MICRO Exam 1 Combined Set - VC

Icterohaemorrhagiae, Australis, and Canicola

3 most common leptospiral serovars

acute respiratory disease, pneumonia, and pharyngitis

Today, C. pneumoniae is recognized as an important respiratory pathogen. It is known to be a cause of

serotypes A, B, Ba, and C

Trachoma is associated with which serotypes of C.trachomatis?

serotypes A, B, Ba, and C

Trachoma serovars

Bilophila wadsworthia

Translucent colonies with a black fish eye center observed on BBE agar (usually at 48 to 72 hours)

Bacteroides ureolyticus

Translucent pitting colonies observed on the anaerobic blood agar plate, with no growth observed on BBE or KVLB agars

Transverse Fission

Treponella reproduce via:

True

True or False: A pleomorphic gram-positive bacillus that is spot indole- and catalase-positive can be presumptively identified as Propionibacterium acnes.

True The only more common STD in the US is genital warts caused by the human papillomavirus

True or False: C. trachomatis is the most common sexually transmitted bacterial pathogen in the United States

False

True or False: Clostridium spp. are especially easy to identify in Gramstained smears of clinical specimens because they always appear as gram-positive rods with terminal or subterminal spores.

False

True or False: Exogenous anaerobes more commonly cause infectious diseases than endogenous anaerobes.

True

True or False: Failure to isolate fusiform gram-negative organisms that were observed on a Gram-stained smear of a clinical specimen could be an indication that a problem exists with the primary medium used for the isolation of anaerobes or the system being used for anaerobic incubation of primary plates.

True

True or False: Large, dark colonies (>1 mm) growing on a BBE plate at 24 hours can presumptively be called a member of the Bacteroides fragilis group

True

True or False: Relapsing fever is the only spirochetal disease in which the organisms are visible in blood with bright-field microscopy

False Humans are the only reservoir.

True or False: Rodents, cats, and platypii are reservoirs for Pediculus humanus.

True

True or False: The serovars causing LGV are able to survive inside mononuclear cells

Pseudomonas aeruginosa P. aeruginosa is the most commonly isolated species of the genus in clinical specimens. It is an uncommon part of the normal bacterial biota and is isolated from less than 12% of normal stool specimens. It may, however, account for 5% to 15% of all nosocomial infections, especially pneumonia and bacteremia.

What Pseudomonas sp. is the nonfermenter that is the leading cause of nosocomial pneumonia and bacteremia?

Oxidase Most nonfermentative gram-negative bacilli are oxidase-positive, a feature that differentiates them from the Enterobacteriaceae (except Plesiomonas, which is oxidase-positive).

What biochemical test will differentiate nonfermenters from Enterobacteriaceae (except Plesiomonas)?

Botulism

What disease does Clostridium botulinum cause

Botulism

What disease does Clostridium botulinum cause? Botulism Tetanus Lyme disease Myonecrosis

gas gangrenes

What disease does Clostridium perfringens cause

Food poisoning C. perfringens is associated with two types of food poisoning: type A, a relatively mild and self-limiting GI tract illness, and type C, a more serious but rarely seen GI tract disease. C. perfringens foodborne disease usually follows ingestion of enterotoxin-producing strains in contaminated food.

What disease does Clostridium perfringens cause? Botulism Tetanus Food poisoning Toxic shock syndrome

Tetanus

What disease does Clostridium tetani cause? Botulism Tetanus Food poisoning Myonecrosis

B fragilis Porphyromonas Prevotella Fusobacterium

What genus comprise the four major groups of anaerobic gram-negative bacilli

EB

What has an outer membrane similar to that of many gram-negative bacteria, with the most prominent feature being the major outer membrane protein? Haemophilus RB EB Intracellular parasites

Weil's disease

What is a Leptospira infection called when it becomes a severe systemic disease

Weil disease Severe systemic disease (Weil disease) includes renal failure, hepatic failure, and intravascular disease and may result in death.

What is a Leptospira infection called when it becomes a severe systemic disease? Niemann-Pick Bordet-Gengou Gaucher disease Weil disease

RPR The two nontreponemal tests widely used today are the Venereal Disease Research Laboratory (VDRL) and the RPR.

What is an example of a nontreponemal test? RPR Fluorescent treponemal antibody, absorbed (FTA-ABS) Treponema pallidum particle agglutination (TPPA) Microhemagglutination-Treponema pallidum (MHA-TP)

B. mallei

What is the causative agent of glanders?

Erythromycin he drug of choice for treating intestinal campylobacteriosis is erythromycin, although most patients recover without antimicrobial intervention.

What is the drug of choice for treating intestinal campylobacteriosis?

Clostridium perfringens

What is the most common causative agent of gas gangrene? Staphylococcus aureus Neisseria gonorrhoeae Clostridium perfringens Haemophilus influenzae

The first tier is an immunofluorescent antibody (IFA) or enzyme immunoassay (EIA) screen. Positive or equivocal results are confirmed with Western blot, which is the second tier.

What is the recommended methodology for laboratory diagnosis of Lyme borreliosis?

Doxycycline and amoxicillin are equally effective in treating early stages For refractile or late stages, prolonged treatment with ceftriaxone has been effective.

What is used to treat lyme disease?

Fletcher's Isolation of leptospira is accomplished by direct inoculation of 1 to 2 drops of freshly drawn blood or CSF into laboratory media, such as Fletcher's, Stuart, or EMJH, and incubating the media in the dark at room temperature. Leptospira are difficult to isolate therefore culture is infrequently attempted.

What medium is used in the laboratory to grow leptospiral organisms? MacConkey Fletcher's Sheep blood agar None of the above

Direct fluorescent antibody (DFA)

What method is used to confirm a positive Chlamydia trachomatis EIA? Cytologic methods Direct fluorescent antibody (DFA) Cell culture NAAT

Burkholderia cepacia

What nonfermenter may produce a weak, slow, positive oxidase reaction?

B. pseudomallei

What organism causes melioidosis?

Borrelia recurrentis B. recurrentis causes relapsing fever. As the name suggests, the acute infection causes febrile episodes that subside spontaneously and tend to recur over a period of weeks.

What organism causes relapsing fever? Borrelia recurrentis B. burgdorferi Leptospira interrogans C. psittaci

Campylobacter

What organism has a microscopic morphology of tiny, curved, gram-negative rods, with S-shapes or seagull-wing shapes on Gram stain?

P. aeruginosa

What organism is a common cause of pulmonary disease among individuals with cystic fibrosis?

Chromobacterium violaceum

What organism is an opportunistic pathogen that strikes the immunocompromised patient with neutrophil deficits and produces a violet pigment on nonselective agar?

Burkholderia cepacia

What organism is associated with pneumonia in patients with cystic fibrosis or chronic granulomatous disease (CGD)?

Campylobacter

What organism may play a role in Guillain-Barré syndrome (GBS)?

C. perfringens Myonecrosis, or gas gangrene, usually occurs when organisms contaminate wounds, through either trauma or surgery. C. perfringens, C. histolyticum, C. septicum, C. novyi, and C. bifermentans are members of the histotoxic group and can cause myonecrosis. C. perfringens, however, is the most common cause.

