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What is a defining characteristic of non-fermenting gram-negative rods (GNR)?

  • They are obligate anaerobes.
  • They primarily use carbohydrates for energy.
  • They are primarily found in dry environments.
  • They do not ferment carbohydrates. (correct)
  • Which biochemical test is NOT commonly used for identifying non-fermenting gram-negative rods?

  • Nitrate reduction
  • Fermentation of glucose (correct)
  • Oxidase test
  • Growth at 42°C
  • What type of environment do non-fermenting GNR prefer?

  • Cold storage facilities
  • Dry, arid environments
  • High altitude regions
  • Wet environments such as sinks and flower vases (correct)
  • What unique metabolic characteristic do non-fermenting gram-negative rods exhibit?

    <p>They are asaccharolytic and do not degrade carbohydrates at all. (B)</p> Signup and view all the answers

    Which of the following is a common characteristic of Pseudomonas species?

    <p>They possess a polysaccharide capsule. (A)</p> Signup and view all the answers

    What type of growth pattern is expected for non-fermenting gram-negative rods on MacConkey agar?

    <p>Poor growth or no growth. (B)</p> Signup and view all the answers

    What does an alkaline slant and no change in the deep butt reaction of TSI and KIA indicate?

    <p>No fermentation of carbohydrates occurring. (A)</p> Signup and view all the answers

    Which of the following statements about Pseudomonas aeruginosa is false?

    <p>It is highly susceptible to multiple antibiotics. (C)</p> Signup and view all the answers

    What characteristic feature of Pseudomonas aeruginosa colonies is often associated with a sweet, fruity odor?

    <p>Mucoid consistency (D)</p> Signup and view all the answers

    What is the typical coloration of Pseudomonas aeruginosa under UV light due to its pigmentation?

    <p>Yellow fluorescence (A)</p> Signup and view all the answers

    Which of the following pathways can Pseudomonas aeruginosa use for respiration when oxygen is absent?

    <p>Using nitrate as a respiratory electron acceptor (C)</p> Signup and view all the answers

    Which enzyme produced by Pseudomonas aeruginosa helps in breaking down host physical barriers during infection?

    <p>Elastase (A)</p> Signup and view all the answers

    What distinguishes the mucoid colonies of Pseudomonas aeruginosa from its other colony types?

    <p>Production of alginate slime (C)</p> Signup and view all the answers

    Which of the following is a common biochemical characteristic of Pseudomonas aeruginosa?

    <p>Reduces nitrate (A)</p> Signup and view all the answers

    What factor contributes to the opportunistic pathogenicity of Pseudomonas aeruginosa in hospital settings?

    <p>Natural resistance to a variety of antibiotics (C)</p> Signup and view all the answers

    During an infection, which stage involves the local invasion by Pseudomonas aeruginosa following colonization?

    <p>Local invasion (A)</p> Signup and view all the answers

    What type of consistency do larger, smoother colonies of Pseudomonas aeruginosa typically exhibit?

    <p>Mucoid appearance (A)</p> Signup and view all the answers

    What role do the pigments pyocyanin and pyoverdin play in identifying Pseudomonas aeruginosa?

    <p>They provide characteristic colors to the colonies. (B)</p> Signup and view all the answers

    What is the primary reason for the presence of S. maltophilia in urine?

    <p>Colonization of the urinary catheter (C)</p> Signup and view all the answers

    Which antibiotic combination is usually required for treating S. maltophilia infections?

    <p>Rifampin plus a fluoroquinolone (A)</p> Signup and view all the answers

    What characteristic differentiates B. cepacia from S. maltophilia?

    <p>Ability to oxidize mannitol (D)</p> Signup and view all the answers

    Which media is specifically mentioned for selecting and differentiating the Burkholderia cepacia complex?

    <p>Burkholderia cepacia selective agar (BCSA) (D)</p> Signup and view all the answers

    What is the most significant environmental habitat for Burkholderia cepacia?

