I.

What is the historical relationship between the genera Staphylococcus and Micrococcus?
1. Answer: Historically, the genus Staphylococcus was included with the genus
Micrococcus in the family Micrococcaceae.
How has molecular phylogenetic and chemical analysis affected the classification of
Staphylococcus spp.?
2. Answer: Molecular phylogenetic and chemical analysis has indicated that
Staphylococcus spp. is not closely related to Micrococcus, and Staphylococcus has now
been combined with the Bacillaceae, Planococcaceae, and Listeriaceae into the order
Bacillales.
How many species and subspecies are there within the genus Staphylococcus?
3. Answer: There are approximately 45 species and 21 subspecies within the genus
Staphylococcus.
What are the genera that some of the Micrococcus species are now reclassified into?
4. Answer: Some of the Micrococcus species are now reclassified into the genera Kocuria,
Nesterenkonia, Kytococcus, and Dermacoccus.
Into which families have the genera Kocuria, Nesterenkonia, Kytococcus, and Dermacoccus
been reorganized?
5. Answer: These genera have now been reorganized into two families, the
Micrococcaceae and the Dermacoccaceae.
Which family does the organism Alloiococcus otitidis belong to?
6. Answer: The only other organism, Alloiococcus otitidis, that biochemically reacts similar
to the families included in this chapter belongs to the family Carnobacteriaceae.
What are the characteristics of the organisms described in this chapter?
7. Answer: The species described in this chapter are all catalase-positive, gram-positive
cocci. The organisms are aerobic or facultative anaerobic, nonmotile and non–spore
forming organisms.
Which Staphylococcus species are obligate anaerobes?
8. Answer: Staphylococcus aureus subsp. anaerobius and Staphylococcus saccharolyticus
are obligate anaerobes, and may be catalase negative.
Which group of coagulase-negative staphylococci demonstrates novobiocin susceptibility?
9. Answer: The CoNS group that demonstrates novobiocin susceptibility includes
Staphylococcus epidermidis, Staphylococcus capitis, Staphylococcus haemolyticus,
Staphylococcus hominis subsp. hominis, Staphylococcus lugdunensis, S.
saccharolyticus, Staphylococcus warneri, and other species.
Which genera are easily confused with staphylococci and occasionally associated with skin
lesions?
10. Answer: Three genera of skin-colonizing organisms, the Micrococcus spp., Kocuria spp.,
and Kytococcus spp., are easily confused with staphylococci. Occasionally, these
genera will be associated with skin lesions and are more commonly isolated from
immunocompromised patients.
II.
Which species of staphylococci is the most virulent?
1. Answer: S. aureus
What factors contribute to S. aureus's ability to cause diseases?
2. Answer: A wide spectrum of factors, not all of which are completely understood,
contribute to S. aureus's ability to establish infections and cause several diseases.
What do S. aureus and S. epidermidis produce that inhibits phagocytosis?
3. Answer: A polysaccharide capsule
How does the capsule produced by S. aureus and S. epidermidis allow organisms to adhere to
inorganic surfaces?
4. Answer: It appears as a slime layer or biofilm
What is the role of the peptidoglycan in the mediation of pathogenesis?
5. Answer: It activates complement, interleukin 1 (IL-1), and acts as a chemotactic factor
for the recruitment of polymorphonuclear cells (PMNs).
What is the function of protein A in S. aureus?
6. Answer: It has a high affinity for the Fc receptor on IgG molecules as well as
complement, allowing S. aureus to directly bind immunoglobulins, thereby decreasing
the immune-mediated clearance of organisms from the site of infection.
What are two toxin-mediated diseases caused by S. aureus?
7. Answer: Scalded skin syndrome and toxic shock syndrome
Which staphylococci are normal microbiota of a variety of animal species, including dogs?
8. Answer: Other coagulase-positive or variable staphylococci, such as Staphylococcus
intermedius, Staphylococcus pseudintermedius, and Staphylococcus delphini.
Which coagulase-negative staphylococci is the most commonly encountered?
