(F) Lesson 13: Non-fermenters and Miscellaneous Gram-Negative Bacilli (Part 3) Flashcards
(72 cards)
1
Q
- Family: Alcaligenacea
- Found in water
- Isolated in specimens from hospitalized patients: urine, feces, sputum, and wound specimens
- Resistant to disinfectants: chlorhexidine and quaternary ammonium compounds
- Motile using peritrichous flagella and are obligate anaerobes, G(-) bacilli
- (+) MAC, nitrate reducers
- (+) SBA = non-pigmented colonies
- (+) OF = non-oxidative isolates w/ deep blue coolor at the top
A
- Alcaligenes spp.
- Achromobacter spp.
2
Q
T or F: Asacchaorlytic members are isolated more frequently than saccharolytic ones.
A
T
3
Q
The only exception in Alcaligenes spp. and Achromobacter spp. wherein they are glucose-positive and xylose-positive.
A
A. xylosoxidans
4
Q
- Usually seen in clinical specimens
- Usually in patient blood with or without septicemia
- Linked to eye infections, pancreatic abscesses and other infections
- Nitrite reducer to nitrogen gas
A
Alcaligenes faecalis
5
Q
Asaccharolytic species of Achromobacter?
A
- Achromobacter piechaudii
- Achromobacter denitrificans
6
Q
This asaccharolytic organism from the Achromobacter spp. is retrieved from the ear of a diabetic patient.
A
Achromobacter piechaudii
7
Q
Asaccharolytic Achromobacter spp.
Resistant/Susceptible?
- Aztreonam
- Aminoglycosides
A
Resistant
8
Q
Asaccharolytic Achromobacter spp.
Resistant/Susceptible?
- SXT
- Piperacillin
- Ticarcillin
- Ceftazidime
- Quinolones
A
Susceptible
9
Q
The only saccharolytic Achromobacter spp.
A
Achromobacter xylosoxidans
10
Q
- Most commonly isolated
- Causes nosocomial infection associated with intravenous catheters, patients of advanced age experiencing neutropenia
- Linked to otitis media, meningitis, pneumonia, surgical wound infections, UTIs, peritonitis, bacteremia
- Colonizer of patients with CF
- Nitrite reducer to nitrogen gas
- Treatment: there is increasing resistance
A
Achromobacter xylosoxidans
11
Q
Achromobacter xylosoxidans
Resistant/Susceptible?
* Aminoglycosides
* Ampicillin
* First- and second-gen cephalosporins
* Chloramphenicol
* Fluoroquinolones
A
Resistant
12
Q
Achromobacter xylosoxidans
Resistant/Susceptible?
* Piperacillin
* 3rd-gen cephalosporins
* Carbapenems
* SXT
A
Susceptible
13
Q
- Recovered from sputum, wounds, and blood
I’m sorry, eto lang talaga description niya. </3
A
Advenella incenata
14
Q
- Infrequent isolates
- Can be a significant pathogen
- B. diminuta and B. vesicularis are differentiated by esculin hydrolysis
A
Brevudimonas spp.
15
Q
Brevudimonas spp.
Positive for esculin hydrolysis?
A
Brevudimonas vesicularis
16
Q
Brevudimonas spp.
Negative for esculin hydrolysis?
A
Brevudimonas diminuta
17
Q
- In blood, CSF, urine, and wounds as a contaminant
- Pathogenic in those immunocompromised
- (+) VIM-2-metallo-β-lactamase causing multidrug resistance
- Motile with a single polar flagellum
- (+) oxidase, glucose
- (+) MAC
- (-) esculin hydrolysis
A
Brevudimonas diminuta
18
Q
Brevudimonas diminuta
Resistant/Susceptible?
* Ampicillin
* Cefoxitin
* Nalidixic acid
* Fluoroquinolones
A
Resistant
19
Q
- Causes meningitis, infective endocarditis, and infections in CAPD patients
- Isolated in urine and eye specimens
- Motile with a single polar flagellum
- (+) oxidase, glucose, maltose
- (+) esculin hydrolysis
A
Brevudimonas vesicularis
20
Q
Brevudimonas vesicularis
Resistant/Susceptible?
