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How is DNA sequencing a helpful addition to gram staining and biochemical testing when identifying bacterial species?

Define the term “aseptic”; explain how this term could be used to describe both microbiology lab and patient care protocols

Describe the inoculation method, stain, and growth media choices you might use to isolate a pure culture in the laboratory

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Jean Keeling
Jean KeelingLv2
28 Sep 2019
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Related questions

1. An organism, observed on direct Gram stain from a clinical specimen, does not grow on blood or chocolate agars incubated at 35°C in CO2. This can be explained by all of following statements except

a. the organism is an anaerobe.

b. the organism is dead due to previous antibiotic therapy.

c. the organism requires nicotinamide adenine dinucleotide for growth.

d. the organism is fastidious and is not being provided the growth factor it needs.

2. The laboratory should be notified in advance when the physician suspects Francisella tularensis because the organism is

a. fastidious and requires special medium.

b. infectious for laboratory personnel.

c. not culturable.

d. a and b.

e. b and c.

3. The HACEK organisms share all of the following characteristics except

a. gram-negative coccobacilli that are oxidase and catalase positive.

b. slow growing and stimulated by carbon dioxide.

c. part of the normal oral flora.

d. causative agents of bacterial endocarditis.

4. Legionella pneumophila and Francisella tularensis share the characteristic of

a. being easily identified by biochemical testing.

b. a requirement for cysteine to grow in culture.

c. the necessity for the use of Gimenez stain rather than Gram stain to visualize.

d. having an animal reservoir.

5. Legionella pneumophila and Francisella tularensis share all of the following characteristics except

a. poor Gram staining properties.

b. ability to cause pneumonia.

c. ability to diagnose infection with detection of serum antibodies.

d. fluorescence of colonies.

6. A blood culture isolate that stains as pleomorphic gram-negative coccobacillus and only grows on chocolate agar should be

a. identified using the ALA test.

b. identified using the ALA and horse blood agar tests.

c. presumptively identified under BSL 2 conditions.

d. identified using X and V factor disks and horse blood agar.

7. Which of the following organisms requires factor X only on initial isolation but loses the requirement on subculture?

a. Aggregatibacter actinomycetemcomitans

b. Eikenella corrodens

c. Francisella tularensis

d. Aggregatibacter aphrophilus

8. Haemophilus ducreyi is unique among the genus because it requires

a. factors X and V.

b. no factors.

c. heme only.

d. NAD only.

9. Streptobacillus moniliformis is most easily isolated from blood cultures because it requires _____ for growth.

a. heme

b. serum

c. cysteine

d. 1% α-ketoglutarate

10. A 57-year-old male farmer sees his physician complaining of fever, night sweats, and lethargy that come and go over the past three months. The patient’s history reveals that he raises sheep for wool and meat and goats for milk. The physician suspects undulant fever. What is the optimal specimen(s) for culture of this suspected organism?

a. Blood

b. Bone marrow

c. Lymph node biopsy

d. All of the above

e. B and C

11. A microbiologist processes a specimen for culture using a buffered charcoal yeast extract agar plate. What was the original specimen used for inoculation of this agar plate?

a. Blood

b. Lower respiratory specimen

c. Nasopharyngeal

d. Urine

12. A nasopharyngeal swab containing ciliated epithelial cells is the best specimen for the recovery of the organism that causes

a. whooping cough.

b. undulant fever.

c. rat bite fever.

d. legionnaire’s disease.

13. What is the clinical significance of ALA-positive, gram-negative coccobacilli in a sputum culture?

Normal flora

Potential pathogen

Significant if it is hemolytic on horse blood agar

Further testing is needed to assess significance

14. A small, slender, gram-negative rod was recovered from the blood cultures of a patient following root canal surgery. At 48 hours, the following results were observed:

BAP and CHOC agars: small gray colonies that tend to pit the agar

MAC agar: no growth

Odor upon opening the agar plates: bleach-like

This organism will also be

a. catalase and oxidase positive.

b. catalase positive and oxidase negative.

c. catalase and oxidase negative.

d. catalase negative and oxidase positive.

15. A pleomorphic gram-negative coccobacillus is isolated from the blood cultures of 58-year-old male who had recent dental surgery. His history is significant for rheumatic fever as a child. The organism only grows on chocolate agar. It should be tested using

a. ALA.

b. X and V factor disks.

c. ALA and horse blood agar.

d. X and V factors and horse blood agar.

16. The virulence of Bordetella pertussis is related to its

a. toxin’s ability to paralyze ciliated epithelial cells.

b. ability to hide in the reticuloendothelial system.

c. easy dissemination.

d. ability to live inside white blood cells.

17. Infection due to Brucella spp. is often slow to develop, long term, and displaying periodicity. This can be explained by the organism’s ability to

a. colonize the upper respiratory tract prior to infection.

b. travel and hide in the reticuloendothelial system.

c. cause infection as the vaccine wanes in adults.

d. change its surface antigens.

