Aerobic Gram Positive Bacilli

the important clinical species of _____ include:

• C. diptheriae

• C. jeikeium

• C. urealyticum

corynebacterium

other _____ species include the following:

• part of normal flora of humans

• usually (skin) contaminants, although some can cause disease in immunocompromised patients

  • “diphtheroids”

  • clinical labs do not speciate unless requested or thought to be clinically significant

corynebacterium

corynebacterium are anaerobic and grown on BAP (24 hours). true or false?

false

corynebacterium is non-motile. true or false?

true

corynebacterium is catalase ____.

positive

which species of corynebacterium is associated with the following:

• Found only in humans

• Identifying characteristics:

  • Gram Stain:

    • Gram Positive Rod

    • Non-spore forming

    • Pleomorphic: can be tapered, curved, or club-shaped (“koryne” is Greek for “club”)

    • “Chinese letters” or “picket fences” or palisades

corynebacterium diphtheriae

corynebacterium diphtheriae staining with methylene blue will reveal ____ (red-purple intracellular granules).

metachromatic granules

which bacteria is the cause of diptheria?

corynebacterium diphtheriae

which specialized media for corynebacterium diphtheriae isolation refers to forming black colonies from hydrolysis of tellurite?

cystine tellurite

which specialized media for corynebacterium diphtheriae isolation refers to forming brown-black colonies with halos from hydrolysis of tellurite?

tinsdale’s agar

which specialized media for corynebacterium diphtheriae isolation refers to enhancing formation of metachromatic granules where colonies will appear small, white/grey?

loeffler agar

which species of corynebacterium is associated with the following:

• will grow happily on BAP in 24 hours

  • most are non-hemolytic

• urease, pyramidase negative

• nitrate, catalase positive

• non-motile

corynebacterium diphtheriae

diphtheria is vaccine preventable (DPT). the vaccine the a formalin-treated toxin → ____.

toxoid

humans can be carriers of diphtheria. true or false?

true

the transmission of ____ include:

• droplet

• direct contact with cutaneous lesions

• contact with fomites (rarer)

diphtheria

the production of ____ is necessary for pathogenicity as the cytotoxic features inhibit protein synthesis.

exotoxins

the structural gene for the diptheria toxin is contained in a ____ genome (tox gene).

bacteriophage

only strains that have been infected by ____ can produce the exotoxin that causes diphtheria.

bacteriophage

low ____ levels are associated with gene expression/virulence of diphtheria.

iron

the biotypes of _____ include intermedius, belfanti, mitis, and gravis.

diphtheria

the incubation of diphtheria is ____ days.

2-4

the presentation of ____ includes pharyngitis or tonsillitis which will include fever, malaise, and sore throat.

diphtheria

for diphtheria, a patch of exudate or _____ develops on the tonsils, uvula, soft palate, or pharyngeal wall.

membrane

which condition is associated with the following:

• grey-white membrane

• composed of fibrin, leukocytes, cellular debris

• can extend down to the larynx and trachea

• can have cervical adenitis and edema: “bullneck” appearance

diphtheria

other organisms can cause a ____ in the throat/over tonsils including streptococcus species, CMV, EBV, C. albicans, Arcanobacter haemolyticum.

membrane

_____ cases of diphtheria include membrane being coughed up after 5-10 days.

uncomplicated

_____ cases of diphtheria include mechanical respiratory obstruction from membrane, edema, and hemorrhage; it can be sudden and complete (suffocation) especially if large sections of membrane separate.

complicated

____ effects of the absorbed toxin for diphtheria include the following:

• heart: myocarditis (cardiac enlargement/weakness, arrhythmia, congestive heart failure)-most common/serious

• nervous system: paralysis of soft palate, eye muscles; generally reversible and not as serious unless diaphragm is involved

systemic

diphtheria is fatal in 5-10% of cases with higher mortality in young children. true or false?

true

the elek test tests for ____ production in isolates identified as C. diphtheriae.

toxin

what test is described:

• strip of filter paper soaked with diphtheria antitoxin embedded in agar

• isolates and + control, - control streaked onto agar surface

• incubated 1-2 days

• when diphtheria toxin reacts with antitoxin, a line of precipitate forms in the agar = toxigenic strain

elek test

C. diphtheria ____ testing detects the regulatory gene for toxin production (dtxR) and the diphtheria toxin gene (tox).

PCR

the organism/histopathologic dx must have both an isolate and an epidemiologic link to a known case to confirm ____.

