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MLS BULLETS: BACTERIOLOGY 4. Staphylococcus saprophyticus

1. DIFFERERENTIATION OF STAPHYLOCOCCUS  Common cause of urinary tract infections,
FROM MICROCOCCUS sometimes progressing to septicemia,
Test Staphylococcus Micrococcus
Catalase + + especially in young, sexually active female

Aerobic growth + + patients

 Coagulase negative
Anaerobic + -
 Resistant to novobiocin
growth
5. CLASSIFICATION OF STREPTOCOCCUS AND
Glucose Fermentative Oxidative
ENTEROCOCCUS
utilization Species Lancefield Hemolysis
Lysostaphin S R Group Types
S. pyogenes A Beta
Furazolidone S R
S. agalactiae B Beta
Bacitracin R S S. dysgalactiae C Beta
Micrococcus and Staphylococcus can be S. equi
differentiated by susceptibility to furazolidone. E. faecalis D Alpha, beta,
 Staphylococcus is susceptible
E. faecium gamma
 Micrococcus is resistant
2. Staphylococcus aureus S. bovis group D Alpha, gamma
 Gram-positive cocci in clusters S. pneumoniae - Alpha
 Βeta-hemolytic on sheep blood agar
6. Streptococcus pyogenes
 Medium to large, raised colonies on blood
 Also known as group A strep
agar and colistin-nalidixic acid agar (CNA)
 Gram-positive cocci, usually arranged in
with cream to golden yellow pigmentation
chains
 Bound coagulase (clumping factor) positive
 Catalase negative
 Free coagulase positive
 Beta-hemolytic
 Growth and fermentation on MSA
 Bacitracin sensitive
 DNase positive
 Identity is confirmed by using group A strep
Strains known as methicillin-resistant S. aureus
antiserum
(MRSA) are resistant to most antibacterial agents. 7. Streptococcus agalactiae
 Drugs useful for treating most MRSA strains  Also known as group B strep
 Normal flora of female genital tract
are vancomycin, linezolid (Zyvox), and
 Most common cause of neonatal
quinupristindalfopristin (Synercid). septicemia and meningitis
MIC tests should be performed to determine the  Gram-positive cocci, usually arranged in
chains
susceptibility of all isolates of staphylococci to
 Catalase negative
vancomycin.  Usually produces a narrow zone of beta-
D ZONE TEST hemolysis with a soft outer margin
 Hippurate hydrolysis positive
 Used to test for inducible resistance on the
 CAMP test positive
S. aureus strains demonstrating an INITIAL  Identity confirmed by using group B strep
ANTIBIOTIC SUSCEPTIBILITY PROFILE OF: antiserum
 ERYTHROMYCIN RESISTANT, CLINDAMYCIN 8. Enterococcus spp.
 Gram-positive cocci or coccobacilli in pairs
SUSCEPTIBLE
and chains
3. Staphylococcus epidermidis  Catalase negative
 Associated with bacterial endocarditis  Usually alpha-hemolytic or nonhemolytic
 PYR positive
following the insertion of artificial heart
 Bile-esculin positive
 Coagulase negative  Will grow in 6.5% NaCl
 Sensitive to novobiocin
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TESTS TO DIFFERENTIATE GROUP D ENTEROCCUS 13. Neisseria meningitidis
FROM GROUP D NON-ENTEROCOCCUS  Also known as meningococcus
GROWTH IN PYR  Gram-negative diplococci
6.5% NaCl  Not as fastidious as N. gonorrhoeae
D Enterococcus Growth Positive  Oxidase positive
D Non-Enterococcus No growth Negative  Produces acid from glucose and maltose but
not from other sugars
9. Steptococcus bovis Group
Glucose Maltose Sucrose Lactose
 Formerly categorized as Group D
Streptococcus N. gonorrhoeae + - - -
 Either nonhemolytic or α-hemolytic
 Bile-esculin positive N. meningitidis + + - -
 PYR negative
N. subflava + + +/- -
 Will not grow in 6.5% NaCl
S. gallolyticus (formerly Streptococcus bovis) N. lactamica + + - +
10. Streptococcus pneumoniae
M. catarrhalis - - - -
 Also known as pneumococcus
 Gram-positive cocci, usually arranged in 14. Family Enterobacteriaceae
pairs (diplococci)  Also known as enteric bacilli
 Catalase negative  Gram-negative bacilli
 Alpha-hemolytic  Glucose fermenters
 Optochin sensitive  Grow on MacConkey agar
11. Nutritionally-variant Streptococci  Oxidase negative
 Organisms previously known as nutritionally  Nitrate positive
variant streptococci (NVS) have been KEY FACTS REGARDING MEMBERS OF THE FAMILY
reclassified as Abiotrophia and ENTEROBACTERIACEAE
Granulicatella spp.  Hydrogen sulfide–positive members of the
 Abiotrophia and Granulicatella will not grow
family include Citrobacter freundii,
on blood or chocolate agars unless
PYRIDOXAL (vitamin B6) is supplied either by Edwardsiella tarda, Proteus mirabilis, Proteus
placement of a pyridoxal disk, by cross vulgaris, and Salmonella spp.