18. A 10-year-old male gave mouth-to-mouth resuscitation to his pet guinea pig, which proceeded to bite him on the lip. The guinea pig did not survive. Two days after the guinea pig’s funeral, the boy became ill with fever, chills, joint pain, and a rash. What organism should the physician suspect based on the patient’s history?

a. Brucella spp.

b. Francisella tularensis

c. Streptobacillus moniliformis

d. Eikenella corrodens

19. You and your best friend get into a fist fight. Your knuckles are torn and bleeding afterwards. What organism are you likely to isolate if your wounds become infected?

a. Kingella kingae

b. Eikenella corrdens

c. Aggregatibacter aphrophilus

d. Cardiobacterium hominis

20. Epiglottitis, a severe life-threatening infection occurring in non-vaccinated infants and children, is most commonly caused by

a. a pleomorphic gram-negative coccobacillus that is ALA positive and horse blood agar positive.

b. a gram-negative coccobacillus that is identified by direct fluorescent antibody and slide agglutination tests.

c. a gram-negative coccobacillus that is best identified by a rise in antibody titer in serum samples drawn two weeks apart.

d. a pleomorphic gram-negative coccobacillus that requires X and V factors and is horse blood agar negative.

21. An organism isolated from the swab of purulent eye drainage shows no fluorescence on the ALA test. The horse blood agar displays no hemolysis. This organism should be reported as

a. Haemophilus influenzae.

b. H. aegyptius.

c. H. influenzae or H. aegyptius, biochemically similar.

d. H. parainfluenzae.

22. Because of the nature of the profession, a veterinarian is at increased risk of acquiring

1. Brucella spp.

2. Aggregatibacter actinomycetemcomitans

3. Francisella tularensis

4. Streptobacillus moniliformis

5. Eikenella corrodens

a. 1, 2, 4, and 5

b. 1, 3, and 4

c. 2, 3, and

d. 3 and 4

Investigation of Possible Bioterrorism-Related Activity


Patient History:

A 38-year-old woman who resided in the Northeast was admitted to the hospital with fever, myalgia, and weakness, which progressed over 3 days to respiratory failure requiring mechanical ventilation. On day 22, after 3 weeks of intensive care, the patient was still febrile. Cultures of blood were negative.

Hospital personnel interviewed family members who reported no history of traditional risk factors for fever of unknown origin (e.g., relevant food, infected animal contact, or travel history). On day 24, the patient's family reported to hospital personnel that the patient's illness might have been caused by exposure to laboratory flasks and cultures kept in her apartment by her boyfriend. He was described as a foreign national studying biology, but recently he had returned to his country of citizenship. On day 25, the patient's family brought laboratory flasks, Petri dishes, and culture media to the hospital from the patient's apartment. Several contained an unidentified clear liquid. The patient’s unresponsiveness and the acknowledged potential for some bacterial species to be used as bioterrorist agents raised concerns among the infection control staff that this case might be associated with a bioterrorist event or unintentional exposure to contaminated materials in the patient's home. The hospital contacted local law enforcement, the Department of Public Health, and the Federal Bureau of Investigation about the unusual circumstances surrounding the case.

On day 30, under the authority of state communicable disease statutes and in cooperation with the local police department, fire department, and hazardous materials unit, NHDHHS personnel entered the patient's apartment to assess any possibility of an ongoing public health hazard. Remaining flasks were removed and cultured. After 48 hours, growth of a translucent, pinpoint, and smooth colony appeared on blood agar and chocolate agar.

Gram stain of the colonies revealed faintly staining Gram-negative rods that were catalase positive, oxidase positive, and rapidly urea positive. On day 33, the patient began to get better after extensive antibiotic therapy.

Early detection is essential to ensure a prompt response to a biological terrorist event. Local public health authorities must rely on clinicians to recognize and report suspicious or unusual presentations of disease. However, correlating suspicious cases originating from diverse locations or discerning an increase in common presentations above the normal baseline is difficult. As in this case, public health practitioners coordinating disease surveillance may be able to receive reports of rare diseases and to determine whether they are occurring at a higher than normal rate in a large surveillance area.

The CDC, in collaboration with local, state, and territorial health departments, is enhancing existing disease surveillance systems for specific diseases that are normally rare in the United States but thought to have a high potential for public health impact if used as biological terrorism agents. This is being accomplished by improving training of clinical, laboratory, and public health personnel in recognizing suspicious disease presentations and by expanding of existing, disease-specific surveillance infrastructure. In addition, surveillance is being improved for disease presentations, such as acute respiratory distress, hemorrhagic, or meningeal symptoms normally caused by common infectious agents, but that could indicate an increase in illnesses caused by a biological agent used in terrorism. Surveillance mechanisms to rapidly assess changes in rates of disease include monitoring of calls to local emergency medical systems, regularly reviewing emergency department discharge diagnoses, and linking infection control practitioner networks.

Assignment:

For this case study, write a 1-page report that describes the possible agent of bioterrorism along with pathogenesis, treatment, and prevention. Include a brief discussion of sentinel labs and their role in recognizing potential episodes of bioterrorism.

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