diphetheria

which species of corynebacterium refers to the CDC group JK?

corynebacterium jeikieium

corynebacterium jeikieium is susceptible to many antibiotics. true or false?

false

corynebacterium jeikieium is pyazidamidase _____.

positive

corynebacterium jeikieium is ____, so it loves fat/lipids.

lipophilic

corynebacterium urealyticum is susceptible to antibiotics. true or false?

false

the immunocompromised are most at risk for ____ through UTIs and wounds.

corynebacterium urealyticum

which species of corynebacterium is rapidly urease positive?

corynebacterium urealyticum

which species of corynebacterium may be responsible for the formation of stones in the urinary tracts of some patients?

corynebacterium urealyticum

which species has the following characteristics:

• large gram positive/gram variable rods

• aerobic or facultatively anaerobic

• grows on BAP and PEA (phenylethyl alcohol)

• do not normally grow on agars for enterics (MAC, etc.)

• spore-forming

  • spores can be central or terminally located

  • can survive adverse conditions for prolonged periods of time and are frequent contaminants of laboratory cultures

bacillus

which species has the following characteristics:

• gram stain: straight bacilli with square ends (“box-car”) in chains and singly

• cultures: large, flat colonies “ground glass”

bacillus

most species of bacillus are pathogenic. true or false?

false

what are the two species of bacillus that are pathogenic?

bacillus anthracis; bacillus cereus

which bacteria causes anthrax?

bacillus anthracis

which species of bacillus is considered a potential bioterrorism agent?

bacillus anthracis

bacillus species is catalase ____.

positive

which bacillus species has the following characteristics:

• GPR with spores

• catalase positive

• non-motile

• non-hemolytic

bacillus anthracis

which bacillus species has the following characteristics on a BAP:

• filamentous projections “medusa head”

• consistency of beaten egg whites: when the edge of the colony is lifted with a loop, the colony remains in an upright position

bacillus anthracis

bacillus anthracis can form “string of pearls” (chains of spherical bacilli) when incubated several hours on agar with ____.

penicillin

what condition is associated with the following:

• zoonosis (usually found in herbivores: cattle, deer, etc.)

  • disease can spread via spores in pastures contaminated with exudates of infected animals

• human infections are rare in the U.S.

  • contact with infected animals/animal products

  • mostly associated with imported animal products (wool/hides, bone/contaminated with fertilizer containing bone meal)

anthrax

bacillus anthracis is susceptible to ____ (cipro stockpile post 9/11).

penicillin

which clinical form of anthrax refers to the following:

• most common form worldwide

• incubation 2-5 days

• invades skin, usually through unrecognized breaks

• initially forms an erythematous papule, which could be mistaken for an insect bite

cutaneous anthrax

by day 7-10, cutaneous anthax may progress into a necrotic lesion known as ____, surrounded by edema (“malignant pustule” but neither malignant nor a pustule).

black eschar

what condition is pulmonary anthrax associated with?

woolsorter’s disease

which clinical form of anthrax refers to the following:

• contracted by inhalation of spores

  • handling contaminated hides, hair, wool in a confined space

  • lab exposure

• incubation 1 day

pulmonary anthrax

which clinical form of anthrax refers to the following:

• initial symptoms (1-5 days)

  • nonspecific malaise, mild fever, nonproductive cough

• progression:

  • progressive respiratory distress and cyanosis

  • massive edema of neck, chest, mediastinum

• if untreated:

  • fatal outcome is usually rapid once edema has developed

  • enormous amounts of organisms can be found in lungs, blood, and all other organs

pulmonary anthrax

which clinical form of anthrax refers to the following:

• ingestion of raw or inadequately cooked meat containing bacillus anthracis spores

  • can affect the upper GI tract (throat and esophagus), stomach, intestines

• incubation: 1-7 days post exposure

• untreated: 50% mortality

• treated: 40% mortality

• rarest form

gastrointestinal anthrax

which species of bacillus is associated with the following:

• food poisoning

  • enterotoxin: 2 types

    • emetic

    • diarrheal

• associated with fried rice and chinese food restaurants

• mac and cheese from powdered milk

• “meals on wheels”

bacillus cereus

which enterotoxin for bacillus cereus is associated with the following:

• cereulide

• short incubation period: 1-6 hours

• nausea, vomiting, cramps (“emetic”)

• heat tolerant and pre-formed

emetic

which enterotoxin for bacillus cereus is associated with the following:

