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Micro Unit 4

J Sarge Unit 4 Microbiology

QuestionAnswer
This organism inhabits the mucous membranes of warm blooded hosts. Neisseria spp.
A new term was introduced in the Neisseria section of this unit. "Reduced Oxygen Tension" What does this mean. CO2 is added to the environment.
This organism is a gram-negative diplococci, oxidase-positive, grows well on chocolate not so well on BAP, @35-37°C, and stimulated by CO2. Neisseria gonorrhoeae and Nesseria meningitidis
The colonies of these organisms appear "wet" and light grey on chocolate agar under CO2. Neisseria gonorrhoeae and Nesseria meningitidis
Specimens of these organisms are senstive to desiccation (drying out) and cold. Neisseria gonorrhoeae and Nesseria meningitidis
This organism is the causative agent of gonorrhea. Neisseria gonorrhoeae
Humans are the only natural host of this organism and it is spread sexually from person to person. Possible transmission via fomites, although the organism has a great sensitivity to desiccation and fluctuations in temperature. Neisseria gonorrhoeae
This organism produces no toxins but does have protein antigen in the outer membrane giving rise to at least 16 different serotypes. Neisseria gonorrhoeae. Pili antigens T1,2,3, and 4 contribute to virulence. T1 and T2 are found in virulent strains. T3 and T4 on avirulent strains.
This organism has LAF (leukocyte-association factor) that attaches onto WBCs and compromises their phagocytic activities. Neisseria gonorrhoeae
In males, this organism produces purulent (pus) urethritis with discharge within 2-3 days post-infection. Neisseria gonorrhoeae
How long does the infection with Neisseria gonorrhoeae last? 1 to 2 weeks and spontaneously resolves. May recur and persist for years.
Sequellae (after affects) from this organism include chronic urethritis, prostatitis, and periurethral abcescess. Neisseria gonorrhoeae
We should culture discharge from the infection of this organism on chocolate or selective media. Neisseria gonorrhoeae
In females this organism involves the genitourinary tract and may be largely asymptomatic, therefore females may be good carriers. Neisseria gonorrhoeae
If Neisseria gonorrhoeae infection is involved in the cervix, where should the specimen be collected from. The Cervical Os and plated on chocolate or selective agar and CO2.
Why is the vagina not a good source for culture of Nessieria gonorrhoeae? Because of its natural acidity
Other not so typical places to culture for Neisseria gonorrhoeae depending on sexual activity. Oral cavity, rectum, or anal canal.
Neisseria gonorrhoeae can be passed to a newborn via an infected birth canal. What preventative measures are usually taken to prevent infection of the newborn? Eye drops.
Most selective agars for this organism are chocolate based (except NYC)and have antimicrobial agents that inhibit other bacteria, yeast, and mold. Neisseria gonorrhoeae
What are the selective media for Neisseria gonorrhoeae? Modified Thayer Martin (MTM), NYC, and Martin Lewis
Neisseria spp. do not like to get cold so what must we be sure of before we plate the organism? The media should be at room temperature
If Neisseria gonorrhoeae is collected on a swab, how should it then be plated? Rolled in a Z pattern and then streaked
How do we get the maximum recovery of Neisseria gonorrhoeae for plating. When specimens are plated dirrectly from the source. Separate swab for culture and gram stain.
How should Neisseria spp. be incubated? Aerobically at 35°C in CO2
We can get a presumptive diagnosis of this organism using a direct gram-stain of the organism collected from males 90-95% of the time. If we see intracellular gram-negative diplococci the organism is probably? Neisseria gonorrhoeae. Unable to diagnose from direct stain in females due to normal flora interference.
In the rapid carbohydrate test for Neisseria spp., what CTA sugars does Neisseria gonorrhoeae ferment? Glucose only!!! Remember, GLUCOSE for GONORRHEA!!!
