Non-fermenting and Miscellaneous Gram-Negative Rods
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* __Fail__ to **acidify an oxidative-fermentative (OF) medium** when it is – (with mineral oil)
* __Fail__ to **acidify triple sugar iron agar (TSIA) butts**.
* Grows in __**aerobic environment**__
* __Some members__ oxidize carbohydrates – oxidizers; others are non-oxidizers or asaccharolytic
* __**Oxidase positive**__
* All species except *B. mallei (Burkholderia mallei)* are **motile, having one or several polar flagella**
* For __non-fermenters__, optimum temperature range: 30 to 37 degrees Celsius (mesophilic)
* *Acidovorax facilis* is the **only MacConkey negative**
* *Pseudomonas spp.* are __**catalase positive**__
* __Fail__ to **acidify triple sugar iron agar (TSIA) butts**.
* Grows in __**aerobic environment**__
* __Some members__ oxidize carbohydrates – oxidizers; others are non-oxidizers or asaccharolytic
* __**Oxidase positive**__
* All species except *B. mallei (Burkholderia mallei)* are **motile, having one or several polar flagella**
* For __non-fermenters__, optimum temperature range: 30 to 37 degrees Celsius (mesophilic)
* *Acidovorax facilis* is the **only MacConkey negative**
* *Pseudomonas spp.* are __**catalase positive**__
General Characteristics of Non-fermenters
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^^**Biochemical Characteristics and Identification**^^
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* **Oxidase** __**__**__ **reaction**, although reaction can be weak and variable
* Nonreactivity in 24 hours in commercial multi-test kit systems used primarily for the identification of *Enterobacteriaceae*
* No acid production in the slant or butt of TSIA or KIA
* **Resistance to a variety of classes of antimicrobial agents**, such as aminoglycosides, third-generation cephalosporins, penicillin, and fluoroquinolones
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* **Oxidase** __**__**__ **reaction**, although reaction can be weak and variable
* Nonreactivity in 24 hours in commercial multi-test kit systems used primarily for the identification of *Enterobacteriaceae*
* No acid production in the slant or butt of TSIA or KIA
* **Resistance to a variety of classes of antimicrobial agents**, such as aminoglycosides, third-generation cephalosporins, penicillin, and fluoroquinolones
positive
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^^**Clinically Significant Non-fermentative, Gram-negative Bacilli**^^
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* __**Gram-negative bacillus or coccobacillus**__
* **Strictly aerobic metabolism**
* Motile usually with polar flagellum or polar tuft of flagella
* __**Oxidase positive**__ (__except__ *P. luteolus* and *P. oryzihabitans*)
* __**Catalase positive**__
* Usually **grows on MAC agar**
* Usually an **oxidizer of carbohydrates**, but **some species** are __asaccharolytic__
* Produce water-soluble pigments, **yellow green pigment** (__pyoverdine__), **blue pigment** (__pyocyanin__)
* when the __pyocyanin has been combined with pyoverdine__ it will result in a **bright green color**
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* __**Gram-negative bacillus or coccobacillus**__
* **Strictly aerobic metabolism**
* Motile usually with polar flagellum or polar tuft of flagella
* __**Oxidase positive**__ (__except__ *P. luteolus* and *P. oryzihabitans*)
* __**Catalase positive**__
* Usually **grows on MAC agar**
* Usually an **oxidizer of carbohydrates**, but **some species** are __asaccharolytic__
* Produce water-soluble pigments, **yellow green pigment** (__pyoverdine__), **blue pigment** (__pyocyanin__)
* when the __pyocyanin has been combined with pyoverdine__ it will result in a **bright green color**
*A. Pseudomonas*
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^^**Clinically Significant Non-fermentative, Gram-negative Bacilli**^^
What group is this?
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* *Pseudomonas aeruginosa*
* *Pseudomonas fluorescens*
* *Pseudomonas putida*
* *Pseudomonas monteiliii*
* *Pseudomonas veronii*
* *Pseudomonas mosseliii*
*pseudomonas* are classified as a fluorescent group and non fluorescent group
able to **produce a yellow green or yellow brown pigment** and that is what we __called “Pyoverdine”__. **Pyoverdine** is a __water-soluble pigment__
aside from pyoverdine, again, *pseudomonas aeruginosa* also __produce pyocyanin__
What group is this?
