1
Q
What is the correct in order to do O antigen agglitunation test ?
A
D (O9)
B (O4)
C (O6, O7)
A(O2)
2
Q
What are the spp in Kauffmann-White group A?
A
Salmonella Paratyphi A
S. Nitra
3
Q
What are the spp in Kauffmann-White group B?
A
S typhimurium
S paratyphi B
S java
4
Q
What are the spp in Kauffmann-White group C?
A
S infantis
S bareilly
S Paratyphi C (Very rare)
5
Q
What are the spp in Kauffmann-White group D?
A
S enteritidis
S typhi
S javiana
6
Q
What are the classification system of meningococcal bacteria?
A
1-Capsular types: 13 serogroups (Commonest : A, B, C, W, X &Y)
2-Outer membrane proteins (porA and fetA)
3-Clonal Complexes using MLST
7
Q
What are the virulence factors of Meningococcal bacteria?
A
1-Polysaccharide capsule
2-Lipooligosaccharide
3-Outer membrane proteins: PorA, PorB, and Opa
4-Pilli
5- IgA1 protease
8
Q
Biochemical teats that can aid meningococcal identification?
A
Oxidase-positive
Catalase-positive
Glucose and maltose fermentation positive
9
Q
What routine Sensitivity testing should be done for Meningococcal isolate?
A
benzylpenicillin
rifampicin
ciprofloxacin
cefotaxime
9
Q
Treatment recommendation of meningococcal meningitis?
A
Ceftriaxone IV 2 gms BD
10
Q
What are the significant contact in case of meningococcal meningitis?
A
Household contacts
Kissing contacts
Healthcare workers exposed to respiratory secretions
11
Q
How to manage contact of Meningococcal meningitis ?
A
1-Chemoprophylaxis (ciprofloxacin, rifampicin, or ceftriaxone)
2-vaccination for unimmunized contacts if appropriate
12
Q
What are the routine meningococcal vaccinations in UK?
A
1-MenB vaccine:
Routine at 2, 4, and 12 months
2-MenACWY :
Routine for adolescents at 14 y
3-MenC: part of the Hib/MenC at 12 months
13
Q
What is the GC media ?
A
Selective media for Gonococci
VCAT:
- Vancomycin
- Colistin
- Amphotericin B
- Trimethoprim
14
Q
What are the Virulence Factors of Klebsiella Species?
A
- Polysaccharide Capsule
- Lipopolysaccharide
- Fimbriae/Pili
- Iron acquisition system
- Type 6 Secretory System
15
Q
K. aerogenes is intrinsically resistant to….?
A
Amoxicillin
Co-amoxiclav
1st generation cephalosporins, Cefoxitin (but not cefuroxime)
16
Q
Common susceptibility pattern of Burkholderia pseudomalii?
A
- R to aminoglycosides and colistin
- S to coamoxiclav
17
Q
What are 3 commonest Citrobacter species in UK ?
A
Citrobacter freundii
Citrobacter koseri
Citrobacter braakii
18
Q
What empiric Antibiotics to avoid when treating citrobacter species?
A
Avoid amoxicillin for C koseri
Avoid coamoxiclav/pip-taz/1st generation cephalosporin for C freundii.
19
Q
What is the prodigiosin?
A
A red/pink pigment produced by Serratia marcescens
20
Q
Serratia marcescens Intrinsic resistance ?
A
Ampicillin, amoxicillin
Co-amoxiclav
Ampicillin-sulbactam
1st/2nd gen cephalosporins
Colistin/polymyxin B
Macrolides
Nitrofurantoin
21
Q
What are the SMEs?
A
Serratia marcescens enzyme
SME-1, SME 2, SME-3, etc.
Hydrolyses penicillin, aztreonam, and first-generation cephalosporins in addition to imipenem.
22
Q
What is the plague reservoir and vector?
A
Reservoir:
Wild rodent
———–
Vector:
Xenopsylla cheopis (Oriental rat flea)
Ctenocephalides felis (Cat flea)
23
Q
Mode of transmission of Plague?