streaking with Staphylococcus, or by  Voges-Proskauer-positive members of the
inoculation of vitamin B6–supplemented family include Enterobacter spp., Hafnia spp.,
culture media Klebsiella spp., Pantoea spp., and Serratia spp.
12. Neisseria gonorrhoeae  PAD-positive members of the family include
 Also known as gonococcus Morganella spp., Proteus spp., and
 Gram-negative diplococci
Providencia spp.
 Fastidious
 Capnophilic and borderline microaerophilic  Members of the family that are nonmotile at
 Oxidase positive 35 oC to 37 oC include Klebsiella spp., Shigella
 Produces acid from glucose but not from spp., and Yersinia spp. (motile at 22 oC)
other sugars EXTENDED-SPECTRUM β-LACTAMASE (ESBLs)
 Positive superoxol test (bubbling when 30%  Some Gram-negative bacilli (e.g., some
H2O2 is added
isolates of Klebsiella pneumoniae, K. oxytoca,
 Antimicrobial resistance in Neisseria
gonorrheae is widespread Escherichia coli, Enterobacter spp.,
 N. gonorrhoeae that produces beta-
Citrobacter spp., and Proteus mirabilis)
lactamase are resistant to penicillin
Pathogenic Neisseria spp. have several characteristics produce enzymes known as extended-
that contribute to their virulence, including the spectrum β-lactamases
following:
 ESBL-producing strains may be resistant to
 Receptors for human transferrin
 Capsule (N. meningitidis) certain drugs (e.g., PENICILLINS,
 Pili (fimbriae)
CEPHALOSPORINS, and AZTREONAM) to
 Cell membrane proteins
 Lipooligosaccharide (LOS) or endotoxin which most strains of these species are
 Immunoglobulin A (IgA) protease that cleaves
susceptible.
IgA on mucosal surfaces
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15. Escherichia coli  Lactose-fermenting members of the
 Motile Gram-negative bacillus Enterobacteriaceae family; pink colonies on
MAC
 Lactose-fermenting member of the
 Encapsulated strains produce mucoid
Enterobacteriaceae family; pink colonies on colonies
MAC  A/AG reaction on TSI and KIA; usually
abundant gas
 Many serotypes are opportunistic
 IMViC results: indole negative (except K.
pathogens; enterovirulent serotypes are oxytoca which is indole positive), methyl red
always pathogens negative, Voges-Proskauer positive, citrate
positive
 Most common cause of urinary tract
 Oxidase negative, nitrate positive
infections and very common causes of Klebsiella pneumoniae is usually RESISTANT TO
septicemia and nosocomial infections AMPICILLIN.
 A/A reaction on triple sugar iron (TSI) and 17. Enterobacter spp.
Kligler iron agar (KIA), with or without gas  Gram-negative bacilli, usually motile
 IMViC results: indole positive, MR positive,  Opportunistic pathogens that live in the
intestinal tract
Voges-Proskauer negative, citrate negative
 Lactose-fermenting members of the family
 Oxidase negative, nitrate positive Enterobacteriaceae; pink colonies on MAC
 MUG positive  Encapsulated strains produce mucoid
colonies
The MUG test is a fluorogenic assay to detect the
 A/A reaction on TSI and KIA, with or without
presence of the enzyme beta-glucuronidase. gas (usually abundant gas)
 Disk containing 4-methylumbelliferyl-beta-  IMViC results: indole negative, methyl red
negative,
D-glucuronide (MUG) is dampened with
 Voges-Proskauer positive, citrate positive
water, the organism to be tested applied,  Oxidase negative, nitrate positive
and the disk incubated at 35 oC for up to 2 LDC ODC ADH
hours. Then a long-wave ultraviolet light is K. pneumoniae + - -
K. oxytoca + - -
shined on the disk.