* Carbapenems
* Aztreonam
* Cephalosporins
A
Resistant
21
Q
Brevudimonas vesicularis
Resistant/Susceptible?
* Fluoroquinolones
* Piperacillin-tazobactam
A
Susceptible
22
Q
- Unclear taxonomy
- EO means eugonic oxidizer
- (+) oxidase, glucose, xylose wherein they differ in oxidation of lactose and mannitol
- Weak grower, if at all, on MAC
- Non-motile, saccharolytic coccobacilli
- Unknown susceptibility to antimicrobial agents
A
CDC Groups EO-3, EO-4, and Paracoccus
23
Q
- Now named Paracoccus yeeii
- From blood cultures and wound infections and cutaneous bullae
- Found in at least one case of uveitis as a potential pathogen
- In infections following keratoplasty, myocarditis in heart transplant patient, infections associated with CAPD
- Produces characteristic coccoid or O-shaped cells on G/S (from vacuolated or peripherally stained cells)
A
EO-2
24
Q
- In CAPD infection
- Isolated from urine, eye discharge, blood, pleural fluid, CSF, lung and genitourinary tract specimens (same with EO-4)
- Produce a yellow non-diffusible pigment as well as some EO-4
A
EO-3
25
* Only clinically relevant from this genus
* **Reservoirs**: soil and water
* Commonly found in tropical and subtropical climates
* **Opportunist**
* In cases of osteomyelitis, abscesses, septicemia, urine and gastrointestinal infections
* **Skin lesions** are typical portal of entry
* G(-) bacilli, fermentative
* (+) oxidase, motile (polar flagella), glucose fermentation, sucrose (variably), MAC, enteric media, 42 deg C
* Produces **violacein**
* Causes fever, sepsis, skin lesions, abdominal pain, localized abscesses in the liver
* **Risk Factors:** young age, (+) localized abscess, short clinical course, inappropriate antimicrobial treatment
* Possible relapse and reinfections
Chromobacterium violaceum
26
# Chromobacterium violaceum
**Resistant/Susceptible?**
* Fluoroquinolones
* Tetracyclines
* Carbapenems
* Gentamicin
* SXT
Resistant
27
# Chromobacterium violaceum
**Resistant/Susceptible?**
* B-lactam antibiotics
Susceptible
28
* Straight to slight curved rods
* Alkaline in OF media
* (+) oxidase, catalase, nitrate reducer
* Motile w/ multitrichous polar flagella
* In soil and water
* Rarely from specimens, but in hospital equipment and fluids
Comamonas and Delftia
29
* Difficult to distinguish phenotypically, reported as ____ spp.
Comamonas spp.
30
These Comamonas spp. cause nosocomial bacteremia.
| Two (2)
Comamonas testeroni and Comamonas terrigena
31
* Associated with keratitis in soft contact lens wearers and nosocomial infections (bacteremia, endocarditis)
* (+) oxidize fructose and mannitol
* Resistant: aminoglycoside
Delftia acidovorans
32
* Associated with catheter-related bacteremia
* Incorrectly ID-ed by VITEK 2 as D. acidovorans
Delftia tsuruhatensis
33
# Delftia spp.
**Resistant/Susceptible?**
* Ampicillin
* Aminoglycosides
* Colistin
Resistant
34
# Delftia spp.
**Resistant/Susceptible?**
* Fluoroquinolones
* Carbapenems
* 3rd-gen cephalosporins
* Piperacillin-tazobactam
Susceptible
35
* **Family**: Weeksellaceae
* In soil and water
* Not part of the normal human microbiota
* Causes **nosocomial infections** as they often contaminate hospital equipment
* Are weak fermenters, hence, their reactions are usually delayed
Weeksellaceae spp.
