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Medical Microbiology – Haemophilus and Other Fastidious GNR

question
bordetella spp. virulence
answer
pertussis toxin
extracytoplasmic adenylate cyclase
filamentous hemagglutinin (FHA)
tracheal cytotoxin
question
pertussis toxin
answer
targets immune cells and alters their functionality
question
extracytoplasmic adenylate cyclase
answer
weakens WBCs ability to remove organism from system
question
filamentous hemagglutinin
answer
promotes attachment to ciliated epithelial cells of bronchi
question
tracheal cytotoxin
answer
destroys ciliated epithelial cells in trachea
question
three stages of pertussis infection
answer
1. catarrhal phase - nonspecific flulike symptoms; highly contagious
2. paroxysmal stage - develop cough, lasts 4 weeks and up to 1 year
3. convalescent stage - decreased coughing, patient no longer contagious
question
Lab ID of Bordetella spp.
answer
requires calcium alginate swab
regan-low transport medium containing charcoal
bordet-gengou potato infused agar or charcoal agar with 10% horse blood
question
francisella tulaensis
answer
CDC reportable
easily spread person to person
zoonotic - rabbits, squirrels, beavers, muskrats
transmitted via insects + animal blood
question
tularemia
answer
ulceroglandular
pneumotic - acquired though skinning or evisceration of animal
question
brucella spp.
answer
CBC reportable
zoonotic: associated w/ livestock
question
brucella infection
answer
acquired from direct contact with infected meat/ingesting infected milk
assoc. with meat packers, vets, farmers
uncommon in US due to immunized cattle
question
brucella melitensis is assoc. with
answer
goats + sheep
question
brucella abortus assoc. with
answer
cattle
question
brusella suis assoc. with
answer
pigs/swine
question
brucella canis assoc. with
answer
dogs
question
pasturella multocida habitat
answer
normal flora of domestic and wild cats
question
pasturella multocida infection
answer
localized wound infection
can progress to bones/joints
question
lab ID of pasturella multocida
answer
macro:
grow on BAP + CHOC (non hemolytic wet colonies)
no growth on MAC
micro:
GNPBC; bipolar staining (safety pin appearance)
key biochem:
nonmotile, catalase and oxidase pos, glucose fermenter
question
streptobacillus moniliformis
answer
normal flora of rodent oropharynx
causes rat bite fever

long thin falmentous fusiform GNR
require hose serum agar
inhibited by SPS
question
capnocytophaga spp.
answer
found in oropharynx of humans and dogs
associated with:
periodontal disease, splenectomy, cancer, dog bites

