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Bacterial Differentials (General) Flashcards

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1
Q

Gram Neg Diplococci

A

Neisseria

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2
Q

Gram Neg Cocobacilli

A

Acinetobacter
Morganella
Haemophilus (CHOC only, wet mouse)

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3
Q

Gram Neg Rods - lactose fermenters

A 
E. coli
Klebsiella
Enterobacter
Serratia
Citrobacter
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4
Q

Gram Neg Rods - non-lactose fermenters

A 
Pseudomonas (grape)
Burkholderia
Stenotrophomonas
Salmonella
Shigella
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5
Q

Curved Gram Neg Rod

A

Campylobacter
Helicobacter
Vibrio
Flexispira

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6
Q

Gram Neg Rods - special atmosphere

A

HACEK

Eikenella (bleach)

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7
Q

Gram Neg Rods - special media

A

Yersinia
Brucella
Fransicella

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8
Q

Gram Neg Rods - strict anerobe

A

Bacteroides

Fusobacterium

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9
Q

Gram Pos Cocci - clusters

A 
Staph (catalase pos)
Micrococcus
Finegoldia
Rothia
Aerococcus
Pediococcus
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10
Q

Gram Pos Cocci - pairs and chains

A 
Streptococci (catalase neg)
Enterococci (catalase neg)
Leuconstoc
Lactococcus
Gemella
Globictella
Vagococcus
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11
Q

Gram Pos Rods - anaerobic

A

Clostridium
Proprionibacterium
Actinomyces

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12
Q

Gram Pos Rods - aerobic

A 
Bacillus
Corynebacterium
Listeria
Erysipelothrix
Lactobacillus
Arcanobacterium
Mycobacteria (beaded)
Nocardia (beaded)
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13
Q

Gram Pos Rods - beaded

A

Nocardia
Actinomyces (anaerobic)
Mycobacteria

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14
Q

Gram Pos Rods - pallisading

A

Corynebacterium

Arcanobacterium

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15
Q

Gram Pos Rods - box car shaped

A

Clostridium

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16
Q

Gram Pos Rods - Nest like

A

Proprionibacterium acnes

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17
Q

Which bug produces double-zone hemolysis?

A

Clostridium perfringens

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18
Q

Smells like Indole?

A

E. coli

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19
Q

Smells like grapes?

A

Pseudomonas

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20
Q

Smells like Butterscotch?

A

Strep. anginosis

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21
Q

Smells like wet mouse?

A

Haemophilus

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22
Q

Smells like bleach?

A

Eikenella

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23
Q

Which biochemical differentiates between Staph and Strep?