    <p>Soil and water (C)</p> Signup and view all the answers

    What type of hemolysis is associated with the colonies of Burkholderia cepacia on sheep's blood agar?

    <p>No hemolysis (C)</p> Signup and view all the answers

    What method is recommended for susceptibility testing for S. maltophilia?

    <p>Broth dilution (D)</p> Signup and view all the answers

    Which characteristic is unique to Pseudomonas stutzeri compared to Acinetobacter species?

    <p>Can grow at temperatures ranging from 4-45°C (A)</p> Signup and view all the answers

    What is the primary method of classification for Acinetobacter species?

    <p>DNA homology groups (C)</p> Signup and view all the answers

    Which of the following statements about Acinetobacter baumannii is false?

    <p>It is exclusively found in human infections. (D)</p> Signup and view all the answers

    Which antibiotic is not typically used to treat Pseudomonas stutzeri infections?

    <p>Vancomycin (C)</p> Signup and view all the answers

    Which of the following features does Pseudomonas putida exhibit?

    <p>Known for bioremediation capabilities (A)</p> Signup and view all the answers

    What color do colonies of Pseudomonas stutzeri exhibit when grown on blood agar plates?

    <p>Brown or yellowish (A)</p> Signup and view all the answers

    Which statement about Acinetobacter's ecological distribution is true?

    <p>It is ubiquitous in soil, water, and foodstuffs. (D)</p> Signup and view all the answers

    What is the optimum growth temperature for Pseudomonas putida?

    <p>25°C (B)</p> Signup and view all the answers

    Which organism is identified as a rare opportunistic pathogen that acts as a soil denitrifier?

    <p>Pseudomonas stutzeri (C)</p> Signup and view all the answers

    What is a primary method through which Acinetobacter baumannii is acquired during hospital stays?

    <p>Direct contact with contaminated surfaces (A)</p> Signup and view all the answers

    What is a key characteristic of A.baumanii that contributes to its virulence?

    <p>It can form biofilms on various surfaces. (A)</p> Signup and view all the answers

    In which environment is A.baumanii most commonly found?

    <p>In moist and dry surfaces within healthcare settings. (A)</p> Signup and view all the answers

    Which of the following treatments is typically effective against most strains of A.baumanii?

    <p>Carbapenems. (D)</p> Signup and view all the answers

    What is a significant feature of Stenotrophomonas maltophilia in clinical settings?

    <p>It produces ammonia-like odors. (C)</p> Signup and view all the answers

    Which feature is associated with the clinical significance of Stenotrophomonas maltophilia?

    <p>It is associated with pneumonia in immunocompromised individuals. (A)</p> Signup and view all the answers

    What is true regarding the transmission of A.baumanii?

    <p>Transmission is primarily due to environmental contact or healthcare worker hands. (C)</p> Signup and view all the answers

    Which characteristic is NOT associated with A.baumanii's antibiotic resistance?

    <p>Natural susceptibility to all antibiotic classes. (B)</p> Signup and view all the answers

    What helps Stenotrophomonas maltophilia exhibit a brownish discoloration on McConkey agar?

    <p>Non-lactose fermentation. (C)</p> Signup and view all the answers

    Which of the following is NOT a common characteristic of A.baumanii?

    <p>Free-living in freshwater. (D)</p> Signup and view all the answers

    What does the TSI result of K/NC indicate for A.baumanii?

    <p>No carbohydrate fermentation. (C)</p> Signup and view all the answers

    Flashcards

    Non-Fermenting Gram-Negative Rods (NF)

    Bacteria that do not use carbohydrates for energy and are gram-negative rods.

    Opportunistic Pathogens

    NF bacteria that can cause infection in immunocompromised individuals.

    Asaccharolytic

    Microorganisms that cannot ferment carbohydrates.

    Obligate Aerobes

    Organisms that need oxygen for survival.

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    Oxidase Test (Positive)

    A test indicating the presence of cytochrome c oxidase, a protein essential for aerobic respiration in some bacteria.