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* *Pseudomonas aeruginosa*
* *Pseudomonas fluorescens*
* *Pseudomonas putida*
* *Pseudomonas monteiliii*
* *Pseudomonas veronii*
* *Pseudomonas mosseliii*
*pseudomonas* are classified as a fluorescent group and non fluorescent group
able to **produce a yellow green or yellow brown pigment** and that is what we __called “Pyoverdine”__. **Pyoverdine** is a __water-soluble pigment__
aside from pyoverdine, again, *pseudomonas aeruginosa* also __produce pyocyanin__
*Pseudomonas* Fluorescent Group
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^^**Clinically Significant Non-fermentative, Gram-negative Bacilli**^^
What group is this?
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* *Pseudomonas stutzeri*
* *Pseudomonas mendocina*
* *Pseudomonas alcaligenes*
* *Pseudomonas pseudoalcaligenes*
* *Pseudomonas luteola*
* *Pseudomonas oryzihabitans*
What group is this?
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* *Pseudomonas stutzeri*
* *Pseudomonas mendocina*
* *Pseudomonas alcaligenes*
* *Pseudomonas pseudoalcaligenes*
* *Pseudomonas luteola*
* *Pseudomonas oryzihabitans*
*Pseudomonas* non-fluorescent group
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^^***Pseudomonas*** **Fluorescent Group**^^
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* __**Motile and rod shaped**__
* **Obligate aerobe**
* Producing a __**sweet or grape- like or corn taco-like odor**__ (due to the presence of 2- aminoacetophenone)
* Produces the **fluorescent bluish pigment, pyocyanin**
* Produces the **fluorescent pigment pyoverdine**
* May also produce a __dark red pigment__ (pyorubin) or a __brownblack pigment__ (pyomelanin)
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* __**Motile and rod shaped**__
* **Obligate aerobe**
* Producing a __**sweet or grape- like or corn taco-like odor**__ (due to the presence of 2- aminoacetophenone)
* Produces the **fluorescent bluish pigment, pyocyanin**
* Produces the **fluorescent pigment pyoverdine**
* May also produce a __dark red pigment__ (pyorubin) or a __brownblack pigment__ (pyomelanin)
*Pseudomonas aeruginosa*
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**What agar is this?**
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Culture media: ______________-selective and differential
* this medium also **enhances the production of 2 pigments** which is __pyoverdine and pyocyanin.__
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Culture media: ______________-selective and differential
* this medium also **enhances the production of 2 pigments** which is __pyoverdine and pyocyanin.__
\
Cetrimide Agar
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* __**acts as a detergent**__
* their growth at 42 degree C can help to differentiate it from other *pseudomonas spp* or other fluorescent group
* for the identification of P.A usually we base on colonial morphology with the presence of pigment, with the oxidase positivity, and their growth at 42 C
* their growth at 42 degree C can help to differentiate it from other *pseudomonas spp* or other fluorescent group
* for the identification of P.A usually we base on colonial morphology with the presence of pigment, with the oxidase positivity, and their growth at 42 C
Cetrimide
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* Can grow at 4° C
* **Produce pyoverdine**
* __Cannot__ **reduce nitrate to nitrogen gas**
* __Can__ **produce acid from xylose**
* Gelatin hydrolysis:
*P. putida*: **negative**
*P. fluorescens*: **positive**
* these organisms can be **isolated from respiratory specimens**, contaminated blood products, urine, and other hospital equipment
* **Produce pyoverdine**
* __Cannot__ **reduce nitrate to nitrogen gas**
* __Can__ **produce acid from xylose**
* Gelatin hydrolysis:
*P. putida*: **negative**
*P. fluorescens*: **positive**
* these organisms can be **isolated from respiratory specimens**, contaminated blood products, urine, and other hospital equipment
*Pseudomonas fluorescens* and *Pseudomonas putida*
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^^***Pseudomonas*** **Nonfluorescent Group**^^
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* __**Wrinkled, leathery, adherent colonies**__
* **Light-yellow** or **brown pigment**
* __**ADH negative**__
* Starch hydrolysis **positive**
* Can grow in an anaerobic environment in nitrate-containing media --- nitrogen gas
* Septicemia, meningitis in the human immunodeficiency virus-infected patient, pneumonia (especially in CF and immunocompromised patients), endocarditis, postsurgical wound infections, septic arthritis, conjunctivitis, and UTIs