9. Answer: S. epidermidis
What is the clinical significance of coagulase-negative staphylococci?
10. Answer: They are frequently found as contaminants in clinical specimens, and their
emergence as health care–associated pathogens complicates laboratory interpretation
of their clinical significance. Every effort should be made to substantiate their clinical
relevance in a particular patient when they are isolated from clinical specimens.

III.
What type of agar can be used to grow the organisms?
1. Answer: 5% sheep blood and chocolate agars.
What types of broths can be used to grow the organisms?
2. Answer: Thioglycollate, dextrose, and brain-heart infusion broth.
What is the purpose of selective media for staphylococci isolation?
3. Answer: To eliminate contamination by gram-negative organisms in heavily
contaminated specimens such as feces.
Which agars are used for selective isolation of staphylococci?
4. Answer: Phenylethyl alcohol (PEA) or Columbia colistin-nalidixic acid (CNA) agars and
mannitol salt agar.
What is the purpose of mannitol salt agar?
 5. Answer: To eliminate contamination by gram-negative organisms and to differentiate S.
aureus from other staphylococci.
What is the indicator used in mannitol salt agar?
6. Answer: Phenol red.
How does S. aureus appear on mannitol salt agar?
7. Answer: S. aureus ferments mannitol and produces a yellow halo on this media as a
result of acid production altering the pH.
What is the purpose of CHROMagar?
8. Answer: CHROMagar is a selective and differential media for the identification of MRSA.
Why is CHROMagar selective?
9. Answer: It contains cefoxitin, and MRSA is resistant to this antibiotic.
Which organisms are typically grown on CHROMagar?
10. Answer: MRSA.

IV.
What are Streptococcus, Enterococcus, and Similar Organisms?
1. Answer: They are catalase negative, gram-positive cocci, 0.5 to 1.2 µm in diameter and
arranged in pairs or chains.
How are Streptococcus and Enterococcus species differentiated?
2. Answer: They are differentiated based on cell wall structure, hemolytic patterns on
sheep blood agar (beta, alpha, or gamma), reaction of antibodies to specific bacterial
antigen, the Lancefield Classification scheme, and biochemical identification relating to
physiologic characteristics.
What is the Lancefield Classification scheme?
3. Answer: The Lancefield Classification scheme is a system of classification used to
differentiate streptococci based on the presence of specific antigens in their cell walls.
What are some of the medically important species within the Streptococcaceae family?
4. Answer: Some of the medically important species within the Streptococcaceae family
include Streptococcus spp. and Enterococcus spp.
Which species are most commonly encountered in infections in humans?
5. Answer: The species that are most commonly encountered in infections in humans
include S. pyogenes, S. agalactiae, S. pneumoniae, E. faecalis, E. faecium, and the
viridans streptococci group.
How does the traditional system of classification differ from molecular analysis of the 16S
ribosomal ribonucleic acid (rRNA) sequences?
6. Answer: The traditional system of classification differs in some cases with the molecular
analysis of the 16S ribosomal ribonucleic acid (rRNA) sequences.
What are the biochemical identification tests used for identifying Streptococcus and
Enterococcus species?
7. Answer: Biochemical identification tests are used to identify Streptococcus and
Enterococcus species based on their physiologic characteristics.
What are the hemolytic patterns on sheep blood agar?
8. Answer: The hemolytic patterns on sheep blood agar can be beta, alpha, or gamma.
What is the difference between viridans streptococci and enterococci?
 9. Answer: Viridans streptococci and enterococci are differentiated based on their cell wall
structure, hemolytic patterns on sheep blood agar, reaction of antibodies to specific
bacterial antigen, and biochemical identification.
What are some of the species listed in the tables that are rarely found in clinically relevant
settings or are usually considered contaminants?
10. Answer: Some of the species listed in the tables that are rarely found in clinically
relevant settings or are usually considered contaminants include Streptococcus
anginosus, Streptococcus constellatus, Streptococcus intermedius, and Streptococcus
bovis.

