non fermenting GN

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gen characteristics of nonfermenters

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1

gen characteristics of nonfermenters

  • saccharolytic or asaccharolytic

  • long thin GN rod or ccb

  • mostly ox pos

  • TSI is K/K

  • moist environments (soil, water, plants, decaying vegetation)

  • prefer aerobic environment

  • resistant to multiple classes of antibiotics

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2

what infections are these bacteria typically isolated in?

septicemia, meningitis, osteomyelitis, wound infections

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3

pseudomonas spp

  • ubiquitous; some ppl’s skin normal flora

  • pools, hot tubs, catheters, humidifiers in hospitals

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4

clinical infections - p. aeruginosa

  • leading cause of nosocomial RTIs

  • wound infections/burn pts

  • pulm infections (CF)

  • nosocomial UTIs, bacteremia

  • endocarditis

  • eye infections

  • ear infections (swimmer’s ear)

  • skin infections (hot tub folliculitis)

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5

p. aeruginosa virulence factors

  • endotoxins, motility, pili, capsule, phospholipases

  • exotoxins: protease, hemolysin, lecithinase, elastase, DNase

  • exotoxin A blocks protein synthesis

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6

p. aeruginosa morphology

  • GNR

  • spreading colonies (mucoid in CF pts), beta hemolytic

  • metallic sheen on BAP, NLF on MAC

  • blue green pigment produced

  • grape like/tortilla chip odor

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7

cetrimide agar

  • nutritive

  • 0.1% cetrimide

  • cetyl trimethyl ammonium bromide: inhibits bacteria other than p. aeruginosa

  • enhances production of fluorescent pigments

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8

p. aeruginosa biochemicals

  • ox pos, cat pos

  • nitrate pos

  • oxidizes carbs

  • ADH pos

  • citrate pos

  • growth 42C (differs from other in fluoro group)

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9

p. aeruginosa AST

  • kanamycin R, carbenicillin S

  • opposite for fluorescens/putida

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10

CLSI p. aeruginosa

  • presumptive: ox pos, indole neg

  • additional: fruity odor of grapes

  • notes: strong beta hemolysis

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11

p. fluorescens and putida

  • other fluoros

  • make pyoverdin (not pyocyanin)

  • no growth at 42C

  • neg nitrate

  • low virulence

  • infections: UTIs, post op abscesses, empyema, septic arthritis, wound infections

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12

p. stutzeri

  • rare isolate/pathogen

  • dry, wrinkled, tough, adherent, yellow/brown with age

    • confused with b. pseudomallei

  • BICH:

    • nitrate pos, ox pos

    • neg ADH, gelatinase

    • produce acid from glucose not lactose

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13

acinetobacter spp

  • second most common isolate of these organisms

  • normal flora in 25% adults

  • hospitals (vents, humidifiers, catheters)

  • UTI, pneumonia, endocarditis, septicemia, meningitis, wounds, eye infections

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14

acinetobacter morphology appearance

  • GN ccb: large diplococci similar to neisseria, moraxella

    • difficult to decolorize

  • varies on BAP: gray to white, yellow to tan, beta/gamma hemolytic

  • NLF but can appear pink on MAC from oxidation of lactose with aging (not as pink as true LF)

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15

acinetobacter biochemicals

  • strict aerobes

  • ox neg, cat pos

  • non motile

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16

a. baumanii

  • saccharolytic

  • resistant to a lot of antibiotics

  • CRAB: carbapenemase resistant a. baumanii (isolate pt)

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17

a. lwoffi

  • asaccharolytic

  • less virulent, more often contaminant or colonizer

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18

stenotrophomonas maltophila

  • third most common isolate of these organisms

  • water, sewage, plant materials, hospital environment

  • pneumonia, endocarditis (surgery/IV drug users), bacteremia, wound infections

  • resistant to multiple antimicrobials (S to SXT)

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19

s. maltophilia morphology

  • slight odor of ammonia

  • pale yellow on BAP (sometimes green with aging)

  • NLF on MAC

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20

s. maltophilia biochemicals

  • ox neg, cat pos

  • motile

  • pos DNase, esculin, LDC, gelatin, ONPG

  • strong oxidizer of maltose

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21

b. cepacia

  • nosocomial pathogen: hospital environment (fluids, anesthetics, nebulizers, detergents, disinfectants)