Just to have them in front of you, flip the card for the commercial tests for N. gonorrhoeae. Enzyme substrate tests….Gonochek, BactiCard Multitest ID systems…Rapid Id, Vitek NHI, Microscan (modified conv. Test) DNAprobe……amplify N. gon. Specific nucleic acid sequences
For this unit what organism is the causative agent of meningitis? Neisseria meningitidis
When culturing non-sterile sources of Neisseria meningitidis, what selective agars should we use? Modified Thayer Martin (MTM) or NYC
Meningitis caused by Neisseria meningitidis is more common in what age groups? Children and young adults
What is the habitat of Neisseria meningitidis? Human nasopharynx
There can be asymptomatic carriers of Neisseria meningitidis. What percentage of the normal population are carriers? 5 to 30%
What age group might be more likely carriers of Neisseria meningitidis? "Older" children and young adults
How does one become a carrier of Neisseria meningitidis? Depends on the rapidity of their antibody response.
How is Neisseria menigitidis transmitted? Via aerosols between persons
What are the other less common disease states associated with N. meningitidis? Meningococcal sepsis, Pneumonia, and Sexual transmission
N. meningitidis strains are grouped by virulence factors which consist of toxic, anti-phagocytic polysaccharide capsules. What are the main types? There are actually 13 serotypes or Groups but the main ones are A,B,C,Y, and W135
What strains of Neisseria meningitidis have vaccines available? A,C,Y,and W135
What Group or strain of N. meningitidis causes epidemic meningitis outbreaks? Group A
What time of year do epidemic meningitis outbreaks occur? Late winter and spring
Individual infections with Neisseria meningitidis usually occur with what groups (strains)? Groups B and C
What group of Neisseria meningitidis has no capsule and causes infections in the general public and is the most common group in the US? Group B. No vaccine licensed in the US
What Group of Neisseria meningitidis is responsible for infection among military recruits? Group C
What organism produces prodromal (an early symptom) sore throat, ankle and wrist lesions (meningococcal arthritis)? Neisseria meningitidis
Infections with this organism extends to the CNS (central nervous system) and produces inflammation of meninges (brain covering). Neisseria meningitidis
This organism produces meningococcemia which may be life-threatening. Neisseria meningitidis
N. meningitidis infections may cause adrenal collapse and death. This syndrome is called what? Waterhouse-Friedrickson Syndrome
The mortality rate of infections with this organism is 85-90% if untreated and 10% if properly treated. Neisseria meningitidis
Infections with this organism are known to cause death within hours if untreated. Neisseria meningitidis
What biosafety level is N.meningitidis classified as? Biosafety level 2 ans must be handled in a bio safety cabinet
How is it suggested that laboritorians might acquire meningococcal infections? By manipulation of cultures
How might a direct gram-stain of Neisseria meningitidis appear? Gram-negative diplococci which may be extra or intracellular
What might we see in a direct gram-stain of an active infection with N. meningitidis? Intracellular organisms within PMNs (Polymorphonuclear WBCs)
To be sure of assumption of infection with N. meningitidis in a direct gram-stain of CSF we must look for... Presents of organisms, presents of leukocytes and decreases glucose
How might a laboratory make a presumptive ID of Neisseria meningitidis? By direct gram-stain of CSF
In the rapid carbohydrate test for Neisseria spp., what CTA sugars does Neisseria meningitidis ferment? Glucose "AND" Maltose. Remember Maltose for meningitis!!! N. gonorrhoeae is Glucose only.
What is the drug of choice for meningococcal meningitis? Penicillin G
What are the recommended drugs for Neisseria gonorrhoeae? Cephalosporins and fluoroquinolones. N. gonorrhoeae has widespread resistance to penicillin and tetracycline.
What drugs does Moraxella catarrhalis usually respond to? Ampicillin and penicillin but beta-lactamse testing is necessary to determine resistance.
This organism was formerly known as Branhamella catarrhalis. Moraxella catarrhalis
Is Moraxella catarrhalis normal in the upper respiratory tract? Yes
What diseases and infections are caused by Moraxella catarrhalis? Pneumonia, otitis media, sinusitis, rarely bacteremia and wound infections.
M. catarrhalis is very similar to Neisseria in that it is a gram-negative diplococci that is oxidase-positive. How might we differentiate this organism? In the rapid carbohydrate test M. catarrhalis does not ferment any sugars and is DNase-positive.