E. aerogenes + + -
 Blue fluorescence indicates that the E. cloacae - + +
substrate was hydrolyzed to 4- LDC: Lysine decarboxylase
ODC: Ornithine decarboxylase
methylumbelliferyl; this constitutes a
ADH: Arginine dihydrolase
positive test result. 18. Citrobacter spp.
 E. coli is MUG positive except E. coli  Motile Gram-negative bacilli
 Opportunistic pathogens that live in the
O157:H7 (MUG negative)
intestinal tract
SORBITOL-SUBSTITUTED MACCONKEY (SMAC) AGAR  Late lactose-fermenting members of the
 Sorbitol replaces lactose in MacConkey Enterobacteriaceae family; pink colonies on
MAC at 48 hours
 E. coli O157:H7 does not ferment sorbitol,
 Can use citrate as their sole carbon source
whereas other species of E. coli are positive (citrate positive)
for the fermentation of sorbitol.  A/AG reaction on TSI and KIA; H2S positive
 IMViC results: indole variable, methyl red
 This makes the media a good screen for
positive, Voges-Proskauer negative, citrate
O157:H7. positive
16. Klebsiella spp.  Oxidase negative, nitrate positive
 Nonmotile Gram-negative bacilli Salmonella Citrobacter
 Opportunistic pathogens that live in the LDC + -
intestinal tract KCN - + growth
BACTERIOLOGY LEMAR REVIEW HUB
 Salmonella are positive for lysine
decarboxylase and most are negative for
KCN, malonate and ONPG.
 Citrobacter are negative for lysine
decarboxylase and positive for growth in
KCN.
19. Serratia spp.
 Motile Gram-negative bacilli
 Late lactose-fermenting members of the
family Enterobacteriaceae; may or may not
produce pink colonies on MAC at 48 hours
 Can use citrate as their sole carbon source
(citrate positive)
 A/A reaction on TSI and KIA, with or without
gas
 IMViC results: indole negative, methyl red
variable, Voges-Proskauer variable (S.
marcescens is Voges-Proskauer positive),
citrate positive
 Oxidase negative, nitrate positive
20. Yersinia pestis
 Nonmotile Gram-negative bacillus
 Causative agent of plague
 Potential bioterrorism agent
 Has a characteristic bipolar (safety pin)
appearance in clinical material, when
stained with Wayson stain
 Non-lactose-fermenting member of the
family Enterobacteriaceae; colorless colonies
on MAC
 K/AG reaction on TSI and KIA
 IMViC results: indole negative, methyl red
positive, Voges-Proskauer negative, citrate
negative
 Oxidase negative, nitrate positive, urease
negative
21. Yersinia enterocolitica
 Enterocolitis characterized by fever,
diarrhea, and abdominal pain
 Acute MESENTERIC LYMPHADENITIS, which
may present clinically as appendicitis
(pseudoappendicular syndrome)
 Cefsulodin irgasan novobiocin (CIN) agar is a
selective and differential medium for the
isolation and differentiation of Y.
enterocolitica
Motility at 35 - 37 oC 25 oC
Y. pestis - -
Y. pseudotuberculosis - +
Y. enterocolitica - +
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22. Salmonella spp.
 Gram-negative bacilli, usually motile
• Cause a diarrheal disease known as
salmonellosis; Salmonella serotype Typhi
causes typhoid fever
• Non-lactose-fermenting members of the
Enterobacteriaceae family; colorless colonies
on MAC
• K/A reaction on TSI and KIA, with or without
gas; most species H2S positive
• IMViC results: indole negative, methyl red
positive, Voges-Proskauer negative, citrate
variable
 Oxidase negative, nitrate positive, urease
negative
Salmonella Citrobacter
LDC + -
KCN - + growth
 Salmonella are positive for lysine
decarboxylase and most are negative for
KCN, malonate and ONPG.