* usually the isolates are ADH negative and starch hydrolysis positive can be used to distinguish the *Pseudomonas stutzeri* from most other Pseudomonas species; this is one of their characteristics
* they are also able to **produce nitrogen gas** (can also be used to distinguish Pseudomonas stutzeri from most other pseudomonas species
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* __**Wrinkled, leathery, adherent colonies**__
* **Light-yellow** or **brown pigment**
* __**ADH negative**__
* Starch hydrolysis **positive**
* Can grow in an anaerobic environment in nitrate-containing media --- nitrogen gas
* Septicemia, meningitis in the human immunodeficiency virus-infected patient, pneumonia (especially in CF and immunocompromised patients), endocarditis, postsurgical wound infections, septic arthritis, conjunctivitis, and UTIs
* usually the isolates are ADH negative and starch hydrolysis positive can be used to distinguish the *Pseudomonas stutzeri* from most other Pseudomonas species; this is one of their characteristics
* they are also able to **produce nitrogen gas** (can also be used to distinguish Pseudomonas stutzeri from most other pseudomonas species
*Pseudomonas stutzeri*
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^^***Pseudomonas*** **Nonfluorescent Group**^^
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* **contaminant**
* produces __nonwrinkled, flat colonies that may appear with a yellowish-brown pigment__
* pigmentation can be a variable trait but many exhibit a smooth buttery appearance.
* many exhibit a __**smooth buttery appearance.**__
* __**oxidase and ADH positive**__
* does __not produce pyoverdin__ – that is why they classified it as nonflourescent group.
* **acetamide negative**.
* **Motile** with the means of __single polar flagellum__
* __**oxidizes glucose and xylose**__
* nonproteolytic and does not hydrolyze starch
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* **contaminant**
* produces __nonwrinkled, flat colonies that may appear with a yellowish-brown pigment__
* pigmentation can be a variable trait but many exhibit a smooth buttery appearance.
* many exhibit a __**smooth buttery appearance.**__
* __**oxidase and ADH positive**__
* does __not produce pyoverdin__ – that is why they classified it as nonflourescent group.
* **acetamide negative**.
* **Motile** with the means of __single polar flagellum__
* __**oxidizes glucose and xylose**__
* nonproteolytic and does not hydrolyze starch
*Pseudomonas mendocina*
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^^***Pseudomonas*** **Fluorescent Group**^^
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* **nonpigmented** and **nonhemolytic**
* **positive** for __oxidase, catalase, and ADH__
* optimal **growth occurs at 30 C**
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* **nonpigmented** and **nonhemolytic**
* **positive** for __oxidase, catalase, and ADH__
* optimal **growth occurs at 30 C**
*Pseudomonas mosselii*
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^^***Pseudomonas*** **Nonfluorescent Group**^^
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* both are __**oxidase positive**__
* biochemically __negative in many tests__
* they are **often considered as contaminants**, if they have been __isolated from clinical specimens__
* Grow on **MAC agar**
* **motile** by means of __polar flagellum__
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* both are __**oxidase positive**__
* biochemically __negative in many tests__
* they are **often considered as contaminants**, if they have been __isolated from clinical specimens__
* Grow on **MAC agar**
* **motile** by means of __polar flagellum__
*Pseudomonas pseudoalcaligenes* and *Pseudomonas alcaligenes*
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^^***Pseudomonas*** **Nonfluorescent Group**^^
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* __**ADH positive**__ and will __**weakly ferment fructose**__
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* __**ADH positive**__ and will __**weakly ferment fructose**__
*P. pseudoalcaligenes*
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^^***Pseudomonas*** **Nonfluorescent Group**^^
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* __**gram-negative, nonfermentative, oxidase- negative bacilli.**__
* **catalase positive** and **motile,** __**oxidize glucose**__, grow on **MAC agar**
* produce an __intracellular nondiffusible yellow pigment__.