  • pneumonia in CF pts

  • endocarditis, UTIs, osteomyelitis, dermatitis, wound infections

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22

b. cepacia morphology

  • opaque, glistening

  • NLF on MAC: may appear pink from strong lactose oxidation after aging

  • earthy odor

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23

OFPBL agar

  • ox-ferm, polymixin B, bactracin, lactose

  • bromthymol blue

  • b. cepacia looks yellow from acidic end products (lactose metabolism)

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24

BC agar

  • CV, bile salts, ticarcillin, polymixin B, pyruvate

  • phenol red

  • b. cepacia looks pink/red from alkaline end products (pyruvate metabolism)

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25

b. cepacia biochemicals

  • slow ox pos

  • motile

  • LDC pos

  • ODC neg

  • oxidizes glu, mal, lac, mannitol

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26

b. mallei

  • glanders: disease in horses, transmitted via contact with infected animals (zoonotic)

    • severe suppurative or acute pulm infections

    • 1 case of human disease (lab accident)

  • potential bioterrorism agent

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27

b. mallei biochemicals

  • V MAC, slow grower on BAP, non pigmented

  • non motile

  • slow oxidizer (not xylose/sucrose)

  • ADH pos

  • nitrate pos

  • ox V

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28

b. pseudomallei

  • SE asia, north aus, mexico

  • melioidosis: aggressive pulm disease with septicemia, pneumonia; latent infections can relapse

  • ingestion, inhalation, inoculation

  • tier 1 select agent, agent of bioterrorism

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29

b. pseudomallei morphology

wrinkled colonies (differentiate from p. stutzeri)

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30

b. pseudomallei biochemicals

  • putrid (later earthy odor)

  • motile

  • nitrate, gelatinase, ADH pos

  • 42C growth

  • oxidizes carbs

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31

where is moraxella found?

  • normal flora of mucous membranes

  • isolated from resp tract, urinary tract, eye but rarely cause disease

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32

moraxella ID

  • ox pos

  • asaccharolytic

  • strict aerobes, slow growers

  • non motile GN ccb (only catarrhalis is cc)

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33

m. nonliquefaciens

  • neg gelatin, urease, PAD, no MAC growth

  • bacteremia, keratitis, endophthalmitis

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34

m. osloensis

like nonliquefaciens but can acidify etoh and produce alk rxn in acetate medium

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35

m. atlantae

  • MAC growth, will pit any agar

  • neg gelatin, PAD, nitrate

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36

m. lacunata

  • unable to grow on MAC

  • gelatin pos

  • urease neg

  • PAD V

  • conjunctivitis

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37

alcaligenes and achromobacter

  • divided into asaccharolytic and saccharolytic

  • found in water (pools, tap)

  • hospital pts (urine, stool, sputum, wound, blood)

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38

alcaligenes and achromobacter ID

  • ox pos

  • OF media: no oxidation with blue at top

  • motile

  • nitrate pos

  • neg indole, esculin, gelatin

  • some a. faecalis have fruity green apple odor

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39

flavobacteriaceae

  • ubiquitous (soil/water)

  • contams of hospital equipment = nosocomial

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40

flavobacteriaceae ID

  • nonmotile

  • yellow pigment, can turn BAP lav/green color

  • fruity odor (juicy fruit)

  • no/poor growth on MAC

  • pos: ox, DNase, gelatin, indole (w)

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41

chryseobacterium indologenes

  • most frequently isolated species

  • nosocomial: bacteremia, ocular infections

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42

elizabethkingia meningosepticum

  • cause of most flavo-related diseases

  • NB meningitis, septicemia (preemies)

  • pneumonia, endocarditis, bacteremia, meningitis

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43

chromobacterium violaceum

  • violet colored pigment (violacein)

  • opportunistic; tropical and subtropical climates in soil, water

  • skin lesion is portal of entry

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44

methylobacterium

  • bacteremia, perionitis, synovitis, skin ulcers

  • slow grower 4-5days; grow on fungal media, no MAC growth, prefer 25-35C

  • large vacuolated pleomorphic rods

  • use methanol as sole source of carbon/energy

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45

roseomonas

  • pink pigment

  • mucoid

  • catheter related blood infections

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