V.

What are beta-hemolytic streptococci characterized by?

1. Answer: Beta-hemolytic streptococci are characterized by Lancefield groups based on
carbohydrates in the cell wall.
Are beta-hemolytic streptococci considered opportunistic bacteria?
2. Answer: Yes, beta-hemolytic streptococci are considered opportunistic bacteria.
Which Lancefield groups are clinically significant?
3. Answer: Some clinically significant Lancefield groups are S. pyogenes (group A) and S.
agalactiae (group B).
What are the large colony-forming pyogenic strains of streptococci with group A, C, or G
antigens and strains with group B antigen considered as part of?
4. Answer: They are considered as part of the beta hemolytic group.
Which small colony-forming beta-hemolytic strains are considered part of the viridans group?
5. Answer: Small colony forming beta-hemolytic strains with group A, C, F, or G are
considered part of the viridans group.
Which Lancefield group is the most clinically important group A?
6. Answer: Group A S. pyogenes is the most clinically important Lancefield group A.
What contributes to the virulence of S. pyogenes?
7. Answer: Several factors, including streptolysin O and S, contribute to the virulence of S.
pyogenes.
What is responsible for the beta hemolytic pattern on blood agar plates used as a guide to
identify S. pyogenes?
8. Answer: Streptolysin O and S are responsible for the beta hemolytic pattern on blood
agar plates used as a guide to identify S. pyogenes.
What is streptolysin S?
9. Answer: Streptolysin S is an oxygen-stable, nonimmunogenic hemolysin capable of
lysing erythrocytes, leukocytes, and platelets in the presence of room air.
What is streptolysin O?
10. Answer: Streptolysin O is immunogenic, capable of lysing the same cells and cultured
cells, is broken down by oxygen, and will produce hemolysis only in the absence of room
air.
What inhibits the development of protective antibodies associated with skin infection caused by
S. pyogenes?
 11. Answer: The cholesterol in skin lipids inhibits the development of protective antibodies
associated with skin infection caused by S. pyogenes.
What are the localized infections caused by S. pyogenes?
12. Answer: Localized infections caused by S. pyogenes include acute pharyngitis and skin
infections, such as impetigo and erysipelas.
What is the characteristic of S. pyogenes infections?
13. Answer: S. pyogenes infections are prone to progression with involvement of deeper
tissues and organs, a characteristic that has earned the designation in general
publications as the “flesh-eating bacteria.”
What are streptococcal pyrogenic exotoxins (SPEs)?
14. Answer: Streptococcal pyrogenic exotoxins (SPEs) are erythrogenic toxins produced by
lysogenic strains. They are heat-labile and rarely found in group C and G streptococci.
What serious disease is mediated by the production of potent SPE?
15. Answer: Streptococcal toxic shock syndrome, typified by multisystem involvement
including renal and respiratory failure, rash, and diarrhea, is a serious disease mediated
by production of potent SPE.
VI.
What is the cellular division pattern of streptococci?
1. Answer: Cellular division occurs along a single axis resulting in chains or pairs.
How do staphylococci differ from streptococci in terms of cellular division?
2. Answer: Staphylococci divide along multiple axes resulting in a cluster of cells.
What is the typical shape of streptococci?
3. Answer: Streptococci are typically round or oval-shaped.
Under what conditions might streptococci appear rodlike?
4. Answer: Streptococci might appear rodlike if the patient has been on antibiotics or if the
culture is very young.
What might cause streptococci to appear gram-negative?
5. Answer: Streptococci might appear gram-negative if the cultures are dying due to
deteriorating cell walls resulting in the failure of the primary stain being retained in the
cell wall.
What is the typical shape of S. pneumoniae?
6. Answer: S. pneumoniae is typically lancet-shaped and occurs singly, in pairs, or in short
chains.
How can broth cultures be used to determine cellular morphology?
7. Answer: Broth cultures can be used for determination of cellular morphology if there is a
question regarding staining characteristics from solid media.
