maroon to brown-black colonies

1445
Q

Yeast - Cryptococcus neoformans - urease, phenol oxidase

A

positive

1446
Q

Yeast - Cryptococcus neoformans - found

A

-bird & bat droppings
-decaying vegetation
-fruit
-milk

1447
Q

Yeast - Cryptococcus neoformans - India Ink prep

A

capsule seen in about 50% of cases

1448
Q

Yeast - Cryptococcus neoformans - AIDS

A

disseminated cryptococcosis

1449
Q

Yeast - Malassezia furfur - infections

A

Tinea versicolor

1450
Q

Yeast - Malassezia furfur - cells

A

-oval or bottle-shaped budding yeast
-3-8 um in diameter
-characteristic collar between mother & daughter cells

1451
Q

Yeast - Malassezia furfur - skin scrapings

A

chains of short, slightly curved septate hyphae may be seen

1452
Q

Yeast - Malassezia furfur - lab ID

A

KOH prep of skin scrapings

1453
Q

Yeast - Pneumocystis jirovecii - infections

A

atypical interstitial plasma cell pneumonia (PCP)

1454
Q

Yeast - Pneumocystis jirovecii - cysts

A

cysts are 4-12 um spheres with intracystic bodies

1455
Q

Yeast - Pneumocystis jirovecii - culture

A

can’t be cultured

1456
Q

Yeast - Pneumocystis jirovecii - diagnosis

A

histopathological staining

1457
Q

Yeast - Pneumocystis jirovecii - opportunistic infection

A

-preterm infants
-immunocompromised

1458
Q

Contaminants/Opportunistic Fungi - Rhizopus - classification

A

mucorales

1459
Q

Contaminants/Opportunistic Fungi - Rhizopus - significance

A

-common lab contaminant
-propensity to attack vascular system of immunocompromised
-rapidly spreading
-often fatal

1460
Q

Contaminants/Opportunistic Fungi - Rhizopus - colonial morphology

A

-mature within 4 days
-“Lid lifter”
-FRONT: dense cotton candy-like growth, white at first, turning gray or yellow-brown
-REVERSE: white

1461
Q

Contaminants/Opportunistic Fungi - Rhizopus - microscopic morphology

A

-Hyphae: large, broad, nonseptate
-produces horizontal stolons that attach by rhizoids
-sporangiophores in clusters opposite rhizoids
-terminate in dark, round sporangia containing sporangiospores

1462
Q

Contaminants/Opportunistic Fungi - Mucor - classification

A

Mucorales

1463
Q

Contaminants/Opportunistic Fungi - Mucor - significance

A

-common lab contaminant
-propensity to attack vascular system of immunocompromised
-rapidly spreading
-often fatal

1464
Q

Contaminants/Opportunistic Fungi - Mucor - colonial morphology

A

-mature within 4 days
-“Lid lifter”
-FRONT: dense cotton candy-like growth, white at first, turning gray
-REVERSE: white

1465
Q

Contaminants/Opportunistic Fungi - Mucor - microscopic morphology

A

-Hyphae: large, broad, nonseptate
-produces horizontal stolons
-sporangiophores in clusters or branched
-NO rhizoids
-terminate in dark, round sporangia containing sporangiospores

1466
Q

Contaminants/Opportunistic Fungi - Aspergillus - classification

A

hyaline

1467
Q

Contaminants/Opportunistic Fungi - Aspergillus - most common species

A

A. fumigatus

1468
Q

Contaminants/Opportunistic Fungi - Aspergillus - significance

A

-common contaminant
-can cause invasive infection, colonization, toxicosis, allergy

1469
Q

Contaminants/Opportunistic Fungi - Aspergillus - colonial morphology

A

-mature within 3 days
-FRONT: fluffy, granular, or powdery texture; white at first, then color depends on species:
A. fumigatus - white to blue-green
A. niger - black
A. flavus - yellow to green
A. terreus - tan to cinnamon
-REVERSE: white, goldish, or brown

1470
Q

Contaminants/Opportunistic Fungi - Aspergillus - microscopic morphology

A

-septate hyphae, branching at 45* angle
-unbranched conidiophore arises from foot cell
-expands into large, spherical vesicle covered with phialides that produce chains of round conidia