* Produce **wrinkled or rough colonies** at 48 hours
* ONPG test, we used it to detect the enzyme __beta galactosidase__, this __beta galactosidase__ is present in **late lactose fermenters**
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* __**gram-negative, nonfermentative, oxidase- negative bacilli.**__
* **catalase positive** and **motile,** __**oxidize glucose**__, grow on **MAC agar**
* produce an __intracellular nondiffusible yellow pigment__.
* Produce **wrinkled or rough colonies** at 48 hours
* ONPG test, we used it to detect the enzyme __beta galactosidase__, this __beta galactosidase__ is present in **late lactose fermenters**
*Pseudomonas luteola* and *Pseudomonas oryzihabitans*
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* __**aerobic, catalase-positive, oxidase negative, Gram- negative bacteria**__
* may also appear as __**diplococci**__ on smears and then __resemble__ __*Neisseria*__
* grow best at 35°C to 37°C
* may also appear as __**diplococci**__ on smears and then __resemble__ __*Neisseria*__
* grow best at 35°C to 37°C
*Acinetobacter*
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* most **commonly isolated in clinical laboratories**
* __**glucose-oxidizing, nonhemolytic strain**__
* __**glucose-oxidizing, nonhemolytic strain**__
*Acinetobacter baumannii*
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* __described__ to **colonize human skin** and __cause__ occasionally **infections in immunocompromised patients.**
*Acinetobacter radioresistens*
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* __**Glucose negative nonhemolytic strain.**__
*Acinetobacter Iwoffii*
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^^***Acinetobacter***^^
**Clinical Infections**
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* primarily __**affect patients with weakened immune systems**__ and __**coexisting diseases**__
* usually, when we talk about *Acinetobacter*, they are able to **affect the immunocompromised patients.**
* UTIS; pneumonia, tracheobronchitis, or both; endocarditis
* septicemia; meningitis
* **Cellulitis** – from the __contamination from catitters__ or from introduction of foreign body.
* ______________________- eye infections: such as endophthalmitis, conjunctivitis, and corneal ulcerations
**Clinical Infections**
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* primarily __**affect patients with weakened immune systems**__ and __**coexisting diseases**__
* usually, when we talk about *Acinetobacter*, they are able to **affect the immunocompromised patients.**
* UTIS; pneumonia, tracheobronchitis, or both; endocarditis
* septicemia; meningitis
* **Cellulitis** – from the __contamination from catitters__ or from introduction of foreign body.
* ______________________- eye infections: such as endophthalmitis, conjunctivitis, and corneal ulcerations
*Acinetobacter baumannii*
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^^***Acinetobacter***^^
**Identifying Characteristics**
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* __**can resist decolorization**__ and __**retain the crystal violet**__
* development of __purplish hue__ produced by some species on **MacConkey agar**
* ___________ __is__ __**saccharolytic**____,__ and ___________is **asaccharolytic**
* **CRAB** (carbapenem resistant *A. baumannii*)- __only susceptible to colistin__ and __tigecycline__
* *Acinetobacter baumannii* on MacConkey a organisms saccharolyn, which may **cause to re lactose fermenting organism**
**Identifying Characteristics**
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* __**can resist decolorization**__ and __**retain the crystal violet**__
* development of __purplish hue__ produced by some species on **MacConkey agar**
* ___________ __is__ __**saccharolytic**____,__ and ___________is **asaccharolytic**
* **CRAB** (carbapenem resistant *A. baumannii*)- __only susceptible to colistin__ and __tigecycline__
* *Acinetobacter baumannii* on MacConkey a organisms saccharolyn, which may **cause to re lactose fermenting organism**
*A. baumannii, A. Iwoffii*
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* __**third most common non-fermentative**__, **gram- negative bacillus** in the clinical laboratory
* __Colonies__ may appear **bluish on MAC agar positive for catalase**, **DNase, esculin and gelatin hydrolysis, and lysine decarboxylase**
* this has been known because of the **characteristic bluish on MAC agar.**
* __Colonies__ may appear **bluish on MAC agar positive for catalase**, **DNase, esculin and gelatin hydrolysis, and lysine decarboxylase**
