1
Q
Enumerate the gram positive bacillus
A
Corynebacterium
Listeria
Bacillus
Clostridium
Mycobacterium (weak gram pos)
2
Q
read and skip | OBLIGATE AEROBES
Gram (+):
Nocardia, B. cereus
Gram (-):
Neisseria, Pseudomonas, Bordetella, Legionella, Brucella
Acid fast:
Mycobacterium & Nocardia
Obligate aerobes needs 21% O2 | 0.03% CO2
A
OBLIGATE ANAEROBES
Gram (+): Clostridium
Gram (-): Bacteriodes
Obligate anaerobes: 0% O2
3
Q
read and skip |FACULTATIVE ANAEROBES
Gram (+)
Staph, B. anthracis, Corynebacterium, Listeria, Actinomyces
Gram (-)
Most other gram neg
Mycoplasma (+/-)
most pathogens, ENTEROBACTERIA
Facultative anaerobes do not require O2 bu grows better O2
A
AEROTOLERANT grows at the same rate with or without O2
“unbothered kween”
4
Q
#read and skip |MICROAEROPHILIC
Gram +: Streptococcus
Gram -: Spirochetes (TBL), Campylobacter, Helicobacter
Microaerophilic increased CO2 | decreased 5-10% O2
A
CAPNOPHILE
* Haemophilus
* HACEK
* Neisseria
* S. pneumoniae
Capnophiles needs 5-10% CO2
5
Q
what is the principle of autoclave?
temp & psi also
biological indicator: B. stearothermophilus
A
principle: steam under pressure
15 psi 121C 15-30mins
autoclave for sterilizing broth and media
6
Q
read and skip!!
inspissation - denatures protein-rich medium such as LJ agar
dry heat - biological indicator B. atrophaeus
filtration - heat sensitive materials
incineration - safest method
A
7
Q
E. coli that only grows on BAP
A
Enterotoxigenic E. coli (ETEC)
which causes traveler’s diarrhea
8
Q
MEMO!!!
enumerate the types of E. coli strains and their infection
A
- EPEC - infantile diarrhea
- ETEC - traveler’s diarrhea
- EIEC - dysentery/shigella-like
- EHEC - HUS & hemorrhagic colitis
- EAEC - persitent watery diarrhea
- DAEC - pediatric diarrhea & uti
- UPEC - uti (most common in humans)
EHEC 0157:H7 - most virulent serotype
9
Q
enumerate the growth factor/s needed for each haemophilus sp.
A
- influenzae, aegypticus, haemolyticus - X, V
- ducreyi - X
- parahaemolyticus & parainfluenzae - V
10
Q
enumerate the associated infection/disease in each haemophilus sp
A
- influenzae - otitis media, meningitis (children)
- aegypticus - pink eye conjunctivitis
- ducreyi - soft chancre
- parahaemolyticus - pharyngitis
- parainluenzae - endocarditis
H. influenzae serotype b - 2nd otitis media
11
Q
All HACEK group ferment glucose & maltose EXCEPT?
A
Eikenella corrodens
12
Q
HACEK
IDENTIFY only — of the group:
* only catalase positive
* only indole positive
* only lactose fermenter
* only assacharolytic member
A
- catalase (+) = A. actinomycetemcomitans
- indole (+) = C. hominis
- lactose fermenter = A. aprophilus (H. paraaphrophius)
- assacharolytic = E. corrodens
NTK: C. hominis shows false gram-positive reaction
13
Q
gram-negative rods that secretes acid phosphatase & alkaline phosphatase
A
Kingella kingae
NTK: K. kingae resist decolorization
14
Q
gram (-) coccobacilli that causes malta | crimean | mediterranean | undulant fever
A
Brucella
15
Q
Which brucella sp. is inhibited by thionine dye?
A
Brucella abortus
but this requires niacin or nicotinic acid for growth
16
Q
enumerate the bioterrorism agents
A
A: Fransicella tularensis & Y. pestis
B: Brucella
(potential): C. botulinum
they both require biosafety level 3
17
Q
what stain does F. tularensis needed to properly visualize organisms obtained from a blood c/s?