1471
Q

Contaminants/Opportunistic Fungi - Acremonium - classification

A

hyaline mold

1472
Q

Contaminants/Opportunistic Fungi - Acremonium - significance

A

-can be a contaminant
-can cause mycetoma, corneal & nail infections

1473
Q

Contaminants/Opportunistic Fungi - Acremonium - colonial morphology

A

-mature within 5 days
-FRONT: white, spreading, moist, colorless; becomes cottony with gray top
-REVERSE: yellow or rose

1474
Q

Contaminants/Opportunistic Fungi - Acremonium - microscopic morphology

A

-small, hyaline, septate hyphae
-unbranched phialides
-oblong, 1- to 2-celled conidia in clusters at tips of phialides

1475
Q

Contaminants/Opportunistic Fungi - Fusarium - classification

A

hyaline mold

1476
Q

Contaminants/Opportunistic Fungi - Fusarium - significance

A

-can be a contaminant
-can cause eye, skin, nail, systemic infections

1477
Q

Contaminants/Opportunistic Fungi - Fusarium - colonial morphology

A

-mature within 4 days
-FRONT: white & cottony, developing a pink or violet center
-REVERSE: light

1478
Q

Contaminants/Opportunistic Fungi - Fusarium - microscopic morphology

A

-septate hyphae
-unbranched conidiophores
-large, canoe-shaped, multiseptate macroconidia
-small 1- to 2-celled oval or cylindrical conidia in singles or clusters on simple conidiophores

1479
Q

Contaminants/Opportunistic Fungi - Penicillium - classification

A

hyaline mold

1480
Q

Contaminants/Opportunistic Fungi - Penicillium - significance

A

-can be a contaminant
-can cause keratitis, external ear infections, endocarditis with artificial heart valves

1481
Q

Contaminants/Opportunistic Fungi - Penicillium - colonial morphology

A

-matures within 4 days
-FRONT: white at first; becomes powdery, blue-green with white border
-REVERSE: usually white

1482
Q

Contaminants/Opportunistic Fungi - Penicillium - microscopic morphology

A

-septate hyphae
-branched or unbranched conidiophores
-“brush-like”
-flask-shaped phialides bearing unbranched chains of round conidia

1483
Q

Contaminants/Opportunistic Fungi - Alternaria - classification

A

Dematiaceous

1484
Q

Contaminants/Opportunistic Fungi - Alternaria - significance

A

-can be contaminant
-can cause subcutaneous infection

1485
Q

Contaminants/Opportunistic Fungi - Alternaria - colonial morphology

A

-mature within 5 days
-FRONT: gray-white & wooly at first; becomes green-black or brown with light border
-REVERSE: black

1486
Q

Contaminants/Opportunistic Fungi - Alternaria - microscopic morphology

A

-dark septate hyphae
-conidiophores of variable length, sometimes branched
-large brown, drumstick-shaped conidia with transverse & longitudinal septations, in singles or chains

1487
Q

Contaminants/Opportunistic Fungi - Cladosporium - classification

A

Dematiaceous

1488
Q

Contaminants/Opportunistic Fungi - Cladosporium - significance

A

non-pathogenic

1489
Q

Contaminants/Opportunistic Fungi - Cladosporium - colonial morphology

A

-mature within 7 days
-FRONT: green-brown or black with velvety nap; becomes heaped & slightly folded
-REVERSE: black

1490
Q

Contaminants/Opportunistic Fungi - Cladosporium - microscopic morphology

A

-dark septate hyphae
-dark branching conidiophores producing 2 or more chains of oval brown conidia

1491
Q

Contaminants/Opportunistic Fungi - Curvularia - classification

A

Dematiaceous

1492
Q

Contaminants/Opportunistic Fungi - Curvularia - significance

A

-can be a contaminant
-can cause sinusitis, keratitis

1493
Q

Contaminants/Opportunistic Fungi - Curvularia - colonial morphology

A

-mature within 5 days
-FRONT: dark olive green to brown or black with pink-gray wooly surface
-REVERSE: black

1494
Q

Contaminants/Opportunistic Fungi - Curvularia - microscopic morphology

A

-dark septate hyphae
-simple or branched conidiophores, bent where conidia attach
-large, 4-celled, curved conidia
-central cell is larger & darker

1495
Q

Fungal pathogens by site - blood/bone marrow

A

-Histoplasma capsulatum
Cryptococcus neoformans
-Candida spp.
-Blastomyces dermatitidis
-Malassezia furfur

1496
Q

Fungal pathogens by site - CSF

A

-Cryptococcus neoformans
-Coccidioides spp.
-Histoplasma capsulatum
-Candida spp.