This organism is the causative agent of anthrax. Bacillus anthracis
This organism produces spores which are metabolically inactive and resistant to heat and chemicals. Bacillus anthracis
This organism is aerobic or facultatively anaerobic, grows on sheep BA, and are large boxy gram-positive rods with subterminal endospores appearing as holes inside the rods. Bacillus anthracis
This organism forms large, non-hemolytic, medusa-head colonies on BAP. Sporulates under aerobic conditions. Bacillus anthracis
Like other organisms we have studied this Bacillus sp. produces capsules which impart anti-phagocytic properties. Bacillus anthracis
The spores from this organism are formed only in air and are highly resistant. These spores can infect us through ingestion or inhalation and germination. Bacillus anthracis
This organism forms "strings of pearls" (chains of spherical bacilli) when incubated for several hours on agar containing low concentration of penicillin. Bacillus anthracis
What bio-safety level is Bacillus anthracis? Bio-safety Level 3
The pathogenicity of this organism is due to overwhelming septicemia, capillary damage and death. Bacillus anthracis
This organism produces toxins composed of multiple components. Bacillus anthracis
There are three clinical manifestations of Bacillus anthracis. What are they? Cutaneous anthrax, Pulmonary anthrax, and Gastrointestinal anthrax
Cutaneous anthrax produces a papule to black scar on the skin at the site of spore penetration. What is this black scar called? Black Eschar
What is the usual way people get cutaneous anthrax? From contaminated hides, wool, or hair
This form of Bacillus anthracis infection is characterized by generalized hemorrhage and edema and rarely progresses to meningitis or pneumonia. Cutaneous anthrax
This clinical manifestation of Bacillus anthracis is called "Wool Sorter's Disease." Pulmonary anthrax
This manifestation of Bacillus anthracis produces severe respiratory infection with nearly 100% mortality whether treated or not. Pulmonary anthrax
This Bacillus anthracis infection begins with malaise, mild fever and nonproductive cough, progressing to respiratory distress, massive chest edema, cyanosis and death. Pulmonary anthrax
This Bacillus anthracis infection has very rapid dissemination, initially producing bronchopneumonia, severe mediastinitis (area separating the lungs), invovling many lymph nodes, hemothorax, septicemia or meningitis and multiple organ failure. Pulmonary anthrax (Rapidly Fatal)
What manifestation of Bacillus anthracis will you get from eating raw meat or massive numbers of spores? Gastrointestinal anthrax
Gastrointestinal anthrax, ingestion of spores, will affect what part of the body? Oropharyngeal or abdominal area
What do most patients die from after ingestion of Bacillus anthracis spores? Toxemia and overwhelming sepsis
What is the most likely bioterroristic organism used for agents of mass destruction? Bacillus anthracis
This organism is recovered from soil or GRAINS. It is a causative agent of food poisoning (intoxication)producing a self-limiting, non-fatal nausea and vomiting similar to that caused by S. aureous. Bacillus cereus
Infections with this organism is usually associated with partially cooked, fried, or boiled rice. Baciluus cerseus
Bacillus cereus may cause septicemia in who? Drug abusers or those on hemodialysis
The gram-stain morphology of this organism is a gram-negative, non-spore-forming pleomorphic rod often "club shaped"-short or slightly curved rods with rounded ends- some resembling Chinese letters-some in parallel rows-some with rudimentary branching. Corynebacterium diphtheriae
Some species of this club shaped rod produce a variety of diseases, generally associated with bacteremias, septicemias, endocarditis, or meningitis. Corynebacterium spp.
This organism is the causative agent of diphtheria. Leathery throat lesion (pseudomembranous "diphth") Corynebacterium diphtheriae
This organism is also known as Klebs-Loeffler's bacillus. Corynebacterium diphtheriae
Man is the sole habitat for Corynebacterium diphtheriae and some are asymptomatic carriers. Where does the organism hang out? Mucous membrane of the nose and throat, skin and vagina.
Infection with this organism represents a true intoxication. Toxin only is disseminated and acts on PNS (peripheral nervous system?) and heart. Corynebacterium diphtheriae
Toxigenic strains of this organism are infected with bacteriophage that carries a toxic gene. Corynebacterium diphtheriae
Incubation of this gram-negative club shaped organism is 1-7 days with low fever, pallor, tachycardia, and weakness. Corynebacterium diphtheriae
This organism produces a fibrinous exudate and necrotic tissue. It may erode the epiglotis and can extend to the larynx and close off the trachea. It can also produce vascular damage and death. Corynebacterium diphtheriae
Recovery from this organism does not impart immunity. Corynebacterium diphtheriae
Sequellae from this organism include myocarditis and chronic peripheral neuritis. Corynebacterium diphtheriae
Is there a cutaneous form of diphtheria? Yes. It produces non-healing ulcers with membrane formation.
