Week 6 Flashcards

Question

What is Burkholderia pseudomallei

Answer 1

-BIOTERRORISM -causes meliodosis granulomatous pulmonary disease with lung lesions when you inhale or ingest organism -endemic in water muddy areas SE asia, Mexico, N Australia -ability to cause latent infection - vets were known as veit time bombs --bipolar safety pin staining on GNB -Wrinkled and dry

Answer 2

-2ND most isolated non fermenter -found as A. baumannii complex (very resistant) and A. lwoffi -found in nature water, soil and food and in hospital ventilators, humidifiers, catheters -normal on skin, mucous membrane - pharynx and vagina

Answer 3

-colonizer- opportunistic -seasonal pneumonia in late summer, bronchitis -it is insignificant if found in vaginal secretions, resp specimen -because if its resistance need to see how pure it is , type of pt and if it was isolated anywhere else A.. baumannii increasing resistance to carbapenems: eye infections, corneal ulcerations

Answer 4

non fermenter -Grows well on MAC; strict aerobe -GNCB (short plump bacilli can be confused with cocci), similar to Moraxella may look gndc (can be confused with GC in vaginal smears) -Oxidase negative (GC: oxidase positive) -TSI: NA/NC -Oxidizer ***** -Nitrate: Nitrates not reduced -*Non motile ** -Citrate: V (51% pos) -SIM: -/-/- -ONPG: neg A. baumannii – Growth@42C can differieniate from A baumanni with oxidase and A lwoffi because its asaccharolytic Acinetobacter differentiated from other non fermenters by its oxidase and motility reactions COCCOID AND PLEOMORPHIC

Answer 5

A. baumannii very resistant; A. lwoffi more susceptible to antibiotics Acinetobacter baumannii Infections Among Patients at Military

Answer 6

-mostly in nature -3RD most isolated Non Fermentative GNB -not normal flora but can colonize pts especially those on antimicrobial therapy and also in CF pt

Answer 7

--nosocomial infections especially in central venous catheter -bacteremia, wound , rare meningitis and UTI -opportunistic --mostly infect those immunocompromised or on AB for a long time -multi resistant -Cotrimoxazole (SXT) is most effective

Answer 8

non fermenter -Yellow-tan pigment on TSA, purple-green halo on sheep blood agar -MAC: NLF -Ammonia-like odor -Similar in characteristics to Pseudomonas but: Oxidase negative***** while pseudo is POS -TSI: NA/NC -Nitrate not reduced *** -Oxidizes glucose & maltose (strong) -Grows at 42C -Motile ***** -Citrate: + (75%) -SIM: -/-/+ (at the top) -ONPG: + (70%) -Catalase +, Gelatin hydrolysed, Lysine +

Answer 9

-NF on skin - rarely isolated same as faecalis -normal in soil, water, pools, water in incubators, resp equipment

Answer 10

non fermenter -GNB looks alpha -Strict aerobe -May have fruity odor -Nitrates reduced to nitrites ** -Oxidase positive -Grows on MAC -Asaccharolytic no reactions in OF -Motile by peritrichous flagella

Answer 11

non fermenter on MAC -Colonizes CF patients -Resistant to many antimicrobials -discoloration on BA -Motile -Strict aerobe -Oxidase positive

Answer 12

-Zoonotic infection -found in resp tract and GI of domestic and wild animals -transmission through animal exposure -opportunistic in cats and dogs part of NF but can cause abscesses through bites P. multocida – from cat bites P. canis – from dog bites

Answer 13

-the type that causes the most infections is P. multocida – from cat bites and it leads to pneumonia, bacteremia, arthritis and osteomyelitis Treatment SUS- Penci while other GNB are resistant RESIS - Ery and Clinda

Answer 14

-Grows well on ordinary media ; NG on MAC**** -Small, translucent colonies with brown discoloration -GNCB -Oxidase + (may be slow) -Catalase + -TSI: A/Ag ** -Nitrate to nitrites -Citrate: neg -SIM: -/+/- -O-F: F ***** -Easy identification Vitek, API 20E

Answer 15

cause enteric disease Family Vibrionaceae Genus Vibrio Species: V. cholerae V. parahemolyticus, V. vulnificus V. alginolyticus Found -aquatic environments Brackish – more salinity than freshwater but not as much as salt water Estuarine – coastal-free connection to open sea -Like water temps over 20 -mostly in summer or warm climates