1497
Q

Fungal pathogens by site - hair

A

-Trichophyton
-Microsporum

1498
Q

Fungal pathogens by site - nail

A

-Trichophyton
-Epidermophyton
-Candida
-Aspergillus

1499
Q

Fungal pathogens by site - sputum, bronchial washings, transtracheal aspirates

A

-Candida
-Aspergillus
-Rhizopus
-Mucor
-Penicillium
-Blastomyces dermatitidis
-Coccidioides spp.
-Paracoccidioides brasiliensis
-Histoplasma capsulatum
-Sporothrix schenckii

1500
Q

Fungal pathogens by site - skin

A

-Candida
-Trichophyton
-Microsporum
-Epidermophyton

1501
Q

Fungal pathogens by site - throat

A

Candida albicans

1502
Q

Fungal pathogens by site - urine

A

-Candida
-Blastomyces dermatitidis
-Coccidioides spp.
-Histoplasma capsulatum
-Cryptococcus neoformans

1503
Q

Fungal pathogens by site - vaginal/cervical

A

Candida albicans

1504
Q

Viral structure

A
  1. virion
  2. nucleocapsid
  3. nucleic acid
  4. capsid
  5. envelope
1505
Q

Viral structure - virion

A

complete virus particle

1506
Q

Viral structure - nucleocapsid

A

nucleic acid & capsid

1507
Q

Viral structure - nucleic acid

A

-DNA or RNA
-single- or double-stranded
-linear or circular

1508
Q

Viral structure - capsid

A

-protein coat that encloses genetic material
-may be helical (rod-like) or icosahedral (cuboid)
-composed of protein subunits called capsomers
-protects nucleic acid
-enables virus to attach to & enter host cell

1509
Q

Viral structure - envelope

A

-outer membrane surrounding capsid in some viruses
-aids in attachment to host cell
-viruses without called naked nucleocapsids

1510
Q

Viral replication - adsorption

A

attachment of virus to host cell receptor

1511
Q

Viral replication - penetration

A

virus enters host cell by direct penetration, endocytosis (entering in a vacuole), or fusion with cell membrane

1512
Q

Viral replication - eclipse/synthesis

A

-eclipse: several hours during which virions can’t be detected
-synthesis: mRNA is produced; directs synthesis of viral particles

1513
Q

Viral replication - uncoating

A

-loss of capsid
-genome enters cytoplasm (most RNA viruses) or nucleus (most DNA viruses)

1514
Q

Viral replication - maturation/release

A

-genetic material assembled into protein coat-virions migrate to cytoplasmic membrane
-released by budding off, leaking out, or lysing host cell with enzymes

1515
Q

Human DNA viruses - Adenoviruses - representative viruses

A

-adenoviruses
->60 serotypes divided into subgroups

1516
Q

Human DNA viruses - Adenoviruses - infections

A

-mild respiratory, urinary tract, GI, & eye infections
-can cause highly contagious pink eye (conjunctivitis)

1517
Q

Human DNA viruses - Hepadnaviruses - representative viruses

A

HBV

1518
Q

Human DNA viruses - Hepadnaviruses - infections

A

Hepatitis B

1519
Q

Human DNA viruses - Herpes viruses - representative viruses

A

-Herpes simplex viruses (HSV-1, HSV-2)
-Varicella-zoster virus (VZV)
-Epstein-Barr virus (EBV)
-Cytomegalovirus(CMV)
-Human herpesviruses 6-8