 Citrobacter are negative for lysine
decarboxylase and positive for growth in
KCN.
23. Shigella spp.
 Nonmotile Gram-negative bacilli
 Cause a diarrheal disease known as
shigellosis
 Non-lactose-fermenting members of the
family Enterobacteriaceae; colorless colonies
on MAC
 K/A reaction on TSI and KIA, with or without
gas (usually without)
 IMViC results: indole variable, methyl red
positive, Voges-Proskauer negative, citrate
negative
 Oxidase negative, nitrate positive
Most are biochemically inert and are classified into
serogroups A, B, C, and D as a result of their
biochemical similarity.
 Shigella dysenteriae (subgroup/serogroup A)
 Shigella flexneri (subgroup/serogroup B)
 Shigella boydii (subgroup/serogroup C)
 Shigella sonnei (subgroup/serogroup D)
24. Proteus spp.
 Motile Gram-negative bacilli, sometimes
highly motile
 Opportunistic pathogens that live in the
intestinal tract
 Often produces swarming growth on blood
agar
 Non-lactose-fermenting members of the
Enterobacteriaceae family; colorless colonies
on MAC
BACTERIOLOGY LEMAR REVIEW HUB
 K/A reaction on TSI and KIA, with or without
gas (usually with); H2S positive
 Proteus vulgaris is indole positive; Proteus
mirabilis is indole negative
 Oxidase negative, nitrate positive
 Phenylalanine deaminase (PAD) positive
Proteus, Morganella, and Providencia spp. are the
only members of the Enterobacteriaceae family that
produce phenylalanine deaminase (PAD)
25. Providencia spp.
 Motile Gram-negative bacilli
 Non-lactose-fermenting members of the
family Enterobacteriaceae; colorless colonies
on MAC
 K/A reaction on TSI and KIA, with or without
gas (usually without); H2S negative
 IMViC results: indole positive, methyl red
positive, Voges-Proskauer negative, citrate
positive
 Oxidase negative, nitrate positive
 Phenylalanine deaminase (PAD) positive
26. Morganella morganii
 Motile Gram-negative bacillus
 Non-lactose-fermenting member of the
family Enterobacteriaceae; colorless colonies
on MAC
 K/AG reaction on TSI and KIA; H2S negative
 IMViC results: indole positive, methyl red
positive, Voges-Proskauer negative, citrate
negative
 Oxidase negative, nitrate positive
 Phenylalanine deaminase (PAD) positive
27. Pseudomonas aeruginosa
 Motile, Gram-negative bacillus having the
same morphology as other nonfermenters
and members of the family
Enterobacteriaceae
 Resistant to many antimicrobial agents
 Can survive in soap and weak disinfectant
solutions
 Nonfermenter (does not ferment glucose)
 Produces characteristic pigments (pyoverdin
and pyocyanin)
 Has a characteristic fruity odor
 Catalase, oxidase, and nitrate positive
 Non–lactose fermenter on MAC
 Pseudomonas aeruginosa grows at 42˚C but
this temperature is inhibitory for other
Pseudomonas species.
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28. Burkholderia cepacia
 Motile, Gram-negative bacillus having the
same morphology as other nonfermenters
and members of the family
Enterobacteriaceae
 One of the most drug-resistant organisms
encountered in the clinical microbiology
laboratory
 Nonfermenter (does not ferment glucose)
 Weakly oxidase positive
 Produces punctate, tenacious colonies on
MAC, which become dark pink to red after 4
to 7 days of incubation as a result of lactose
oxidation
 Has a characteristic earthy or dirtlike odor
Burkholderia cepacia is associated with
respiratory infections in cystic fibrosis patients.
29. Burkholderia pseudomallei
 Motile, short, Gram-negative bacillus, often
having a bipolar, or safety pin, appearance
on staining
 Cause of melioidosis
 Disease may reactivate many years after
exposure and has been called the
“VIETNAMESE TIME BOMB”
 Potential bioterrorism agent
 Nonfermenter (does not ferment glucose)
 Oxidase and nitrate positive
 Non–lactose fermenter on MAC
 Produces a pronounced earthy odor
30. Vibrio spp.
 Curved, motile, halophilic Gram-negative
bacilli
 Vibrio cholerae causes cholera
 Vibrio parahaemolyticus causes diarrhea,
septicemia, and wound infections
 Vibrio vulnificus causes septicemia and
wound infections
 TCBS agar is useful for isolation of Vibrio
spp.