* this has been known because of the **characteristic bluish on MAC agar.**
*Stenotrophomonas maltophilia*
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^^***Burkholderia***^^
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* usually, they **contain plant pathogens**, but they can also affect humans. They can be classified as __**opportunistic organism.**__
* **weak, slow,** __**positive oxidase reaction**__**.**
* __**oxidize glucose**__, and __many will oxidize maltose, lactose, and mannitol.__
* **lysine decarboxylase** and **ONPG positive**
* **ornithine decarboxylase negative** and __fail__ to **reduce nitrate to nitrite**
* motile by means of polar tufts of flagella
* Causes __**onion bulb**__ **rot in plants and foot rot in humans**
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* usually, they **contain plant pathogens**, but they can also affect humans. They can be classified as __**opportunistic organism.**__
* **weak, slow,** __**positive oxidase reaction**__**.**
* __**oxidize glucose**__, and __many will oxidize maltose, lactose, and mannitol.__
* **lysine decarboxylase** and **ONPG positive**
* **ornithine decarboxylase negative** and __fail__ to **reduce nitrate to nitrite**
* motile by means of polar tufts of flagella
* Causes __**onion bulb**__ **rot in plants and foot rot in humans**
*Burkholderia cepacia* Complex
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^^***Burkholderia***^^
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* old name is *Pseudomonas mallei*
* **Smooth and cream to white colonies** in BAP and __**weakly oxidase (+)**__ .
* The __**only non-motile**__ among all pseudomonads
* **CAN'T GROW** in 42 C
* Causes __**GLANDER'S DISEASE**__ - __infectious disease of horses, goats, sheep, & donkey__. Rare cause of human infection acquired by direct contact, trauma, or inhalation.
* this is __**respiratory tract zoonosis.**__
* __**FARCY**__- **disseminated** form of **glander's disease**
* considered as a __**potential bioterrorism agent**__- meaning those are __pathogenic organism that are usually used in order__ to __**produce death**____.__
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* old name is *Pseudomonas mallei*
* **Smooth and cream to white colonies** in BAP and __**weakly oxidase (+)**__ .
* The __**only non-motile**__ among all pseudomonads
* **CAN'T GROW** in 42 C
* Causes __**GLANDER'S DISEASE**__ - __infectious disease of horses, goats, sheep, & donkey__. Rare cause of human infection acquired by direct contact, trauma, or inhalation.
* this is __**respiratory tract zoonosis.**__
* __**FARCY**__- **disseminated** form of **glander's disease**
* considered as a __**potential bioterrorism agent**__- meaning those are __pathogenic organism that are usually used in order__ to __**produce death**____.__
*Burkholderia mallei*
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^^***Burkholderia***^^
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* **Cream to tan wrinkled colonies** in BAP
* **Motile via** __**polar tuft flagella**__
* __**ADH (+)**__
* __Highly oxidative__- **glucose, maltose lactose, mannitol**
* causes __**MELIOIDOSIS**__- This is an pulmonary disease; transmitted via ingestion, inhalation or in inoculation in the organism. Glanderslike disease which has a long latent period.
* Manifestation of symptoms takes years hence the (it has been called) synonym __**Vietnam Time Bomb**__
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* **Cream to tan wrinkled colonies** in BAP
* **Motile via** __**polar tuft flagella**__
* __**ADH (+)**__
* __Highly oxidative__- **glucose, maltose lactose, mannitol**
* causes __**MELIOIDOSIS**__- This is an pulmonary disease; transmitted via ingestion, inhalation or in inoculation in the organism. Glanderslike disease which has a long latent period.
* Manifestation of symptoms takes years hence the (it has been called) synonym __**Vietnam Time Bomb**__
*Burkholderia pseudomallei*
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^^***Burkholderia***^^
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* produces **yellow pigment** after **48-72 hours of incubation**
* **motile** by means of __one or two polar flagella__
* __**catalase and urease positive**__
* Grows on surface of **MAC agar**
* **Oxidizes** __**glucose**__
* **mannitol positive** and **decarboxylase negative**, and is **negative for oxidase**, although __some strains are weakly positive__.