What organism mostly commonly causes gas gangrene? Clostridium difficile C. tetani C. perfringens C. botulinum

Chlamydia

What organism's unique life cycle contains an elementary body (EB) and a reticulate body (RB)? Haemophilus Chlamydia Ureaplasma Mycoplasma

KVLB, BBE, and anaerobic BAP

What plates are used for Gram-Negative Anaerobes

Carbohydrates

What substances do nonfermenters fail to ferment in traditional media?

42° C

What temperature is an optimal growth temperature for Campylobacter jejuni?

Microaerophilic and capnophilic

What type of an atmosphere do campylobacters require for growth?

spore-forming anaerobic bacilli - gram positive

What type of bacteria are those in the genus Clostridium

Cary-Blair

When collecting specimens that may contain Campylobacter spp. bacteria, what transport medium should they be placed in, if a delay in transport is possible?

Most cases are contracted in Hawaii. Because the incubation period is typically 10 to 12 days, it is likely that visitors to Hawaii can become infected but not show symptoms until they return home.

Where are most cases of leptospiroses contracted within the United States, and why is this important when considering the typical incubation period of the infection?

Hemolymph an arthropod's interstitial fluid

Where do Borrelia live inside the lice?

palms and soles

Where is the unusual rash seen in secondary syphilis

Palms and soles Approximately 2 to 12 weeks after development of the primary lesion, the patient may experience secondary disease, with clinical symptoms of fever, sore throat, generalized lymphadenopathy, headache, and rash. While the rash can occur anywhere, it is unusual compared to other infectious diseases in that it can also occur on the palms and soles.

Where on the body is the secondary syphilis rash typically seen? Chest and back Back and soles Buttocks and palms Palms and soles

Honey Once ingested, the spores germinate and the vegetative cells then colonize the colon and subsequently produce toxins

Which food is most commonly associated with infant botulism?

A. Porphyromonas spp. and Prevotella spp.

Which gram-negative bacilli produce brown to black pigment on KVA agar and brick red fluorescence when exposed to an ultraviolet (UV) light source? A. Porphyromonas spp. and Prevotella spp. B. Fusobacterium spp. and Actinomyces spp. C. Bacteroides spp. and Fusobacterium spp. D. All of these options

Acinetobacter spp.

Which gram-negative coccobacilli can appear as gram-positive cocci in smears made from blood culture bottles?

Burkholderia mallei zoonosis glanders

Which nonfermenter is considered by government agencies to be a potential bioterrorist agent?

B. garinii and B. afzelii

Which of the 3 species of Borrelia burgdorferi klaatu barada nikto have been confirmed in Asia.

Alcaligenes faecalis Burkholderia cepacia Acinetobacter lwoffii Yersinia entercolitica ----- you don't belong here

Which of the following Gram negative bacteria ferments glucose?

Actinomyces, Propionibacterium propionicum, and closely related organisms, such as P. acnes

Associated with sulfur granules

Burkholderia cepacia

A 17 year old girl with cystic fibrosis is diagnosed with pneumonia. A sputum sample grew gram negative bacilli with yellow smooth colonies that have the following biochemical reactions: Oxidase: positive TSI: K/K glucose: oxidized fluorescence: negative lysine decarboxylase: positive The most likely organism is: Burkholderia cepacia Klebsiella pneumoniae Shewanella putrifaciens Stenotrophomonas maltophlia

An IgM titer greater than 1 :32 or an IgG single titer greater than 1 : 512

A C. pneumoniae titer in this range warrants further investigation

type C food poisoning

C. perfringens Food poisoning - a more serious but rarely seen disease. Associated with strains that produce β-toxin and, less commonly, α-toxin. After an incubation period of at least 5 to 6 hours, symptoms begin as an acute onset of severe abdominal pain and diarrhea, which is often bloody, and may be accompanied by vomiting. Early symptoms are followed by necrotic inflammation of the small intestines, at times leading to bowel perforation. Without treatment, the disease is often fatal; even with treatment, the fatality rate is 15% to 25%.

C. perfringens

Large, irregular-shaped colonies on SBA demonstrating a double zone of β-hemolysis can be identified as _______. These organisms will stain as large, boxcar-shaped bacilli.

Type A food poisoning

C. perfringens Food poisoning - a relatively mild and self-limited GI illness. Caused by a C. perfringens enterotoxin linked to sporulation. After an 8- to 30-hour incubation period, the patient experiences diarrhea and cramping abdominal pain for about 24 hours. Other than fluid replacement, therapy is usually unnecessary.

Positive

C. perfringens is lecithinase _________.

Negative

C. perfringens is lipase _________.

enteritis necroticans

C. perfringens type C food poisoning is also called

Guillain-Barré syndrome GBS

C. pneumoniae has been established as a risk factor for ______________, an immunologically mediated neurologic disease.

prolonged sore throat (5 to 7 days) and hoarseness, followed by flulike lower respiratory tract symptoms (8 to 15 days)

C. pneumoniae infection progress

Brucella agar base, 10% sheep red blood cells, vancomycin, trimethoprim, polymyxin B, amphotericin B, and cephalothin.

CAMPY-BAP (blood agar plate) contains

Hippurate hydrolysis positive

Campylobacter jejuni can be identified by its microscopic morphology, characteristic motility, oxidase positivity, and this.

T. pallidum subsp. endemicum

Causative agent of endemic syphilis

Treponema carateum

Causative agent of pinta

T. pallidum subsp. pallidum

Causative agent of syphilis

T. pallidum subsp. pertenue

Causative agent of yaws

Orientia (formerly Rickettsia) tsutsugamushi via chiggers Rash does not involve the palms, soles, OR face

Cause of orientia

R. akari Rash is on trunks, extremities, and face, NOT on palms or soles

Cause of rickettsialpox

certain Clostridium, Actinomyces, Propionibacterium, and Lactobacillus spp

Certain aerotolerant anaerobes can grow on the CO2-incubated chocolate agar, but they usually grow much better on the anaerobically incubated plate

Pseudomonas aeruginosa

Cetrimide agar is used as a selective isolation agar for which organism? Acinetobacter spp. Pseudomonas aeruginosa Moraxella spp. Stenotrophomonas maltophilia

weak fermenters. cause of nosocomial infections. ubiquitous in soil and water. All the above

Characteristics of most members of the family Flavobacteriaceae

LGV and conjuctivitis

Chlamydia trachomatis infections have been implicated in: LGV and conjuctivitis gastroenteritis and urethritis neonatal pneumonia and gastroenteritis neonatal meningitis and conjuctivitis

obligate intracellular

Chlamydiae are deficient in energy metabolism and are therefore ________ _________ parasites.

Soil

Clostridia or their toxins usually gain access to the body through ingestion or open wounds that have become contaminated with ________

Negative differentiates from positive bacillus

Clostridium catalase test

Burkholderia cepacia

Colonies of this bacteria are nonwrinkled, and this trait may be used to differentiate isolates from P. stutzeri, which also produces a yellow pigment. It does not fluoresce like P. aeruginosa, but can produce a nonfluorescing yellow or green pigment that may diffuse into the media.

Campylobacter The typical colony morphology of Campylobacter jejuni and other enteric campylobacters is moist, "runny looking," and spreading. Colonies are usually nonhemolytic; some are round and raised, whereas others may be flat.

A Campy blood agar plate incubated at 42° C from a stool exhibits colonies that are nonhemolytic, moist, "runny looking," and spreading. The Gram stain shows tiny gram-negative rods with some S-shapes and seagull-wing shapes. What is growing on the plate?