fusiform GNR that are straight or slightly curved
spreading clear colonies on CHOC
question
bordetella
answer
whooping cough
human pathogen
highly contagious
question
legionella virulence
answer
facultative intracellular organism
amoebas ingest organism + multiply
biofilm
resistant to chlorination
associated with legionnaires disease and pontiac fever
question
legionella lab ID
answer
pleomorphic, small, weakly staining GNR
fastidious: require BYCE agar
question
bartonella spp.
answer
zoonotic: via cat fleas
facultative intracellular
small slightly curved GNR
question
bartonella henslae
answer
cat scratch fever
question
haemophilus general characteristics
answer
GNPRB/short rods
capnophilic
fastidious
slow growing
habitat: mucosal membranes
infection: opportunistic
require X and V factor
question
x factor
answer
hemin
question
v factor
answer
NAD
question
haemophilus major pathogens
answer
h. influenzae
h. ducreyi
h. aegypticus
question
satellitism
answer
growth of fastidious organisms around other bacteria that release the factors that fastidious organisms require for growth
question
example of satellitism
answer
s. aureas, s. pneumo, Neisseria spp. all produce V factor missing on BAP (some haemophilus spp. will grow surrounding these organisms)
question
h. influenzae
answer
requires x and v factor
habitat: normal flora of resp. tract in ~10% of adults
question
h. influenzae infection
answer
upper respiratory: sinusitis, epiglottitis, otitis media
lower resp.: pneumonia
invasive: septicemia, meningitis
question
h. infulenzae virulence
answer
capsule (more likely to cause invasive infections)
IgA protease
lipopolysaccharide outer membrane
pili
beta-lactamase production
question
serotype B (HiB)
answer
most infectious serotype for h. influenzae because it has a PRP capsule (inhibits immune response)
question
HiB vaccine
answer
protection again h. influenzae type B
provided at 15 months, 2, 4, +6 years
question
h. influenzae gram stain
answer
faintly staining, small, GNBC
easily missed in smears containing mucous/protein
question
h. aegypticus
answer
requires x and v factors
infections:
pink eye
brazilian purpuric fever (70% mortality rate, rapidly disseminates)
question
h. ducreyi
answer
true pathogen (can cause disease to anyone)
requires x factor only
direct gram stain: school of fish
question
h. ducreyi infection
answer
STI
chancroid or genital ulcer disease - infection & ulceration of lymphs in the groin area
question
haemophilus spp. specimen processing
answer
organisms die rapidly - should be planted within 10 minutes
require selective media: enriched CHOC agar with bacitracin (influenzae R) or vancomycin (ducreyi R)
question
lab ID of haemophilus spp.
answer
grey-buff translucent, moist, convex colonies
encapsulated appear mucoid
mousy odor
question
X + V factor testing
answer
1. transfer colonies to nutrient broth
2. inoculate broth as lawn on nutrient or mueller-hinton agar
3. add X + V strips/disks
4. incubate 37 degrees Celsius in 5% CO2 for 18-24 hours
question
an organism that requires only x factor will grow
answer
surrounding ONLY the x factor strip/disk
question
an organism that requires only v factor will grow
answer
surrounding ONLY the v factor strip/disk
question
an organism that requires x and V will grow
answer
in between the x and v strips/disks
question
quad plate
answer
Q1 - x factor
Q2 - v factor
Q3 - x and v factor
Q4 - 5% horse blood (for visualization of hemolysis
question
quad plate results
answer
organism that requires x + v: grows on 3 and 4
organism that requires v only: grows on 2, 3, 4
organism that requires x only: grows on 1, 3, 4
question
what does HACEK stand for
answer
Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella
question
HACEK habitat
answer
normal upper respiratory/oral flora
question
HACEK characteristics
answer
GNR
do not grow on MAC
fastidious
capnophilic
slow growing
question
HACEK infection
answer
associated with opportunistic endocarditis due to:
poor oral hygeine
human bite wounds
IV users who lick their needle clean
question
haemophilus aphrophilus
answer
variable x factor requirements
yellow convex granular colonies on CHOC only
smells like glue
GNBC gram stain
question
cardiobacterium
answer
gram variable pleomorphic rods
rosette clusters on direct smears
colony may put agar
associated with oral abscesses and endocarditis
question
eikenella
answer
associated with human bite wounds and dental procedures
colonies pit or corrode agar
smells like bleach
longer, faint GNR on direct smears
question
aggregatibacter
answer
primary animal pathogen but isolated as normal flora
adherent star-like colonies
faint GNBC
question
kingella
answer
GVCB or GVR with squared ends +/- chaining
some strains pit agar
difficult to recover in culture
associated with joint and bone infections in kids under 5
1 of 57
question
bordetella spp. virulence
answer
pertussis toxin
extracytoplasmic adenylate cyclase
filamentous hemagglutinin (FHA)
tracheal cytotoxin
question
pertussis toxin
answer
targets immune cells and alters their functionality
question
extracytoplasmic adenylate cyclase
answer
weakens WBCs ability to remove organism from system
question
filamentous hemagglutinin
answer
promotes attachment to ciliated epithelial cells of bronchi
question
tracheal cytotoxin
answer
destroys ciliated epithelial cells in trachea
question
three stages of pertussis infection
answer
1. catarrhal phase - nonspecific flulike symptoms; highly contagious
2. paroxysmal stage - develop cough, lasts 4 weeks and up to 1 year
3. convalescent stage - decreased coughing, patient no longer contagious
question
Lab ID of Bordetella spp.
answer
requires calcium alginate swab
regan-low transport medium containing charcoal
bordet-gengou potato infused agar or charcoal agar with 10% horse blood
question
francisella tulaensis
answer
CDC reportable
easily spread person to person
zoonotic - rabbits, squirrels, beavers, muskrats
transmitted via insects + animal blood
question
tularemia
answer
ulceroglandular
pneumotic - acquired though skinning or evisceration of animal
question
brucella spp.
answer
CBC reportable
zoonotic: associated w/ livestock
question
brucella infection
answer
acquired from direct contact with infected meat/ingesting infected milk
assoc. with meat packers, vets, farmers
uncommon in US due to immunized cattle
question
brucella melitensis is assoc. with
answer
goats + sheep
question
brucella abortus assoc. with
answer
cattle
question
brusella suis assoc. with
answer
pigs/swine
question
brucella canis assoc. with
answer
dogs
question
pasturella multocida habitat
answer
normal flora of domestic and wild cats
question
pasturella multocida infection
answer
localized wound infection
can progress to bones/joints
question
lab ID of pasturella multocida
answer
macro:
grow on BAP + CHOC (non hemolytic wet colonies)
no growth on MAC
micro:
GNPBC; bipolar staining (safety pin appearance)
key biochem:
nonmotile, catalase and oxidase pos, glucose fermenter
question
streptobacillus moniliformis
answer
normal flora of rodent oropharynx
causes rat bite fever