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    Pseudomonas

    Gram-negative bacteria characterized by their oxidative metabolism and motility.

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    Motile by Single Polar Flagellum

    Pseudomonas move using a single flagellum at a pole of the cell.

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    Oxidative Metabolism

    Pseudomonas break down glucose by oxidation (not fermentation).

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    Pseudomonas aeruginosa

    A gram-negative, rod-shaped bacterium often found in soil and water, capable of causing opportunistic infections.

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    Oxidative Metabolism

    Pseudomonas uses oxygen to break down nutrients for energy.

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    Alginate Slime

    A substance produced by some Pseudomonas strains that contributes to their mucoid (sticky) colony appearance.

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    Pyoverdin

    A yellow pigment produced by Pseudomonas aeruginosa, detectable only under UV light.

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    Pyocyanin

    A blue pigment produced by Pseudomonas aeruginosa, especially in low-iron environments.

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    Opportunistic Pathogen

    A bacterium that causes disease primarily when the host's defenses are weakened.

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    Colony Appearance (Pseudomonas)

    Pseudomonas colonies can be smooth, flat, elevated, or mucoid, and sometimes have a metallic sheen, blue-green pigment, or a sweet fruity odor.

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    Extracellular Enzymes (Pseudomonas)

    Pseudomonas secrete enzymes that break down host tissue and aid in infection.

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    Infection Stages (Pseudomonas)

    Pseudomonas infections typically involve attachment, local invasion, and systemic spread through the blood.

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    Bacterial Resistance

    Pseudomonas aeruginosa exhibits resistance to certain antibiotics.

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    Putida bioremediation

    Putida bacteria's ability to break down pollutants like oil and toluene.

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    Pseudomonas stutzeri colony

    Adherent, wrinkled or leathery, hard and dry colonies, sometimes yellowish or brownish.

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    Pseudomonas stutzeri growth temp.

    Can grow from 4°C to 45°C, optimally at 35°C.

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    Acinetobacter species

    25 DNA homology groups, several species named including baumannii, iwoffi, haemolyticus, ubiquitous in environments.

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    Acinetobacter common habitat

    Soil, water, food, hospitals & medical equipment.

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    Acinetobacter colonization

    Common on skin and pharynxes of 25% & 7% of adults, respectively. Easily colonizes hospitalized patients.

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    Acinetobacter virulence

    A. baumannii is quite pathogenic, A. iwoffi is less pathogenic.

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    Acinetobacter infections

    Associated with various health issues including UTIs, pneumonia, endocarditis, and septicemia.

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    Acinetobacter identifying characteristic

    Strictly aerobic, gram-negative coccobacilli, oxidase negative, catalase positive, non-motile.

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    Putida optimum growth temp

    25°C

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    iwoffi (Acinetobacter baumannii)

    A gram-negative bacterium known for producing biofilms, resisting disinfectants, and exhibiting multi-drug resistance.

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    Multi-drug resistance

    The ability of a microorganism to survive and grow even in the presence of multiple antibiotics.

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    Biofilms

    A community of microorganisms, often in complex mixtures, that adhere to a surface and are protected by an extracellular matrix.

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    Stenotrophomonas maltophilia

    A gram-negative, non-fermenting bacterium that causes infections, often in hospital settings.

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    Nosocomial Pathogen

    A pathogen that is responsible for infections that are acquired in a healthcare setting.

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    Identification Characteristics (baumannii)

    Produces a K/NC reaction, primarily beta-hemolytic. Important for recognizing the organism.

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    Oxidation Test (maltophilia)

    Rapid oxidation of maltose, but weaker for glucose; used to identify Stenotrophomonas maltophilia.

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    Clinical Significance (maltophilia)

    Common cause of infections in immunocompromised patients and frequently present in medical devices.

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    Contact Precautions

    Procedures implemented for minimizing the spread of contagious organisms through direct or indirect contact.