CF

A ____ test had been the traditional assay most often used for C. pneumoniae detection, but it is rarely used today

B. fragilis

A biletolerant, gram-negative anaerobic bacillus indicates that the isolate is likely a member of the _______ group.

Peptococcus niger

A black-pigmented, anaerobic, gram-positive coccus

growth at 42 degrees C

A characteristic that is helpful in separating Pseudomonas aeruginosa from other members of the Pseudomonas family is: a positive test for cytochrome oxidase oxidative metabolism of OF test production of fluoescein pigment growth at 42 degrees C

Burkholderia pseudomallei

A college student who recently studied a semester abroad in Southeast Asia is admitted to the hospital with a diagnosis of "glanders-like" infection (melioidosis) . A sputum specimen grows a small gram-negative rod that is positive for oxidase, reduces nitrate to gas and oxidizes glucose, lactose and mannitol. What is the most likely organism? Stenotrophomonas maltophilia Burkholderia pseudomallei Pseudomonas aeruginosa Acinetobacter baumannii

urea broth

A gastroenterologist submits a gastric biopsy from a patient with a peptic ulcer. To obtain presumptive evidence of Helicobacter pylori, a portion of the specimen should be added to which media? urea broth tetrathionate selenite tryptophan

Chromobacterium

A genus that is found in soil and water and causes infections in immunocompromised patients has the following characteristics: Sheep blood agar: Violet pigment MacConkey agar: growth Oxidase: positive OF glucose: fermenter indole: negative The genus is: Campylobacter Chromobacterium Aeromonas Serratia

F. nucleatum Growth of F. nucleatum indicates that the agar was maintained under near-anaerobic conditions

A good quality control procedure to ensure that the agar is maintained under proper conditions is to inoculate an agar plate with ________ and place the plate in the holding jar.

Helicobacter pylori Keyword: gastric biopsy

A gram stain touch prep from a gastric biopsy shows gram negative bacilli that are slender and curved. The most likely pathogen is:

Propionibacterium acnes

A gram-positive anaerobic diphtheroid that is both catalase positive and spot indole-positive

a. Clostridium perfringens

A gram-positive bacillus was isolated from a wound specimen and had the following characteristics: double zone of β-hemolysis, lecithinase-positive, lipase-negative, indole-negative. What is the most likely identification of this organism? a. Clostridium perfringens b. Clostridium ramosum c. Clostridium septicum d. Clostridium tetani

gastroenteritis

Elizabethkingae meningosepticum causes all the following diseases, except

Tick

Endemic relapsing fever is _______-borne.

b. Eubacterium

Endogenous anaerobes least likely to be involved in cases of bacteremia are: a. Bacteroides b. Eubacterium c. Fusobacterium d. Peptostreptococcus

Helicobacter pylori

Major cause of Type B gastritis and associated with gastric cancer

MOMP major outer membrane protein Also LPS

Major component of the EB's outer membrane

trachoma, lymphogranuloma venereum, and mouse pneumonitis (renamed C. muridarum)

Name the 3 conditions associated with the 3 C. trachomatis biovars

B. burgdorferi sensu stricto B. garinii and B. afzelii

Name the 3 species of Borrelia burgdorferi sensu lato that cause Lyme disease.

Louse

Epidemic relapsing fever is ______-borne.

Chromobacterium violaceum

Fermentative, gram-negative bacillus that may be oxidase positive, so it may be mistaken initially as a nonfermenter in the laboratory. It is motile with polar flagella and, as its name implies, produces a violet pigment about 91% of the time.

cardiolipin and lecithin

Flocculation tests for syphilis use antigen composed of: Treponema pallidum reagin cardiolipin and lecithin charcoal

Bacteroides fragilis

Good growth (>1 mm in diameter) of gray colonies on a BBE plate, characteristic of members of the ______ group.

Fusobacterium nucleatum Porphyromonas Prevotella intermedia

Gram negative anaerobic rods that are spot indole positive

Actinomyces israelii

Gram staining of a smear taken from the periodontal pockets of a 30-year-old man with poor dental hygiene showed sulfur granules containing gram-positive rods (short diphtheroids and some unbranched filaments) and were non-acid fast. Colonies on blood agar resembled "molar teeth" in formation. The most likely organism is: A. Actinomyces israelii B. Propionibacterium acnes C. Staphylococcus intermedius D. Peptostreptococcus anaerobius

Leptospira

Organisms of this genus are tightly coiled, thin, flexible spirochetes, 0.1 µm wide and 5 to 15 µm long (Figure 23-1). With spires that are very close together, so the organism may appear as a chain of cocci.

Fusobacterium nucleatum

Ground-glass or breadcrumb-like colonies of long, slender, gram-negative rods with pointed ends are usually

Fusobacterium nucleatum

Ground-glass or breadcrumb-like colonies of long, slender, gram-negative rods with pointed ends

B. fragilis

Growth of large (>1 mm) gray-black colonies on BBE agar with growth on the KVLB agar after an overnight incubation is sufficient to identify an isolate as a member of the _______ group

Lactobacillus

After 24-hour incubation, an SBA from a vaginal culture reveals heavy growth of α-hemolytic, pinpoint, rough colonies. A catalase test is performed, and it is negative. What organism should you suspect? Lactobacillus Diphtheroids Listeria Arcanobacterium

arthropod

All Borellia are ________-borne.

indole-positive.

All of the following are characteristics of pseudomonads, except

Clostridium

All of the following are non-spore-forming, anaerobic, gram-positive bacilli EXCEPT

Anemia Poor prognostic factors associated with P. aeruginosa bacteremia include septic shock, granulocytopenia, inappropriate antimicrobial therapy, and the presence of septic metastatic lesions.

All of the following are poor prognostic factors associated with Pseudomonas aeruginosa bacteremia, except

Veillonella spp.

All of the following genera are anaerobic cocci that stain gram positive except: A. Peptococcus spp. B. Peptostreptococcus spp. C. Streptococcus spp. D. Veillonella spp.

Clostridium

All of the following organisms are found on the skin under normal conditions, except Propionibacterium. Peptostreptococcus. Streptococcus. Clostridium.

Propionibacterium P. acnes on skin

All the following organisms are found in the GI tract, except Bacteroides. Clostridium. Propionibacterium. Bifidobacterium.

Propionibacterium

All the following organisms are found in the gastrointestinal (GI) tract EXCEPT

past infection or exposure

An C. pneumoniae IgG titer of 1 : 16 or higher but less than 1 : 512 is evidence of

Peptostreptococcus anaerobius

An SPS-sensitive, gram-positive anaerobic coccus can be presumptively identified as

b. Fusobacterium necrophorum

An anaerobic, pleomorphic, gram-negative bacilli was recovered from a liver abscess. The special potency antimicrobial disks demonstrated that the organism was vancomycin-resistant, and colistin- and kanamycin-sensitive. Other results were as follows: chartreuse fluorescence, spot indole-positive, and lipase-positive. What is the most likely identification of the organism? a. Fusobacterium mortiferum b. Fusobacterium necrophorum c. Fusobacterium nucleatum d. Fusobacterium varium

Leptospira

An animal attendant at the zoo developed symptoms that included fever, chills, headache, severe myalgia, and malaise. His urinalysis revealed the presence of protein and blood. A couple of weeks earlier, the attendant was handling the chimpanzees, and one of the chimps urinated on him. What is the most likely cause of illness? Borrelia Leptospira Treponema Helicobacter

Clostridium difficile

An elderly patient in a nursing home is recovering from bacterial pneumonia. The patient has been on a lengthy regiment of antibiotics to kill the organism causing the disease. A few days later, the patient is diagnosed with pseudomembranous colitis. What organism is the most likely cause?