36
# Weeksellaceae spp.
**Resistant/Susceptibility?**
* Aminoglycosides
Resistant
37
# Weeksellaceae spp.
**Resistant/Susceptible?**
* Vancomycin
Susceptible
38
* In newborns as **meningitis** or **septicemia** in conjunction with immaturity
* In adults as **pneumonia, endocarditis, bacteremia, and meningitis**, especially in those critically ill
* Infections follow the use of materials contaminated with the organism
* (+) fermentation of glucose, maltose, mannitol, esculin hydrolysis, indole, MAC (variable)
* Long, thin bacilli, often with **bulbous** ends
* **Susceptible** to clindamycin and vancomycin
Elizabethkingia meningoseptica or Meningosepticum
39
* Reduced activity to vancomycin
* Good activity to SXT, fluoroquinolones, and piperacillin-tazobactam
Chryseobacterium
40
* Most frequently isolated but are insignificant in **rare** numbers or from only one medium or specimen.
* Linked to **nosocomial infections**: bacteremia in immunosuppressed or those who have been receiving long-term antimicrobial therapy, and to ocular infections
* Long, thin bacilli, often with bulbous ends
Chryseobacterium indologens
41
* Causes **endophthalmitis** following cataract surgery due to poor sterilization procedures
Empedobacter brevis
42
* From blood and surgical wounds
* Resemble E. brevis
Wautersiella
43
* Asaccharolytic, nonmotile
* Has intracellular pigment: salmon-pink or pale yellow
* Some have distinct fruity odor
* (+) indole (weak), oxidase, DNase, gelatin hydrolysis
* (-) MAC
Weeksella
44
T or F: In Indole Test, Kovac's Reagent is more recommended over Erlich.
F *(other way around)*
45
* In genitourinary specimens
* (+) on Modified Thayer-Martin and other media selective for Neisseria gonorrhoeae
Weeksella virosa
46
* Susceptible to penicillin and other antimicrobial agents
Bergeylla
47
* From cellulitis, tenosynovitis, septicemia, pneumonia, and meningitis
* Associated with **dog and cat bite wound** *(it is part of their normal oral biota)*
Bergeylla zoohelicum
48
* **Family**: Methylobacteriaceae
* Characteristic **pink to coral** pigment
* Uses **methanol** as sole source of carbon and energy
* From soil, vegetation, sewage, water, hospital nebulizers
* In throat swabs bronchial washes, blood
* Presence in blood cultures can be attributed to **contaminated tap water** from irrigations during bone marrow transplant
* Causes **bacteremia, peritonitis, synovitis, skin ulcers** in the immunocompromised
Methylobacterium spp.
49
* Usually isolate
* Prefers low temperatures at 25-350C
* Distinctive large vacuolated pleomorpihc rods
* Oxidase variable, motile with polar flagellum
* Slow grower, producing 1mm dry, coral/pink colonies in 4-5 days
* Grows on fungal media: **Sabouraud dextrose agar**
* Not as well on SBA, chocolate, modified Thayer-Martin, Buffered Charcoal-Yeast Extract (BCYE)
* (-) MAC
Methylobacterium mesophilicum and Methylobacterium zatmanii
50
* **Family**: Acetobacteraceae
* Most common: **Pink-pigmented, non-fermentative, G(-) bacilli** recovered
* From the environment and clinical specimens: blood, CSF, sputum, abscess, wound specimens
* In immunocompromised, mainly producing **catheter-related bloodstream infection**
* **SDA growth:** pink, mucoid, almost runny colonies that do not appear black under long wavelength UV light
* Nonvacuolated, coccoid bacteria, forming pairs or short chains
* (+) oxidase (weak), urease, MAC
Roseomonas spp.
51
Most common isolate of Roseomonas spp.
Roseomonas mucosa
52
* **Family**: Burkholerdiaceae which includes Ralstonia, Cupriavidus, Burkholderia
Ralstonia spp. and Cupriavidus spp.