A
acridine orange
18
Q
common isolate in dog and cat bite infection
A
Pasteurella multocida
- dog-bite infection - Capnocytophaga canimorsus
- human bite infection - Eikenella corrodens
19
Q
agent of Pontiac fever
A
L. pneumophila
“Legionnaire’s disease”
- isolated in ACs, cooling towers, humidifiers, nebulizers
- preferred specimen: broncheoalveolar lavage/washing
20
Q
Pittsburg pneumonia agent
A
Legionella micdadei
21
Q
read and skip!! runyon classification
group - classification - growth rate:
* I: Photochromogen (10-21 days)
* II: Scotochromogens (10-21)
* III: Non-photochromogens (10-21)
* IV: Rapid growers (3-7 days)
A
COLOR PRODUCTION (in the dark)
* I = cream/buff
* II = yellow to orange
* III = cream/buff
* IV = varying pigments
COLOR PRODUCTION after light exposure
* I = yellow to orange
* II = yellow to orange
* III = cream/buff
22
Q
enumerate the runyon group 1 “Photochromogens”
A
- M. marinum
- M. asiaticum
- M. kansasii
- M. branderi
- M. intermedium
- M. nebraskense
remember: cream/buff | yellow to orange
23
Q
enumerate the runyon group 2
“Scotochromogens”
A
- M. gordonae
- M. scrofulaceum
- M. szulgai
- M. europaeum
- M. interjectum
- M. heckeshornense
- M. lentiflavum
remember: yellow to orange both
24
Q
enumerate the runyon group 3 “Nonphotochromogens”
A
- M. avium complex
- M. celatum
- M. genavense
- M. shimoidei
- M. simiae
- M. terrae complex
- M. xenopi
- M. ulcerans
- M. tuberculosis
remember: cream buff both
25
enumerate the runyon 4
**"rapid growers"**
* M. abcessus
* M. fortuitum
* M. chelonae
26
enumerate the AFB staining methods
1. Ziehl-Neelsen (hot)
2. Kinyoun (cold)
3. Auramine-rhodamine fluorochrome
27
# read and skip!!
Auramine-rhodamine
* most sensitive, reliable, and specific of the three
* *potassium pergmanganate* - counterstain
* (+) = **bright yellow orange bacilli**
positive QC: M. tuberculosis
negative QC: E. coli
QUANTITATIVE REPORT:
* 0 no afb seen
* 1-2/300 fields = repeat collection
* 1-9/100 fields = **1+**
* 1-9/10 fields = **2+**
* 1-9/field = **3+**
* >9/field = **4+**
| DSSM according to WHO: **100 fields**
28
# read and skip! :)
IMVC **+ + - -**
* Yersinia
* E. coli
* P. vulgaris
* Edwardsiella
IMVC **- - + +**
* Klebsiella pneumoniae
* Enterobacter
* Serratia
IMVC **- + - +**
* Citrobacter
IMVC **- + - -**
* P. mirabilis
* Salmonella
* Shigella
* Morganella
IMVC **+ + - +**: Providencia
IMVC **+ - + +**: K. oxytoca
29
enumerate those organisms that are
IMVC **+ + - -** and **- - + +**
**+ + - -**
* Yersinia
* E. coli
* P. vulgaris
* Edwardsiella
**- - + +**
* Klebsiella pneumoniae
* Enterobacter
* Serratia
30
enumerate those organisms that are
IMVC **- + - -**
* P. mirabilis
* Salmonella
* Shigella
* Morganella
31
# read and skip! **summary of TSI reaction**
**A/A (+) gas**
* E. coli
* Klebsiella
* Enterobacter
**K/A**
* Shigella
* Yersinia
* Providencia
* Plesiomonas
| A/A + gas: **EKE** | K/A: **SPPY**
**K/A (+) gas**
* Morganella
* Citrobacter koserri
* Serratia
**K/A (+) has (+) H2S**
* P. mirabilis
* E. tarda
* C. freundii
* Salmonella
| K/A + gas: **MCS** | K/S + gas + h2s: **PECS**
32
# read and skip | **CHLAMYDIA**
**C. trachomatis**
* A-C: trachoma
* D-K: genital infection, neonatal pnuemonia
* L1-L3: lymphogranuloma venereum
giemsa - Halberstaedter-Prowazek inclusion
Mccoy cells
* **C. pneumoniae** - atypical pneumonia
* **C. psitcacci** - Bird fancier's diease
33
# read and skip | **RICKETTSIAE**
* Rocky mountain spotted fever - R. rickettsii
* Rickettsial pox - R. akari
* Epidemic typhus - R. prowazekii
* Endemic typhus - R. typhi
* Scrub typhus - O. tsutsugamushi
* Q fever - C. burnetti
* Ehrlichiosis - E. chaffeensis
**Coxiella burnetti**
- only one without vector
- only one with chronic onset
- only one without rash
- has highest mortality
- only one with gradual onset
- only one with **eschar**
34
Donovan bodies look like safety pins is seen on what pathogen?