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    Antibiotic Susceptibility Testing

    A laboratory test to determine the effectiveness of different antibiotics against a specific microorganism.Crucial in guiding treatment.

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    S. maltophilia Urine Colonization

    Presence in urine often due to urinary catheter use or manipulation; can also be found in wounds but usually a colonizer, unless associated with WBCs as indicative of inflammation

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    S. maltophilia Resistance

    Intrinsically resistant to many antibiotics; due to beta-lactamases, carbapenemases, plasmids, altered OM proteins, and efflux mechanisms, readily develops antibiotic-resistance.

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    Burkholderia cepacia Complex

    A mix of 9 subspecies known as GNB (gram-negative bacteria) frequently associated with cystic fibrosis patients; inhabits soil and water, not normal microbiota.

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    Burkholderia cepacia Identification

    Grows on sheep blood agar, and other standard media; shows delayed, but eventual, oxidation of lactose changing color to pink/red after 4-7 days; identified by differential media like BCSA or OFPBL

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    Burkholderia cepacia Differentiating Tests

    Weakly oxidative; decarboxylates lysine; oxidizes glucose, maltose, and lactose; DNAse negative; negative arginine reactions differentiate it from certain Burkholderia.

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    Burkholderia cepacia v. S. maltophilia

    B. cepacia oxidizes mannitol; S. maltophilia is DNAse positive. This helps distinguish them.

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    Treatment and Prevention of Burkholderia cepacia

    Strict precautions, including standard and contact precautions, needed for management. Antimicrobial therapy often requires a combination of drugs like rifampin, fluoroquinolone or beta-lactam, tailored to the specifics of the infection. Susceptible to TMP-SXT, Colistin and Polymyxin B.

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    Study Notes

    Non-Fermenting GNR

    • Prefer wet environments like sinks, respiratory equipment, and vases.
    • Usually not part of healthy human microbiota.
    • Considered opportunistic pathogens, colonizing and infecting immunocompromised individuals.
    • Often found in hospitalized patients, potentially becoming nosocomial pathogens.
    • Aerobic, gram-negative rods.
    • Do not use carbohydrates as an energy source, primarily through non-fermentation metabolic pathways.
    • Most are obligate aerobes, growing poorly in anaerobic conditions.
    • Oxidizers and non-fermenters.
    • Asaccharolytic; do not degrade carbohydrates.
    • Typically show abundant growth on sheep BAP and CAP within 24-48 hours.

    Clues for Isolating a Non-Fermenter (NF)

    • The organism does not ferment carbohydrates.
    • Shows an alkaline slant/no change on deep butt reaction in TSI and KIA.
    • Requires oxygen for carbohydrate metabolism if carbohydrates are utilized.
    • Fails to ferment carbohydrates.

    Pseudomonas aeruginosa

    • Gram-negative rod that may be encapsulated.

    • Motile via a single polar flagellum.

    • Non-spore forming.

    • Often associated with a "polysaccharide capsule".

    • Aerobic; requires oxygen for metabolism.

    • Oxidase and catalase positive.

    • Simple nutritional requirements; non-fastidious.

    • Optimum growth temperature is 37°C, able to grow at 42°C.

    • Resistant to salts, dyes, weak antiseptics, and many antibiotics.

    • Common inhabitant of soil, water, and the gastrointestinal tract. Includes species like P. fluorescens, P. putida, and P. stutzeri.

    • Can grow in the absence of oxygen if nitrate is available as a respiratory electron acceptor.

    • Rarely part of human microbiota.

    • Often a beta-hemolytic opportunistic pathogen, with rough spreading, ground glass colonies. The colonies have serrated or jagged edges.

    • May display metallic sheen and blue-green, red, or brown pigmentation.

    • Often associated with a sweet fruity odor (similar to grapes or tacos).

    • Mucoid colony consistency is attributed to alginate slime production; pigments (pyoverdin/fluorescein – yellow under UV light, pyocyanin – blue pigment).