Actinomycosis

An immunosuppressed patient notices sinus tracts that are draining pus. He also notices that there appear to be small, hard "nuggets" in the pus. What disease is he most likely suffering from? Gas gangrene Pseudomembranous colitis Actinomycosis Myonecrosis

Actinomycosis

An immunosuppressed patient notices sinus tracts that are draining pus. He also notices that there appear to be small, hard "nuggets" in the pus. What disease will his doctor most likely diagnose

Clostridium difficile

An older adult patient in a nursing home is recovering from bacterial pneumonia. The patient has been on a lengthy regiment of antimicrobial agents. Subsequently, the patient is diagnosed with pseudomembranous colitis. What organism is the most likely cause? Clostridium difficile C. tetani C. perfringens C. botulinum

growth at 42 degrees C, pyocyanin production, gelatinase production

An organism has been identified as a member of the fluorescent group of Pseudomonas. Which of the following sets of tests should be used to determine the species of the organism?

d. Aerotolerant anaerobe

An organism that can live and grow in reduced concentrations of oxygen but prefers an anaerobic environment is known as a(n): a. Capnophile b. Obligate anaerobe c. Facultative anaerobe d. Aerotolerant anaerobe

Pseudomonas stutzeri Pseudomonas stutzeri typically produces a dry, wrinkled colony. The colony morphology resembles Burkholderia pseudomallei. This bacterium in not a common clinical isolate and is a rare pathogen.

An oxidase-positive, nonfermentative gram-negative bacillus that characteristically produces dry, wrinkled colonies describes

skin

Anaerobes outnumber aerobes in all of the following locations, except skin. oral cavity. gastrointestinal (GI) tract. genitourinary tract.

peptostreptococci

Anaerobic gram positive cocci are generally called

Fusobacterium mortiferum

Appears pleomorphic and exhibit globular forms, swellings, and other bizarre shapes

proteolytic enzymes (proteases)

Organisms that produce ___________ have a completely clear zone, often quite narrow, around their colonies. Proteolysis is best observed by holding the plate up to a strong light source. It is reminiscent of the complete clearing seen with β-hemolytic organisms on SBA plates, but this is on a EYA plate.

Burkholderia cepacia

Oxidative-fermentative base-polymyxin B-bacitracin-lactose (OFPBL) media is the best media to use to isolate which one of the following organisms from the sputa of patients with cystic fibrosis? A. delafieldii R. pickettii B. cepacia B. pseudomallei

Nosocomial

In what single setting does Stenotrophomonas maltophilia typically produce disease?

serovars D through K, Da, Ia, and Ja

Inclusion conjunctivitis is assocaited with which serotype of C. trachomatis?

Erythromycin

Infants born in the United States receive prophylactic eyedrops of this, to prevent eye infections by C. trachomatis and N. gonorrhoeae.

Traveling through an infected birth canal detour reccommended

Infants can be infected with Chlamydia spp. by

Fletcher, Stuart, or EMJH

Isolation of leptospires is accomplished by direct inoculation of blood or CSF into these media, and incubating in the dark at room temperature.

Lactobacillus acidophilus complex but L. fermentum, L. vaginalis, L. salivarius, L. plantarum, and others have also been recovered.

Predominant lactobacilli of a healthy vagina

NAAT

Prefferential diagnostic method for C. trachomatis genital infections

Serology

Primary method used for the laboratory diagnosis of syphilis.

blood culture contamination

Propionibacterium acnes is most often associated with: food poisoning post antibiotic diarrhea tooth decay blood culture contamination

Pyocyanin

Pseudomonas aeruginosa also produces this pigment in addition to pyoverdin

β-hemolysis

Pseudomonas aeruginosa displays what type of hemolysis

Fluoroquinolones

Pseudomonas aeruginosa is resistant to all the following antimicrobial agents, except

R. rickettsii, R. conorii, and R. africae

Rickettsia: The spotted fever group includes a number of species generally recognized as human pathogens, such as

R. akari, R. australis, and R. felis.

Rickettsia: The transitional group contains

R. prowazekii and R. typhi

Rickettsia: The typhus group contains these two species

B. Serological analysis

Routine laboratory testing for Treponema pallidum involves: A. Culturing B. Serological analysis C. Acid-fast staining D. Gram staining

Peptoniphilus (Peptostreptococcus) asaccharolyticus

SPS-resistant, spot indole-positive, gram-positive anaerobic coccus can be identified as

nongonococcal urethritis (NGU), epididymitis, and prostatitis

Serovars D through K are associated with these clinical infections in men

urethritis, follicular cervicitis (leukorrhea hypertrophic cervical erosion), endometritis, proctitis, salpingitis, pelvic inflammatory disease (PID), and perihepatitis. Reiter syndrome (urethritis, conjunctivitis, polyarthritis, and mucocutaneous lesions) in adults is believed to be caused by C. trachomatis.

Serovars D through K are associated with these clinical infections in women

Weil disease

Severe systemic disease includes renal failure, hepatic failure, and intravascular disease and can result in death.

Spirochetes

Slender, flexuous, helically shaped, unicellular bacteria ranging from 0.1 to 0.5 µm wide and from 5 to 20 µm long, with one or more complete turns in the helix.

P. acnes.

Small, opaque colonies that are catalase- and indole-positive and stain as coryneform rods can be identified as

Peptostreptococcus spp

Small, peaked, circular colonies appearing after 24 hours that stain as gram-positive cocci can be considered

c. Superoxide dismutase

Some anaerobes are particularly susceptible to oxygen because they lack the enzyme: a. Amylase b. β-Lactamase c. Superoxide dismutase d. Glucose-6-phosphate dehydrogenase

sputum, bronchial lavage fluid, nasopharyngeal aspirates, throat washings, and throat swabs

Specimens collected for the detection of C. pneumoniae include

a flexible cell wall around which several fibrils are wound

Spirochetes differ from other bacteria in that they have:

C. bifermentans and C. sordelli

Spot indole positive clostridium

DNase

Stenotrophomonas maltophilia is positive for this test. Oxidase Lactose fermentation DNase None of the above

Acinetobacter spp

Strictly aerobic coccobacilli or even cocci. Oxidase NEGATIVE, nonmotile, purple hue.

Jarisch-Herxheimer reaction

Studies indicate that up to 39% of patients treated with antimicrobial agents experience fever, chills, headache, and myalgia believed to be caused by the sudden release of endotoxin from the spirochetes, a condition referred to as

great imitator

Syphilis has a wide variety of clinical manifestations, which gave rise to the name the "_______________"

Pinta

T. pallidum subsp. carateum Found in the tropical regions of Central and South America Spread by person-to-person contact (rarely by sexual relations) Lesions begin as scaling, painless papules followed by an erythematous rash that becomes hypopigmented with time This is descriptive of: Yaws Pinta Endemic syphilis rat bite fever

Face

The RMSF rash extends to the palms and soles but does not affect the ______

Kelly

The borreliae are typically cultivated in the clinical laboratory using _____ medium.