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* produces **yellow pigment** after **48-72 hours of incubation**
* **motile** by means of __one or two polar flagella__
* __**catalase and urease positive**__
* Grows on surface of **MAC agar**
* **Oxidizes** __**glucose**__
* **mannitol positive** and **decarboxylase negative**, and is **negative for oxidase**, although __some strains are weakly positive__.
*Burkholderia gladioli*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
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* both of these isolates can be **found on water, like swimming pool, tap water** and **dialysis fluid**, they are usually __resistant to disinfectants.__
* __**obligately aerobic gram-negative bacilli**__
* both **posses** __**peritrichous flagella**__
* may **produce a** __**fruity odor**__
* on the surface of **Sheep blood Agar agar plate**, they can exhibit **green discoloration.**
* **Oxidation-Fermentation media**: nonoxodative, produce a deep blue color at the top, except for *Achromobacter xylosoxidans*- old name “Achromobacter xylosoxidans variety denitrificans”
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* both of these isolates can be **found on water, like swimming pool, tap water** and **dialysis fluid**, they are usually __resistant to disinfectants.__
* __**obligately aerobic gram-negative bacilli**__
* both **posses** __**peritrichous flagella**__
* may **produce a** __**fruity odor**__
* on the surface of **Sheep blood Agar agar plate**, they can exhibit **green discoloration.**
* **Oxidation-Fermentation media**: nonoxodative, produce a deep blue color at the top, except for *Achromobacter xylosoxidans*- old name “Achromobacter xylosoxidans variety denitrificans”
*Alcaligenes* and *Achoromobacter*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
***Brevundimonas***
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* **Motile** and possess a **single polar flagellum**
* __**Oxidize glucose**__
* __**Oxidase positive**__
* Most **strains grow on MAC agar**
***Brevundimonas***
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* **Motile** and possess a **single polar flagellum**
* __**Oxidize glucose**__
* __**Oxidase positive**__
* Most **strains grow on MAC agar**
*B. diminuta*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
***Brevundimonas***
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* __**Slender rod**__, with **polar flagella**
* Only about **25% grows on MAC agar**
* Most strains __produce__ an **orange intracellular pigment**
* __**Oxidase positive**__ and __**oxidizes glucose and maltose**__
* **Esculin Hydrolysis**: to differentiate *B. diminuta* (**rarely positive, contaminant**) and *B. vesicularis* (**positive**)
***Brevundimonas***
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* __**Slender rod**__, with **polar flagella**
* Only about **25% grows on MAC agar**
* Most strains __produce__ an **orange intracellular pigment**
* __**Oxidase positive**__ and __**oxidizes glucose and maltose**__
* **Esculin Hydrolysis**: to differentiate *B. diminuta* (**rarely positive, contaminant**) and *B. vesicularis* (**positive**)
*B. vesicularis*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
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* __**Oxidase positive**__
* **Nonmotile, saccharolytic coccobacilli** that grow weakly, if at all, on MAC agar
* __**All oxidize glucose and xylose**__
* EO-3 and many EO-4 isolates have a **yellow non- diffusible pigment**
* EO refers to **Eugonic oxidizer**
* *P. yeei* (EO-2): coccoid or O-shaped cells on gram stain
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* __**Oxidase positive**__
* **Nonmotile, saccharolytic coccobacilli** that grow weakly, if at all, on MAC agar
* __**All oxidize glucose and xylose**__
* EO-3 and many EO-4 isolates have a **yellow non- diffusible pigment**
* EO refers to **Eugonic oxidizer**
* *P. yeei* (EO-2): coccoid or O-shaped cells on gram stain
CDC Groups EO-3, EO-4 and *Paracoccus*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
***Chromobacterium***
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* **Motile, facultative anaerobe,** __**oxidase positive**__
* __Rare cause__ of **human infection**
* Found in **soil and water**
* Unique because of the **violet pigment that it produces** – __**VIOLACEIN**__
***Chromobacterium***
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* **Motile, facultative anaerobe,** __**oxidase positive**__
* __Rare cause__ of **human infection**
* Found in **soil and water**