Answer 16

-diarrheal disease due to undercooked fish or shellfish -spread via contaminated water including pools -poor hygiene/sanitation -endemic to India and Bangladesh -wounds in immunocompromised Vibrio cholerae O1 (Asiatic or epidemic cholera) – El Tor biotype most virulent: most common strain,

Answer 17

-need LARGE dose for illness -severe diarrhea -rice water *** with mucus in it -org produces enterotoxin (cholera toxin) which affects SI causing it to dump electrolytes and water which causes the diarrhea -it overwhelms the GI tract absorptive ability -AB can help to shorten diarrhea and reduce fluid loss

Answer 18

-2nd most common Vibrio in gastroenteritis -#1 cause of summer diarrhea in US, Canada, Japan -symptoms occur 24-48 hours after eating contaminated seafood like oysters -sometimes you can have extra intestinal eye and wound infections -Halophilic likes the coast because it likes salt to grow Virulence: ?Kanagawa phenomenon Organism produces heat stable hemolysin able to lyse human RBC in high salt mannitol medium

Answer 19

-Coastal areas including North America -Wound infection, septicemia (50% mortality) Cellulitis; rarely, necrotizing fasciitis & multiple organ failure primary Septicemia from GIT after ingestion of seafood -death in those with liver disease Risk factors: patients with liver dysfunction and conditions leading up to increased serum levels of iron. Patients with organism have a history of some type of traumatic aquatic wound that often presents as a cellulitis.

Answer 20

-Medical history is very important -BH on BA -Curved GNB/“comma”-often seen in direct clinical specimen’s Gram smear); highly pleomorphic -Motile: polar flagella (most), some peritrichous (V para –so is a bit “spready”) -Facultative anaerobes (fermenters) -MAC: NLF (but occ strains may be LF) -Oxidase positive*** -Reduce nitrates to nitrites -Citrate: V (50%+), SIM: -/+/+, -O-F: Fermenter -Salt loving (halophilic) - (most media OK) -Vitek, API, Tube biochemicals Polar sheathed flagella when grown in broth Peritrichous unsheathed flagella when grown on solid media

Answer 21

causes enteric disease investigation based on history and symptoms Aeromonas -same as pseudo found in water or moist places sink, faucets and can cause nocosomial infections -seasonal prefers warm months Aeromonas caviae -more common than A. hydrophilia -gastrointestinal Aeromonas hydrophilia -septicemia -cellulitis and wound infections -due to recent water traumatic exposure aka after tsunami -UTI, liver, ear and endocarditis -acute diarrhea similar to Campy and Shig

Answer 22

Similar to Enterobacteriaceae its facultative -similar to vibiro -MAC: LF or NLF; TSI: A/Ag or NA/A -GNB (straight) -Oxidase positive ** good indicator that it isnt Enterobacteriaceae -Motile- single polar flagella -O-F: Fermentative -Most are indole + -BH or NH -Nitrate: reduced to nitrites -SIM: -/+/+ -ONPG: pos -Can be misidentified as Vibrio by some systems -Does not grow in 6% NaCl differentiates between vibrio

Answer 23

-from greek word Neighbour -P. shigelloides only species -Habitat: surface waters, soil Commonly infects many warm blooded and cold blooded animals Dogs, cats, pigs, vultures, turtles, snakes, lizards

Answer 24

-Gastroenteritis -mild, watery diarrhea after ingestion of contaminated water or unwashed food Uncooked seafood, traveler's diarrhea -(Few) Extra-intestinal infections -Occupational exposure (animal contact) -septicemia, neonatal meningitis, cellulitis, septic arthritis, acute cholecystitis

Answer 25

-Short, rounded Gram negative bacilli -Grows on BA, MAC ( most LF) -Non-hemolytic on BA -Oxidase positive -Motile monotrichous or lophotrichous (1-5 polar flagella) -Indole positive -Fermentative (delayed) -INO well on API +, Aeromonas – (differentiating) -Does not grow in 6% NaCl VIBRIO WILL GROW IN 6% NACL BUT AERO AND PLESI WILL NOT

Answer 26

C. jejuni, C. coli, C. lari -microaerophilic -leading bacterial cause of gastroenteritis -water, bloody diarrhea 2-5 days after ingestion -uptake during summer bbq season - uncooked foods found in -GI tract of animals - farm animals -reproductive organs of animals can cause animal abortions