What is the subdivision of the genera described in this chapter based on?
8. Answer: The genera described in this chapter are subdivided based on whether they
have a “strep”-like Gram stain or a “staph”-like Gram stain.
Which genera form long chains of cocci when growing in broth?
9. Answer: Streptococcus and Abiotrophia form long chains of cocci when growing in broth.
How do Leuconostoc primary morphology appear?
10. Answer: Leuconostoc primary morphology is cocci, although they may elongate to form
coccobacilli.
VII.
What kind of organisms are included in the Enterobacteriaceae family?
1. Answer: Gram-negative bacilli or coccobacilli that are non-spore forming, facultative
anaerobes capable of fermenting glucose.
What method is used for determining species identification within the Enterobacteriaceae
family?
2. Answer: Sequences of single-copy housekeeping gene regions used in multilocus
sequence analysis, along with a DNA-DNA hybridization cutoff of 70% or greater and an
average nucleotide identity of 95% or greater.
Are Enterobacteriaceae oxidase positive or negative?
3. Answer: They are oxidase negative, except for Plesiomonas sp.
What is the catalase status of commonly isolated Enterobacteriaceae?
4. Answer: They are catalase positive, except for Shigella dysenteriae type 1.
Can nucleic acid-based analysis definitively characterize all organisms in the
Enterobacteriaceae family?
5. Answer: No, it has not proven effective for definitively characterizing all the organisms
and genera included within the family.
What is a polyphasic taxonomic classification system?
6. Answer: It is a classification system that uses multiple methods of identification and
characterization to classify organisms.
Why does the classification and nomenclature of Enterobacteriaceae change over time?
7. Answer: Because identification and characterization methods improve, resulting in
reclassification of organisms and changes in nomenclature.
VIII.
1. What are the two groups of clinically relevant Enterobacteriaceae?
 The clinically relevant members of the Enterobacteriaceae can be considered as two
groups: the opportunistic pathogens and the intestinal pathogens.
2. Which bacteria are classified as intestinal pathogens?
 Typhi and Shigella spp. are classified as intestinal pathogens and are causative agents
of typhoid fever and dysentery, respectively.
3. What is the causative agent of plague?
 Y. pestis is the causative agent of plague, but it is not an intestinal pathogen.
4. Which bacteria are considered opportunistic pathogens?
 Citrobacter spp., Enterobacter spp., Klebsiella spp., Proteus spp., Serratia spp., and a
variety of other organisms are considered opportunistic pathogens.
5. What is the pathogenic classification of E. coli?
 Although E. coli is a normal bowel inhabitant, its pathogenic classification is somewhere
between that of the overt pathogens and the opportunistic organisms.
6. What are the different strains of enterotoxigenic E. coli (ETEC)?
 Diuretic strains of E. coli, such as enterotoxigenic E. coli (ETEC), enteroinvasive E. coli
(EIEC), and enteroaggregative E. coli (EAEC), express potent toxins and cause serious
gastrointestinal infections.
7. What are the genetically undefined diarrheagenic E. coli strains referred to as?
  The diarrheagenic E. coli capable of causing hemorrhagic colitis and hemolytic uremic
syndrome are not completely genetically defined and are collectively referred to as
Shiga-toxin–producing E. coli or STEC throughout this text.

VIII.
What is A. dalhousiensis and what specimens is it commonly identified from?
1. Answer: A. dalhousiensis is a bacterial organism that has been identified from blood and
wound specimens.
Why is A. dalhousiensis often misidentified in commercial systems and what is the current
situation for identification schemes?
2. Answer: A. dalhousiensis is often misidentified as Kluyvera ascorbata or Salmonella
enterica in commercial systems. There is currently no recommended identification
scheme available for A. dalhousiensis.

IX.
Which part of the human body is most commonly affected by Citrobacter organisms?
1. Answer: The urinary tract.
What are the other infections associated with Citrobacter spp. besides urinary tract infections?