    • Grows well on most lab media; oxidizes glucose, fructose, and xylose but not lactose or sucrose.

    Pseudomonas aeruginosa ID

    • Grows at 42°C.
    • Deaminates acetamide.
    • Reduces nitrate.
    • Decarboxylates arginine.

    Pseudomonas aeruginosa Infection

    • Requires a break in the body's defenses.
    • Has a natural resistance to many antibiotics from bacteria and fungi.
    • Invasive and toxigenic.
    • Infections consist of three stages: (1) bacterial attachment and colonization, (2) local invasion, (3) dissemination via blood and systemic disease.
    • Often found in hospitalized individuals.
    • Ability to invade tissues due to toxins and enzymes breaking down physical barriers, damaging host cells, and evading host defenses.
    • Extracellular proteases (elastase, alkaline protease), cytotoxins and hemolysins (phospholipase, lecithinase).
    • The blue pigment can impair upper respiratory cilia's ability to clear mucus and debris, damaging lung epithelium by inhibiting catalase activity.
    • Causing apoptosis of white blood cells.

    Pseudomonas aeruginosa Virulence Factors

    • LPS (endotoxin), Exoenzyme S, Exotoxin A.
    • Associated with respiratory infections, prevalent in ICU patients and those receiving broad-spectrum antibiotics.
    • Individuals with cystic fibrosis often have a unique mucoid strain that is difficult to eradicate.
    • Associated with bacteraemia and septicemia.
    • Cause of endocarditis in intravenous drug users and those with prosthetic heart valves.
    • Well known cause of swimmer's ear, bacterial keratitis (often due to poor contact lens hygiene), and chronic osteomyelitis (in bones).
    • UTI/infection caused by catheterization, instrumentation or surgical procedures.
    • Cause of necrotizing enterocolitis in infants and skin/soft tissue infections (burn wounds, pyoderma, dermatitis, folliculitis).

    Pseudomonas Prevention and Treatment

    • Observe proper isolation procedures, aseptic techniques.
    • Carefully clean respirators, catheters, and other instruments.
    • Treatments include anti-pseudomonal beta-lactams, fluoroquinolones, and aminoglycosides, alongside carbapenems (imipenem).
    • Current standard often involves a combination of anti-pseudomonal beta-lactam and an aminoglycoside.

    Pseudomonas fluorescens and P. putida

    • Often described together.
    • Motile, aerobic, ox/+. Oxidase positive.
    • Gram-negative bacilli.
    • Produces pyoverdin or fluorescein, but not pyocyanin.
    • Environmental organism often found in soil, water, plants, including contaminated milk.
    • Rarely isolated from clinical specimens due to poor growth at 35°C.
    • Optimum growth temperature is 25-30°C.
    • Typical colonies on BAP appear wet, gray, and non-lactose fermenting (NLF) on McConkey.
    • Can grow at 4°C and hydrolyze gelatin.

    A. baumannii

    • Ubiquitous in various environments.
    • Associated with ventilators, humidifiers, catheters.
    • Found in soil, water, and food products.
    • About 25% of adults carry A. baumannii on their skin, 7% in their pharynx.

    A. baumannii Identifying characteristics

    • Strictly aerobic gram-negative coccobacilli.
    • Oxidase negative, catalase positive, and non-motile.
    • Can appear gram-positive in blood smears.
    • Purplish hue on MacConkey resembles lactose-fermenting bacteria, not A baumannii.
    • Optimal growth at pH 5.5-6.0, temperature 30-35°C.
    • A. baumannii is saccharolytic; A. iwoffi is assaccharolytic.

    A. baumannii Clinical Significance

    • Hospitalized patients may become easily colonized.
    • Is an opportunistic pathogen, second to P. aeruginosa in isolation frequency.
    • Associated with UTI, pneumonia, tracheobronchitis, endocarditis, septicemia, meningitis, cellulitis, trauma, burns and the introduction of foreign bodies.
    • Reported in eye infections.
    • A. iwoffi is less virulent, isolation indicates colonization (rather than infection).