1520
Q

Human DNA viruses - Herpes viruses - infections

A

-Herpes simplex viruses (HSV-1, HSV-2): oral, genital, neonatal, & ocular herpes, HSV encephalitis
-Varicella-zoster virus (VZV): Chicken pox (varicella), shingles (zoster)
-Epstein-Barr virus (EBV): infectious mononucleosis
-Cytomegalovirus(CMV): infections in newborns & immunocompromised
-Human herpesviruses 6-8: Roseola, Kaposi sarcoma

1521
Q

Human DNA viruses - Papillomaviruses - representative viruses

A

Human papilloma virus (HPV)

1522
Q

Human DNA viruses - Papillomaviruses - infections

A

warts, including genital warts that are linked to cervical cancer

1523
Q

Human DNA viruses - Parvoviruses - representative viruses

A

Parvovirus B19

1524
Q

Human DNA viruses - Parvoviruses - infections

A

Fifth disease (erythema infectiosum)

1525
Q

Human DNA viruses - Poxviruses - representative viruses

A

Variola

1526
Q

Human DNA viruses - Poxviruses -infections

A

Smallpox

1527
Q

Human RNA viruses - Arenaviruses - representative viruses

A

-Lymphocyte choriomeningitis virus (LCM)
-Lassa fever virus

1528
Q

Human RNA viruses - Arenaviruses - infections

A

-LCM: aseptic meningitis or meningoencephalitis
-Lassa fever virus: Lassa fever

1529
Q

Human RNA viruses - Astroviruses - representative viruses

A

Astrovirus

1530
Q

Human RNA viruses - Astroviruses - infections

A

gastroenteritis in children, elderly, and immunocompromised

1531
Q

Human RNA viruses - Hantaviridae - representative viruses

A

Hantavirus (Sin Nombre virus)

1532
Q

Human RNA viruses - Hantaviridae - infections

A

Hantavirus pulmonary syndrome (HPS)

1533
Q

Human RNA viruses - Caliciviruses - representative viruses

A

Noroviruses

1534
Q

Human RNA viruses - Caliciviruses - infections

A

most common cause of infectious gastroenteritis in the US

1535
Q

Human RNA viruses - Coronaviruses - representative viruses

A

Coronavirus

1536
Q

Human RNA viruses - Coronaviruses - infections

A

-severe acute respiratory syndrome (SARS)
-cold-like infections
-pediatric diarrhea
-COVID-19

1537
Q

Human RNA viruses - Filoviruses - representative viruses

A

-Marburg
-Ebola

1538
Q

Human RNA viruses - Filoviruses - infections

A

hemorrhagic fever

1539
Q

Human RNA viruses - Filoviruses - infections

A

hemorrhagic fever

1540
Q

Human RNA viruses - Flaviviruses - representative viruses

A

-Yellow fever virus
-Japanese encephalitis virus
-dengue virus
-West Nile virus
-Zika virus
(Note: above viruses are arboviruses - arthropod-borne viruses)

-Hepatitis C virus (HCV)

1541
Q

Human RNA viruses - Flaviviruses - infections

A

-Yellow fever virus: yellow fever
-Japanese encephalitis virus: Japanese encephalitis
-dengue virus: dengue fever
-West Nile virus: West Nile virus infection
-Zika virus: Zika
(Note: above viruses are arboviruses - arthropod-borne viruses)

-Hepatitis C virus (HCV): Hepatitis C

1542
Q

Human RNA viruses - Orthomyxoviruses - representative viruses

A

Influenzae A, B, & C

1543
Q

Human RNA viruses - Orthomyxoviruses - infections

A

Influenzae

1544
Q

Human RNA viruses - Paramyxoviruses - representative viruses

A

-Measles virus
-Mumps virus
-Parainfluenza virus
-Respiratory syncytial virus (RSV)
-Human metapneumovirus (HMPV)

1545
Q

Human RNA viruses - Paramyxoviruses - infections

A

-Measles virus: measles (rubeola)
-Mumps virus: mumps
-Parainfluenza virus: RTI in children
-Respiratory syncytial virus (RSV): RTI in infants, elderly, immunocompromised
-Human metapneumovirus (HMPV): RTI

1546
Q

Human RNA viruses - Picornaviruses - representative viruses

A

-Enteroviruses (polioviruses, coxsackieviruses A & B, echoviruses, enteroviruses)
-Hepatitis A virus (HAV)
-Rhinovirus