* Unique because of the **violet pigment that it produces** – __**VIOLACEIN**__
*Chromobacterium violaceum*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
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* **Straight to slightly curved rods**
* Produce **alkalinity in OF media**
* __**Catalase and oxidase positive**__
* **Motile** by __multitrichous polar flagella__
* **Reduce nitrate to nitrite**
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* **Straight to slightly curved rods**
* Produce **alkalinity in OF media**
* __**Catalase and oxidase positive**__
* **Motile** by __multitrichous polar flagella__
* **Reduce nitrate to nitrite**
*Comamonas* and *Delftia*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
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* Have been reported to __**cause nosocomial bacteremia**__
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* Have been reported to __**cause nosocomial bacteremia**__
*Comamonas testosteroni* and *Comamonas terrigena*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
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* Associated with __**keratitis in soft contact lens wearers**__ and **nosocomial infections** including __bacteremia and endocarditis__
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* Associated with __**keratitis in soft contact lens wearers**__ and **nosocomial infections** including __bacteremia and endocarditis__
*Delftia acidovorans (Comomonas acidovorans)*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
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* Associated with __**catheter-related bacteremia**__
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* Associated with __**catheter-related bacteremia**__
*Delftia tsuruhatensis*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
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*Balaneatrix, Bergeyella, Chryseobacterium, Elizabethkingia, Empedobacter, Myroides, Weeksella, Wautersiella, Sphingobacterium spp.*
* **Non-motile** __except__ *Balaneatrix alpaca*
* **Lavender green discoloration** of the agar on the media with blood
* **Fruity odor**
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*Balaneatrix, Bergeyella, Chryseobacterium, Elizabethkingia, Empedobacter, Myroides, Weeksella, Wautersiella, Sphingobacterium spp.*
* **Non-motile** __except__ *Balaneatrix alpaca*
* **Lavender green discoloration** of the agar on the media with blood
* **Fruity odor**
*Flavobacteriaceae*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
***Flavobacteriaceae***
\
* **Meningitis or septicemia** in a __newborn__
* produce __**acid from glucose, maltose, and mannitol**__
* **hydrolyze esculin,** __**indole positive**__
* growth on **MacConkey is variable**
***Flavobacteriaceae***
\
* **Meningitis or septicemia** in a __newborn__
* produce __**acid from glucose, maltose, and mannitol**__
* **hydrolyze esculin,** __**indole positive**__
* growth on **MacConkey is variable**
*Elizabethkingia meningoseptica (Chryseobacterium meningosepticum)*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
***Flavobacteriaceae***
\
* __First isolated in 1987__ during an **outbreak of pneumonia and meningitis** linked to individuals attending hot springs spa
* **Curved to straight rod**
* The __**only Motile by polar flagella**__
* **Pale yellow**, becoming **Brown with age**
* P__**ositive for oxidase and indole**__
* Saccharolyticus, oxidizing glucose, mannose, fructose, and other sugars
***Flavobacteriaceae***
\
* __First isolated in 1987__ during an **outbreak of pneumonia and meningitis** linked to individuals attending hot springs spa
* **Curved to straight rod**
* The __**only Motile by polar flagella**__
* **Pale yellow**, becoming **Brown with age**
* P__**ositive for oxidase and indole**__
* Saccharolyticus, oxidizing glucose, mannose, fructose, and other sugars
*Balaneatrix alpaca*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
***Flavobacteriaceae***
\
* linked to **nosocomial infections - bacteremia**
***Flavobacteriaceae***
\
* linked to **nosocomial infections - bacteremia**
*Chryseobacterium indologenes*
40
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
***Flavobacteriaceae***
\
* __**Endophthalmitis**__ following **cataract surgery**
***Flavobacteriaceae***
\
* __**Endophthalmitis**__ following **cataract surgery**
*Empedobacter brevis*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
***Flavobacteriaceae***
\
* __**environmental**__**,** __**low-virulence**__**, nonfermenting, gram negative bacillus**
