Unit 15 Mycobacteria Flashcards
Explain the differences between a typical bacteria and mycobacteria. (4)
- High lipid content and mycolic acid in cell wall creates hydrophobic permeability barrier
- Resist decolorization with acidified alcohol (3%) when strained with carbolfuchsin
- Grows more slowly because of hydrophobic cell surface
- Require increased CO2
What is the purpose of collecting early morning specimens in 3 successive days when dealing with specimens such as sputum, urine, and gastric washings?
Secretions pool overnight so the morning specimens have the highest concentration
Explain the reason for the decontamination process and what types of specimens require decontamination?
Nonsterile sites; These sites contain mixed flora and decontamination reduces bacterial overgrowth and breaks up the mucus without killing/hurting the mycobacterium
Explain thoroughly the NALC-NaOH procedure used to decontaminate/concentrate patient specimens for acid fast bacilli.
1) 2% NaOH and N-acetyl-L cysteine are mixed (must be used within 24 hours). Sputum is added to tube. NALC is added to for 1:1 ratio.
2) Vortex for 10 sec
3) Sit for 15 minutes (too long it will kill myco, not enough and not all the flora is killed)
4) Phosphate buffer is added to the 50 mL mark and tilted to neutralize.
5) Centrifuge with separate screw tops for 15 min.
6) Open under hood and decant supernatant. Lip cannot tough bucket. Leave at least 1mL supernatant.
7) Vortex ready to inoculate
List the 3 reagents used in the NALC-NaOH concentration method and describe their functions.
2% NaOH- decontaminating agent
N-acetyl-L cysteine- mucolytic agent
Phosphate buffer- “washes” the specimen, neutralizes the digestion mixture and lowers the specific gravity
List 2 advantages of the Auramine O fluorescent stain for the demonstration of AFB in direct smears of clinical specimens compared with either the Ziehl-Nielsen or Kinyoun’s procedures.
1) Dead mycobacterium will still stain
2) Anti-TB meds not clear yet
What is the “tap water bacillus”?
M. gordonae
What is considered the optimal environment (temperature and atmosphere) for isolation of most mycobacterium species?
35-37C For most (some 30C and one 42C)
3-11% CO2
Discuss the general characteristics of the four Runyon groups.
1) Photochromogen- forms pigment after light exposure
2) Scotochromogen- bright yellow/orange in dark or light
3) Nonphotochromogen- No pigment at all; buff
4) Rapid growers
Describe in detail the principle of the niacin test. Include in your answer what a positive niacin test indicates.
Those that lack the enzyme to convert niacin into niacin ribonucteotide will have niacin accumulation; chemical reaction released cyogen bromide gas causes the strip to discolor to brown OR fluid will turn yellow for accumulation
Special temperature requirements or other specific growth requirements: M. marinum
25-30C
Special temperature requirements or other specific growth requirements: M. xenopi
42C
Special temperature requirements or other specific growth requirements: M. haemophilum
requires hemin to grow; CHOC @ 25-30C
Special temperature requirements or other specific growth requirements: M. ulcerans
25-30C
Rapid grower, nitrate negative, arylsulfatase positive within 3 days, sodium chloride positive.
M. chelonae
Rapid grower, nitrate positive, arylsulfatase positive within 3 days, sodium chloride positive.
M. fortuitum
infection in AIDS patients
M. avian complex
cutaneous lesions known as “Bairnsdale ulcer”-
M. ulcerans
skin infections; associated with surgical wounds, skin trauma, or needle injections:
M. fortuitum/chelonae
highly communicable respiratory infection-
M. tuberculosis
pulmonary disease; noncommunicable from person to person-
M. kansasii
lymphadenitis; commonly affecting children during “teething” years-
M. crofulaceum
What is the drug(s) of choice to treat a Mycobacterial infection? Primary
Primary: Streptomycin Isoniazide-most common prophylaxis Rifampin Ethambutol
What is the drug(s) of choice to treat a Mycobacterial infection? Secondarys
Secondary:
Pyrazinamide
Clarithromycin
Fluoroquinolones
Key tests that will help to differentiate each of the following pairs of mycobacteria: M. tuberculosis vs. M. bovis
- TB is Niacin and Nitrate POS
2. TB grows on T2H/TCH
Key tests that will help to differentiate each of the following pairs of mycobacteria: M. fortuitum vs. M. chelonei
- MF is Nitrate POS
Key tests that will help to differentiate each of the following pairs of mycobacteria: M. gordonae vs. M. scrofulaceum
MG Tween 80 hydrolysis POS
Key tests that will help to differentiate each of the following pairs of mycobacteria: M. kansasii vs. M. marinum
- MK Nitrate POS
2. MK Urease POS
3. MK is catalase POS