K. granulomatis
| K. granulomatis causes granuloma inguinale "donovanosis"
35
enumerate the major causes of **non-tuberculous mycobacteria human infection**
* M. avium complex
* M. kansasii
## Footnote
other NTM: kansasii, marinum, gordonae, scrofulaceum, xenopi, ulcerans, etc..
36
enumerate the pathogens from most resistant to most sensitive
MOST RESISTANT
1. Prions
2. Endospore
3. Mycobacteria
4. Naked/nonlipid virus
5. Fungi
6. Bacteria
7. Enveloped/lipid viruses
| NTK!! samples for TB detection: **2 samples!!**
37
# read and skip! classification of AFB after Ziehl or Kinyoun staining
Distinct AFB: **Mycobacterium**
Partially AFB:
1. Nocardia
2. Gordonia
3. Rhodococcus
4. Tsukamurella
5. Legionella micdadei
C/S for Mycobacteria:
* LJ agar - most commonly used
* Petragani medium - for recovery from heavily contaminated specimen
* incubated at 33-37C and in 5% - 10% CO2
* **niacin** - most commonly used test between M. tuberculosis and other MTC
| M. tuberculosis is **negative in both Catalase**
38
# identify the following
1. appears as gram ghost
2. resist decolorization
3. poorly stained with *gram stain*
4. not stained
5. poorly stained with *safranin*
1. Mycobacteria
2. Acinetobacter, Kingella
3. Campy, Brucella, T. whipplei
4. Chlamydia, rickettsia, coxiella, mycoplasma, etc
5. Legionella, gram (-) anaerobes, Francisella
| G/S QC: (**gram +**) S. aureus | (**gram -**) E. coli
39
# read and skip! **DIRECT SMEAR REPORTING**
Organisms:
* none = no organisms seen
* rare (1+) = <10 on complete smear
* few (2+) = 3-5 per OIF
* mod (3+) = 6-10 per OIF
* many (4+) = >20 per OIF
***ENDOSPORE*** made of caldium dipicolinate, makes the bacteria resistant to heat, chemicals, nutient deprivation and drying:
* B. anthracis = **center**
* C. tetani = **terminal**
* C. botulinum = **subterminal**
40
# identify the following! **GRANULES**
1. C. diptheria
2. Y. pestis
3. M. tuberculosis
4. Nocardia
5. Actinomadura
6. Anaerobes
1. Babes-Ernst granules
2. Bipolar bodies
3. Much granules
4. Sulfur granules
5. Sulfur granules
6. Sulfur granules
41
# identify the following! **FLAGELLA**
1. multiple flagella around the surface of the cell
2. single flagellum located at one end of the cell
3. group of glagella located at one end of the cell
4. single flagellum located at both ends of the cell
5. no flagella
## Footnote
choices: **amphitrichous, monotrichous, atrichous, lophotrichous, peritrichous**
1. **Peri**trichous = around the surface
2. **Mono**trichous = single at one end
3. **Lopho**trichous = group of flagella
4. **Amphi**trichous = both ends
5. **A**trichous = no flagella
42
# read and skip!
**MOTILITY:**
* twitching = Kingella, B. henselae
* tumbling = Listeria
* darting = Campylobacter
* rapid shooting star = Vibrio
* cork screw = Treponema
* gliding = Capnocytophaga
***HALOPHILES*** are salt-loving bacteria that requires NaCl for growth:
* S. aureus = **7.5 NaCl Mannitol salt agar**
* Enterococcus = **6.5% NaCl broth**
* Vibrio = **0, 3, 5, 8, 10% NaCl broth**
43
# read and skip! **SPECIAL GROWTH REQUIREMENTS**
* Haemophilus - X, V factors
* Legionella - cysteine and iron
* F. tularensis - cysteine and cystine
* Granulicatella, Abiotrophia - cysteine and vit. B6
* Anaerobes - hemin and vitamin K
* B. anthracis - vitamin B1 (thiamine)
**GROWTH CURVE:**
* Adjustment/Lag phase = increase cell size
* Exponential/Log phase = increase in number of living cells
* Stationary/Plateau phase = equal no. of dead & alive cells
* Death/Decline phase = increase in number of dead cells
44
# read and skip! **CULTURE MEDIA**
**NUTRITIVE:** *Nutrient agar, Trypticase soy*
**ENRICHMENT:**
* Selenite
* BCYE
* THIO
* LIM
**ENRICHED:** *BAP & CAP*
**DIFFERENTIAL:**
* MAC
* BAP
* EMB
* HEA
| sterilization: **AUTOCLAVE 121C 15psi 15 mins**
**SELECTIVE:**
* HEA
* MAC
* XLD
* MSA
**SPECIAL MEDIA:**
* LJ
* TCBS
* Cysteine agar
45
enumerate the inhibitors of gram positive and the inhibitors of gram negative
## Footnote
**NTK!** antimicorbials used for Neisseria to inhibit the growth of:
gram positive = vancomycin & lincomycin
gram negative = colistin
fungi = nystatin, amphotericin B, anisoymycin
Gram **+**
1. Crystal violet
2. Basic fuchsin
3. Bile salt (sodium deoxycholate)
Gram **-**
1. Phenylethyl alcohol
2. Potassium tellurite
3. Sodium azide
46
Order of CSF bottle
3 or more bottles:
1. Chemistry
2. **Micro**
3. Hema
Only 1 bottle:
1. **Micro**
2. Hema
3. Chemistry
47
differentiate lactose fermenter and non-lactose fermenter in **MAC**
Lactose fermenter: **PINK**
Non-lactose fermenter: **COLORLESS**
48
#FINAL PABAON QUIZ!