What selective media are used for Corynebacterium diphtheriae? Cystine-tellurite BA (black or grey colonies), Tinsdale's agar (black colonies with dark brown halo), Loeffler's medium (shows metachromatic granules in cells)
What organism do they use guinea pigs for toxic lethality testing. Corynebacterium diphtheriae
The treatment for this organism includes antitoxin to neutralize toxins plus penicillin or erythromycin to kill the oragnism. Corynebacterium diphtheriae
About one in ten persons who get infected with this organism dies. It is more severe for those under 5 and over 40 years of age. Corynebacterium diphtheriae
There is a vaccine for this organism and it is usually incorporated with tetanus and begun at infancy. Boosters required every 10 years. Corynebacterium diptheriae
Persons exposed to this organism are treated with single dose IM penicillin or 7-10 day oral course. Follow-up throat cultures at 2 weeks (repeat 10 day if positive), also revaccinated. Corynebacterium diphtheriae
This organism causes profound neonatal sepsis and death. It is primarily a disease of persons under 1 month and over 40 years of age. Not C. diphtheria which affects persons under 5 and over 40 years. Listeria monocytogenes
This organism is dangerous due to the ability to survive inside phagocytes due to formation of Listeriolysin toxin. Listeria monocytogenes
Infection from this organism is by ingestion of contaminated food such as meat and dairy products. Also colonized mothers pass organism to fetus. Entry is usually from GI tract to blood and sometimes to meninges. Listeria monocytogenes
A peculiar property of this organism that affects its food-borne transmission is the ability to multiply at low temperatures. Listeria monocytogenes
You might acquire an infection from this organism from eating foods that have been in the refrigerator too long. Listeria monocytogenes
Meningitis accounts for 75% if infections from this organism but it is not N. meningitidis. Listeria monocytogenes
Infection with this organism causes septic military granulomatosis which causes cardiorespiratory distress in mititary recruits. Not N. meningitidis. Listeria monocytogenes
Signs and symptoms of military granulomatosis caused by Listeria monocytogenes are? Vomiting, diarrhea, dark red skin papules, hepatoslenomegaly (swelling of the liver and spleen), Abscesses of liver, spleen, adrenals, lungs, pharynx, GI, and CNS
This condition, caused by L. monocytogenes, causes severe conjuctivitis and /or corneal ulceration. What is this condition or disease called? Oculoglandular listeriosis
Populations most susceptible to infection with this organism are elderly, immunocompromised or if underlying disease is present; (transplant patients, diabetics, Hodgkin's disease). Listeria monocytogenes
What is the selective media for Listeria monocytogenes? Oxford media. For non-sterile sources (Black colonies)
For isolation of L. monocytogenes, what specimens might be collected? CSF, blood, placenta, fetal tissue, stool
What hemolytic reaction will L. monocytogenes have 5% BAP? Beta hemolytic
What is the gram-stain morphology for Listeria monocytogenes? Small, Gram-positive rods which are sometimes arranged in short chains. In direct smears they may be coccoid so they can be mistaken for streprococci. Longer cells may resemble corynebacteria.
A presumptive ID of this organism may be made by direct mount (end-over-end tumbling) in nutrient broth at RT for 1-2 hrs. Listeria monocytogenes. This organism is also catalase-positive and esculin-positive.
An alternate presumptive ID of this organism can be made by an umbrella-shaped pattern from overnight RT incubation in a tube of semi-solid media. Listeria monocytogenes. This organism is also catalase-positive and esculin-positive.
Immunocompromised and pregnant woman shoud avoid eating soft cheeses and reheat hotdogs and cold cuts before eating to avoid this organism. Listeria monocytogenes
What are the treatment options for Listeria monocytogenes? Ampicillin and penicillin
Are PCR assays available for testing food products suspected of infection with L. monocytogenes? Yes
These organisms are ubiquitous in nature, are anaerobic spore-forming rods, and produce a variety of infections and intoxications. Clostridium spp. The key here is "Anaerobic spore-forming rods. Not to be confused with Bacillus anthracis.