 Oxidase positive
STRING TEST
 Used to differentiate Vibrio spp. from
Aeromonas spp.
 In this test, organisms are emulsified in 0.5%
SODIUM DEOXYCHOLATE, which lyses Vibrio
cells, but not those of Aeromonas spp.
BACTERIOLOGY
31. Aeromonas spp.
 Infection usually results from ingestion of
contaminated food or water
 Motile Gram-negative bacilli or coccobacilli
 Oxidase, catalase, nitrate, and indole
positive
 Ferment various sugars, either with or
without gas production
 Aeromonas hydrophilia and other
Aeromonas spp. have been implicated in
acute diarrheal disease as well as cellulitis
and wound infections
 Infections usually follow exposure to
contaminated soil, water, or food
 Aeromonas growing on enteric media are
differentiated from the Enterobacteriaceae
by demonstrating that colonies are OXIDASE
POSITIVE.
32. Haemophilus influenzae
 Small Gram-negative bacilli or coccobacilli
 One of the leading causes of meningitis, ear
infections, and sinus infections
 Requires both X and V factors
 Grows well on chocolate agar in 5% CO2 in
24 hours, but not on sheep blood agar
 Will satellite around Staphylococcus aureus
 Porphyrin synthesis (delta-aminolevulinic
acid test) negative
The HACEK group of organisms are gram negative
bacilli that require increased CO2 for growth.
 Commonly associated with endocarditis and
include Haemophilus species (especially H.
aprophilus), Actinobacillus
actinomycetemcomitans, Cardiobacterium
hominis, Eikenella corrodens and Kingella
species.
33. Campylobacter spp.
 Curved, motile, Gram-negative bacilli
 Gull wing morphology is often observed
 Diseases caused by Campylobacter spp. are
considered zoonoses
 Campylobacter spp. are common causes of
foodborne illnesses
 C. jejuni is the most common cause of
bacterial diarrhea in the United States
 Microaerophilic and capnophilic
 Isolate using Campy agar and Campy gas at
o
42 C
 Oxidase positive
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 Campylobacter coli/jejuni require a
microaerophilic atmosphere for optimal
recovery
 Selective media fro Campylobacter contains
antibiotics to inhibit the growth of enteric
gram-negative flora
 Unlike other enteric pathogens, C. coli/
jejuni grow well at 42˚C
Campylobacter jejuni and C. coli are closely related
and both are pathogens. The test that differentiates
the two is hippurate hydrolysis (C. jejuni is
hippurate hydrolysis positive).
34. Helicobacter spp.
 Curved, motile Gram-negative bacilli
 H. pylori is a common cause of gastritis,
peptic ulcers, and gastric malignancy
 Microaerophilic and capnophilic
 Oxidase positive
 H. pylori is urease positive
Helicobacter pylori produce large amounts of
extracellular urease and are positive for urea within
2 hours.
35. Bordetella pertussis
 Small Gram-negative coccobacilli
 Etiologic agent of whooping cough
(pertussis)
 Media for isolation are Bordet-Gengou
potato infusion medium and Regan-Lowe
medium
 Colonies are small, round, domed, shiny, and
silver—like mercury droplets or pearls
pushed halfway into the agar
Regan-Lowe agar is an enriched and selective
medium for the isolation of Bordetella pertussis.
 Cephalexin is added to inhibit
nasopharyngeal flora
 It provides better isolation of Bordetella
pertussis than Bordet-Gengou medium.
36. Legionella pneumophila
 Motile, faintly staining Gram-negative
bacilli, ranging in appearance from small
coccobacilli to filaments
 One of the etiologic agents of legionellosis
(Legionnaires disease)
 Does not grow well on standard culture
media but will grow on chocolate agar; the
primary Legionella isolation medium is BCYE
agar, supplemented with alpha-
ketoglutarate, L-cysteine, and ferric
pyrophosphate
BACTERIOLOGY LEMAR REVIEW HUB
URINE ANTIGEN TEST
 FDA has approved several methods, such as
radioimmunoassay, microplate enzyme
immunoassay, and rapid
immunochromatographic assay for
Legionella antigen detection in URINE
specimens.