A
- Vector-borne Transmission (Bubonic Plague)
- Respiratory Plague
- Direct Contact Transmission (Septicemic Plague)
- Ingestion (pharyngeal plague)
24
Post Exposure prophylaxis of Plague?
Ciprofloxacin OR Doxycycline for 7 days
25
IPC Measures of Pneumonic plague?
1- Strict isolation
2-Negative-pressure room
3-Airborne precautions with FFP3/N95 mask
4-Isolation 48 post Abx
5-PPE : Gloves, fluid-resistant gown, eye protection
26
Environmental Decontamination When dealing with a case of plague ?
1-Chlorine-based disinfectants (1,000 ppm)
2- Terminal cleaning
3- Handling of deceased patients requires special precautions
27
Selective media fir yersinia ?
Cefsulodin-Irgasan-Novobiocin (CIN) agar
28
What is the serovar classification system of Salmonella species ?
Kauffmann-White classification
29
Which strains of Salmonella has Vi antigens?
Salmonella Typhi
Salmonella Paratyphi C
Salmonella Dublin
30
T/F:
All strains of Salmonella produce red colonies with black centres when grow on XLD agar?
F
Salmonella Typhi and Paratyphi A may not produce a black centre
31
As per SMI what is the optimum agar combination is the best as a primary plating medium to isolate Salmonella spp?
1- Xylose-lysine-desoxycholate agar (XLD), Plus:
2- mannitol lysine crystal violet brilliant green agar (MLCB),
32
How dose salmonella colonies look like on CLED , XLD & DCA ?
- CLED - Salmonella produces non-lactose fermenting colonies
- XLD - red, and usually with a black centre (except Typhi & Paratyphi A: no black centre)
- DCA - colourless and usually with a black centre (except Typhi & Paratyphi A: no black centre)
33
How dose salmonella colonies look like on BGA, Salmonella- shigella agar & Hekton agars?
- BGA - red to pink colonies surrounded by brilliant red zones in the agar
- Salmonella -shigella agar: colourless with a black centre
- Hektoen : green with black centre
34
T/F:
All salmonella spp belong to Hazard group2?
F
All except following w are group 3:
1- Salmonella Typhi
2- Salmonella Choleraesuis
3- Salmonella Paratyphi A, B & C
35
List 5 risk factors for salmonella infection?
- Asplenia/ hyposplenia
- Haemoglobinopathy eg SCD
- Common variable Immunodeficiency (Recurrent Salmonella gastroenteritis)
- Schistosoma bowel infection
- Unpasteurised milk, contaminated poultry and egg
36
Which animal are commonly ass with salmonella spp ?
1-Salmonella arizonae - reptiles, & turtle
2-Salmonella diarizonae & Paratyphi B variant - Snakes
3- Salmonella salamae - sea turtle
4- S poona & S vitkin: turtles
37
Rodent-associated Salmonella?
S derby,
S indiana
S enteritidis
38
Which salmonella species is associated with Birds contact?
S typhimurium
39
What are the commonest complications in NTS infections?
1-Bacteremia
2-Osteomyelitis
3-Abscess
4-IE and mycotic aneurysm
5- CNS infection
40
T/F:
If salmonella enteritis is expected , stool is plated directly onto XLD and in Mannitol selenite broth (MSBr)?
T
MSBr is incubated for 24 hrs and then sub-cultured onto XLD agar
41
What Abx that can be used to treat NTS sever infection? duration ?
Drug of choice: Ciprofloxacin PO
Others :
Ceftriaxone
Cotrimoxazole
Azithromycin
Amoxicillin
Duration :
7/7 if immunocompetent
14/7 if immunocompromised
42
What treatment can be offered to eradicate chronic carriage of NTS ?
1- Cipro for 4 weeks, Or:
2- Amox 6 weeks , Or:
3- Cotrim 12 weeks
To start 1 week after completing treatment
Test for cure:
3 stool cultures obtained over a week
43
What are the risk factors for Yersinia entirocolitica infection?