A

Catalase

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24
Q

Catalase positive organisms

A 
Staphylococcus
Micrococcus
Listeria
Bacillus
Corynebacterium
Most Gram Negs
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25
Catalase positive GPCs
Micrococcus Aliococcus Staphylococcus Rothia mucilaginosa
26
The CAMP test is for presumptive identification of what?
Group B Streptococcus (S. agalactiae)
27
CAMP positive organisms
GBS Listeria P. acnes Turicella otitidis
28
Reverse CAMP test is specific for which orgs?
C. perfringens | Archanobacterium haemolyticum
29
What does hippurate hydrolysis test for?
The presence of hippurate hydrolase, which hydrolyses hippuric acid to benzoic acid and glycine
30
Hippurate hydrolysis positive orgs
GBS Campylobacter jejuni ``` Lengionella pneumophila Gardnerella vaginalis Listeria monocytogenes Bacillus Aerococcus ```
31
Group A Strep (Morphology and defining biochemicals)
GPC, chains, "string of pearls" very round cells Beta-hemolytic on SBA Catalase neg, PYR pos, Bacitracin sensitive
32
Strep pneumoniae (Morphology and defining biochemicals)
``` Lancet shaped GPC pairs, with capsule Alpha-hemolytic on SBA Donut shaped (dent in middle) colonies Optichin sensitive (presumptive) Bile soluble (confirmatory) ```
33
Viridans Streptococci groups
``` Mutans Anginosis (milleri) Mitis Salivarius Bovis ```
34
Strep mutans group (characteristics)
Rod morphology off agar, cocci morphology off broth
35
Strep mutans group (species)
S. mutans | S. sobrinus
36
Strep anginosis group (characteristics)
Butterscotch odor
37
Strep anginosis group (species)
S. anginosis S. constellatus S. intermedius
38
Strep mitis group (characteristics)
Optichin sensitive, bile soluble
39
Strep mitis group (species)
``` S. mitis S. pneumoniae S. sanguinis S. gordonii S. oralis ```
40
Strep salivarius group (species)
S. salivarius | S. vestibularis
41
Strep bovis group (characteristics)
Bile esculin positive, cannot survive 6.5% NaCl
42
Strep bovis group (species)
S. gallolyticus subsp gallolyticus S. gallolyticus subsp pasteurians S. infantarius S. alactolyticus
43
Nutritionally Variant Streptococci (species)
Abiotrophia | Granulicatella
44
Nutritionally Variant Streptococci requirements to grow
pyrodoxal or cysteine
45
Nutritionally Variant Streptococci grow on which agar?
CHOC
46
Nutritionally Variant Streptococci are usually resistant to which antibiotic?
Penicillin
47
What test is presumptive for Enterococcus
Bile Esculin (turns BEZ dark brown to black)
48
Bile esculin positive organisms
``` Enterococcus S. bovis group Lactococcus Vagococcus B. fragilis ```
49
PYR positive GPCs
Enterococcus S. pyogenes Staphylococcus (lugdunensis, schleferi, intermedius, haemolyticus) NVS (Abiotrophia, Granulicatella) ``` Aerococcus viridans Aliococcus Gemella Globicatella Lactococcus Vagococcus ```
50
Enterococcus sp (defining biochemicals)
PYR positive Bile esculin positive grow in 6.5% NaCl
51
Non-enterococci GPCs that are Bile esculin positive
Lactococcus | Vagococcus
52
Non-enterococci GPCs that grow in NaCl
Leuconostoc | Lactococcus
53
Glucose fermenters
Enterobacteriaceae Vibrio Aeromonas Pasteurella
54
Non-glucose fermenters
Pseduomonas Burkholderia Stenotrophomonas Acinetobacter
55
What member of the Enterobacteriaceae is oxidase positive?
Plesiomonas
56
Oxidase positive orgs
Pseudomonas aeruginosa Burkholderia cepacia Plesiomonas ``` Aeromonas Vibrio Moraxella Neisseria Bordatella parapertussis Burkholderia pseduomallei Capnocytophaga (dog species) Brucella Campylobacter Helicobacter H-CEK Chromobacterium violaceum Methylobacterium Ochrobactrum Pasteurella Psychrobacter Roseomonas ```