* UTIS, endocarditis, ventriculitis, and cutaneous infections in immunocompromised patients
***Flavobacteriaceae***
\
* __**environmental**__**,** __**low-virulence**__**, nonfermenting, gram negative bacillus**
* UTIS, endocarditis, ventriculitis, and cutaneous infections in immunocompromised patients
*Myroides odoratimimus*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
***Flavobacteriaceae***
\
* **asaccharolytic, indole and oxidase positive**, and __fail to grow on MAC agar__
***Flavobacteriaceae***
\
* **asaccharolytic, indole and oxidase positive**, and __fail to grow on MAC agar__
*Weeksella*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
***Flavobacteriaceae***
\
* found in __**genitourinary specimens**__
* grows on **modified Thayer-Martin medium** or other media **selective for** ***Neisseria gonorrhoeae***
***Flavobacteriaceae***
\
* found in __**genitourinary specimens**__
* grows on **modified Thayer-Martin medium** or other media **selective for** ***Neisseria gonorrhoeae***
*Weeksella virosa*
44
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
***Flavobacteriaceae***
\
* **cellulitis, tenosynovitis, septicemia, pneumonia, and meningitis,** in particular in association with __**dog and cat bite wounds**__
***Flavobacteriaceae***
\
* **cellulitis, tenosynovitis, septicemia, pneumonia, and meningitis,** in particular in association with __**dog and cat bite wounds**__
*Bergeyella (Weeksella) zoohelicum*
45
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
\
* **Pink pigmented colonies**
* **Nonvacuolated, coccoid bacteria**, forming __pairs and short chains__
\
* **Pink pigmented colonies**
* **Nonvacuolated, coccoid bacteria**, forming __pairs and short chains__
*Methylobacterium* and *Roseomonas*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
***Ralstonia and Cupriavidus***
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* __**Slow growers**__
* **Oxidase and catalase positive**
* Grows on **MAC agar, reduces nitrate**, **oxidizes glucose and xylose,** and is motile by means of a __single polar flagellum__
***Ralstonia and Cupriavidus***
\
* __**Slow growers**__
* **Oxidase and catalase positive**
* Grows on **MAC agar, reduces nitrate**, **oxidizes glucose and xylose,** and is motile by means of a __single polar flagellum__
*Ralstonia pickettii*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
***Ralstonia and Cupriavidus***
\
* **Motile (**__**peretrichous flagella**__**),** **oxidase positive, catalase positive, asaccharolyticus, gram negative bacillus**
* __Most strains__ grow on **MAC agar**
***Ralstonia and Cupriavidus***
\
* **Motile (**__**peretrichous flagella**__**),** **oxidase positive, catalase positive, asaccharolyticus, gram negative bacillus**
* __Most strains__ grow on **MAC agar**
*Cupriavidus pauculus*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
\
* **Mucoid**
* Produce a **Tan to Brown pigment** causing __greenish discolorization of SBA__
* Motile, ornithine decarboxylase and nitrite reductase positive, and produce profuse H2S I TSI agar
* __***S. algae***__ – **requires NaCl (**__**halophilic**__**)** and is **asaccharolyticus**
* __***S. putrifaciens***__ – __**non-halophilic**__ and **saccharolyticus**
\
* **Mucoid**
* Produce a **Tan to Brown pigment** causing __greenish discolorization of SBA__
* Motile, ornithine decarboxylase and nitrite reductase positive, and produce profuse H2S I TSI agar
* __***S. algae***__ – **requires NaCl (**__**halophilic**__**)** and is **asaccharolyticus**
* __***S. putrifaciens***__ – __**non-halophilic**__ and **saccharolyticus**
*Shewanella*
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
***Sphingomonas***
\
* Y**ellow pigmented**
* does __not grow__ on MAC agar
* requires more than 48 hours for culture on SBA
* __**weakly oxidase positive**__
* motile at 18° to 22°C but not at 37°C, indole negative, and oxidizers.
***Sphingomonas***
\
* Y**ellow pigmented**
* does __not grow__ on MAC agar
* requires more than 48 hours for culture on SBA
* __**weakly oxidase positive**__
* motile at 18° to 22°C but not at 37°C, indole negative, and oxidizers.
*S. paucimobilis*
50
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^^**Less Commonly Encountered Nonfermentative, Gram- Negative Bacilli**^^
***Sphingomonas***
\
* **H2S positive** by the **lead a**__**cetate method**____,__ **Simmon citrate positive**, and **DNase negative**
***Sphingomonas***
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* **H2S positive** by the **lead a**__**cetate method**____,__ **Simmon citrate positive**, and **DNase negative**
*S. parapaucimobilis*