1- < 5 years of age
2- Elderly
3-Iron overload conditions
4- Patients receiving desferrioxamine
5-Immunocompromised
6-Diabetes mellitus
7- Liver cirrhosis
44
T/F:
Yersinia pseudotuberculosis is Fully susceptible to ampicillin and first-generation cephalosporins unlike entirocolitics?
T
45
What is gold standard diagnostic test for Typhoid fever?
Blood culture typically plated on blood agar, chocolate agar and CLED
-----------
Stool culture on XLD and mannitol selenite broth (which is a subculture onto XLD)
46
T/F:
Salmonella spp has EUCAST Breakpoint for chloramphenicol and azithromycin ?
F:
1- Chloramphenicol (ECOFF based - MIC >16 mg/L; zone diameter <17 mm is R)
2-azithromycin (ECOFF based MICs above 16 mg/L = R) ,
47
Risk factors for chronic salmonella carriage ?
1-Females
2-Abnormalities in the biliary tree
3-Biliary tract stones
4-Renal tract abnormality 5-Renal calculi
6-Urinary schistosomiasis
48
How to treat a confirmed Typhoid chronic carrier ?
1-Ciprofloxacin (750 mg PO BD x 28 d)
2-Azithromycin (500 mg OD x 28d)
3-Amoxicillin (1 g PO TDS x 28d)
49
T/F:
Typhoid Chronic carriers can have antibody titers against the Vi antigen?
T
50
How to follow up a chronic carrier after Treatment ?
1-Monthly stool sample starting one month after treatment
2-Any negative should be followed by two samples 48 h apart
3-Consider USS and a cholecystectomy if antibiotic fails
51
What is the Multidrug-resistant enteric fever (MDR EF)??
S. Typhi or Paratyphi A, B or C, and is R to:
1- Ampicillin
2-Chloramphenicol
3-Co-trimoxazole.
52
What is the Extensively drug resistant enteric fever (XDR EF)??
It is the MDR EF with additional R to
1- Ciprofloxacin
2-3rd GC
53
What is the ESBL Enteric fever?
It is the EF that is R to 3rd GC but S to at least one of:
1-Chloramphenicol or
2-Co-trimoxazole or
3-Ciprofloxacin
54
Morganella morganii is Intrinsic R to which Abx??
Amoxicillin
Coamoxiclav
Ampicillin-sulbactam
1st GC
Tetracycline
Polymyxin/colistin, Nitrofurantoin
55
What are the mechanisms of R seen in Morganella ?
- ESBL
- inducible ampC
- hyperproduction of beta-lactamase
56
Commonest infections caused by proteus spp?
UTI
Wound infections
Burn infections
57
T/F:
Proteus spp. can result in alkalinization of urine ?
T
- Hydrolyze urea to ammonia and CO2
- Leading to precipitation of magnesium-ammonium phosphate = struvite
58
What are the virulence factors of Proteus spp?
Pili or fimbriae
Flagella
Haemolysin
Urease
Endotoxin
59
T/F:
All Proteus spp are intrinsically R to nitrofurantoin, colistin/polymyxin and tetracycline?
T
penneri and vulgaris are also intrinsically R to amoxicillin and 1st & 2nd-generation
60
Which Enterobacteriaceae spp which has natural resistance to fosfomycin?
Leclercia adecarboxylata
61
PSA Virulence factors?
- Drug resistance (efflux upregulation/porin loss)
- Biofilm formation
- Quorum-sensing
- Pilli (Type IV pili)
- Flagella
-LPS
-Type 1,2, 3, 5, & 6
-Secretory system,
Protease, elastase, exotoxins, leucocidin, pyocyanin, etc
62
SSTI that can be caused by PSA?
- Hot tub folliculitis
- Infection in burn patients
- Ecthyma gangrenosum
- Osteomyelitis/septic arthritis following a nail puncture wound
- Green nail syndrome
63
Lab ID for PSA SPP?