57
What does spot indole test for?
The ability to split indole into tryptophan
58
Indole pos orgs
``` E. coli Klebsiella oxytoca Klebsiella ornithinolytica Proteus vulgaris Proteus penneri Citrobacter koseri ``` ``` Cardiobacterium hominis Aeromonas Pasteurella multocida Vibrio Pleisiomonas Proprionibacterium acnes ```
59
H2S positive orgs
``` Salmonella Erysipelothrix (on TSI) Proteus vulgaris Proteus mirabilis Proteus penneri Edwardsiella tarda Citrobacter freundii ``` Brucella abortus Campylobacter coli Aeromonas hydrophila
60
Gram negatives that are CATALASE NEGATIVE
Bartonella Capnocytophaga Streptobacillus H-CEKs
61
Gram negatives that are OXIDASE NEGATIVE
``` Enterobacteriaceae (not Pleisiomonas) Stenotrophomonas Bartonella Francisella Burkholderia gladiolii Bordetella parapertussis Bordetella holmseii Pseudomonas luteola Pseudomonas oryzihabitans Aggregatibacter Acinetobacter Capnocytophaga (human) ```
62
Non-motile Enterobacteriaceae @ 37 degrees C
(SKY) Shigella Klebsiella Yersinia
63
Enterobacteriaceae - General characterisitcs
``` Glucose fermenters Biopolar staining (Gram) Oxidase negative (exp. Pleisiomonas) Catalase positive Motile @ 37C (exp SKY) Both LF and NLF ```
64
Enterobacteriaceae - Lactose Fermenters
``` Enterobacter E. coli Klebsiella Citrobacter (late) Serratia (Late) ```
65
Enterobacteriaceae - Non-lactose Fermenters
``` Edwardsiella Hafnia alvei Morganella Proteus Providencia Salmonella Shigella Yersinia ```
66
Common cause of infection from cat or dog bites
Pasteurella multocida
67
Pasteurella multocida general features
``` Gram neg cocobacillus NO GROWTH on MAC From mouth of dogs or CATS Glucose fermenter Musty odor "COIN" - Catalase + - Oxidase + - Indole + - Nitrate + ```
68
Klebsiella general characteristics
Lactose fermenters Short, fat, chubby, w/ and w/o capsule Bipolar staining
69
K. oxytoca - features/disease
Indole + | ABx associated hemorrhagic colitis
70
K. pnuemoniae - disease
"Red currant jelly" sputum Multiple lung abscesses Freilander's pneumonia High mortality
71
K. pneumoniae K1 capsular Ag - characteristics/disease
Hyper-viscous Pyogenic liver abscess (Asia, diabetes) Monomicrobial, solitary lesion
72
K. rhinoscleromatis - disease
Rhinoscleroma (can spread to trachea and larynx) | DDx: Histo, Actino, Nocardia, Wegener's
73
K. ozaenae - disease
Atrophic rhinitis (restricted to nose)
74
K. granulomatis - disease/features
``` Granuloma inguinale (painless ulcers, swelling genitalia, can spread to bones, joints, liver) Donovan bodies ```
75
Salmonella - general features
NLF on MAC | H2S +
76
Salmonella that cause enteric fever
Salmonella serotype Typhi | Salmonella serotype Paratyphi A, B, C
77
Yersinia pestis - features
``` GNR, safety pin shaped Slow growing, "fried egg" Grows better at 25-28C NLF on MAC Non-motile at 35C and RT Oxidase - Catalase + Indole - Urea - ```
78
Yersinia entercolitica - features
Growth on CIN @ 25c Sequelae: Reiter's syndrome (immune relate arthritis) Reservoir is domesticated pigs (worldwide) >50 serotypes, O3, O8, O9 majority of disease
79
Aeromonas - features
K/A +Gas production Indole + Typically NLF Oxidase + Catalase +
80
Aeromonas that cause gastroenteritis
Due to toxin genes A. cavie A. veronii
81
What does catalase test for?
The ability to convert H2O2 (hydrogen peroxide) into O2 and H2O
82
What does tube coagulase test detect?
Presence of FREE and BOUND coagulase
83
What does slide coagulase test detect?
Presence of clumping factor (in 85-95% in S. aureus)
84
Which orgs cause false positives for slide coagulase test? How do you tell them apart from S. aureus?