1547
Q

Human RNA viruses - Picornaviruses - infections

A

-Enteroviruses (polioviruses, coxsackieviruses A & B, echoviruses, enteroviruses): Polio, hand-foot-mouth disease, aseptic meningitis, others
-Hepatitis A virus (HAV): Hepatitis A
-Rhinovirus: common cold

1548
Q

Human RNA viruses - Reoviruses - representative viruses

A

Rotavirus

1549
Q

Human RNA viruses - Reoviruses - infections

A

Rotavirus: most common cause of gastroenteritis in infants & children

1550
Q

Human RNA viruses - Retroviruses - representative viruses

A

-HIV-1, HIV-2
-Human T-lymphotropic viruses (HTLV-1, HTLV-2)

1551
Q

Human RNA viruses - Retroviruses - infections

A

-HIV-1, HIV-2: AIDS
-Human T-lymphotropic viruses (HTLV-1, HTLV-2): T-cell leukemia & lymphoma, tropical spastic paraparesis

1552
Q

Human RNA viruses - Rhabdoviruses - representative viruses

A

Rabies virus

1553
Q

Human RNA viruses - Rhabdoviruses - infections

A

Rabies virus: rabies

1554
Q

Human RNA viruses - Togaviruses - representative viruses

A

-Rubella virus
-Eastern, Western, & Venezuelan equine encephalitis viruses

1555
Q

Human RNA viruses - Togaviruses - infections

A

-Rubella virus: rubella (German measles)
-Eastern, Western, & Venezuelan equine encephalitis viruses: Eastern, Western, & Venezuelan encephalitis

1556
Q

Common viruses by site - CNS - specimens

A

-CSF
-throat swab
-stool
-brain tissue
-blood

1557
Q

Common viruses by site - CNS - common viruses

A

-Enteroviruses
-HSV
-arboviruses

1558
Q

Common viruses by site - Eye - specimens

A

-conjunctival swab
-corneal scraping

1559
Q

Common viruses by site - Eye - common viruses

A

-HSV
-adenoviruses

1560
Q

Common viruses by site - Genital tract - specimens

A

-genital swab
-vesicle swab or fluid
-lesion biopsy

1561
Q

Common viruses by site - Genital tract - common viruses

A

-HSV
-HPV

1562
Q

Common viruses by site - GI tract - specimens

A

-stool
-rectal swab

1563
Q

Common viruses by site - GI tract - common viruses

A

Adults: noroviruses, adenoviruses, enteroviruses

Infants/children: rotavirus, adenoviruses

1564
Q

Common viruses by site - Respiratory tract - specimens

A

-nasal aspirate
-throat swab
-nasopharyngeal swab
-bronchoalveolar lavage
-lung biopsy

1565
Q

Common viruses by site - Respiratory tract - common viruses

A

-Influenzae A & B
-parainfluenza virus
-adenoviruses
-RSV
-HMPV
-rhinovirus
-enteroviruses
-coronavirus

1566
Q

Common viruses by site - Skin - specimens

A

vesicle fluid or scrapings

1567
Q

Common viruses by site - Skin - common viruses

A

-HSV
-VZV
-measles
-rubella
-enterovirus
-parvovirus B19

1568
Q

Common viruses by site - Skin - common viruses

A

-HSV
-VZV
-measles
-rubella
-enterovirus
-parvovirus B19

1569
Q

Common viruses by site - Urinary tract - specimens

A

urine

1570
Q

Common viruses by site - Urinary tract - common viruses

A

-adenoviruses
-HSV
-CMV

1571
Q

Viral specimen collection and transport - time of collection

A

during acute phase (1st 3-5 days)

1572
Q

Viral specimen collection and transport - site of collection

A

site of infection, entry & exit sites

1573
Q

Viral specimen collection and transport - collection containers

A

sterile, leak-proof, nonbreakable

1574
Q

Viral specimen collection and transport - swabs

A

-dacron
-rayon
-other polyester tips
-plastic or aluminum shafts
-calcium alginate, cotton, wood are inhibitory for some viruses

1575
Q

Viral specimen collection and transport - transport media

A

-VTM
-Amies
-Stuart transport media
(NOT required for blood, CSF, or urine)