Gram-negative rods
Strict aerobic
Motile
Non-spore-forming
Oxidase +ve
Catalase +ve
#Typical pungent grape-like smell
#CN agar
64
What are the commonest pigment produced by PSA?
1-pyoverdine (yellow-green)
2-Pyocyanin (a bluish)
65
What is the selective agar for PSA growth ?
C-N Selective Agar (Cetrimide Agar)
66
Why dose PSA Has a typical grape like smell?
due to aminoacetophenone
67
Typing used for Pseudomonas aeruginosa ?
variable number tandem repeat (VNTR) analysis
68
Please make a Pseudomonas sensitivity panel ?
- Panel 1:
Pip-taz / ciprofloxacin / meropenem /ceftazidime/ aztreonam / amikacin
-------
- Panel 2:
Cefiderocol
ceftazidime-avibactam
ceftolozane-tazobactam
tobramycin
-------
- Broth microdilution (if required) - Colistin
69
What are the unusual resistance patterns in PSA , if present, send the isolate to AMRHAI?
1. Resistance to ALL of imipenem, meropenem, ceftazidime and piperacillin/tazobactam With strong imipenem/EDTA synergy (irrespective of AZT )
2. R to Ceftolozane/tazobactam (MIC >2 mg/L)
3. Colistin R by broth microdilution
70
What are the antipseudomonal cephalosporin ?
Ceftazidime
Ceftazidime-avibactam
Ceftolozane-tazobactam
Cefepime
Cefiderocol
71
PSA Carbapenemase Production is
relatively uncommon. Name the 2 commonest ones?
blaKPC
blaVIM
72
What are the commonest PSA R mechanisms ?
- Porin loss (OprD)
- PDC enzymes (pseudomonal AmpC)
- Efflux pumps (OprM)
- Mutations in PBP
- Expanded-spectrum β-lactamases (e.g., blaOXA-10)
73
Acinetobacter lab ID?
Gram-negative coccobacilli
Strictly aerobic
Non-motile
Non-fermenting
Catalase-positive
Oxidase-negative
Colonies : smooth, mucoid, non-pigmented.
74
Which spp are in Acinetobacter calcoaceticus-baumannii complex" (ACB complex)?
A. calcoaceticus
A. baumannii
A. pittii
A. nosocomial
75
Commonest infection that can be caused by Acinetobacter spp?
VAP/HAP
Bacteraemia
Wound infections
UTI
Meningitis (less common)
76
Gram and microscopy of Acinetobacter spp?
The are short GNB that can appear as diplococci
not readily decolourise
77
What are the IPC measures to reduce Acinetobacter cross infection?
- Strict hand hygiene
- Contact precautions for colonised/infected pt
- Environmental cleaning and disinfection
- Hydrogen peroxide vapour or UV light for terminal cleaning
- Staff Education: Regular training on IPC measures
- Antibiotic stewardship
- Active surveillance in high-risk units
78
What are the commonest R mechanism in Acinetobacter spp?
- OXA-type (e.g., OXA-23, OXA-24/40, OXA-51)
- Efflux Pumps : AdeABC
- Porin loss
- Alterations in PBP = β-lactam R
- Acinetobacter-derived cephalosporinases (ADCs)
79
What are the 2 commonest Acinetobacter species causing bacteraemia?
A. lwoffii
A. baumannii
80
All PSA spp are Oxidase positive except 2 spp?
P Luteola
p oryzihabitans
81
Oxidase negative Nonfermenters?
1- P luteola and oryzihabitans
2- B mallie / B gladeoli
3- sten mal
4- Acinetobacter spp
5-pandoreae
6- Roseomonas
82
What is the preferred treatment combination for moderate to sever CRAB /MDRAB ?
Sulbactam-durlobactam 1g/1g IV q6h over 3 hours +
meropenem 1g IV q8h or
imipenem-cilastatin 1g IV q6h
83
What is the recommended empiric therapy for suspected CRAB outbreak/VAP ICU?
1- Colistimethate Sodium (CMS) loading
+
2-High-dose meropenem
+
3- Tigecycline pending cultures.