53
* Most common species out of the 7 genus
* In sterile hospital fluids, urine, nasopharynx, abscess, wound, blood specimen as colonizers or contaminants
* Colonization increased in **patients mechanically ventilated**
* Linked to meningitis, endocarditis, ostomyelitis
* Along with **R. mannitolytica** are isolated from respiratory specimens from CF and non-CF patients
* Slow growers, requiring >72 hours in primary cultures
* (+) oxidase, catalase
* **Opportunistic**, causing septicemia, peritonitis, abscesses, tenosynovitis, in immunocompromised
Ralstonia pickettii
54
# Ralstonia spp.
* Most common cause of infections in CF patients
Ralstonia mannitolytica
55
* Outbreak rooting from the unusual practice of moistening culturette swabs with tap water before collecting microbiology samples
* Motile with pertitrichous flagella
* Asaccharolytic G(-)
* (+) oxidase, catalase, MAC
Cupriavidus pauculus
56
# Cupriavidus spp.
**Resistant/Susceptible?**
* Aminoglycosides
* Ampicillin
* 1st- and 2nd-gen cephalosporins
Resistant
57
# Cupriavidus spp.
**Resistant/Susceptible?**
* Quinolones
* 3rd-gen cephalosporins
* Piperacillin
* Doxycycline
Susceptible
58
# Cupriavidus spp.
* Found in CF patients
Cupriavidus gilardi
59
* **Family**: Shewanellaeae
* **Colonies**: mucoid, with tan to brown pigment with greenish discoloration on SBA
Shewanella spp.
60
* Infrequent isolates from various human specimens: abscesses, traumatic ulcers, otitis media, ocular infections, osteomyelitis, peritonitis, septicemia, and mixed culture
* In the **environment**: stagnant water, natural gas (petroleum), brine, spoiled dairy products, meat, fish
* Rarely pathogenic
* Motile
* (+) ornithine decarboxylase, nitrate reductase,
* H2S producers in TSIA
Shewanella algae and Shewanella putrefaciens
61
# Shewanella spp.
* Like Enterobacterales *(except Plesiomonas)* which are differentiated ____
Oxidase Test
62
# Shewanella spp.
Positive for Oxidase Test?
Shewanella spp.
63
# Shewanella spp.
Negative for Oxidase Test?
Enterobacteriaceae
64
# Shewanella spp.
**Resistant/Susceptible?**
* Penicillin
* Cefazolin
Resistant
65
# Shewanella spp.
**Resistant/Susceptible?**
* Ampicillin
* Tetracycline
* Chloramphenicol
* Erythromycin
Susceptible
66
# Shewanella spp.
* Halophilic → requires NaCl
* Asaccharolytic
Shewanella algae
67
# Shewanella spp.
* Nonhalophilic
* Saccharolytic
Shewanella putrefaciens
68
Two significant species of Sphingomonas?
* Sphingomas paucinobilis
* Sphingomonas parapaucinobilis
69
* From many water sources (swimming pools), hospital equipment, laboratory supplies
* Causes **peritonitis** associated with CAPD, septicemia, meningitis, leg ulcers, empyema, splenic and brain abscesses
* **Yellow-pigmented**
* **(+) oxidase**
* **(-) MAC, indole**
* Requires >48hrs incubation on SBA
* **Motile at 18-22 deg C**, not at 37 deg C
* Variable resistance to antimicrobial agents
* Its susceptibility to **polymyxin B** differentiates it from other Sphingobacterium
* Its **vancomycin susceptibility is unusual** for a G(-) bacteria
Sphingomonas paucinobilis
70
# Sphingomonas paucinobilis
**Resistant/Susceptible?**
* Colistin
Resistant
71
# Sphingo paucinobilis
**Resistant/Susceptibility?**
* Aminoglycosides
* Tetracyclines
* Chloramphenicol
* SXT
* 3rd-gen cephalosporins (ceftazidime, ceftriaxone, ceftizoxime) (variable)
* Fluoroquinolones (variable)
Susceptible
72
* From **sputum, urine, vaginal specimens**
* Produce **esterases, endotoxin, lipases, and phosphatases**, inherent virulence is limited
* Considered **colonizers or contaminants**, unless repeatedly isolated from samples
* Resemble **S. paucinobilis**
* (+) H2S by lead acetate method, Simmon citrate
* (-) DNase
Sphingomonas parapaucinobilis