1576
Q

Viral specimen collection and transport - transport

A

-deliver immediately
-if not possible, keep at 2-8*C & deliver within 2 hours
-EXCEPTION: keep whole blood at room temperature

1577
Q

Viral specimen collection and transport - storage

A

-best to process upon arrival
-if not possible, hold at 2-8C for up to 48 hours
->48 hours, freeze at -70C (not recommended)

1578
Q

Methods for diagnosis of viral infections - cytology/histology

A

microscopic examination of specimen for viral cytopathic effect (CPE)

1579
Q

Methods for diagnosis of viral infections - electron microscopy

A

-rarely used
-labor intensive, expensive

1580
Q

Methods for diagnosis of viral infections - direct fluorescent antibody stain

A

-fluorescent-labeled antibody added to patient cells fixed to slide
-if viral antigen present, antibody binds
-fluorescence seen with fluorescent microscope

1581
Q

Methods for diagnosis of viral infections - antigen detection

A

solid-phase & membrane ELISAs

1582
Q

Methods for diagnosis of viral infections - shell vial culture

A

-rapid modification of conventional cell culture
-detection in 1-2 days
-specimen centrifuged onto monolayer of cells growing on coverslip
-coverslips stained with viral-specific immunofluorescent conjugate
-used primarily by reference labs

1583
Q

Methods for diagnosis of viral infections - molecular methods

A

-PCR
-real-time PCR
-branched DNA
-nucleic acid hybridization

-faster & more sensitive than cell culture
-can detect multiple viruses simultaneously

1584
Q

Methods for diagnosis of viral infections - serology

A

-detects antibodies in serum
-presence of antibodies isn’t always indicative of current infection
-useful in evaluating immune status or diagnosing
-alternatively, can detect antigen from swabbed site

1585
Q

Which of the following specimen collection scenarios would be cause for rejection?

A. use of JEMBEC plate for Neisseria gonorrhoeae
B. the use of calcium alginate swab for Chlamydia
C. collection tubes with boric acid for urine culture
D. viral swab collected during acute infection

A

B. the use of calcium alginate swab for Chlamydia

1586
Q

Select the media of choice for culturing fastidious organisms such as Haemophilus & Neisseria.

A. MAC agar
B. Hektoen agar
C. CHOC agar
D. Eosin methylene blue agar

A

C. CHOC agar

1587
Q

Xylose lysine deoxycholate (XLD) agar is used for the recovery of which of the following organisms?

A. *Staphylococcus spp.
B. Yeast
C. Salmonella & Shigella
D. Clostridium difficile

A

C. Salmonella & Shigella

1588
Q

Which nonfermenting GNR is most often associated with cystic fibrosis?

A. Pseudomonas aeruginosa
B. Morganella morganii
C. Helicobacter pylori
D. Yersinia pestis

A

A. Pseudomonas aeruginosa

1589
Q

Which of the following organisms is both motile and produces urease?

A. Streptococcus spp.
B. Proteus vulgaris
C. Serratia marcescens
D. Francisella

A

B. Proteus vulgaris

1590
Q

Which of the following Haemophilus spp. requires X-factor?

A. Haemophilus parainfluenzae
B. Haemophilus parahaemolyticus
C. Haemophilus influenzae
D. All of the above

A

C. Haemophilus influenzae

1591
Q

Which of the following tests is used to differentiate micrococci from staphylococci?

A. modified oxidase (microdase)
B. catalase
C. Voges-Proskauer (VP)
D. Gram stain

A

A. modified oxidase (microdase)

1592
Q

Which antibiotic is used to screen for penicillin susceptibility in S. pneumoniae?

A. ampicillin
B. imipenem
C. tetracycline
D. oxacillin

A

D. oxacillin

1593
Q

Which of the following flagellates is sexually transmitted and recovered from the urogenital tract?

A. Chilomastix mesnili
B. Giardia
C. Trichomonas vaginalis
D. Pentatrichomonas hominis

A

C. Trichomonas vaginalis

1594
Q

KOH is used for the examination of fungal elements from which of the following specimens?

A. blood
B. skin and nails
C. sputum
D. bone marrow

A

B. skin and nails

AMT MT Exam (12 decks)

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