S. lugdunensis and S. schleferi (also produce clumping factor, but not coagulase) Both are PYR positive, S. aureus is PYR negative
85
Which orgs cause false positives for tube coagulase test? How do you tell them apart from S. aureus?
S. intermedius and S. hyicus are tube coagulase pos S. intermedius is PYR positive, S. aureus is PYR negative Erysipelothrix is coagulase pos (is a GPR)
86
What does Staphaurex detect? What does this do?
Detects clumping factor AND Protein A (spec. to S. aureus) | Removes false positives (99.8% sensitive, 99.5% specific)
87
What tests are presumptive ID for S. pyogenes (Group A Strep)?
PYR positive, Bacitracin susceptible | also has small colony and large zone of hemolysis
88
What tests are presumptive ID for S. agalactiae (Group B Strep)?
Hippurate positive, CAMP test positive | also has large colony and small zone of hemolysis 'candlelight'
89
Group A Strep - Diseases
Rheumatic fever Acute glomerulonephritis ``` Pharyngitis Scarlet fever Pyoderma/Impetigo Erysipelas Cellulitis Necrotizing fasciitis TSS ```
90
Aeromonas that cause soft tissue infections
A. veronii (leeches)
91
Aeromonas that cause sepsis and necrotizing fasciitis
A. hydrophila A. veronii A. jandaei
92
Vibrio - features
Curved GNR Grows on TCBS selective agar K/A no gas String test + NLF Catalase + Oxidase + Mostly Beta-hemolytic
93
How do you tell Vibrio from Aeromonas?
String test: Vibrio + Aeromonas -
94
Vibrio cholerae - disease serotypes
O1 and O139 (rice water diarrhea) | Non-O1 and Non-O139 - milder diarrhea (raw oysters)
95
Vibrio that are indole positive
V. cholerae V. parahaemolyticus V. vulnificus
96
Vibrio - Yellow on TCBS
V. cholerae V. fulvialis V. alginolyticus
97
Vibrio - Green on TCBS
V. parahaemolyticus V. mimicus V. vulnificus
98
Pseudomonas - General features
``` Long, thin GNR Glucose non-fermenter NLF Oxidase + (except P. oryzihabitans and P. luteola) R to bactrim (trim/sulfa) S to colistin Yellow/green colonies ```
99
Stenotrophomonas - General features
Long, thin GNR Non-glucose fermenter NLF Oxidase negative Los of intrinsic resistance inc. natural metallo beta-lactamases Treat with Trim/Sulfa, then fluoroqunilone
100
Burkholderia - General features
``` Long, thin GNR Non-glucose fermenter NLF Gen. sensitive to bactrim (trim/sulfa) resistant to colistin ``` Endemic in SE Asia, N Australia, Carribbean Soil, rice paddies, rodents
101
Bartonella - General features
``` Oxidase negative Catalase negative Urease negative 5-15 days to grow (v. hemin dependent) Grows on CHOC, slowly on SB and blood Cx NG on MAC Small GNR, slightly curved PCR is best for diagnosis ```
102
Causative agent of cat scratch fever, disease symptoms, and vector?
Bartonella henselae Nodule at scratch, cutaneous lesions Cat vector
103
Causative agent of trench fever, disease symptoms, and vector?
Bartonella quintana 3-8 febrile paroxysms, or continuous fever Flea vector
104
Causative agent of oroya fever, disease symptoms, and vector?
Bartonella bacilliformis Fever, profound anemia, skin lesions (miliary to nodular) Sand fly vector
105
Pasturella multocida - Gram stain and common source
Gram negative coccobacilli | Mouth of dogs and cats
106
Pasturella multocida - Colony morphology and culture
Mucoid colonies on SB and CHOC No growth on MAC Musty odor
107
Pasturella multocida - Biochemical reactions
"COIN" | Catalase +, Oxidase +, Indole +, Nitrate +
108
Burkholderia cepacia complex - biochemicals, growth conditions, colony morphology
``` Catalase + Oxidase + Grows on MAC variable growth at 42 deg Cols turn purple on MAC Dirt like odor ```
109
Burkholderia gladiolii - biochemicals, growth conditions, colony morphology
Catalase + Oxidase variable Grows on MAC NG at 42 deg