long thin falmentous fusiform GNR
require hose serum agar
inhibited by SPS
question
capnocytophaga spp.
answer
found in oropharynx of humans and dogs
associated with:
periodontal disease, splenectomy, cancer, dog bites

fusiform GNR that are straight or slightly curved
spreading clear colonies on CHOC
question
bordetella
answer
whooping cough
human pathogen
highly contagious
question
legionella virulence
answer
facultative intracellular organism
amoebas ingest organism + multiply
biofilm
resistant to chlorination
associated with legionnaires disease and pontiac fever
question
legionella lab ID
answer
pleomorphic, small, weakly staining GNR
fastidious: require BYCE agar
question
bartonella spp.
answer
zoonotic: via cat fleas
facultative intracellular
small slightly curved GNR
question
bartonella henslae
answer
cat scratch fever
question
haemophilus general characteristics
answer
GNPRB/short rods
capnophilic
fastidious
slow growing
habitat: mucosal membranes
infection: opportunistic
require X and V factor
question
x factor
answer
hemin
question
v factor
answer
NAD
question
haemophilus major pathogens
answer
h. influenzae
h. ducreyi
h. aegypticus
question
satellitism
answer
growth of fastidious organisms around other bacteria that release the factors that fastidious organisms require for growth
question
example of satellitism
answer
s. aureas, s. pneumo, Neisseria spp. all produce V factor missing on BAP (some haemophilus spp. will grow surrounding these organisms)
question
h. influenzae
answer
requires x and v factor
habitat: normal flora of resp. tract in ~10% of adults
question
h. influenzae infection
answer
upper respiratory: sinusitis, epiglottitis, otitis media
lower resp.: pneumonia
invasive: septicemia, meningitis
question
h. infulenzae virulence
answer
capsule (more likely to cause invasive infections)
IgA protease
lipopolysaccharide outer membrane
pili
beta-lactamase production
question
serotype B (HiB)
answer
most infectious serotype for h. influenzae because it has a PRP capsule (inhibits immune response)
question
HiB vaccine
answer
protection again h. influenzae type B
provided at 15 months, 2, 4, +6 years
question
h. influenzae gram stain
answer
faintly staining, small, GNBC
easily missed in smears containing mucous/protein
question
h. aegypticus
answer
requires x and v factors
infections:
pink eye
brazilian purpuric fever (70% mortality rate, rapidly disseminates)
question
h. ducreyi
answer
true pathogen (can cause disease to anyone)
requires x factor only
direct gram stain: school of fish
question
h. ducreyi infection
answer
STI
chancroid or genital ulcer disease - infection & ulceration of lymphs in the groin area
question
haemophilus spp. specimen processing
answer
organisms die rapidly - should be planted within 10 minutes
require selective media: enriched CHOC agar with bacitracin (influenzae R) or vancomycin (ducreyi R)
question
lab ID of haemophilus spp.
answer
grey-buff translucent, moist, convex colonies
encapsulated appear mucoid
mousy odor
question
X + V factor testing
answer
1. transfer colonies to nutrient broth
2. inoculate broth as lawn on nutrient or mueller-hinton agar
3. add X + V strips/disks
4. incubate 37 degrees Celsius in 5% CO2 for 18-24 hours
question
an organism that requires only x factor will grow
answer
surrounding ONLY the x factor strip/disk
question
an organism that requires only v factor will grow
answer
surrounding ONLY the v factor strip/disk
question
an organism that requires x and V will grow
answer
in between the x and v strips/disks
question
quad plate
answer
Q1 - x factor
Q2 - v factor
Q3 - x and v factor
Q4 - 5% horse blood (for visualization of hemolysis
question
quad plate results
answer
organism that requires x + v: grows on 3 and 4
organism that requires v only: grows on 2, 3, 4
organism that requires x only: grows on 1, 3, 4
question
what does HACEK stand for
answer
Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella
question
HACEK habitat
answer
normal upper respiratory/oral flora
question
HACEK characteristics
answer
GNR
do not grow on MAC
fastidious
capnophilic
slow growing
question
HACEK infection
answer
associated with opportunistic endocarditis due to:
poor oral hygeine
human bite wounds
IV users who lick their needle clean
question
haemophilus aphrophilus
answer
variable x factor requirements
yellow convex granular colonies on CHOC only
smells like glue
GNBC gram stain
question
cardiobacterium
answer
gram variable pleomorphic rods
rosette clusters on direct smears
colony may put agar
associated with oral abscesses and endocarditis
question
eikenella
answer
associated with human bite wounds and dental procedures
colonies pit or corrode agar
smells like bleach
longer, faint GNR on direct smears
question
aggregatibacter
answer
primary animal pathogen but isolated as normal flora
adherent star-like colonies
faint GNBC
question
kingella
answer
GVCB or GVR with squared ends +/- chaining
some strains pit agar
difficult to recover in culture
associated with joint and bone infections in kids under 5
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