B. Preformed toxin in food

The classic form of foodborne botulism is characterized by the ingestion of: A. Spores in food B. Preformed toxin in food C. Toxin H D. All of these options

B. burgdorferi sensu lato

The complex _____________ causes a spectrum of syndromes known as Lyme disease

Rickettsia prowazekii. In this case, the arthropod vector, the body louse, can die of the rickettsial infection, and humans act as a natural reservoir.

The exception to Rickettsia transvarial tramission pattern

B. Fusobacterium spp.

The following characteristics of an obligate anaerobic gram-negative bacilli best describe which of the listed genera? Gram staining = Long, slender rods with pointed ends Colonial appearance = Dry bread crumbs or "fried-egg" appearance Penicillin two-unit disk test = Susceptible A. Bacteroides spp. B. Fusobacterium spp. C. Prevotella spp. D. Porphyromonas spp.

T. pallidum subsp. pallidum T. pallidum subsp. pertenue T. pallidum subsp. endemicum Treponema carateum

The four Treponema organisms that are pathogenic for humans.

Mobiluncus. four major groups: the B. fragilis group, Porphyromonas spp., Prevotella spp., and Fusobacterium spp.

The four major groups of anaerobic gram-negative bacilli include all the following, except Bacteroides fragilis. Porphyromonas. Prevotella. Mobiluncus.

C. trachomatis

The genera Chlamydia includes this species

C. pneumoniae, C. psittaci, and C. pecorum.

The genera Chlamydiphila includes these 3 species

EB

The infectious form of Chlamydiae, with the MOMP

Chancre

The lesion, known as a _______, is typically a single erythematous lesion that is nontender but firm, with a clean surface and raised border. The lesion is teeming with treponemes and is extremely infectious.

Infections caused by leptospires

The major renal lesion of these organisms is an interstitial nephritis with associated glomerular swelling and hyperplasia that does not affect the glomeruli

Serum

The most common and productive specimen collected for the laboratory diagnosis of B. burgdorferi sensu lato infection is _______.

Dermacentor variabilis in the southeastern United States and Dermacentor andersoni in the western part of the country

The most common tick vectors for RMSF

R. rickettsii

The most severe of the rickettsial infections, Rocky Mountain spotted fever (RMSF) is caused by

trachoma

The number one cause of preventable blindness in the world

Leptospiraceae and Spirochaetaceae

The order Spirochaetales contains two families:

NAAT

The preferred method of detecting chlamydia infections due to its high sensitivity and specificity and the ability to detect chlamydia and gonorrhoeae in one test is: Complement fixation Cell culture EIA NAAT

Bacteroides fragilis

The presence of 20% bile in agar will allow growth of: Fusobacterium necrophorum Bacteroides fragilis Prevotella melaninogenica Porphyromonas asaccharolytica

MIF

The present method of choice for detecting C. pneumoniae is the _____ assay, which is more sensitive and specific than CF

CSF-VDRL

The serological test for syphilis recommended for detecting antibody in cerebrospinal fluid is: non-treponemal antibody CSF-VDRL FTA-ABS MHA-TP

Pseudomonas aeruginosa

The third most common cause of gram-negative bacillary bacteremia, after E. coli and Klebsiella pneumoniae

Pseudomonas aeruginosa. Acinetobacter spp. Stenotrophomonas maltophilia Pseudomonas putida -------------

The three nonfermenters that make up the majority of isolates routinely seen in clinical laboratories include all the following, except

Ornithodoros

The tick-borne borreliae are transmitted by a large variety of soft ticks of this genus

Transovarial transmission

The transfer of a pathogen from parent to offspring by infection of the egg cell. Typically seen in insects Seen in Rickettsiae

Venereal Disease Research Laboratory (VDRL) and rapid plasma reagin (RPR)

The two nontreponemal tests widely used today

Chlamydiae

Their unique growth cycle involves two distinct forms, an elementary body (EB), which is infectious, and a reticulate body (RB)

Alcaligenes faecalis and Achromobacter spp

These 2 possess peritrichous flagella and are obligately aerobic, oxidase positive gram-negative bacilli.

Tetracyclines

These are the drug of choice for treating Borreliae.

periplasmic flagella (axial filaments)

These fibrils are responsible for motility

Acineetobacter Steno malto Russell Crow Pseudomonas cepacia (slow weak positive) Pseudomonas luteola and P. oryzihabitans

These guys are Oxidase negative.

L. interrogans sensu lato and L. biflexa sensu lato

These two leptospiral serovars are pathogenic for a wide range of wild and domestic animals and humans.

Moraxella spp

These weak ass species are susceptible to penicillin (an unusual characteristic for a nonfermenter), and are notably in the wrong ****ing chapter

Fusobacterium nucleatum

Thin, gram-negative bacilli with tapered ends are suggestive of

Stenotrophomonas "Steno malto" maltophilia

Third most common nonfermentative, gram-negative bacillus isolated in the clinical laboratory. Nosocomial, Oxidase NEGATIVE, SXT drug of choice

Acinetobacter Iwoffi

This acinetobacter spp is asaccharolytic, and susceptible to almost all antimicrobials.

Acinetobacter baumannii

This acinetobacter spp is saccharolytic, and is resistant to many antimicrobials.

Skirrow agar

This agar is selective for H. pylori

Pseudomonas aeruginosa S. aureus smells like an old sock. P. mirabilis smells putrid. Nocardia sp. smells like a freshly plowed field.

This bacterium is said to have a fruity or grapelike smell.

Burkholderia "Are you not entertained" gladioli

This contrarian pathogen is negative for oxidase (some strains weakly positive), motile by means of one or two polar flagella and is catalase and urease positive, oxidizes glucose, is mannitol positive and decarboxylase negative, grows on MAC agar, and is 100% resistant to polymyxin B. Inhabits colosseums and likes swords.

Exotoxin A

This exotoxin of Pseudomonas aeruginosa functions similarly to diptheria toxin by blocking protein synthesis

Burkholderia mallei

This guy causes glanders, a super serious zoonotic disease that affects livestock. Considered a potential bioterrorism agent.

Burkholderia pseudomallei

This guy causes melioidosis, an aggressive pulmonary disease with metastatic abscesses in the lungs.

Egg Yolk Agar (EYA)

This plate can be used to determine the activities of lecithinase, lipase, and proteolytic enzymes. Useful for differentiating clostridium species.

Pseudomonas aeruginosa

This pseudomonad likes to hang out at 42° C with campylobacter

Elizabethkingia meningoseptica

This species is in the running for having the dumbest name ever.

Burkholderia pseudomallei

This species should be suspected when a nonfermatative wrinkled colony with bipolar staining is isolated. Ashdown media is selective for this guy.

Borrelia

This spirochete stains easily and can be visualized by bright field microscopy.

Stage 3

This stage of lyme borreliosis is a late manifestation, or late persistent infection, with a focus on the cardiac, musculoskeletal, and neurologic systems. Arthritis is the most common symptom, occurring weeks to years later.

Stage 2

This stage of lyme borreliosis is early disseminated and produces widely variable symptoms that include secondary skin lesions, migratory joint and bone pain, alarming neurologic fatigue and cardiac pathology, splenomegaly, and severe malaise and fatigue.

Stage 1

This stage of lyme borreliosis is localized, exhibiting the EM skin lesion, beginning as a red macule and expanding to form large annular erythema with partial central clearing, or a target appearance.

Primary Stage

This stage of syphilis is characterized by the formation of the chancre, and no systemic signs or symptoms are evident.

