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03-Non-Fermentative Gram-Negative Bact Eria v1 - 3
03-Non-Fermentative Gram-Negative Bact Eria v1 - 3
Dr. John R. Warren Department of Pathology Northwestern University Feinberg School of Medicine June 2007
Growth without acidification but with alkalinization of broth in Hugh-Leifson tube not sealed by mineral oil (oxidative tube) No growth in Hugh-Leifson tube sealed by a layer of mineral oil (fermentative tube)
Classification of Pseudomonads1
Pseudomonas aeruginosa (family Pseudomonadaceae) rRNA Group I Cytochrome oxidase +, OF glu +, motile, produces fluorescent water-soluble pigment (pyoverdin), polymyxin B susceptible Pseudomonas stutzeri rRNA Group I (family Pseudomonadaceae) Cytochrome oxidase +, OF glu +, motile, does not produce pyoverdin, polymyxin B susceptible
1Pseudomonads
are separated into five taxonomically distinct ribosomal RNA homology groups.
Classification of Pseudomonads1
Burkholderia cepacia (family Burkholderiaceae) rRNA Group II Cytochrome oxidase +, OF glu +, motile, polymyxin B resistant Burkholderia pseudomallei (family Burkholderiaceae) rRNA Group II Cytochrome oxidase +, OF glu +, motile, polymyxin B resistant Stenotrophomas maltophilia (family Xanthomonadaceae) rRNA Group V Cytochrome oxidase , OF glu +, OF maltose ++, motile, polymyxin B susceptible
1Pseudomonads
are separated into five taxonomically distinct ribosomal RNA homology groups.
Classification of NonPseudomonads
Acinetobacter baumanii (family Moraxellaceae) Cytochrome oxidase , OF glu +, OF lactose ++, nonmotile Moraxella (family Moraxellaceae) Cytochrome oxidase +, OF glu (asaccharolytic), non-motile Achromobacter xylosoxidans (family Alcaligenaceae) Cytochrome oxidase +, OF glu +, OF xylose +, motile
Acinetobacter: Genomospecies
Twenty-one different genomospecies based on DNA-DNA hybridization Genomospecies 1, 2, 3, and 13: A. calcoaceiticus-baumanii complex (A. baumanii1) Genomospecies 8/9: A. lwoffi2 Genomospecies 4: A. haemolyticus3 1Saccharolytic, non-hemolytic 2Non-Saccharolytic, non-hemolytic 3Non-Saccharolytic, -hemolytic
Primarily in tropical and subtropical areas (Southeast Asia, tropical Australia, Indian subcontinent, China) Prevalent in rice-growing regions of Thailand and the Top End of the Northern Territory of Australia Human infection and disease (melioidosis) is by inhalation of the organism or through contact with broken skin (cut or abrasion) Pneumonia most common type of infection with progressive pulmonary consolidation in severe cases Mortality increases with bacteremia Pneumonia without septic shock has a reported 4% mortality, pneumonia with septic shock 65% mortality
Moraxella: Microbiology
Cytochrome-oxidase positive gram-negative or gram-variable Neisseria-like diplococci, forming small (0.5-1mm) colonies on blood agar (24-48 hr), smooth, translucent to semiopaque in appearance, occasional strains show pitting of agar Non-motile, indole negative, and asaccharolytic Species identification generally not performed because given the similarity of pathogenic signficance of all species
Environmental organisms (soil and water) and component of endogenous flora of GI tract Most commonly reported infection: bacteremia, often associated with intravascular catheters Also causes biliary tract sepsis, meningitis, pneumonia, peritonitis, osteomyelitis, prosthetic knee infection, and prosthetic valve endocarditis Nosocomial outbreaks due to contaminated solutions (IV, irrigation, hemodialysis)
Recommended Reading
Winn, W., Jr., Allen, S., Janda, W., Koneman, E., Procop, G., Schreckenberger, P., Woods, G. Konemans Color Atlas and Textbook of Diagnostic Microbiology, Sixth Edition, Lippincott Williams & Wilkins, 2006: Chapter 7. The Nonfermentative Gram-Negative Bacteria
Recommended Reading
Murray, P., Baron, E., Jorgensen, J., Landry, M. Pfaller, M. Manual of Clinical Microbiology, 9th Edition, ASM Press, 2007: Blondel-Hill, E., Henry, D.A., and Speert, D.P. Chapter 48. Pseudomonas LiPuma, J.J., Currie, B.J., Lum, G.D., and Vandamme, P.A. Chapter 49. Burkholderia, Stenotrophomonas, Ralstonia, Cupriavidus, Pandoraea, Brevundimonas, Comamonas, Delftia, and Acidovorax. Schreckenberger, P.C., Daneshvar, M.I., and Hollis, D.G. Chapter 50. Acinetobacter, Achromobacter, Chryseobacterium, Moraxella, and Other Nonfermentative Gram-Negative Rods