• longer incubation period: 8-16 hours

• causes fluid excretions in the same manner as toxigenic E. coli and V. cholerae

diarrheal

which species of bacillus has a capsule?

bacillus anthracis

which species of bacillus is non-hemolytic?

bacillus anthracis

which species of bacillus is associated with the following toxin:

• exotoxin (EF, PA, LF)

bacillus anthracis

which species of bacillus is associated with the following toxin:

• enterotoxins

bacillus cereus

what bacteria is associated with the following:

• causes listeriosis in humans

  • meningitis

  • stillbirth

  • death

• animals

  • spontaneous abortions

  • meningitis

• found in the environment

  • soil, water

• normal flora, humans

  • intestines, vagina

listeria monocytogenes

what bacteria is associated with the following:

• grows on most routine media

• resembles group B strep on BAP

• colonies are small, white/grey with small zone of beta hemolysis

listeria monocytogenes

which bacteria displays tumbling motility (end over end) on wet mount at room temperature (25°C) and very little at 37°C?

listeria monocytogenes

which bacteria can depict umbrella motlity in semi-solid media at room temperature (25°C)?

listeria monocytogenes

listeria monocytogenes is catalase ____.

positive

listeria monocytogenes is bile esculin ____.

positive

listeria monocytogenes hippurate hydrolysis ____.

positive

listeria monocytogenes is CAMP ____.

positive

in regards to listeriosis, which intrauterine transmission refers to when a fetus often stillborn has disseminated abscesses and/or granulomas?

granulomatous infantseptica

listeria monocytogenes can prefer ____ temperatures.

cold

what condition can be transmitted in the following ways:

• foodborne

• intrauterine

  • granulomatous infantseptica

• puerperal (post-childbirth)

  • exposed through vaginal colonization

listeriosis

a “foodborned disease outbreak” refers to when ____ or more people get the same illness from the same contaminated food or drink.

two

listeria monocytogenes and group B streptococcus both have a small zone of ____ on BAP.

beta hemolysis

listeria monocytogenes and group B streptococcus are both hippurate hydrolysis ____.

positive

listeria monocytogenes and group B streptococcus are both CAMP ____.

positive

listeria monocytogenes or group B streptococcus: gram stains GPR (diphtheroid) → coccoid?

listeria monocytogenes

listeria monocytogenes or group B streptococcus: gram stains GPC, pairs and chains?

group B streptococcus

listeria monocytogenes or group B streptococcus: bile esculin negative?

group B streptococcus

listeria monocytogenes or group B streptococcus: catalase negative?

group B streptococcus

listeria monocytogenes or corynebacterium: gamma (non-hemolytic) on BAP?

corynebacterium

listeria monocytogenes or corynebacterium: motile at 25°C?

listeria monocytogenes

listeria monocytogenes or corynebacterium: bile esculin negative?

corynebacterium

which bacteria is associated with the following information:

• primarily infects animals, especially pigs

• human generally get infected through animal contact or contact with infected animal products

  • occupational exposure

  • consuming infected meat (rare)

erysipelothrix rhusiopathiae

erysipelothrix rhusiopathiae can be associated with cellulitis with erysipeloid lesions that can resemble erysipelas caused by which bacteria?

streptococcus pyogenes

erysipelothrix rhusiopathiae are GPR that are highly ____ (various shapes) and non-spore forming.

pleomorphic

lactobacillus is the normal flora of the ____.

genitourinary tract

which species of lactobacillus refers to “doderlein’s bacteria” and is common in vagina because they use glycogen → lactic acid?

lactobacillus acidophilus

what bacterial genus has the following characteristics:

• gram stain: medium-long GPR in chains, but variable

• colony on BAP: looks alpha hemolytic (can resemble alpha-strep)

• most are microaerophilic, but some are facultative anaerobes or anaerobic (can be groups with anaerobes)

lactobacillus

lactobacillus are catalase ____.

negative

lactobacillus are non-motile. true or false?

true

which bacteria are strictly anaerobic/microaerophilic and are normal normal inhabitants of the GI tract in humans/animals (from oropharynx → lower bowel)?

actinomyces

which bacteria presents as GPR, filamentous that tend to branch and may fragment in coccobacilliary or coccoid forms (irregular staining)?

actinomyces

what refers to a yellow-orange granules of intertwined actinomyces filaments solidified with elements of tissue exudate in pus?

sulfur granules

most human actinomycosis is caused by which bacteria?

actinomyces israelii