    Identifying characteristics of Acinetobacter

    • Strictly aerobic, gram-negative coccobacilli.
    • Oxidase negative, catalase positive, non-motile.
    • Can appear as gram-positive cocci in smears of blood cultures.
    • Purplish hue on MacConkey agar may resemble lactose-fermenting bacteria.
    • pH 5.5 - 6.0, temperature 30-35°C are preferred.
    • A. baumannii is saccharolytic, A. iwoffi is assaccharolytic.
    • Produces a K/NC reaction.
    • Majority of beta-hemolytic organisms are called Acinetobacter haemolyticus.

    Acinetobacter Clinical Significance

    • Able to form biofilms on inanimate objects.
    • Presence of pili allows organisms to adhere to epithelial cells.
    • Can produce proteins that can cause cell death.
    • Possesses LPS (part of its cell wall).
    • Often resistant to disinfectants.
    • Can survive in moist and dry surfaces; best known for its multidrug resistance.
    • Has the ability to acquire resistance to many classes of antibiotics, including newer beta-lactams; presence of resistance plasmids is a significant virulence feature.
    • Named “gram-negative MRSA”.
    • Reservoir sites include digestive tract, skin, mucous membranes of ICU patients.
    • Transmission occurs from contact with healthcare workers and environmental reservoirs.
    • A. baumannii infections are rare outside hospitals.

    Stenotrophomonas maltophilia

    • Motile, gram-negative, oxidase-negative rod.
    • Commonly found in soil, plants and water, as well as nosocomial pathogens.
    • Previously included in Pseudomonas and then Xanthomonas, now a unique genus.
    • Appears as non-distinct, straight, or slightly curved rods in singles or pairs.
    • BAP colonies are non-hemolytic, large, smooth and shiny; can be gray-white or have a slightly yellow pigment and a distinct ammonia-like odor.
    • NLF on McConkey.
    • Colonies may exhibit a lavender-green/brownish discoloration of agar in areas of heavy growth.
    • Oxidase negative; strong rapid oxidation of maltose.
    • Weaker oxidation of glucose, and lysine decarboxylase.
    • DNAse positive.
    • TSI: K/NC.

    Stenotrophomonas maltophilia Clinical Significance

    • Important nosocomial pathogen in debilitated and immunocompromised individuals.
    • Produces proteases and elastases and has LPS; part of its cell wall.
    • Difficult to distinguish between colonization and infection; its presence is a marker of deterioration.
    • Commonly found in medical devices, such as IV/CV and urinary catheters, causing pneumonia.
    • Cystic fibrosis patients can be colonized by S. maltophilia, along with other fermenters.
    • Urine presence is usually due to colonization of the urinary tract, urinary catheter or manipulation.
    • Can be present in wounds. Absence of WBCs suggests it's only a colonizer.

    Burkholderia cepacia Complex

    • Complex of 9 subspecies not easily differentiated.
    • Very significant, motile, gram-negative bacilli; often associated with cystic fibrosis patients.
    • Previously classified as Pseudomonas.
    • Inhabits soil and water, not part of healthy human microbiota.
    • Commonly known as a plant pathogen, not a significant pathogen in healthy individuals.
    • Found in hospital environments: tap water, disinfectants, soaps, and lotions.
    • Grows on sheep's BAP and CAP.
    • NLF, but after 4–7 days, may become pink or red due to lactose oxidation.

    Burkholderia cepacia Identifying characteristics

    • Able to grow on sheep's BAP, CAP and McConkey.
    • NLF, but after 4-7 days, may become pink or red due to lactose oxidation.
    • BCSA, a medium, selects and differentiates organisms based on CV, polymyxin B, Gm, and Va.
    • OFPBL is a selective and differential medium; colonies are yellow due to lactose oxidation.
    • Commercial identification systems may have difficulty identifying B. cepacia; molecular methods are recommended instead.
    • Weakly Oxi+, TSI: K/NC.
    • Able to decarboxylate lysine.
    • Can oxidize glucose, maltose, and lactose.
    • B. cepacia is able to oxidize mannitol while S. maltophilia is DNAse positive; the negative arginine reaction of B. cepacia differentiates it from B. pseudomallei.
    • B. gladioli is unable to oxidize maltose and lactose.

