Bacteriology

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Bacteriology
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2014-11-11 16:23:17
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  1. Staphylococci epidermis
    • Gram positive
    • cocci
    • facultative anaerobe
    • grape-like clusters
    • normal flora of skin, nose, mouth
    • less virulent than staphylococci aureus
    • biofilms on prosthetic devices
    • coagulase negative
  2. Staphylococci saprophycticus
    • Gram positive
    • cocci
    • facultative anaerobe
    • grape-like clusters
    • coagulase negative
    • urinary tract infection in young women
  3. Staphylococcus aureus
    • Gram positive
    • cocci
    • often gold colonies
    • coagulase positive
    • facultative anaerobe (catalase positive)
    • grape-like clusters
    • toxic shock syndrome toxin 1 leading to toxic shock syndrome
    • enterotoxins A-E, G-I leading to food poisoning
    • exfoliatin/exofliative toxin leading to scalded skin syndrome
    • alpha-toxin/alpha hemolysin
    • panton valentine leukocidin (PVL)
    • protein A
    • septic arthritis and osteomyelitis
    • carbuncle/furuncle
    • endocarditis
    • cellulitis
    • hospital acquired pneumonia
    • treatment with pus drainage, antibiotics
    • MRSA and MRSE are harder
    • prevention with hand-washing and glove-wearing
  4. Streptococcus pneumoniae
    • Gram-positive cocci
    • catalase negative
    • alpha hemolysis (partial clearing-green)
    • community acquired pneumonia
  5. Viridans streptococci spp.
    • Gram-positive cocci
    • catalase negative
    • alpha hemolysis
    • loosely defined group of many species
    • streptococcus mutans and streptococcus sanguis are normal mouth flora
    • streptococcus intermedius and streptococcus anginosus are involved in abscess formation
    • involved in bacterial endocarditis
  6. beta-Hemolytic streptococci spp.
    • Gram-positive cocci
    • catalase negative
    • broken down into groups A B D based on surface carbohydrates (Lancefield grouping)
    • group A is streptococci pyogenes
    • group B is streptococci agalactiae
    • group D streptococci bovis and enterococci spp., which are not actually streptococci (group D often cannot actually do beta hemolysis but we still traditionally group them)
  7. Streptococcus pyogenes
    • Gram-positive cocci
    • catalase negative
    • beta hemolysis by streptolysin O or streptolysin S
    • group A
    • long chains
    • M-proteins
    • streptococcal pyrogenic exotoxins (SPEs) leading to streptococcal toxic shock syndrome or necrotizing fascitis
    • streptokinase lyses fibrin clots via plasminogen to plasmin
    • C5a peptidase prevents phagocyte recruitment via C5a cleavage
    • streptococcal pharyngitis
    • erysipelas
    • Poststreptococcal glomerulonephritis
    • treat with antibodies and surgery if necrotizing fasciitis
    • some physicians do intravenous immunoglobin for streptococcal toxic shock syndrome
    • no vaccines
  8. Streptococcus agalactiae
    • Gram-positive cocci
    • catalase negative
    • beta hemolysis
    • group B
    • neonatal sepsis
    • neonatal meningitis
    • colonize the vagina normally
  9. Streptococcus bovis
    • Gram-positive cocci
    • catalase negative
    • beta hemolysis classically but really gamma hemolysis
    • group D
    • rare infections
    • blood infections associated with gastrointestinal cancer
  10. Enterococci spp.
    • Gram-positive cocci
    • catalase negative
    • beta hemolysis classically but really gamma hemolysis
    • group B
    • “group D streptococci”
    • normal flora of gastrointestinal tract
    • low intrinsic virulence
    • vancomycin resistant enterococci via Van A operon
    • common hospital acquired infection
    • urinary tract, wounds, biliary tract, intra abdominal infections
    • bacteremia from intravascular catheters causing endocarditis
    • easily grown on blood agar
    • can grow in high presence of bile salts and sodium chloride (like GI tract)
    • treat with antibiotics
    • prevention with handwashing, contact precautions
    • should use vancomycin judiciuosly
  11. Bacillus cereus
    • Gram-positive
    • bacilli
    • aerobic
    • causing food poisoning
  12. Bacillus anthracis
    • Gram-positive
    • bacilli
    • aerobic
    • grow in chains described as bamboo rods
    • spore forming (cattle die spore stays)
    • capsule composed of D glutamic acid for antiphagocyticity
    • anthrax toxin
    • cutaneous anthrax
    • inhalation anthrax
    • gastrointestinal anthrax
    • gram-stain cutaneous lesions where you can see 10^7 bacteria per mL
    • grows from sputum streaked and there are serological
    • treat with antibiotics
    • vaccine exists that uses PA for at risk individuals (vets, ag workers, etc)
    • bio warfare
  13. Listeria monocytogenes
    • Gram-positive
    • bacilli
    • beta hemolysis
    • aerobic
    • does not mind refrigeration temperatures
    • unpasteruized milk, cheese, coleslaw and red meat
    • can infect many animals
    • facultative intracellular like salmonella, shigalla, legionella, myobacteria
    • internalin to get in cell
    • listeriolysin O to get out of vesicle
    • ActA comet tail
    • cell to cell without exposure to extracellular environment
    • meningitis in old, young, immunocomprimised
    • fetal infections like premature labor and intrauterine fetal demise
    • neonatal infections can be sepsis, respiratory disease and disseminated absess
    • grow from CSF, blood, or amniotic fluid
    • treat with antibiotcs
    • prevention through cleaning food before you eat
  14. Corynebacteria spp
    • Gram-positive
    • aerobic
    • bacilli with club shape swelling
    • normal inhabitants of the skin
    • also Corynebacteria diptheriae
  15. Corynebacteria diptheriae
    • Gram-positive
    • aerobic
    • bacilli with club shape swelling
    • chinese letter appearance
    • nonspore-forming
    • infects only humans
    • diptheria toxin (DT) leading to psuedomembrane
    • person to person by direct contact or droplets
    • sore throat, horseness, difficulty swallowing, cough, rhinorrhea
    • black colony with gray brown halo on tellurite selective medium
    • check for DT with PCR, antisera reactivity, bio activity in tissue culture/guinea pigs