37. Brucella spp.
 Very small, nonmotile Gram-negative
coccobacilli, may be seen singly
(predominantly), or in pairs, short chains, or
small clusters
 Cause brucellosis in humans and animals
 Potential bioterrorism and biological
warfare agents; very dangerous to work with
in the laboratory
 Nitrate, oxidase, urease, and catalase-
positive
 Indole negative
38. Francisella tularensis
 Tiny, nonmotile, faintly staining Gram-
negative coccobacilli
 Etiologic agent of tularemia (also known as
tick fever, deerfly fever, and rabbit fever)
 Potential bioterrorism and biological
warfare agent; very dangerous to work with
in the laboratory
 Grows poorly, if at all, on most ordinary
media; optimal growth is obtained on media
supplemented with sulfhydral compounds,
such as cysteine, cystine, thiosulfate, and
IsoVitalex
39. Pasteurella multocida
 Contracted by bite or scratch of cat or dog or
contact with infected carcass (dead body of
an animal)
 Wound and respiratory tract infection
 Pleomorphic Gram-negative bacilli with
bipolar staining
 Grows on sheep BAP and CAP but not on
MAC; musty odor
 Oxidase, catalase and indole positive
40. Gardnerella vaginalis
 Associated with bacterial vaginosis (BV)
 Catalase and oxidase negative
 Clue cells: vaginal epithelial cells covere with
gram-variable rods)
 Whiff test: 10% KOH added to vaginal
secretion, positive result is fishy amine-like
odor
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41. Eikenella corrodens
 A member of the HACEK group
 Gram-negative bacilli (primarily) or
coccobacilli
 Fastidious
 Produces colonies that pit the agar surface
 Has a twitching motility
 Has a characteristic bleachlike or musty odor
 Oxidase positive
“Pitting the agar” and the bleach smell of the
colonies are hallmark characteristics of Eikenella
corrodens.
42. Capnocytophaga spp.
 Associated with dog and cat bite wound
infections, periodontitis, septicemia,
endocarditis, endometritis, osteomyelitis,
abscesses, peritonitis, keratitis, meningitis,
and arthritis
 Pale-staining, slightly curved, spindle-shaped
Gram-negative bacilli
 Fastidious, slow growing, and facultatively
anaerobe
 In vitro growth requires rich media and 5%
to 10% CO2 (capno- refers to CO2)
 Colonies have irregular edges and fingerlike
projections that appear as a thin film
surrounding the central part of the colony
 Gliding or sliding motility
43. Calymmatobacterium granulomatis
 Pleomorphic Gram-negative bacillus having
prominent capsule
 Organism has features suggestive of the
family Enterobacteriaceae, especially
Klebsiella spp., and is called Klebsiella
granulomatis by some taxonomists
 Etiologic agent of granuloma inguinale, or
donovanosis, a sexually transmitted disease
44. Bacteroides fragilis Group
 Anaerobic Gram-negative coccobacilli or
straight bacilli of variable length, sometimes
forming filaments; often vacuolated and
bipolar staining
 The most frequently encountered anaerobes
in clinical specimens; B. fragilis is the most
common species of anaerobic bacteria
isolated from soft tissue infectious processes
and bacteremia
 More virulent and drug resistant than most
other anaerobes
 Produce large, convex colonies on blood
agar and laked blood kanamycin vancomycin
(LKV) agar
 Bile resistant, esculin hydrolysis positive
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 Produce large, convex, dark (gray or black)  Produces large, irregular colonies on blood
colonies on Bacteroides bile esculin (BBE) agar, which are surrounded by a double zone
agar of hemolysis
 Bacteroides fragilis grows on BBE agar and  Catalase negative
because it can hydrolyze esculin it produces  Lecithinase positive
black colonies. The reverse CAMP test, production of lecithinase
 B. fragilis is also catalase positive and indole and demonstration of double zone of hemolysis are
negative. tests and characteristics used for the identification
of Clostridium perfringens.