All species of this organism form spores but some only under certain conditions. This organism is "usually" gram-positive but some stain gram-negative. Always catalase-negative and "most" species are motile. Clostridium spp. C. perfringens is non-motile.
These species of organisms may produce profound systemic infections and extensive tissue destruction. Clostridium spp.
These species of organisms can cause bacteremia, cellulitis, intra-abdominal abscesses, female genital tract infections, gas gangrene, food poisoning, tetanus, and colitis. Clostridium spp.
This species is one of several clostridia causing a variety of similar myonecrotic diseases and are causative agents of Gangrene and related infections. It is easily recovered from soil. Clostridium perfringens
This organism produces profound myonecrosis and tissue destruction; induced traumatically via inoculation of wounds, and/or surgical manipulation. Clostridium perfringens
This organism has a preference for anoxic conditions, crushed muscle, and compromised vascularity. Clostridium perfringens
This organism produces exotoxin and enterotoxins. Exotoxins such as "alpha toxin" (beta-hemolysin)- necrotizing enzyme lecithinase which loosens and destroys structural integrity of tissue. Clostridium perfringens. Alpha toxin may not be detected in blood, even in highly toxemic state.
This organism multiplies in the wake of alpha toxin in tissue. Clostridium perfringens
Incubation of this organism is 1-4 days; restlessness, temperature, tachycardia, lower BP and pallor; followed by sever pain and profound systemic manifestations. Rapid vascular collapse and death. Clostridium perfringens
This organism produces stinking ("anaerobic") wounds with brown pus, expanding crepitation (cracking sounds from gas). Clostridium perfringens
After infection with this organism, surgery is often indicated. Antibiotics are of little use due to loss of vascularity. Clostridium perfringens
Food poisoning from this organism produces acute abdominal pain from ingesting meats or meat products (gravy). Enterocolitis: diarrhea, vomiting and abdominal pain manifests about 8-22 hours post ingestion. Clostridium perfringens. Enterotoxin is elaborated as spores germinate in the GI tract.
This organism produces benign cellulitis- Localized superficial and subcutaneous forms; associated with diabetes. Legs and toes are special under-vascularized tissues. Clostridium perfringens. No action on muscle tissue, pain not severe, slight fever and tachycardia. No true lasting damage.
What deadly organism is used to make botox? Clostridium botulinum
The illness from this organism is an intoxication, not an infection. It comes from ingestion of preformed toxin in non-acidic vegetables or mushroom foodstuffs. Clostridium botulinum
This organism produces profound systemic effects produced by Exotoxin arising in contaminated foods (non-acidic vegetables and musshrooms). The toxin is on the food and not produced in the human. Clostridium botulinum
This organism produces large, subterminal endospores. There are at least eight antigenic strains (A-G). There is much antigenic variation in each group. Clostridium botulinum
The pathology of this organism is that contaminated food is eaten by unsuspecting host; toxins are absorbed in the gut which then block neuromuscular transmission in cholinergic nerve fibers causing descending flaccid paralysis. Clostriduim botulinum
Symptoms arising from this organism develop 12-36 hours after ingestion including diplopia (double vision) and respiratory paralysis. Clostridium botulinum
Death can occur within 24 hours ofter symptoms appear from this organism, usually from flaccid paralysis of the diaphragm. Life can be preserved on a respirator. Clostridium botulinum
Which one of our organisms could be dangerous to a child by ingestion of honey. Clostridium botulinum. Infant botulism.