2. Answer: Wound infections, respiratory tract infections, bacteremia, endocarditis,
septicemia, meningitis, brain abscess, and neurologic complications.
Which group of people is most likely to get infections caused by Citrobacter spp.?
3. Answer: Neonates or immunocompromised patients.
How are Citrobacter spp. typically transmitted?
4. Answer: Person-to-person.
What kind of antibiotic resistance is associated with C. freundii?
5. Answer: Resistance to ampicillin and first-generation cephalosporins.
What biochemical tests are used to differentiate between different species of Citrobacter?
6. Answer: Indole, ornithine decarboxylase (ODC), malonate, and acid fermentation from
adonitol, dulcitol, melibiose, and sucrose.
Which species of Citrobacter is positive for indole and ODC?
7. Answer: C. amalonaticus.
Which species of Citrobacter is indole- and sucrose-variable and positive for melibiose?
8. Answer: C. freundii.
What is the primary human pathogen associated with Cronobacter spp.?
9. Answer: C. sakazakii (neonatal infections) and C. malonaticus (adult infections).
What type of antibiotic resistance is associated with Cronobacter spp.?
10. Answer: Intrinsic resistance to ampicillin and first- and second-generation
cephalosporins as a result of an inducible AmpC chromosomal beta-lactamase.
X.

What is the typical source of Edwardsiella tarda infection?

1. Answer: Edwardsiella tarda is typically associated with water harboring fish or turtles.
What types of infections can immunocompromised individuals develop due to Edwardsiella
tarda?
2. Answer: Immunocompromised individuals may develop serious wound infections
(myonecrosis), gastroenteritis, and occasionally septicemia, meningitis, and liver
abscess due to Edwardsiella tarda.

XI.
What are the top 10 most commonly isolated health care-associated infections by the National
Healthcare Safety Network, which include Enterobacter spp.?
1. Answer: Enterobacter spp. are reported as one of the genera listed in the top 10 most
commonly isolated health care-associated infections by the National Healthcare Safety
Network.
What is the function of the capsule in Enterobacter spp.?
2. Answer: The capsule in Enterobacter spp. provides resistance to phagocytosis.
What type of genetic element do plasmids and transposons belong to?
3. Answer: Plasmids and transposons are autonomous replicating extrachromosomal
elements.
How many genomic types of E. coli and Shigella spp. are there?
4. Answer: Recent reports indicate that there are approximately 186 genomic types of E.
coli and Shigella spp. that include pathogenic and commensal strains.
What is the function of bacteriophages in promoting horizontal gene transfer?
5. Answer: Bacteriophages are capable of promoting homologous recombination and
horizontal gene transfer between organisms.
What are the two groups in which pathogenic E. coli strains are classified?
6. Answer: Pathogenic E. coli strains are grouped into diarrheagenic or intestinal and
extraintestinal pathogens.
XIII.
What is the shape of Mycobacteria?
1. Answer: Mycobacteria are slender, slightly curved or straight, rod-shaped organisms.
Do mycobacteria form spores?
2. Answer: No, mycobacteria do not form spores.
What is the characteristic staining behavior of mycobacteria?
3. Answer: Mycobacteria resist staining with commonly used basic aniline dyes, such as
those used in the Gram stain, at room temperature. They take up dye with increased
staining time or application of heat but resist decolorization with acid-ethanol. This
characteristic is referred to as acid fastness.
Are mycobacteria strictly aerobic?
4. Answer: Yes, mycobacteria are strictly aerobic, but increased carbon dioxide (CO2) will
enhance the growth of some species.
What is the Mycobacterium tuberculosis complex?
5. Answer: The Mycobacterium tuberculosis complex consists of M. tuberculosis, M. bovis
(including the vaccination strain bacillus Calmette-Guérin), M. africanum, M. canettii, and
M. microti.
What is the usual route of infection for TB?
6. Answer: TB is usually a disease of the respiratory tract. Tubercle bacilli are acquired
from persons with active disease who are excreting viable bacilli by sneezing or talking.