De-escalate within 48 h
84
T/F:
For CRAB UTI , consider colistin instead of polymyxin B
T
Colistin has better urinary concentration
85
What PCR targets to detect Acinetobacter Baumanii ?
- 16S RNA PCR
- GyrB gene
86
T/F:
All carbapenem can be used to treat Acinetobacter spp?
All Carbapenem (Not Erta)
87
What is the mechanism of Sulbactam-resistance in Acinetobacter spp?
Mutations in PBP3, 1a/1b
88
What are the selective Burkholderia Cepacia Agars?
1-Burkholderia Cepacia Selective Agar (BCSA)
2-Oxidation-Fermentation-Polymyxin-Bacitracin-Lactose (OFBPL)
3-PC (Pseudomonas cepacia) agar
89
What are the contents of BCSA?
Yeast extract
Crystal violet
polymyxin B
gentamicin
vancomycin
Sucrose/ lactose
Phenol red
90
Lab ID burkholderia Cebacia ?
GNR
straight or curved
Aerobic
non-spore-forming
Non-lactose fermenting Catalase: positive
Oxidase: positive/variable
91
What are the commonest BCC Spp isolated from CF patients?
-Burkholderia multivorans
-B cenocepacia (most virulent)
-B. cepacia
-B. vietnamiensis
-B. dolosa
92
What are the 4 Burkholderia that are of clinical importance?
-B. cepacia complex
-B gladioli
-B pseudomallei
-B mallei
93
All Burkholderia species are motile with multiple polar flagella, except...
B. mallei
94
All Burkholderia spp are Hazard group 3 , except...?
BCC
95
Burkholderia spp growth features?
- On MacConkey :
Punctate / tenacious/ dark pink/red
- On blood agar:
Smooth / raised / mucoid
96
Lab ID burkholderia pseudomaleii
Gram-negative bacillus
Oxidase-positive
Catalase positive
Motile
Non-lactose-fermenting
Bipolar staining/ safety pin
Growth :
- Creamy/yellowish colonies initially then become wrinkled and dry
-Selective :Ashdown media
97
What is the Ashdown's selective medium?
selective medium for B. pseudomallei growth
B mallei cannot grow on it
98
B malleii is Intrinsically R to ...?
1-Polymyxins
2-Aminoglycosides
3-Many β-lactams including penicillins
99
What is the culture media for Leptospira?
EMJH media
100
List 4 diagnostic test to confirm leptospirosis (Weils disease)?
PCR : first 5 days
Serological assays
Typing – MLST
Microscopic agglutination test (MAT)
101
What is the primary vector of Borrelia burgdorferi in UK?
Ixodes ricinus
102
What is the Pathognomonic rash of Lyme disease?
Erythema migrans
103
Commonest manifestation of Cardiac Lyme disease?
1- Atrioventricular conduction defects
2-Myopericarditis
104
What are the commonest manifestations of early Neuroborreliosis ?
1-Lymphocytic meningitis
2-Cranial neuropathy (mainly facial nerve palsy, ~60%)
3-Radiculopathy
4-Mononeuritis multiplex
105
What are the commonest manifestations of late Neuroborreliosis ?
- Encephalomyelitis
- Cerebral vasculitis
- Cognitive impairment
106
First line Tx of Lyme disease?
Doxycycline 21 days
Amoxicillin 21 days or Azithromycin 17 days
107
Tx of neuroborreliosis ?
Ceftriaxone 21 days.
If a PO switch is needed - doxycycline
Second line : Doxy 21 days
108
Tx of Lyme arthritis ?
1st line :
Doxycycline 28 days
2nd line :
Amoxicillin 28 days or ceftriaxone 28 days
109
What is the causative agent and vector of Louse-Borne Relapsing Fever?
Borrelia recurrentis
Human body louse (Pediculus humanus corporis)
110
What is the gold standard diagnostic test for louse borne relapsing fever?
Microscopy of thick and thin blood films during febrile episodes
Giemsa or Wright stains
Dark-field microscopy
111
What is the causative agent and vector of Tick-Borne Relapsing Fever (TBRF)?