What is the selective agar for Clostridium difficile? CCFA (cycloserine-cefoxitin-fructose agar)
What is the plate morphology of Clostridium difficile on CCFA? Yellow ground glass colonies
What organism smells like horse manure and fluoresce chartreuse (yellow-green) in UV light? Clostridium difficile
This organism is an important cause of antibiotic-associated diarrhea and pseudomembranous colitis (inflamed colon with membrane-like lesions)mostly seen in hospitalized patients or immunocompromised but can strike healthy individuals. Clostridium difficile
Antimicrobial agents (ie: clindamycin)upset normal flora of the intestines and this organism takes over due to resistance. Clostridium difficile
This organism may be toxigenic or nontoxigenic. Toxigenic strains produce Enterotoxin (Toxin A) and cytotoxin (Toxin B). Clostridium difficile
Tests for this organism include cytotoxicity test of stool determines if toxin is present. Also may perform tests for Toxin A and B as well as latex agglutination testing. Clostridium difficile
How much do anaerobes outnumber aerobes by? 1000:1
Will strict anaerobes grow in the presence of oxygen? No
Where do anaerobic infections occur? Near mucosal surfaces
Do anaerobes grow more quickly or slower than facultative or aerobic bacteria? Many grow more slowly
How long might isolation and identification of anaerobes take? Days to weeks
What are inappropriate specimens for anaerobic bacteria? Throats, sputums, gastric, small and large bowels, feces, vaginal, cervical,surface swabs, voided urines
What are optimal specimens for anaerobic bacteria? Head/neck aspirates, deep bronchial secretions, joint fluid, bile, blood, endometrium, bladder urine, tissue biopsy
What are the best specimens for anaerobic bacteria? Tissue and needle aspirates in transport media
How are anaerobic environments usually created? By use of jars or pouches using commercially available hydrogen and CO2 generator envelops activated by moisture and a catalyst
What must be placed in an anaerobic jar to assure you have an anaerobic environment? An indicator
What are some nonselective media for anaerobic bacteria? ANA Blood (Schaedlers, Bruella, CDC, BHI), Thioglycollate broth, Cooked (Chopped) meat
What are some selective media for anaerobic bacteria? ANA PEA-inhibits enteric neg rods, LKV-Provetella, BBE-Bacteroides fragilis, CCFA-Clostidium difficile
What is a selective media for Bacteroides fragilis? BBE
What is used for blood cultures of anaerobic bacteria? Liquid media commercially available with or without SPS (sodium polyanethol sulfate) prepared under vacuum w/CO2
What are the major sites of normal anaerobic bacteria? Oral, intestinal, and genital
What are some common sources of infection by anaerobic bacteria? Nosocomial, surgical proceedure, trauma. Predisposing factors include burns, malignancy, diabetes,and aspiration.
What is the most dominant gastrointestinal species of anaerobic bacteria? Bacteriodes spp.
What anaerobic bacteria (on our list) might be involved in the infection of an intravenous drug user that lubricated his needle with saliva? Any of the three. Fusobacterium nucleatum, Bacteroides fragilis, or Actinomyces spp.
Disease states that can lead to infection from Bacteriodes are... Ulcers, gastric carcinoma, and biliary tract obstruction
What are some of the clues that you might be dealing with an anaerobe? Foul odor in specimen, infection proximal to mucosal surface, secondary to bite wound, gas in specimen, presence of "sulfur granules" (actinomycosis), positive gram-stain with no aerobic growth.
Considering that most anaerobic specimens come from surgeries and are probably sterile, what are the steps to identifying these bacteria? 1. Gram-stain, 2. Subculture, 3. Aerotolerance
What is the presumptive ID for Bacteroides fragilis? Gram-negative pleomorphic rod, pale staining, resistance to special potency antibiotic disks, resistance to bile (BBE agar)
What is the presumptive ID for Fusobacterium nucleatum? Gram-negative rod with pointed ends, sensitive to Kanamycin and Colistin, catalase and nitrate negative. Produce a rancid oder (butyric acid) and may fluoresce a chartreuse color.
What is a presumptive ID for Actinomyces spp.? Sulfur granules, "molar tooth colony"
What does PRAS stand for? Pre-reduced anaerobically sterilized (biochemicals)
What are some common errors when dealing with anaerobic bacteria? Delay in setting up culture, failure to minimize air exposure, defective ANA jar (crack or leaks), No indicator, No CO2 in ANA gas, failure to do QC on media, failure to bypass indigenous flora in collecting specimen.
What is the Special Potency Disk ID for Bacteroides fraglilis? RRR
What is the Special Potency Disk ID for Fusobacterium nucleatum? SRS
What is the Special Potency Disk ID for Clostridium perfringens? SSR
What is the gram-stain morphology and blood plate hemolytic reaction of Clostridium perfringens? Gram-positive boxcar-shaped rods, "double zone" of Beta hemolysis on anaerobic BA
Created by: 1414395397