110
Burkholderia mallei - biochemicals, growth conditions, colony morphology
``` BSL3 PATHOGEN Catalase + Oxidase variable Indole - Grows on MAC NG at 42 deg Poor growth on SB and CHOC ```
111
Burkholderia pseudomallei - biochemicals, growth conditions, colony morphology
``` BSL3 PATHOGEN Catalase + Oxidase + Indole - Grows on MAC Grows at 42 deg Grows on SB Musty odor Dry wrinkled cols ```
112
Burkholderia thailandensis - biochemicals, growth conditions, colony morphology
``` Catalase + Oxidase + Indole - Grows on MAC Grows at 42 deg Ferments arabinose (pseudolmallei does not) ```
113
Bordetella species - common biochemicals, gram stain, specimen type to collect, best test for Dx
Catalase + Gram neg coccobacillus NP wash or NP swab for diagnosis PCR is best for Dx
114
Bordetella pertussis - biochemicals, growth in Cx, disease
Oxidase + Urea - Non motile NG on routine Cx media Grows on Regan-Low or Bordet Gangou media Has "mercury drop" col morph Causes whooping cough (humans only, severe)
115
Bordetella parapertussis - biochemicals, growth in Cx, disease
``` Oxidase - Urea + (24 hrs) Non motile Grows on routine media Less severe infections, can be mixed with B. pertussis ```
116
Bordetella bronchiseptica - biochemicals, growth in Cx, disease
``` Oxidase + Urea + (4 hrs) Motile Grows on routine media Kennel cough, disease in immuno supp., bacteremia, pertussis, meningitis Has B-lacatamase, ofter R to SXT ```
117
Bordetella holmseii - biochemicals, growth in Cx, disease
``` Oxidase - Urea - Non motile Grows on routine media Causes bacteremia in aslpenic patients ```
118
Helicobacter pylori - diaease, Gram stain, biochemicals. media
Group 1 carcinogen: gastric cancer, mucosa-associated lymphoid tissue (MALT) lymphoma Curved Gram neg rod Oxidase + Catalase + Urease + (CLO test) BHI agar, Brucella agar, Trypticase soy agar
119
H. pylori - Diagnostic tests (non invasive)
``` Urea breath test Stool antigen (good sens and spec, used for Dx and monitoring) Serology IgG (IgM not useful, used for Rx monitoring) ```
120
H. pylori - Diagnostic tests (invasive)
Gastric biopsy Gram stain or Warthin-Starry (silver) stain Cx: 10 days, humid microaeropphilic environment (5% H2), Cx for AST
121
Campylobacter species - Gran stain, biochemicals, Cx conditions
``` Curved Gram neg rod (sea gull) Catalase + (except C. upsaliensis) Oxidase + Darting motility Grows on selective media (CVA) in microaerophilic environment ```
122
Campylobacter jejuni and C. coli - disease, vectors, Cx and biochemicals
``` Bloody diarrhea with WBCs (up to 2 wks) Guillan-Barre, reactive arthritis Poultry, puppies, kittens Cx: 42 deg on selective media Hippurate + ```
123
Campylobacter fetus - disease, Cx
Bacteremia in immuno supp. and pregnant patients DOES NOT grow at 42 deg Suscept to 1st gen Cephalosporin (cephalotin)
124
Campylobacter upsaliensis - disease, Cx and biochemicals
Diarrhea, bacteremia 42 deg selective media Hippurate - Catalase -
125
Campylobacter species - treatment and resistance
Treat with Macrolides (azithro, erythro) Resistance to fluoroquinolones Resistance to B-lactams (except imi?)
126
Spirochetes - Organisms (and disease)
``` Leptospira interrogans (Leptospirosis) Treponema pallidum (Syphillis) Borrelia sp. (Tick borne relapsing fever) Borrelia recurrentis (Relapsing fever) Borellia burgdorferi (Lyme disease) Spirillium minus (rat bite fever) ```
127
Treponema pallidum - Distribution, disease, transmission
Worldwide Syphilis veneral, vertical, direct contact
128
Leptospira interrogans - Distribution, disease, transmission
Worldwide (Hawaii) Leptospirosis Rodent urine, esp. contaminated water
129