45. Bacillus anthracis
48. Clostridium botulinum
 One of most highly pathogenic
 Anaerobic Gram-variable bacillus that
microorganisms
produces a subterminal spore
 Cause of anthrax
 Produces a neurotoxin called botulinal toxin
 Potential bioterrorism organism
(most potent exotoxin), which causes
 Submit to public health laboratory for
botulism
confirmation
 The three types of botulism, classified by the
 Large, nonmotile, aerobic Gram-positive
manner in which the disease is acquired, are
bacilli, often in short or long chains
classical foodborne botulism, wound
 Produces oval central-to-terminal spores
botulism, and infant botulism
that do not cause significant swelling of the
 Laboratory confirmation of botulism, usually
cells
performed at reference and public health
 Produces capsules in vivo, which can be
laboratories
demonstrated using various stains
 Lipase positive
 Produces tenacious nonhemolytic colonies
49. Clostridium tetani
on sheep blood agar
 Anaerobic Gram-positive bacillus with a
 Colonies are flat or slightly convex,
swollen terminal spore, giving the cell the
irregularly round, with an irregular or wavy
appearance of a lollipop
border and a ground-glass appearance
 Produces a neurotoxin called tetanospasmin,
(“medusa head”)
which causes tetanus
 Catalase positive
 Slow growth on blood agar that is smoothly
46. Bacillus cereus
swarming, quite thin, and often difficult to
 Can cause local and systemic infections
see; as a result of the swarming growth, C.
 Food poisoning (fried rice)
tetani is sometimes referred to as “the
 Beta-hemolytic
Proteus of the anaerobe world”
 Motile
50. Clostridium difficile
Tests B. anthracis B. cereus
 Large, straight, thin, anaerobic Gram-
Catalase + + positive bacilli that may produce chains (two
Lecithinase + + to six cells aligned end to end); rarely seen
oval subterminal spores cause swelling of
Motility non-motile motile
the cells
Hemolysis on gamma beta  Enterotoxin is the primary cause of
BAP antibioticassociated diarrhea, whereas the
cytotoxin is the primary cause of
47. Clostridium perfringens
pseudomembranous colitis
 Large, boxcar-shaped, blunt-ended,
 On cycloserine-cefoxitin fructose agar CCFA,
anaerobic Grampositive or Gram-variable
C. difficile produces large, yellow, flattened,
bacillus; produces subterminal spores, which
ground-glass colonies, with yellowing of the
are rarely seen
usually pinkish medium around the colonies
 Clostridium sp. most commonly isolated
 Colonies have a characteristic odor, which
from clinical specimens
has been described as similar to cow
 Most common cause of gas gangrene and a
manure, a barnyard, or a horse stable
very common cause of a relatively mild type
 Diagnosis of C. difficile–associated diseases
of food poisoning
is most often accomplished using some type
of commercial enzyme immunoassay or
cytotoxin tissue culture assay
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51. Corynebacterium diphtheriae 55. Nocardia spp.
 Toxigenic strains cause diphtheria  Aerobic, Gram-positive bacilli
 Gram-positive bacilli, often in V, picket  Fine branching filaments with
fence, or Chinese letter arrangements fragmentation; often beaded
 Catalase positive  Partially acid-fast
 On modified Tinsdale medium, produces  Catalase positive
black colonies surrounded by brown halos  N. brasiliensis most common species to
 Cells from growth on Loeffler serum medium cause skin infections
will contain metachromatic granules after  N. asteroides most common species to cause
staining them with methylene blue lung infections
In order to determine if an isolate of 56. Actinomyces spp.
Corynebacterium diphtheriae produces toxin,
 Infects brain, face, lungs and genitals
testing for the presence of diphtheria toxin must be
 Sulfur granules may be seen in discharge
performed using methods such as Elek test or PCR.