B. duttonii
B. hermsii
B. hispanica
--
Vector :
soft tick Ornithodoros spp.
112
113
What is the potent virulace capsular protein in H influenzae type B?
polyribitol ribose phosphate
114
T/F:
H influenzae has a clinical breakpoint for macrolides ?
F
No breakpoints
115
What are the commonest bacteria that can cause Lemierres syndrome ?
Fusobacterium necrophorum 80%
Others:
- Fusobacterium nucleatum
- Streptococcus anginosus
- Other anaerobes (Bacteroides, Porphyromonas)
- group A Streptococcus
- Staph aureus
- Eikenella corrodens
- Enterobacterales.
116
Gold standanrd Tx of Chronic Q fever?
- Doxycyclin 100 mg po BD +
- Hydroxychloroquine 200 mg TID
Duration : 18 months
Until Phase I IgG <1:200 or a 4-fold titer drop
Cotrim or rif can be added as a 3rd agent
117
118
What is Ecthyma gangrenosum (EG)?
Punched out ulcers with necrosis and violaceous edge
The most common areas are the groin, axilla, perineum
caused by PSA infection in immunocompromised host
119
Image findings if Brodies abscess?
- X-ray:
Solitary, punched-out radiolucent lesion
- MRI :
"Target sign" with central necrosis
- CT:
lobular-shaped lucent lesion
120
121
What is teh selective agar media to grow Campy jejuni?
Charcoal cefoperazone deoxycholate agar (CCDA) contains
- cefoperazone (campy is R, but prevents other GN bacteria from growing),
- amphotericin B (prevent fungus from growing),
122
Eikenella is usually R to ....?
Clindamycin
Macrolides
Aminoglycosides
Metronidazole
123
Common Traditional infections cant can caused by Eikenella?
Clenched fist injury
Fishbone abscess
Needle licker OM
Toothpick septic arthritis
124
Culture growth features of Eikenella ?
- Slow-growing
- Small, pin-point colony
- Bleach-like smell
- Yellow-grey with a small greenish discolouration on BA
- Pitting
- Requires hemin (X factor)
- Oxidase +ve
- Catalase -ve
- Urease -ve
- Indole -ve
- Reduce nitrate
125
Lab ID of Pasturella ?
- Gram-negative void or rod
- Bipolar staining
- Capsules may be present
- Non-motile
- Catalase
- Oxidase +ve (except P. bettyae)
- Non-haemolytic grey
- Viscous colonies
- Strong mucinous odour resembling Haemophilus influenz
- Fails to grow on MacConkey agar/CLED - Can grow on BA
- Always penicillin-sensitive
126
Brucella spp?
- small, faint-staining Gram-negative coccobacilli
- Can grow on Blood and chocolate agar (not MacConkey)
- Colonies: small, non-pigmented, non-haemolytic
- Aerobic, non-motile
- oxidase/catalase/urease-positive
127
Complications of Brucella ?
- Neurobrucellosis : meningoencephalitis
- IE
- Pneumonia/ pleural effusion
- Suppurative infection – spleen, liver
- Sacroiliitis, discitis, arthritis (large joint)
- Pyelonephritis, - Epididymoorchitis/tubo-ovarian abscess
128
What are the commonest aeromonas spp?
Aeromonas caviae
Aeromonas dhakensis
Aeromonas veronii
Aeromonas hydrophila
129
T/F:
Aeromonas are negative for ornithine decarboxylase hydrolysis (except for some A veronii)?
T
Plesiomonas and vibrio are positive for ornithine decarboxylase hydrolysis
130
V. cholerae
- Comma shaped GNB
- Non-spore forming
- Motile- single polar flagellum
- Can grow at 40°C
- On blood agar= strongly
haemolytic (except classical biotype
- On TCBS agar= yellow
- Can utilize sucrose & α-ketoglutarate
- Can grow in the absence of Na+
- oxidase positive
131
T/F:
V. cholerae El Tor is currently the
predominant biotype and Ogawa the predominant subtype
T
132
T/F:
V. cholerae O1 classical biotype is Voges-Proskauer (VP) negative and is sensitive to
polymyxin (50 IU disc). V. cholerae O1 El Tor biotype is VP positive and is resistant to
polymyxin?