What is a granuloma?
7. Answer: A granuloma is an organization of lymphocytes, macrophages, fibroblasts, and
capillaries formed as a result of Mycobacterium tuberculosis infection.
What is the clinical diagnosis of primary TB?
8. Answer: The clinical diagnosis of primary TB is a positive PPD skin test.
How is the diagnosis of TB confirmed?
9. Answer: The diagnosis of TB is confirmed by stained smear and culture of sputum,
gastric aspirates, or bronchoscopy specimen.
Is there a potential for reactivation of TB in infected individuals?
10. Answer: Yes, there is a potential for reactivation of TB in infected individuals.

XIV.
What are the three species in the Mycobacterium fortuitum Group?
1. Answer: The three species in the Mycobacterium fortuitum Group are M. fortuitum, M.
peregrinum, and an unnamed third species.
What are the sources of isolation for the Mycobacterium fortuitum Group?
2. Answer: The Mycobacterium fortuitum Group is isolated from water, soil, and dust.
What types of infections are associated with the Mycobacterium fortuitum Group?
3. Answer: The Mycobacterium fortuitum Group is associated with localized cutaneous
infections.
What are the characteristics of colonies of the Mycobacterium fortuitum Group on Middlebrook
7H11 agars?
 4. Answer: The colonies of the Mycobacterium fortuitum Group on Middlebrook 7H11 agars
have branching filamentous extensions and rough colonies with short aerial hyphae after
1 to 2 days of incubation.
What are the morphological characteristics of the Mycobacterium fortuitum Group?
5. Answer: The Mycobacterium fortuitum Group is pleomorphic, ranging from long and
tapered to short, thick rods partially acid-fast.
What are the biochemical tests used for identifying the Mycobacterium fortuitum Group?
6. Answer: The biochemical tests used for identifying the Mycobacterium fortuitum Group
are a positive 3-day arylsulfatase test and reduction of nitrate.
How many species are in the M. smegmatis Group?
7. Answer: There are two species in the M. smegmatis Group, M. smegmatis and M.
goodie.
What types of infections has M. smegmatis been implicated in?
8. Answer: M. smegmatis has been implicated in rare cases of pulmonary, skin, soft tissue,
and bone infections.
What are the morphological characteristics of cells of the M. smegmatis Group?
9. Answer: The cells of the M. smegmatis Group are long and tapered or short rods with
irregular acid fastness. Occasionally rods are curved with branching or Y-shaped forms;
swollen, with deeper staining, beaded, or ovoid forms are sometimes seen.
What are the characteristics of colonies of the M. smegmatis Group on egg medium?
10. Answer: The colonies of the M. smegmatis Group appearing on egg medium after 2 to 4
days are usually rough, wrinkled, or coarsely folded; smooth, glistening, butyrous
colonies may also be seen.
XV.
What is the Mycobacterium fortuitum Group?
1. Answer: It is a group of mycobacteria that includes M. fortuitum, M. peregrinum, and an
unnamed third species.
What are the sources of isolation of the Mycobacterium fortuitum Group?
2. Answer: It is isolated from water, soil, and dust.
What is the association of the Mycobacterium fortuitum Group with infections?
3. Answer: It is associated with localized cutaneous infections.
What is the appearance of colonies of the Mycobacterium fortuitum Group on Middlebrook 7H11
agar?
4. Answer: After 1 to 2 days of incubation, colonies of the Mycobacterium fortuitum Group
on Middlebrook 7H11 agar have branching filamentous extensions and rough colonies
with short aerial hyphae.
What is the morphology of the Mycobacterium fortuitum Group?
5. Answer: The Mycobacterium fortuitum Group is pleomorphic, ranging from long and
tapered to short, thick rods that are partially acid-fast.
What is the result of the arylsulfatase test for the Mycobacterium fortuitum Group?
6. Answer: The Mycobacterium fortuitum Group gives a positive 3-day arylsulfatase test.
What is the result of the nitrate reduction test for the Mycobacterium fortuitum Group?
