Chpt pertussis

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                                      Bacillus & friends
                                       Chp 18 pg 281

Genera & species to be considered:
B cereus
B. subtilies
General characteristics
Epidemiology pg 282 table 18-1
Pathogenesis & spectrum of disease pg 282 table 18-2
Bug to know: B. anthracis
        Agnet of bioterrorism
Cultivation, incubation, etc: read over
Colonial appearancepg 284 table 18-3, note the 3 species only
Approach to id
Comments regarding specific organisms: note B. anthracis
Antimicrobial sus & therapy
Prevention: vaccine

                          Listeria, Corynebacterium, and Cohorts
                                       Chp 19 pg 289

Genera & species to be considered:
Corynebacterium diphtheriae
C. jeikeium
Listeria monocytogenes
Other Corynebacterium spp
General Characteristics
Epidemiology Table 19-1 The first 3 and note the “normal flora species of Corynebacterium
Pathogenesis & spectrum of disease pg 290 table 19-2
        Know the specific organisms
Gram stain morph colony appearance,etc table 19-3 pg 291-292
        Focus on the specific organisms but note that the morphology for these are sort of the
        same: coryneform gram positive rods see pictures pg 292 & 293
               Appearance on BAP is variable
Approach to identification
Comments regarding specific organisms
        C. diphtheria
               2 test/ media: Tinsdale
               Elek plate for toxin production
From the table on pg 295 (19-4) we can pick & choose to rule out/ screen for specific pathogens
& disregard the others as nf or contaminants
Note the umbrella motility of L. monocytogenes pg 297 fig 19-6
Read over AST
Prevention: vaccines, soft cheese, hot dogs and other such goodies

                   Erysipelothrix, Lactobacillus and questionable buddies
                                       Chpt 20 pg 303

Genera & species to be considered
Erysipelothrix rhusiopathieae
Arcanobacterium spp
Gardnerella vaginalis
Lactobacillus sp

General characteristics
Epidemiology Table 20-1 pg 304
Pathogenesis & spectrum of disease: Table 20-2 pg 304
Laboratory diagnosis:
        Note specimen of choice for Erysipelothrix
Direct detection: gram stain
        Note cellular morphology details
        Clue cells
Media of choice
Colonial appearance: fig 20-2
Approach to id
        Presumptive id of Gvaginalis
        Arcanobacterium: not grp A strep from TC, gram stain, fig 20-4 pg 308
        Lactobacillus: gram stain
        Erysipelothrix : specific characteristics & gram stain
               Pg 308 fig 20-3

                      Nocardia, Streptomyces, Rhodococcus and gang
                                      Chp 21 pg 311
Genera & species to be considered
Nocardia asteroids
N. brasiliensis
Streptomyces (generally)
Read the 2nd paragraph second column pg 311

General characteristics
Branching, beaded morphology
partial acid fastness (vs acid fast, difference?)
Epidemiology: box 21-1 pg 312, 1st paragraph pg 313 (1st column) pg 314 table 21-4 just to see
similarities, not to memorize
Pathogenesis & spectrum of disease: bottom pg 313: Nocardia
Laboratory diagnosis pg 315

Direct detection: gram stain/ acid fast stain, partial acid fast stain
        Pg 316 fig 21-1 and pg 317 fig 21-2
Cultivation: just read to get a feeling of how these grow
        Table 21-7 for overview, focus on Nocardia
Approach to identification: bottom of second column for a general approach
AST for interest
Procedure 21-1 pg 320

                                        Eikenella etal
                                        Chp 31 pg 389

Genera & species to consider
Eikenella corrodens
Note Bergeyelia zoohelcum is from animal bites

General CharacteristicsP asaccharolytic: do not use carbohydrates as a source of Carbon

Epidemiology: pg 390 table 31-1: clenched fist wound infections, (featured on a CSI)
Spectrum of disease: pg 390 table 31-2
Direct detection methods gram stain not remarkable
Cultivation: pg 391 table 31-4
Approach to id: read over
Comments regarding specific organisms: read over

                                        Pasteurella etal
                                           Chpt 32
                                            Pg 393

Genera & species to consider
(note current name and previous name)
Pasteurella multocida
CDC group EF-4a

General Characteristics
Important characteristic is the inability to grow on MacConkey’s Agar, most commonly isolated
gnr will grow on MacConkey’s

Epidemiology pg 394 Table 32-1
       Note the traumatic inoculation w/ association w/ animals
       Otherwise, immunecompromised pt.
Spectrum of disease pg 394 table 32-2

Cultivation :usually media/conditions
       Pg 395 table 32-4
Approach to id

       Read through
Comments regarding specific organisms : read to see how differentiation can be made
AST: note top of pg 393

              Actinobacillus, Kingella, Cardiobacterium, Capnocytophaga, etal
                                        Chp 33, Pg 397

Genera & species to consider
Actinobacillus actinomycetemcomitans
Capnocytophaga canimorsus
Kingelia kingae