T
133
V parahaemolyticus?
- catalase and oxidase positive
- Do not ferment sucrose
- Kanagawa phenomenon
134
V vulnificus?
- On TCBS = green
- Catalase and oxidase positive
- sucrose fermentation = Variable
-
135
Aeromonas spp?
- straight, GN coccobacilli
- Motile and non- spore
- Can grow on blood agar with or without haemolysis
- Can also grow on MacConkey orCIN
- Facultative anaerobic
- Catalase and oxidase positive
- Resistance to vibrostatic compound 0/129 (Pteridine)
- Ornithin decarboxylase negative (except veroni)
- Unable to grow in the
presence of 6.5% Nacl
- Has ability to liquefy gelatin
- Unable to ferment I -
inositol
- Negative string test
136
aeromonas growth on TCBS , CIN and Mackonky?
- on CIN agar – colonies appear as pink bulls eye due to fermentation of D-mannitol.
- On MacConkey agar – colonies are typically non-lactose fermenting
- On TCBS Yellow
137
Brucella spp?
Aerobic, GN
Coccobacilli
non-motile
oxidase-positive
catalase-positive
urease-positive
Can grow on Blood and chocolate agar (not MacConkey)
small colonies nonpigmented non-haemolytic
Special Media:
Brucella agar: Enriched medium for fastidious organisms (not selective)
138
Mechanism of action of Cholera toxin?
- ADP-ribosyltransferase
- The B subunits bind to the GM1 ganglioside receptor, facilitating the entry of the A subunit
- A subunit's active act to ADP-ribosylates a G protein
- increase intracellular cAMP
- cAMP activates ion channels like CFTR, causing a massive efflux of chloride ions and water
139
T x of neurobrucellosis ?
Ceftriaxone (6 weeks) + doxycycline/cotrimoxazole (12 weeks) + rifampicin (12 weeks); may need a longer course.
140
Bordetella selective medium ?
- Bordetella selective medium (charcoal blood agar with cefalexin)
- Modified Cyclodextrin Solid Medium (MCS) with cefdinir
- Regan-Lowe Charcoal Agar
- Bordet Gengou agar
141
bordetella ID?
Gram-negative coccobacilli, aerobic, may have bipolar staining,
Do not grow on nutrient/MacConkey/CLED and grow poorly on blood agar
non-motile
weakly oxidase positive
urease negative
142
Elizabethkingia meningoseptica ?
- Gram-negative bacillus
- slightly curved
- Nonmotile
- Non-spore forming
- Non-lactose fermenter
- Aerobic
- Oxidase +
- Catalase +
- Indole +
- Urase -
- Growth:
can grow on Blood agar and Chocolate (pate yellow)
poor growth on MacCokey
Vanc S / Colistin R pattern
143
infections caused by Elazabethkingia meningoseptica?
- Neonatal sepsis
- Pneumonia
- Bloodstream infections in immunocompromised
- SSTI
- CNS infections
144
E. meningoseptica is colistin-resistant and vancomycin-sensitive like B cepacia (both GNB , LNF & no growth on MacConkey) How to diffrentiate ?
By Indole and pyr test :
both -ve on B cepatia
both +ve on E meningoseptica
FRCpath microbiology part 2
flashcards
Decks in class (18)
# Cards
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Antimicrobial resistance167
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Mycobacterium83
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1- General infection174
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2- General infection182
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Vaccine19
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Treatment172
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Bacterial biochemical tests and agars 2119
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bacterial biochemical test and agars137
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Atypical pneumonia65
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Gram negative145
-
Gram positive Cocci173
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Gram Positive Bacilli167
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Microbiology Laboratory35
-
Antibiotics82
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STI121
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IPC117
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Vaccine7
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MOA35