Binding factor H

This virulence factor of Borrelia burgdorferi allows for complement evasion and immune system suppression and might explain, in part, why IgM antibody does not peak for 3 to 6 weeks.

infected lice are crushed and scratched into the skin rather than through the bite of an infected arthropod

Tick-borne endemic fever is trasmitted via bite, whereas louse-borne epidemic fever is transmitted via:

Veillonella

Tiny, round to oval, gram-negative cocci with a tendency to stain gram-variable are suggestive of

Endotoxin Exotoxins Capsule All of the above----------- P. aeruginosa may produce a variety of factors that lend to its pathogenicity, such as endotoxin (lipopolysaccharides), motility, pili, capsule, and several exotoxins: proteases, hemolysins, lecithinase, elastase, and DNase. Despite a number of virulence factors, this bacterium is still considered an opportunistic pathogen.

Which of the following is a virulence factor of Pseudomonas aeruginosa?

Spore-forming anaerobic bacill All spore-forming anaerobic bacilli are classified in the genus Clostridium and collectively referred to as clostridia

Which of the following is characteristic of members of the genus Clostridium? Catalase positive Spore-forming anaerobic bacilli Spore-forming anaerobic cocci Facultative anaerobes

A. Kanamycin-vancomycin-anaerobe (KVA) agar

Which of the following is the medium of choice for the selective recovery of gram-negative anaerobes? A. Kanamycin-vancomycin-anaerobe (KVA) agar B. Phenylethyl alcohol (PEA) agar C. Cycloserine cefoxitin fructose agar (CCFA) D. THIO broth

Bacteroides and Prevotella

Which of the following pairs of organisms grow on kanamycin, vancomycin, laked blood agar? Bacteroides and Prevotella Mobiluncus and Gardnerella Porphyromonas and Enterococcus Veillonella and Capnocytophaga

Growth at 35-37 degrees C Unlike jejuni

Which of the following results is typical of Campylobacter fetus subspecies fetus?

d. Urethral swab

Which of the following specimens would be unacceptable for anaerobic culture? a. Aspirated pus b. Cerebrospinal fluid c. Tissue from biopsy d. Urethral swab

Burkholderia pseudomallei

Which organism exhibits bipolar staining on the Gram stain, which resembles a "safety-pin" appearance? B. mallei B. pseudomallei B. diminuta B. vesicularis

Acinetobacter spp.

Which organism may be mistaken for a lactose fermenter on MacConkey agar because of colonies exhibiting a purple hue on the media? Acinetobacter spp. P. luteola S. maltophilia Bordetella holmesii

C. botulinum

Which organism produces botulinum toxin?

B. burgdorferi sensu stricto

Which species of Borrelia bugdoorferrari is a strict North Americaphile?

Propionibacterium acnes (indole-positive) other Propionibacterium spp. (indole-negative).

Which species of Propionibacterium is indole positive

Pseudomonas stutzeri

Who dis? Hint: its wrinkled

Acineetobacter

Who dis? Is that a purple hue? Neeto!

Pseudomonas aeruginosa

Who dis? Note the discoloration

Elizabethkingia meningoseptica

Who dis? Note the growth with yellow pigment on sheep blood agar (SBA) (left) and absence of growth on MacConkey plate (right)

D and E

Why it called Lyme disease? a. Persistent taste of lime in the infected. b. Flesh of the infected tastes of lime. c. The infected are disposed of using lyme to kill the organisms. d. The disease was first described after an outbreak among children in Lyme, Connecticut e. This is a stupid question why are you wasting your time you ****ing idiot.

Yes CNAs do support gram-positive facultative anaerobes

Will S. aureus grow on a CNA plate?

No identification is based on the colony appearance on nonselective anaerobic blood and EYAs.

Will gram-positive anaerobes grow on BBE or LKVB plates?

Laked blood component of Kanamycin-vancomycin-laked blood (KVLB) agar, Supports growth of Bacteroides and Prevotella spp.; yeasts and kanamycin-resistant, facultative, gram-negative bacilli will also grow

accelerates production of brown-black pigmented colonies by certain Prevotella spp.

Brill-Zinsser disease

also called recrudescent typhus

Gram negative anaerobic bacilli

are all non-spore-forming and are often found as members of the endogenous microbiota. They can be found as part of the microbiota of the oral cavity and GI and GU tracts. The genera most commonly encountered in clinical specimens include the B. fragilis group, Porphyromonas, Prevotella, and Fusobacterium.

Bilophila wadsworthia

bile-resistant gram negative anaerobe that will grow on BBE agar with a characteristic fish-eye appearance (see Figure 22-20) and will also grow on KVLB agar. The organism is strongly catalase-positive and nitrate-positive.

Coxiella burnetti

causative agent of Q (query) fever

C. trachomatis serovars L1, L2, L2a, L2b, and L3

cause LGV, a sexually transmitted disease (STD); these serovars are more invasive than the others.

Chlamydophila psittaci

cause of psittacosis among psittacine birds, also known as ornithosis or parrot fever

Chlamydophila psittaci

cause of psittacosis among psittacine birds, also known as ornithosis or parrot fever.

Pinta

caused by T. carateum, is found in the tropical regions of Central and South America. It is acquired by person to person contact and is rarely transmitted by sexual intercourse. Lesions begin as scaling, painless papules and are followed by an erythematous rash that becomes hypopigmented with time.

Endemic syphilis (bejel)

caused by T. pallidum subsp. endemicum and closely resembles yaws in clinical manifestations. It is found in the Middle East and the arid, hot areas of the world. The primary and secondary lesions are usually papules that often go unnoticed. They can progress to gummas of the skin, bones, and nasopharynx. Dark field microscopy is not useful because of normal oral spirochetal biota. Poor hygienic conditions are important in perpetuating these infections.

Anaplasma phagocytophilum

causes a disease referred to as human granulocytic anaplasmosis (HGA)

Ehrlichia chaffeensis Ehrlichia ewingii produces a disease indistinguishable from E. chaffeensis, and no currently available serologic test can distinguish these agents

causes human monocytic ehrlichiosis (HME)

Relapsing fever

characterized by acute febrile episodes that subside spontaneously but tend to recur over a period of weeks.

Positive lipase reaction on egg yolk agar. The reaction occurs on the surface of colonies and surrounding medium. A positive reaction by Fusobacterium necrophorum is shown here.

colony covered with an iridescent, multicolored sheen, sometimes described as resembling the appearance of gasoline on water or mother of pearl.