52. Corynebacterium jeikeium  Short or long Gram-positive bacilli
 Hospital-acquired pathogen
 Branched or unbranched; banded
 Highly resistant to antibiotics
appearance
53. Listeria monocytogenes
 A cause of food poisoning and a major cause  “Molar tooth” colonies
of neonatal meningitis
57. Mycobacterium tuberculosis
 Cold enrichment can be used to increase
 Major cause of tuberculosis
recovery from clinical specimens
 Short, nonbranching Gram-positive bacilli,  Slow-growing, strongly acid-fast bacillus
occurring singly or in short chains
 Nonphotochromogen
 Characteristic tumbling motility in a wet
 Optimum growth temperature is 37oC
mount and umbrella-shaped growth in a
liquid or semisolid agar medium  Buff-colored rough colonies
 Catalase positive
 Niacin accumulation positive
 Esculin hydrolysis positive
58. Borrelia spp.
54. Erysipelothrix rhusiopathiae
 Loosely coiled motile spirochetes
 Causes a cutaneous infection called
 B. burgdorferi causes Lyme disease, a
erysipeloid, characterized by purplish red
tickborne zoonosis
bumps, usually located on the hands and
 Lyme disease is the most common
fingers (common among butchers)
vectorborne infectious disease in North
 Usually short, nonmotile, non-spore-forming
America
Gram-positive organisms with rounded ends
 Lyme disease is diagnosed using
 Catalase, oxidase, and urease negative
immunodiagnostic procedures
 Produces hydrogen sulfide (H2S)
 B. recurrentis causes louseborne relapsing
 “Pipe cleaner” or “test tube brush” brush
fever
pattern of growth in gelatin stab cultures
 Relapsing fever is diagnosed by observation
Production of H2S in medium by a Gram-positive
of the spirochetes in peripheral blood
bacillus is highly suggestive of E. rhusiopathiae.
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59. Treponema spp.
 Tightly coiled, motile, extremely thin
spirochetes
 Treponema spp. cause syphilis, yaws, and
pinta
 T. pallidum subsp. pallidum causes syphilis
 T. pallidum does not grow on artificial media
 Primary syphilis is characterized by painless
chancres (hard chancre) at the sites of entry
of the pathogen
 Primary syphilis is diagnosed by observation
of the spirochetes using darkfield
microscopy
 Immunodiagnostic procedures are used to
diagnose secondary and tertiary syphilis
60. Leptospira interrogans
 Weil’s disease (infectious jaundice,
leptospirosis)
 Transmitted by urine of infected animal
 Organism in blood and CSF during first week,
then urine
 Turbidity below surface of semisolid
Fletcher’s medium
61. Chlamydia and Chlamydophila spp.
 Obligate intracellular pathogens that
produce intracytoplasmic inclusion bodies
 Biphasic developmental cycle that includes
elementary bodies and reticulate bodies
 Elementary bodies are metabolically inactive
and infectious
 Reticulate bodies are metabolically active
and noninfectious
 Chlamydiae are considered energy parasites
(preferentially use ATP molecules produced
by host cells)
 Different serotypes of Chlamydia
trachomatis cause different diseases,
including trachoma, inclusion conjunctivitis,
nongonococcal urethritis, and
lymphogranuloma venereum
 Chlamydophila pneumoniae causes
respiratory diseases, including pneumonia
 Chlamydophila psittaci causes psittacosis, a
respiratory disease
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62. Mycoplasma spp.
 Do not possess cell walls, causing them to be
pleomorphic; they range from tiny coccoid
cells to tapered rods
 If they stain at all, they are Gram negative
with the Gram staining technique
 They can be grown on artificial culture
media, but they require complex enriched
culture media
 Colonies of some species of Mycoplasma
(e.g., M. hominis) are referred to as fried-egg
colonies, because they resemble sunny-side-
up fried eggs
Mycoplasma pneumoniae
 Primary atypical pneumonia (walking
pneumonia)
63. Rickettsia/Orientia spp.
 Obligate intracellular Gram-negative bacilli
 Diseases caused by Rickettsia spp. are
arthropod-borne
 Rickettsia spp. cause typhus and similar
diseases, all of which produce a rash
 R. rickettsii is the cause of Rocky Mountain
spotted fever
 Orientia tsutsugamushi is the cause of scrub
typhus
64. Coxiella burnetti
 Pleomorphic coccobacillus
 Obligate intracellular pathogen
 Transmission occurs primarily via aerosol
 Causes Q fever
 Extremely infectious and dangerous to work
with
 Potential bioterrorism and biological
warfare agent
 Immunodiagnostic procedures are used to
diagnose Q fever
Always do your best.
What you plant now, you
will harvest later.
Og Mandino