    Burkholderia cepacia Clinical Significance

    • Extremely pathogenic for those with cystic fibrosis.
    • Possesses few virulence factors (LPS and adhesion to mucous) and resistance to multiple antibiotics.
    • Studies show presence prior to lung transplant, often leading to post-transplant death.

    Burkholderia cepacia Treatment and Prevention

    • Requires isolation of the patient when hospitalized.
    • Antibiotic therapy rarely eradicates the organism from the CF respiratory tract.
    • Resistant to aminoglycosides; multiple antibiotics, including minocycline, meropenem, ceftazidime, fluoroquinolones, and chloramphenicol, are often necessary.
    • Susceptible to TMP-SXT.

    Burkholderia pseudomallei

    • Oxidase positive, motile, aerobic, gram-negative bacilli; slightly curved.
    • Grows on standard lab media (35°C in a CO2 atmosphere).
    • Smooth, mucoid colony or a dry wrinkled colony; resembling P. stutzeri on BAP.
    • Mucoid colonies are a characteristic.
    • Produces a musty or earthy odor.
    • Colonies appear pink on MacConkey due to lactose oxidation.
    • Decarboxylates arginine, whereas P. stutzeri, B. cepacia, and B. gladioli do not.
    • Resistant to colistin and Polymyxin B.

    Burkholderia pseudomallei Clinical Significance

    • Associated with rice paddy surface waters, via aerosolized transmission.
    • Causes melioidosis; known as “Vietnamese time bomb”.
    • The pathogen can survive in phagocytes and reactivate decades after initial infection in immunocompromised individuals.
    • Reactivation often presents as multiple abscesses throughout the body and skin.

    Alcaligenes faecalis

    • Inhabits environments, not part of human microbiota.
    • Found in hospitals (respiratory equipment, disinfectants).
    • Oxidase positive, motile, gram-negative bacilli.
    • Thin, spreading colonies with irregular edges on sheep BAP.
    • Can create green discoloration of the agar; NLF on McConkey (Non-Lactose fermenting).
    • Produces a characteristic "green apple" odor.
    • Assaccharolytic; creates a strong alkaline reaction on OF medium (appears as a blue color).

    Alcaligenes faecalis Clinical Significance

    • Causes opportunistic infections in immunocompromised and those with underlying diseases.
    • Can colonize cystic fibrosis patients who are intubated.
    • Known to reduce nitrate to nitrite.

    Achromobacter xylosoxidans

    • Aerobic, motile, oxidase positive, gram-negative bacilli.
    • Found in moist environments.
    • Can oxidize glucose and xylose.
    • Opportunistic pathogen causing bacteremia, meningitis, pneumonia, and peritonitis.
    • Responsible for colonizing respiratory tracts of patients with cystic fibrosis (CF) and medical equipment/solutions.

    Elizabethkingia meningoseptica (formerly Chryseobacterium meningosepticum)

    • Found in soil, plants, water; not part of normal human flora.
    • Survive in chlorinated water.
    • Oxidase positive; non-motile, slightly filamentous/thread-like gram-negative bacilli.
    • Can be found in hospital tools and devices, such as incubators, sinks, faucets, saline solutions, and respiratory equipment.
    • Colonies are circular, smooth, glistening, pale yellow on BAP.
    • May not grow well on MacConkey.
    • Positive indole reaction using Ehrlich’s reagent.
    • Commonly associated with meningitis and bacteremia in premature infants; also implicated in pneumonia, cellulitis, and abscesses in immunocompromised patients.

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