Borrelia species - Distribution, disease, transmission
Worldwide Tick borne relapsing fever Host: Rat, human, primate Vector: Tick
130
Borrelia recurrentis - Distribution, disease, transmission
S. America, Europe, Asia, Africa Relapsing fever Host: Human Vector: Louse
131
Borrelia burgdorferi - Distribution, disease, transmission
N. America, Europe Lyme disease Host: Rodents, deer Vector: Ixodes scapularis (deer tick)
132
Spirillium minus - Distribution, disease, transmission
Asia Rat bite fever Rat bite
133
Leptospirosis Diagnosis - Culture, serology, specimen
Cx: Fletcher's media, EMJH media, Media with tween and albumin Incubate Cxs at 30 deg for 7-14 days Serology can be done 5-7 days after symptom onset Bld, CSF acceptable up to 10 days, urine up to 1 month Can be seen on darkfield microscopy
134
Syphillis Diagnosis - Culture, serology, specimen
Cx: Rabbit intratesticular inoculation Serology: Screen with non-treponemal (RPR, VDRL), then confirm with treponemal test (FTA-ABS, TP-PA, EIA) Serum or CSF Darkfield microscopy of chancre scrapings
135
Lyme Diagnosis - Culture, serology, specimen
Cx: Skin biopsy in Kelly's media, incubate at 33 deg, microaerophilic Serology: Screen with EIA, confirm wit WB (2/3 IgM bands, >=5 IgG bands) Serum, CSF, Skin Bx
136
HACEK organisms - species
``` Aggrigatibacter aphrophilus A. paraphrophilus A. actinomycetecomitans H. parainfluenzae Cardiobacterium hominis Eikenella corrodens Kingella kingae ```
137
Organisms that pit the agar in culture
Cardiobacterium hominis Eikenella corrodens Kingella kingae
138
Organisms isolated from bite wounds (and type of bite)
``` Eikenella corrodens (human) Capnocytophaga (dog, human) Pasteurella (cat, dog) Streptibacillus (rat) ```
139
Fastidious GNRs that grow in MAC
``` Chromobacterium violcaceum Pasteurella spp (not P. multocida) ```
140
HACEK - Disease, Cx, Treatment
ENDOCARDITIS Cx: will not grow on MAC, like increased CO2 and humidity Produces B-lacatamse (R to Amp), so treat with 3rd gen cephalosporin
141
Aggregatibacter aphrophilus - nutritional requirements
Does NOT require factors X (hemin) or V (NAD) to grow
142
Aggrigatibacter paraaphrophilus and H. parainfluenzae - nutritional requirements
Both require only factor V (NAD)
143
H. influenzae and H. parainfluenzae - biochemicals
Catalase + | Oxidase +
144
Aggregatibacter aphrophilus and A. paraphrophilus - biochemicals
Catalase - | Oxidase -
145
Aggregatibacter actinomycetecomitans - biochemicals
Catalase + | Oxidase -
146
Aggregatibacter actinomycetecomitans - Disease, growth time, colony features
Formerly Actinobacillus Periodontitis, endocarditis, bit wounds grows in 2-3 days (slower) Colonies adhere to glass or plastic (heart valves)
147
Cardiobacterium hominis - Disease, growth time, GS features, biochemicals
Normal oral flora Endocarditis, esp is pts with poor dental hygiene, recent dental work or previously damaged heart valve Grows slowly, 4-7 days Gram stain of GNR is picket fences or "rosettes" and sometime retain crystal violet Catalase - Oxidase + Weakly indole + (all other HACKE are indole -) Pits the agar
148
Eikenella corrodens - Disease, Cx features, biochemicals, resistance
``` Endocarditis (can be subacute) Pits the agar Smells like bleach Catalase - Oxidase + Nitrate to nitrite + R to macrolides and clindamycin ```
149
Kingella kingae - disease, gram stain, Cx features, biochemicals, resistance
Endocarditis, septic arthritis (<4 years old) GN coccobacillus Beta hemolytic on SB, growth on CHOC, 48 hrs Catalase - Oxidase + Some strains produce bets-lactamases

Bacterial Identification (3 decks)

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