R. typhi

endemic typhus

R. prowazekii Rash on Palms and Soles, like RMSF, but ALSO on face

epidemic louse-borne typhus and Brill-Zinsser disease

Fusobacterium mortiferum or F. necrophorum

extremely pleomorphic, gram-negative bacilli with bizarre shapes are suggestive of

F. nucleatum and C. difficile

fluoresce chartreuse

Peptoniphilus

gram positive anaerobic coccus - Spot indole-positive

Anaerococcus tetradius

gram positive anaerobic coccus - only urease-positive

Peptostreptococcus indolicus

gram positive anaerobic coccus - positive nitrate test

Peptostreptococcus anaerobius

gram positive anaerobic coccus - zone of inhibition around an SPS disk

C. difficile

has a characteristic odor, resembling a horse stable, and colonies on blood agar fluoresce chartreuse under UV light.

borreliae

highly flexible organisms varying in thickness from 0.2 to 0.5 µm and in length from 3 to 20 µm. The spirals vary in number from 3 to 10 per organism and are much less tightly coiled than those of the leptospires

Lactobacillus

highly pleomorphic bacilli, which may appear on Gram stain as a coccoid or spiral-shaped organism

Dogs, rats and other rodents

principal animal reservoirs of Leptsospires

Positive lecithinase reaction on egg yolk agar. The reaction occurs within the agar. Clostridium perfringens is shown here.

produces an opaque zone around the colony. This opacity is actually in the medium and is not a surface phenomenon

Peptococcus niger

produces colonies that are initially black to olive green and become light gray when exposed to air, but it is only rarely isolated from clinical specimens

Psychrobacter immobilis

psychrotropic, and the optimal temperature for growth is 20° C. They have been isolated from fish, processed meat, and poultry. Clinically, they have been isolated from the eye of a newborn, who had acquired the infection nosocomially via a water source.

cycloserine-cefoxitin-fructose agar (CCFA) plate

selective and differential medium for the recovery and presumptive identification of C. difficile

Colistin nalidixic acid (CNA) blood agar plate Supports growth of almost all obligate anaerobes (gram-positive and gram-negative) and gram-positive, facultative anaerobes

selective medium containing sheep red blood cells and the antimicrobials colistin and nalidixic acid; used primarily to suppress the growth of any facultative, gram-negative bacilli (e.g., Enterobacteriaceae) that might be present in the clinical specimen, especially swarming Proteus spp

Elementary body (EB)

small metabolically inactive, extracellular, infectious form released by the infected host

Yaws

spirochetal disease caused by T. pallidum subsp. pertenue. It is endemic in the humid, tropical belt, the tropical regions of Africa, parts of South America, India, and Indonesia, and many of the Pacific Islands. It is not seen in the United States. The course of yaws resembles that of syphilis, but the early stage lesions are elevated, granulomatous nodules.

Buboes

swollen lymph nodes, seen in LGV

erythema migrans (EM)

the classic skin lesion that is normally found at the site of the lyme borreliosis tick bite

Borrelia and Treponema

the family Spirochaetaceae contains these two

B. fragilis gram-negative

the most common species of anaerobic bacteria isolated from infectious processes of soft tissue and anaerobic bacteremia

Finegoldia magna

the most pathogenic of the anaerobic cocci and the one most often isolated in pure culture

C. sordellii

the only Clostridium species that is urease-positive.

Treponemes

thin, spiral organisms about 0.1 to 0.2 µm in thickness and 6 to 20 µm in length. They are difficult to visualize with a bright field microscope because they are so thin, but they can be seen very easily using dark field microscopy. The spirals are regular and angular, with 4 to 14 spirals per organism. Three periplasmic flagella are inserted into each end of the cell. The ends are pointed and covered with a sheath. The cells are motile, with graceful flexuous movements in liquid.

Tick-borne borreliae

widely distributed throughout the Eastern and Western hemispheres, and transmission to a vertebrate host takes place via infected saliva during tick attachment

Syphilis Primary syphilis lesions develop 10 to 90 days after infection and are a result of an inflammatory response to the bacteria at the site of inoculation. The lesion, known as the chancre, is typically a single erythematous lesion that is not tender but is firm with a clean surface and raised border. The lesion is teeming with treponemes and is extremely infectious.

A man is taking a shower and notices a lesion on his penis that is not tender but is firm with a clean surface and raised edges. He goes to his physician. The physician orders a rapid plasmin reagin (RPR) and a dark-field microscopy. Both tests are positive. What is the probable diagnosis? Gonorrhea Nongonococcal urethritis Syphilis Human papillomavirus

P. aeruginosa Keywords: metallic sheen, grapelike odor, cetrimide agar

A microbiologist is reading the plates from a sputum culture. On the sheep blood agar (SBA), the microbiologist sees flat spreading colonies with a metallic sheen. On cetrimide agar, a fluorescent green color is seen in the medium with clear colonies. On MacConkey, medium clear colonies are seen that have a fruity or grapelike odor. What is the most likely organism?

Pseudomonas aeruginosa P. aeruginosa is a gram-negative rod that produces a green pigment and sometimes a metallic sheen on culture media. S. marcescens produces a brick-red pigment. C. violaceum produces a purple pigment. P. melaninogenica produces a brown-black pigment.

A microbiologist is reading the plates from a sputum culture. The culture is from a patient with cystic fibrosis. One organism dominates the blood agar, chocolate, and MacConkey plates. The MacConkey plate shows an organism with a green pigment and a metallic sheen. The probable identification for this organism is

Clostridium perfringens

A microbiology technologist is reading an anaerobic culture and observes a double zone of hemolysis on an anaerobically incubated sheep blood agar plate. The Gram stain of that organism was a boxcar-shaped, gram-positive bacillus. What organism is this

B fragilis

A microbiology technologist is reading an anaerobic plate from an intestinal abscess. There is growth on the Bacteroides bile esculin (BBE) plate: gray colonies with a brown color in the area around the colonies. There is also a dark precipitate in the medium in the areas of heavy growth. The technician Gram stains the colonies and observes gram-negative coccobacilli. What is the presumptive identification of this organism

Clostridium difficile

A patient is diagnosed with pseudomembranous colitis. What organism is the most likely cause

C. septicum

A rapidly growing colony exhibiting smooth swarming (as opposed to the waves observed with Proteus) and staining as thin rods with subterminal spores is likely to be

Bacteroides bile esculin (BBE) agar

A selective medium containing gentamicin (which inhibits most aerobic organisms), 20% bile (which inhibits most anaerobes), and esculin; used primarily for rapid isolation and presumptive identification of members of the B. fragilis group, which grow well on BBE (because of their bile tolerance) and turn the originally light-yellow medium to black (because of esculin hydrolysis)

Clostridium tetani

A strict anaerobe that produces terminal spores is: Clostridium tetani Corynebacterium diphthereria Bacillus anthracis Propionibacterium acnes

C. septicum

A swarming, gram-positive, anaerobic bacillus with subterminal spores

C. tetani

A swarming, gram-positive, anaerobic bacillus with terminal spores

Nongonococcal urethritis, Chlamydia trachomatis

A young man goes to his physician complaining of a discharge from his penis. The physician collects a slide for Gram stain and a swab for culture and sends them to the laboratory. The Gram stain reveals greater than 25 white blood cells/high-power field, no bacteria seen. The culture results after 48 hours show no growth. What is the most probable diagnosis and the organism responsible? Urethritis, Streptococcus pneumoniae Epididymitis, Moraxella Nongonococcal urethritis, Neisseria meningitidis Nongonococcal urethritis, Chlamydia trachomatis

Lyme disease and doxycycline

A young woman notices a red bruiselike lesion that looks like a target on her lower leg. She cannot remember getting bruised, even though she went hiking through the woods last weekend. The bruise goes away in about a week and she thinks nothing more about it. About 2 weeks later, she develops joint and bone pain, extreme fatigue, and her heart just "doesn't feel right." What disease does she have, and what antimicrobial agent is used to treat it? Lyme disease and doxycycline Relapsing fever and macrolides Parrot fever and penicillin Hemorrhagic fever and gentamicin

abscess

Acceptable specimen sources for culture of anaerobic bacteria includes: abscess stool clean catch urine vaginal

will grow on MAC and EMB media Iwoffi dont give a **** he grow anywhere

Acinetobacter lwoffi differs from Neisseria gonorrhoeae in that Acinetobacter :

Positive differentiates from negative Clostridium

Bacillus catalase test

Eubacterium

Bacterial vaginosis is a synergistic infectious process involving all the following bacteria EXCEPT

Eubacterium.

