Unit 12 Miscellaneous Body Sites Flashcards

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1
Q

List two of common skin contaminants seen in superficial wound specimens

A
Diphtheroids 
Coag-negative Staph
Alpha hemolytic strep
Nonhemolytic strep
Propianibacterium spp
Bacillus spp
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2
Q

A direct gram stain is performed on all wound, tissues, and body fluids. Why? What is reported out on the direct smear on these culture types?

A

To determine the quality of the specimen. Ideally: Many PMNs and no/rare/few SECs
To compare to culture: are all organisms recovered?

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3
Q

What is the purpose of the thioglycollate broth?

A

To recover fastidious organisms or small amounts

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4
Q

Eikenella: description

A

“Frosty” colony, small thin GNB, , ox+

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5
Q

Bacillus species: description

A

Large ground glass colony, large GPB, Cat +

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6
Q

Lactobacillus: description

A

Alpha, GPB in chains, Cat =

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7
Q

Capnocytophaga: description

A

Glistening “sweaty” colony, long GNB w/ tapered ends

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8
Q

Pasterurella: description

A

Large gray, GNB, Cat+, Ox+, NG on MAC

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9
Q

Acinetobacter: description

A

Mucoid, “Mauve” NLF on MAC, GNB, Short fat GNB, Ox=

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10
Q

Actinomyces: description

A

Small gray white nondescript, sometimes molar tooth; better anaerobic; cat -, paleo GNB

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11
Q

Brucella: description

A

Tiny on BAP/CHOC at 3 days, faint staining GNC or GNCB

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12
Q

Rothia: description

A

Gray sticky nonhemolytic on BAP; GPC clusters, Cat variable

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13
Q

Listeria: description

A

Gray soft beta on BAP; GPB; Cat +

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14
Q

Propionibacterium: description

A

Pleo GPB; anaerobe that may break through on aerobic plates; Cat +, can be beta, If indole + P.acnes

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15
Q

Culture media for Wounds and abscesses

A

BAP
MAC
CHOC
PEA (extremities and sources below the diaphragm)

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16
Q

How to inocculate: order

A

Least selective–> most selective

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17
Q

Potential pathogens wound/abscess

A
S. aureaus
Beta hemolytic strep
Group D strep
S. anginosus
Enterococcus
Enterobacteraciae
Pseudomonas/NLFs
Eikenella corridens
Pasteurella multocida
Anaerobes 
Yeasts
Actinomyces
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18
Q

Susceptibility testing on which organisms for wound/abscess ?

A
S. aureus
Enterococcus
Enterobacteraciae
Ps. aeruginosa
Other nonfermenters
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19
Q

Wound/abscess: for alpha and gamma strep, what needs to be ruled out?

A

Group D

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20
Q

Wound/abscess: for bacillus spp, what needs to be ruled out?

A

B. anthracis

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21
Q

Wound/abscess: What 4 general groups only require limited ID as likely skin contaminants?

A

Diphtheroids
Coag-Neg staph
Viridans strep
Bacillus spp

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22
Q

What could a mixed culture indicate?

A

1) Contaminated specimen
2) Normal flora for site of collection
3) Polymicrobic infection, may be mixed aerobes+anaerobes

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23
Q

What is the rule of 3?

A

Perform ID and susceptibilities on UP TO 3 pathogens

More than 3 semi quantitate all and list descriptive ID

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24
Q

How long do we hold wound cultures?

A

72 hours

25
Q

Special requests (6) and how long we hold

A
Actinomyces: 5 days
Nocardia: 5 days
Francisella: 5 days
Bartonella: 14 days
Propionibacterium: 14 days
Brucella: 28 days
26
Q

Tissues/Bones: Culture media

A
BAP
MAC
CHOC
PEA (extremities and sources below the diaphragm)
Thioglycolate broth
Direct gram stain
27
Q

Tissues/Bones: What 3 general groups only require limited ID as likely skin contaminants?

A

Diphtheroids
Viridans strep-full ID if predominant/pure
Bacillus spp-Rule out B. anthracis

28
Q

Tissues/Bones: How long do we hold plates and broth?