1. C. psittaci infection is most commonly acquired from?
2. What test differentiates S. aureus and S. pyogenes?
3. Which type of influenza virus undergoes both antigenic drift and antigenic shift?
4. What organism is associated with "pea soup stool"?
5. HHV-6 causes which illness?
6. Vector of Babesia
7. Organism refers to “Kanagawa phenomenon”
8. 3rd most common cause of hospital-acquired infection
9. Infection control dilemma/antibiotic associated diarrhea and pseudomembranous colitis
10. Opthalmia neonatorium
11. Morphology of C. jejuni in G/S
12. What additional tests included when IMVC tests are done?
13. MSA is selective because of?
14. Purpose of iodine in gram staining
15. Which test can distinguish M. tuberculosis from M. bovis?
16. What pigment and color does S. marcescens produced?
17. Test for toxin of C. diptheriae
18. S. aureus provides what factor for growth of Haemophilus?
LAST!! differentiate the 3 types of hemolysis (alpha, beta, gamma)
1. Birds (parrots, parakeets, etc)
2. Catalase
3. Influenza A
4. S. typhi (rice watery - V. cholerae)
5. Roseola/Exanthem subitum
6. Ixodes tick
7. V. parahaemolyticus
8. P. aeruginosa
9. C. difficile
10. N. gonorrhea
11. seagull
12. Motility & H2S
13. Salt
14. Fixes the dye
15. Niacin
16. Prodigiosin - red
17. Elek test
18. V factor
LAST!! ikaw nay bahala search kapoi nko type XD
49
#read and skip! LACTOSE FERMENTERS
**RAPID LF** “EKE”
E. coli
Klebsiella
Enterobacter
**LATE LF** “SSHYCi”
Salmonella arizonae
Shigella sonnei
Serratia
Hafnia
Yersinia
Citrobacter
**NON-LF** “SSEEPMPY”
Salmonella
Shigella
Edwardsiella
Erwinia
Proteus
Morganella
Providencia
Yersinia
50
#read and skip!
**UREASE (+)**
Serratia
Klebsiella
Yersinia
Morganella
Providencia
PIGMENTS:
**S. marcescens** - prodigiosin (red)
**P. aeruginosa** - pyoverdin (yellow), pyorubin (red), pyomelanin (brown/black), pyocyanin (blue)
**Flavobacterium (C. meningosepticum)** - flavin (yellow)
| Pyocyanin (blue) - only produced by *P. aeruginosa*
51
#read and skip! | Enterobacteriaceae
**UREASE (+)**
Serratia
Klebsiella
Yersinia
Morganella
Providencia
**H2S (+)**
Salmonella
Proteus
Arizona
Citrobacter
Edwardsiella
**DNASE POSITIVE** “SMASH VSS”
S. marcescens
M. cattarhalis
Aeromonas
S. pyogenes
H. pylori
S. maltophilia
S. aureus
**PYR POSITIVE**
S. pyogenes
Group D strep
S. lugdunensis
S. intermedius
S. urinarilis
52
read and skip! BIOCHEMICAL TESTS
**(+) RED** “IMVUN”
Indole
Methyl red
Voges Proskauer
Urease
Nitrate reduction
**(+) YELLOW** “TOT”
TSI
ONPG
TCBS
**BROMTHYMOL BLUE** INDICATOR
Citrate agar
HE agar
O/F Hugh leifson agar
Thiosulfate citrate bile salts
Sucrose
Simmons citrate agar
**NEUTRAL RED INDICATOR**
MacConkey agar
CIN agar
Salmonella-Shigella agar
**PHENOL RED INDICATOR**
Mannitol salt agar
Xylose lysine dec
Cystine trypticase agar
Urease test broth
TSI
53
read and skip! CHARACTERISTIC ODORS
* bleach-like - E. corrodens & H. influenzae
* putrid, burnt-chocolate cake - Proteus
* rancid butter- Eubacterium
* sweet odor - Peptostreptococcus