7. Answer: The Mycobacterium fortuitum Group shows reduction of nitrate.
What is the Mycobacterium smegmatis Group?
 8. Answer: The Mycobacterium smegmatis Group is a group of mycobacteria that includes
M. smegmatis and M. goodie.
What are the types of infections associated with M. smegmatis?
9. Answer: M. smegmatis has been implicated in rare cases of pulmonary, skin, soft tissue,
and bone infections.
What is the appearance of colonies of M. smegmatis on egg medium?
10. Answer: Colonies of M. smegmatis appearing on egg medium after 2 to 4 days are
usually rough, wrinkled, or coarsely folded; smooth, glistening, butyrous colonies may
also be seen.
What is the result of the arylsulfatase test for M. smegmatis?
11. Answer: M. smegmatis shows a negative arylsulfatase reaction.
How is Mycobacterium leprae identified?
12. Answer: Mycobacterium leprae is identified by its association with Hansen disease
(leprosy), its inability to grow on artificial media, its morphology (the length of the bacillus
is at least five times the width of the bacillus), and by using a mouse footpad.
XVI.
What is the common morphology of Listeria, Corynebacterium, and Similar Organisms?
1. Answer: They are catalase positive, gram-positive rods. They are non–acid-fast, non–
spore-forming, and mostly nonbranching rods.
Which species are included with the gram-positive rods despite exhibiting extensive branching
and vegetative hyphae and penetrating into the agar surface?
2. Answer: Rothia and Oerskovia spp.
Are Corynebacterium spp. aerobic or facultative anaerobic fastidious organisms?
3. Answer: Yes, they are.
Which genera are known as coryneform bacteria that demonstrate similar morphology to that of
Corynebacterium spp.?
4. Answer: Arthrobacter, Brevibacterium, Cellulomonas, Cellulosimicrobium, Dermabacter,
Exiguobacterium, Leifsonia, Microbacterium, Rothia, and Turicella.
What is the significance of Rhodococcus equi (formerly Corynebacterium equi)?
5. Answer: It is an opportunistic pathogen that affects immunocompromised patients.
Which species may also be isolated in medical device–associated infections?
6. Answer: Other species of Corynebacterium.
How is Listeria monocytogenes commonly misidentified in clinical specimens?
7. Answer: As diphtheroids, cocci, or diplococci.
What is the clinical significance of Listeria monocytogenes?
8. Answer: It is clinically significant in specific populations of immunocompromised patients
as well as being associated with foodborne infections in healthy individuals.
What is the virulence factor produced by Listeria monocytogenes once it has been phagocytized
by white blood cells?
9. Answer: Listeriolysin O.
What is the major function of listeriolysin O?
10. Answer: It reduces T-cell responsiveness.
How does Listeria monocytogenes escape from the phagosome of white blood cells and avoid
intracellular killing?
 11. Answer: Through toxin-induced unresponsiveness and phospholipases.
What bacterial surface protein is produced by Listeria monocytogenes?
12. Answer: Act A.
What is the function of Act A?
13. Answer: It induces host cell actin polymerization.
How does Listeria monocytogenes spread from cell to cell?
14. Answer: Through actin polymerization within the host cell, which moves the infecting
organism toward the host cell membrane, forming pseudopod-like projections that are
then ingested by neighboring cells.
What are the systemic disease manifestations of listeriosis?
15. Answer: Stillbirth and neonatal death, meningitis, bacteremia, encephalitis, and
endocarditis.
What are the localized infections caused by Listeria monocytogenes?
16. Answer: Conjunctivitis, skin infections, and lymphadenitis.
How is Listeria monocytogenes primarily transmitted?
17. Answer: Through the ingestion of contaminated food.
How does vertical transmission of Listeria monocytogenes occur?
18. Answer: It occurs transplacentally or through an infected birth canal.
How has cross-infection of Listeria monocytogenes been identified in neonatal nurseries?
19. Answer: It is associated with contaminated mineral oil used for bathing infants.