Answer 27

-needs low infective dose -through contaminated milk, food or raw chicken, improperly pasteurized milk (outbreak) -DOES NOT multiply in food -through lab workers because of the low dose -easier to get -enterotoxin and cytotoxin causes diarrhea

Answer 28

-gram right from stool -direct because there is background staining -motile- darting from side to side -culture must be done in 2 hours of collection or needs to transported in Cary Blair medium -microaerophilic 5% O2 or less must use a Campy pak to introduce CO2 and Nitrogen -will grow at 42-43 or even body temp and incubate for 48-72 hours. -need BAP, Campy-BAP, Skirrow’s or other selective medium (from stool specimens) which may contain horse blood and AB like vanco, trimethoprim, polymyxin, cephalothin, amphotericin B

Answer 29

-NH, pinky-grey, “wet” or mucoid, spread along the streak lines (“puddles”) Screening Tests -Characteristic Gram stain -GULL WING GNB -Oxidase positive -Wet prep- motile –single, polar flagella (darting motility) -HIPPURATE POSITIVE JEJUNI -Some labs report C.jejuni/coli but important to identify species for epidemiological purposes (latex agglutination or hippurate hydrolysis) -C. jejuni most commonly isolated -lari is differeniated by jejuni because it is R to Nalidixic acid while jejuni is R -no susceptibility because it is a self limiting infection

Answer 30

-found in mucus secreting epithelial cells in stomach NOT INTESTINES causing gastritis, duodenal ulcer disease, gastroenteritis and can cause gastric carcinoma

Answer 31

--microaerophilic -Urease breath test where CO2 is released if present , collect breath samples in an hour -Ingest labeled urea - detected in urine -Serology mostly for epidemiological studies , ELISA for IgG and latex agglutination -AG detection in stool -Endoscopy and culture -INVASIVE with gastric biopsies, aspirates, brushing. Make sure sample is kept in saline and must be sent to lab in 3 hours but can be 5 if kept at 4 degrees

Answer 32

-Small, gray, translucent, weak beta-hemolysis -Gram: pale staining, curved Gram negative bacteria “gull-wing” and “U” shapes -Oxidase +, catalase +, rapid urease + -can also be stained using acridine orange -plate on BHI and Skirrows media with vac, poly B and Trimeth and incubate at body temp for 3-5 because it is a slow grower

Answer 33

Group 1- Oxidative or asaccharolytic, oxidase + (most) and nitrates reduced to nitrites, to nitrogen gas or not at all' NON FERMENTER Group 2- Fermentative but oxidase positive

Answer 34

O/F test: most nonfermenters (oxidative or no action) Oxidase test: oxidase + and its fermenter its NOT Enterobacteriaceae Useful preliminary test Although some may be oxidase neg – they will differ in other tests typical of Enterobacteriaceae TEST FROM BAP OR CHOC ONLY NOT MAC because the sugars interfer

Answer 35

Gram Stain Most are similar to Enterobacteriaceae Some GNCB - Acinetobacter, Pasturella Some curved or comma-shaped - Campylo TSI -Enterobacteriaceae & fermenters: A/A or NA/A -Oxidative and Nonfermenters: NA/NA or NA/NC (no change or no reaction) good indicator that its not an Enterobacteriaceae might be oxidative or asycrolotic -First clue that you are dealing with a nonfermenter Rarely produce H2S

Answer 36

MAC-NG or ppt Blood Agar - pigmented Elizabethkingia and P aeruginosa Most grow well on BA but some require supplements (e.g. Campylobacter, Helicobacter)

Answer 37

ALL Enterobacteriaceae reduce nitrates to nitrites Nitrate test These organisms may: Not reduce nitrates Reduce nitrates beyond nitrites to gas Reduce nitrate to nitrites Motility test -Often strict aerobes - stab motility (e.g. SIM) useless as organism cannot grow further down -May see spreading across top (from liquid on surface of media) -Wet prep more reliable test of motility because it helps to determine motility if strict aerobe or facultative

Answer 38

-Motile Enterobacteriaceae are peritrichous - flagella surrounding -“Other gnb” bacteria more often one or more polar flagella (one or more on one end, or one on each end) -Location and number is frequently diagnostic

Answer 39

Pseudomonas aeruginosa (60% of nonfermenters isolated) Acinetobacter spp. Stenotrophomonas maltophilia Campylobacter - number 1 stool pathogen