* dirty musty, rancid/rotten potatoes - S.odorifera
* butterscotch, caramel - Milleri complex & Viridans
* fishy amine - G. vaginalis
* grape, musty, or corn-tortilla - P. aeruginosa
* dirt-like - B. cepacia
* horse-stable or banyard odor - C. difficile
* odor of roses - Psychrobacter
* musty basement, mousy - Haemophilus
* soil or musty basement - Nocardia, Streptomyces
* old stock/stocking - S. aureus
* cheese-like - Brevibacterium
* mushroom - P. multocida
* ammona odor - S. maltophilia
**GROWTH AT 42C**
P. aeruginosa
Acinetobacter
S. maltophilia
Campylobacter
Chromobacterium
54
#read and skip
**ANTIBIOTIC RESISTANT**
Citrobacter
Enterobacter
Serratia
**CAMP (+)**
S. agalactiae (arrowhead)
L. monocytogenes
Rhodococcus
Arcanobacterium
C. perfringens
| Reverse CAMP: **A. haemolyticum**
55
#read and skip! DISEASES
**OTITIS MEDIA**
1. S. pneumoniae
2. H. influenzae
3. M. cattarhalis
**CYSTIC FIBROSIS**
1. P. aeruginosa
2. B. cepacia
**FOOD POISONING**
1. S. aureus - most common
B. cereus
3. C. perfringens
C. botulinum - most severe
L. monocytogenes - coleslaw
**SEPSIS-ASSOCIATED TRANSFUSION OF PACKED RBC**
Y. enterocolitica
P. fluorescens
P. putida
**UTI**
E. coli - community/hospital-acquired
S. saprophyticus - sexually active fem
E. faecalis - multi-drug resistant UTI
UPEC - #1 uncomplicated UTI
C. urealyticum, Proteus, K. pneumoniae, C. freundii, Providencia, R. equi, S. haemolyticus, S. lugdunensis
**BACTERIAL MENINGITIS**
S. pneumoniae - #1 adult
S. agalactiae - #1 neonatal
E. coli (K1) - #2 neonatal
H. influenzae (b) - children
C. jejuni - worldwide
56
Specimens for Salmonella identification for 1st, 2nd, and 3rd week of infection
1st: Blood
2nd: Stool
3rd: Urine
57
#refresher! DISEASES
* most virulent bacteria - B. anthracis
* Paget's dse - M. leprae
* Weil's dse - L. interrogans
* Ragpicker's dse - B. anthracis
* Red dse - E. rhusiopathiae
* Sodoku fever - S. minus/minor
* Swmmng pool granuloma - M. marinum
* Risys sardonicus (lockjaw) - C. tetani
| marker for GIT malignancy - C. septicum
* Crohn's dse - M. marinum
* Lady windermere - M. avium
* Jaw surgery - Veilonella
* Montezuma's revenge - ETEC
* Black death - Y. pestis
* Vietnamese time bomb - pseudomallei
* Kennel's cough - B. bronchiseptica
58
#refresher! DISEASES
* Waterhouse friderichsen syndrome - N. meningitidis
* Struvite kidney stones calculi - P. mirabilis
* Fitz - hugh curtis syndrome - N. gonorrhea
* Infant botulism “floppy baby”, flaccid paralysis (wandering eye) - C. botulinum
* Erysipelas - S. pyogenes
* Erysipeloid - E. rhusiopathiae
| C. jejuni - most common cause of bacterial gastroenteritis WORLDWIDE
* Brazillian purpuric fever - H. aegypticus
* Summer diarrhea Japan - V. parahaemolyticus
* Glander's (Farcy) - B. mallei
* 3rd hospital acquired/ gram-negative bacillary bacteremia - P. aeruginosa
* erythema nodosum - Y. enterocolitica
* erythema gangrenosum - P. aeruginosa
* gastroenteritis (men-men sex) - S. flexneri
* rectal prolapse - Shigella
REVALIDA
flashcards
Decks in class (10)
# Cards