General Characteristics

Epidemiology : pg 398 table 33-1
        Note that these are generally nf of humans & others
Spectrum of disease: pg 33-2 pg 398
        HACEK organisms cause SBE
        Periodontal, animal bites
Direct detection methods: none except gram stain: morse code morphology
        Fusiform bacilli(Capnocytophaga)
Cultivation: generally slow growers (dysgenic)
        Better in blood culture bottles
        Pg 400, table 33-4 for colonial morph on BAP, just for information
        Pitting the agar: colony sinks into the media and very difficult to dig out
Approach to id: rule out the “usual”
Comments regarding specific organisms:
        Note differentiation between Kingella and Neisseria
        Gliding motilityCapnocytophaga

                                          Chpt 37 pg 424

Genera & species to consider: Legionella pneumophilia serotypes 1-15
General Characteristics: faintly staining thin gnr
Epidemiology: pg 425 Box 37-1
      Read over Epidemiology & pathogenesis pg 425-426
      Interesting living conditions and adaptation.
      Note biofilms

Spectrum of disease pg 425
        Read over for info and understanding, not to memorize
Specimen collection& transport: time element
Direct detection methods: Stains, esp immunofluorescent
        Rapid detection in other body fluids, PCR too?
Cultivation: BCYE, slow grower, characteristic colonial morph
        What nutrients and environmental requirements?
Approach to id: reference lab
Drug of choice:

                                          Chpt 38 pg 430

Genera & species to consider
        Brucella abortus
        B. melitensis
        B. suis
        B. canis
General Characteristics Nonmotile, aerobic, gncb or short rods, facultative, intracellular parasites
Epidemiology: pg 431 table 38-1
Spectrum of disease: Brucellosis: animal & human
        Note where organism likes to reside
        Acute & chronic disease
        Read thru pg 430-431, important & interesting
Direct detection methods Poorly stained w/ gram stain
        Read 431
        Specimen collection, transport & processing
        Class III pathogen
        Blood cultures: note length of incubation
        Castaneda type blood culture bottle/ biphasic
Approach to id: Read 431-432, note pics
        Serodiagnosis old standard, read; febrile agglutinins
        AST not done, why?
Prevention vaccine?

                        Bordetella pertussis & Bordetella parapertusis
                                       Chpt 39 pg 435

Genera & species to consider
      B. pertussis
      B parapertussis
General Characteristics : tiny faintly staining coccobacilli singly or pairs/ vy small

Epidemiology: read pg 435, note world wide and historical disease w/ person to person
Colonial morph: pearly luster: mercury drops

Spectrum of disease: Pertussis/ whooping cough
        See table 39-1 for virulence factors & read pg 39: Pathogenesis and Spectrum of disease
        3 stages
Direct detection methods: DFA, what is the preferred specimen? Any special instructions?
Cultivation: Specimen collection, transport and processing very important.
        Selective media table 39-2 pg 437
        How long to incubate and under any special conditions? See fig 39-1 pg 437
Approach to id : DFA
Drug of choice?
Prevention: whole cell vs acellular vaccines????

                                         Chpt 40 pg 440

Genera & species to consider
        Francisella tularensis with several subspecies
General Characteristics: facultative, intracellular pathogen w/ special nutritional requirements
        (cysteine, iron)
        Taxonomic status has some question
Epidemiology: Worldwide, animal disease, animal and possible water/amebae source
        Note the major virulence factors and implications of them
Spectrum of disease: Tularemia
        Biosafety level 2 pathogen for specimens
        Biosafety level 3 for culture
        One of the most common laboratory acquired infections
        Note most common specimens
        Bioterrorism potential
Direct detection methods: fluorescent antibody stains are the norm, PCR is most sensitive
Cultivation: enriched media: cysteine & cystine, slow read over pg 441
        Can use BCYE, blood cultures
Approach to id: routine labs do not try to id
        See box 40-1 pg 442
        Serodiagnosis: febrile aggulinates or EIA,
Prevention: read

                     Streptobacillus moniliformis and Spirillum minus
                                      Chpt 41 pg 444

Genera & species to consider
        Streptobacillus moniformis
        Spirilium minus
General Characteristics: Fastidious gnr
        Spirilium minus never been cultured
S. moniformis:
Epidemiology: rats
        Transmission by 2 routes
        Read pg 445
Spectrum of disease: Rat bite fiever, Haverhill fever
        Spontaneous L forms (which are?)
        Read pg 445
Direct detection methods: fig 41-1 for gram stain of pus
Read over the Specimen collection, transport & processing
        We seldom see suspected cases
Cultivation: S. moniliformis requires:
        Pitted/embedded, fried egg colonies
Approach to id: difficult
Serodiagnosis useful
Prevention no vaccines
S. minus:
General characteristics: gn, helical, aerobic
Transmission by rat
Disease: Sodoku
Direct deteion: spirochetes seen w/ giemsa or wright or dark-field microscopy

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