A

Plates: 3 days
Thio: 5 days
All isolates frozen for 2 years

29
Q

Tissues/Bones: ID and susceptibility

A
S. aureus 
COAG-NEG STAPH
Strep anginosus
Enterococcus
Enterobacteraciae 
Ps. aeroginosa 
Other nonfermenters
Yeast
30
Q

Body fluids: critical values

A

Pos gram stain

**Pos blood culture

31
Q

Tissues/Bones: Culture media non-CSF

A
BAP
MAC
CHOC
Thio broth (on peritoneal dialysis fluids and bone marrows only (rare)
Direct gram stain-cytospin
32
Q

Tissues/Bones: Culture media CSF

A

BAP
CHOC
Thio (on CSF shunt specimens only_
Direct gram stain-cytospin

33
Q

Can we refrigerate CSF specimens?

A

NO

34
Q

One organism seen per oil immersion field= ?? organisms per milliliter of specimen

A

10^5

35
Q

Body fluid in a blood culture bottle?

A

Anticoagulant must be added

Extra fluid must be submitted for gram stain

36
Q

Non CSF body fluid contaminants

A

Coag-neg staph
Diphtheroid bacilli
Viridans strep

37
Q

What is meningitis?

A

Infection in the subarachnoid space

38
Q

Purulent

A

Many PMNs in CSF

39
Q

Aseptic

A

Usually viral

Increase in CSF lymphocytes

40
Q

What 3 clinical results are consistent with a bacterial infection?

A

In WBC
Dec glucose
Inc protein

41
Q

Potential CSF pathogens: neonates/infants

A

S. agalactiae
E. coli
Listeria monocytogenes

42
Q

Potential CSF pathogens: children

A

H. influenzae
S. pneumoniae
N. meningitidis

43
Q

Potential CSF pathogens: young adults

A

N. meningitidis

44
Q

Potential CSF pathogens: adults

A

S. pneumoniae

N. meningitidis

45
Q

Potential CSF pathogens: elderly (>70)

A

S. pneumoniae
Listeria monocytogenes
GNB

46
Q

Potential CSF pathogens: AIDS patients

A

Cryptococcus neoformans (yeast)

47
Q

Causes of septic arthritis

A
S. aureus- most common
N. gonorrhoeae- most common in YA
H. influenzae in young children
Streptococci
Anaerobic bacteria (Bacteroides)
48
Q

Eye culture: 3 major syndromes

A

Conjunctivitis
Bacterial keratitis
Bacterial endophthalmitis

49
Q

Eye culture: culture media

A

BAP
MAC
CHOC
Direct gram stain

50
Q

Eye culture: specimen types

A

swab
corneal scrapings
conjunctival scraping
vitreous fluid

51
Q

Conjunctivitis potential pathogens

A
H. influenzae
S. pneumo
Enterobacteraciae
Ps. aeruginosa
S. aureus
N. gonorrhoeae
52
Q

Bacterial keratitis potential pathogens

A
Ps. aeruginosa
Moraxella
S. aureus
Enterobacteraciae
S. pneumo
Neisseria
H. influenzae
Acanthamoeba spp parasite
53
Q

What causes swimmers ear?

A

Ps. aeruginosa

54
Q

Ear culture: potential pathogens

A
S. pneumo
H. flu
S. pyogenes
S. aureus 
M. catarrhalis
Enterobacteraciae
Ps. aeruginosa 
Candida albicans
55
Q

Ear culture: susceptibility

A

Any single isolate of a potential pathogen, predominant or pure

56
Q

Genital cultures: potential pathogens

A
Neisseria gonorrheoeae
Gardnerella vaginalis
Beta strep (A and B)
Listeria monocytogenes
S. aureus
Enterobacteraceae
Candida albicans 
Actinomyces
57
Q

Which pathogen is associated with bacterial vaginosis and how is it tested for?

A

Gardnerella vaginalis

Rapid test available

58
Q

What genital pathogen is associated with IUDs?

A

Actinomyces