Bacterial vaginosis is a synergistic infectious process involving all the following bacteria, except Eubacterium. Bacteroides. Gardnerella. Peptostreptococcus.

acetylcholine

Botulinum toxin attaches to the neuromuscular junction of nerves and prevents the release of which neruotransmitter, which results in flaccid paralysis and death.

R. conorii

Boutonneuse fever, also known as Mediterranean spotted fever, caused by

Porphyromonas and Prevotella

Brick red fleuresence under UV light is presumptive for these two

Spore former

C. burnetti is unique in that

Rule-out disease If C. pneumoniae- and C. trachomatis-specific IgG and IgM are not detected by MIF and a fourfold rise in chlamydiae antibodies is detected by CF, it be psittaci probably

Diagnoses of C. psittaci is often called a __________

C. perfringens

Double zone of hemolysis on SBA plate incubated anaerobically, suggestive of

Clostridium perfringens

Double zone of hemolysis produced by

Penicillin

Drug of choice for treating patients with syphilis.

facultative anaerobic gram negative Growth on MAC in ambient air or CO2

E. coli

It affects the face, in addition to the palms and soles. There are also Taches noires at the primary site of infection.

How can the Boutonneuse fever rash be differentiated from the RMSF rash?

clinical appearance and Gram staining of vaginal secretions that reveals a shift in the vaginal biota from predominantly gram-positive lactobacilli to a mixture of Gardnerella spp. (gram-variable bacilli) and mixed gram negative anaerobes.

How is BV diagnosed?

A rapid urease test done on a gastric biopsy H. pylori may be presumptively identified in a gastric biopsy specimen by testing for the presence of a rapid urease reaction. Urease activity may also be detected by the urea breath test.

How is Helicobacter pylori presumptively identified?

You ****ing look at it. Easily seen in Wright-stained blood smears during the febrile period.

How is borreliosis diagnosed?

Crossing the placenta

How is congenital syphilis transmitted from the mother to her unborn child? During birth from the birth canal During the microhemorrhages that occur as the placenta breaks away from the uterus Crossing the placenta None of the above

During birth from the birth canal

How is congenital syphilis transmitted from the mother to her unborn child? During birth from the birth canal During the microhemorrhages that occur as the placenta breaks away from the uterus Crossing the placenta None of the above

Special potency disks Although the Gram stain is helpful in the initial identification of an anaerobic isolate, certain species of Clostridium may stain pink and thus appear to be gram-negative bacilli. To determine the true Gram stain reaction of the isolate, special-potency disks can be used.

How is the true Gram stain reaction of an anaerobe determined? Special potency disks Shape and colony morphology Aerotolerance Direct fluorescent antibody (DFA)

5 to 7 days

How long are anaerobic cultures routinely held in the laboratory? 1 to 2 days 3 to 4 days 5 to 7 days 7 to 9 days

CCFA: yellow, ground glass colonies

If a stool specimen is sent to the laboratory to rule out Clostridium difficile, what media should the microbiologist use and what is the appearance of this organism on this medium? BBE: colonies turn black Brucella agar: red pigmented colonies CCFA: yellow, ground glass colonies CNA;double zone hemolytic colonies

they are usually polymicrobic

In general , anaerobic infections differ from aerobic infections in which of the following ? They usually respond favorably to aminoglycoside therapy They usually arise from exogenous sources they are usually polymicrobic Gram stains of specimens are less helpful in diagnosis

IgM

In patients with a leptospiral bacteremia, ______ antibodies are detected within 1 week after onset of disease and may persist in high titers for many months.

Gastric, urea, breath test, Type B gastritis, 37° C

Keywords for Helicobacter pylori

Bubo

LGV results in the formation of this

L1, L2, L2a, L2b, and L3

LGV serovars

Fusobacterium necrophorum a syndrome of thrombophlebitis of the jugular vein that occurs rarely following group A streptococcal pharyngitis

Lemierre's disease is caused by

Rapid and rotational

Leptispira motility is described as

Binary Fission

Leptospira and Borrelia divide via:

neutral;alkaline

Leptospires can survive in ________ or slightly ________ waters for months

Pediculus humanus

Louse-borne fever is transmitted via this species of louse.

Ixodes ticks

Lyme borreliosis causing organisms are transmitted via the bite of infected ______ _____.

B. fragilis

Material from an intestinal abscess produces gray colonies with a brown color in the area around the colonies on a BBE plate incubated anaerobically. There is also a dark precipitate in the medium in the areas of heavy growth. A Gram stain of the colonies reveals gram-negative coccobacilli. What is the presumptive identification of this organism? Bacteroides vulgatus B. fragilis B. pneumoniae B. denticola

aminoglycosides ---- This one ceftazidime. SXT. piperacillin

Members of the Alcaligenes are usually susceptible to all the following antimicrobial agents, except

Pyoverdin

Members of the Pseudomonas fluorescent group all produce this pigment

Reticulate body (RB)

Metabolically active form of Chlamydia that has conventional bacteria-like properties

B. fragilis group

Most commonly isolated anaerobes from blood cultures.

RB

Non-infectious form of Chlamydiae

Actinomyces, Bifidobacterium, Eubacterium, Mobiluncus, Lactobacillus, and Propionibacterium spp.

Non-spore-forming, anaerobic, gram-positive bacilli include

Pseudomonas.

Not including organisms in the Enterobacteriaceae family, the most common gram-negative bacilli encountered in clinical specimens are: Pseudomonas. Burkholderia. Ralstonia. Vibrio.

Bilophila wadsworthia

Note the fish eye appearance of the colonies

The organism systematically changes its surface antigens during the course of a single infection.

Once infected with Borrelia recurrentis, a 2- to 15-day incubation period follows where high numbers of organisms are found in the blood. The infected individual experiences high fever, rigors, severe headache, muscle pains, and weakness. This febrile period lasts for about 3 to 7 days, but ends quickly with the induction of an immune response. However, a similar but less severe course of symptoms recurs several days to weeks later. What causes this relapse? The organism systematically changes its surface antigens during the course of a single infection. The organism produces extracellular toxins that cause the symptoms. This organism survives inside infected cells and once the cell dies, the organism is released into the blood, causing this relapse. This relapse occurs as the host is trying to mount the secondary antibody response.

Propionibacterium acnes

pleomorphic rods with a diphtheroid appearance.

Actinomyces spp

irregular staining can produce a beaded or banded appearance, much like that seen with Nocardia spp.

Leptospirosis

is a zoonoses primarily associated with occupational or recreational exposure. Working with animals or in ratinfested surroundings poses hazards for veterinarians, dairy workers, swine handlers, slaughterhouse workers, miners, sewer workers, and fish and poultry processors.

C. trachomatis

most common sexually transmitted bacterial pathogen in the United States.

NAAT

most frequently used method for direct detection of E. chaffeensis

Veillonella spp.

often fluoresce red, but the fluorescence is dependent on the culture medium. It is weaker than the fluorescence produced by pigmented species of Porphyromonas and Prevotella and fades completely if the colonies are exposed to air for 5 to 10 minutes.

A. israelii

older colonies usually have a molar tooth appearance