    • treat with horse antisera, antibiotics to stop spread, boosters for family
    • prevention with toxoid vaccine
  16. Clostridium spp.
    • Gram-positive
    • anaerobic rods
    • spore forming
    • various species with very different presentations
    • clostridium tetani, clostridium botulinum, clostridium perfingens, and clostridium difficile
  17. Clostridium tetani
    • Gram-positive
    • anaerobic rods
    • spore forming
    • terminal spores (tennis racket)
    • tetanus, found in soil and animal feces (spores)
    • tetanus toxin causing lockjaw then neck, shoulder, back
    • eventually abdominal and leg
    • spasms with minor stimuli can compromise respiration
    • hypertension, tachycardia, arrhythmia, sweating, vasoconstriction
    • neonatal tetanus infection of umbilical stump causing spasms and rigidity
    • clinical findings are consistent enough that isolation is not helpful
    • tetanus toxin production for definitive ID
    • treat with human tetanus immunoglobulin (antibiotics used but of unproven value) and breathing assistance if needed
    • prevention with tetanus toxoid
  18. Clostridium botulinum
    • Gram-positive
    • anaerobic rods
    • spore forming
    • subterminal spores
    • found in soil, ponds, lakes, plants, pollen (honey!)
    • weaponized can be absorbed through skin
    • botulinum toxin leading to decreased motor neuron activity
    • associated with canning
    • 3 types
    • foodborne with symmetric descending paralysis, vomiting, abdominal pain, rarely fever
    • wound botulism same as foodborne minus GI findings (even ptosis)
    • infant botulism with paralysis, often from honey
    • diagnose through history and symptoms
    • isolation of toxin (occasionally from blood) or organism
    • treat with respiratory support, trivalent equine antitoxin and antibiotics (unproven efficacy) to eliminate residual bacteria from bowel
    • no vaccine but be careful with canning technique
  19. Clostridium perfingens
    • Gram-positive
    • anaerobic rods
    • spore forming
    • contaminated food
    • food poisoning
    • gangrene
  20. Clostridium difficile
    • Gram-positive
    • anaerobic rods
    • spore forming
    • diarrhea with antibiotic use
  21. Actinomycetes
    • family of bacteria that resemble fungi
    • related to mycobacteria
    • Nocardia spp.
    • Actinomyces spp.
    • some are very acid-fast
  22. Nocardia spp.
    • Gram-positive
    • aerobic
    • bacilli
    • chains or branched fillaments with irregular gram staining causing a beaded appearance
    • found in soil
    • neutralize oxidants, prevent phagosome lysosome fusion
    • many neutrophils found in lesions but do not kill
    • infects those immunodeficient
    • pulmonary nocardiosis
    • transcutaneous inoculation aka actinomycetoma
    • partial stain with acid-fast
    • treat with drainage and debridement and sulfa drugs
    • no vaccine
  23. Actinomyces israelii
    • Gram-positive
    • anaerobic
    • non-spore forming
    • flora of mouth, GI, female genital tract
    • indolent (pain free) suppurative (pus forming) with fistulas and sulfur granules
    • infected foci spread contiguously (ignore tissue planes)
    • poor dentition leads to oral-cervicofacial disease
    • aspiration leads to pulmonary parenchyma and pleural infection
    • intestinal rupture or IUD can cause abdominal or pelvic disease
    • gram stain the sulfur granules and culture
    • not very acid fast
    • treat with long term antibiotic
    • no vaccine
  24. Other Gram-positive Anaerobes
    • flora of GI, respiratory, female genital tract
    • opportunistic
    • cause polymicrobial abscesses involving other facultative anaerobes
    • Peptostreptococcus spp. are common anaerobic
  25. Enterobacteriaceae
    • Large family of bacteria
    • gram-negative facultative anaerobic
    • many are flora of human colon but some are pathogens
    • thus many are opportunisitic
    • Escherichia coli
    • Shigella spp.
    • Salmonella enterica
    • Yersinia spp.
  26. Escherichia coli
    • gram-negative
    • bacilli
    • facultative anaerobic
    • lactose fermentor
    • colon flora
    • uropathogenic E. coli does urinary tract infections
    • 5 types of diarrhea
    • enterotoxigenic E. coli ETEC usually does traveler’s diarrhea with 1-3 day latency via heat labil toxin (LT) and heat stable toxin (ST)
    • enterohemorrhagic E. coli EHEC type III secretion system with shiga-like toxin causing hemolytic uremic syndrome (HUS) in 10%, no/low fever, cattle resevoir, undercooked meat/unpasteurized milk and juices. O157:H7 most common serotype
    • enteropathogenic E. coli EPEC bundle forming pili attach to intestinal epithelium, intimin (bacetial surface protein) is adhesin, and a type III secretion system (attaching kills microvilli, forms pedestals) many proteins injected including Tir (intimin receptor)
    • enteroinvasive E. coli EIEC
    • enteroaggregative E. coli EAEC
    • alpha hemolysin
    • aerobactin (an iron siderophore)
    • polysaccharide capsule reducing phagocytosis
    • type 1 pili bind bladder
    • P pili bind upper urinary tract causing pyelonephritis
    • meningitis in neonates
    • nosocomial infections (hospital acquired) pneumonia, urinary tract infection, bacteremia, intra abdominal infections
    • routinely grown on media with biochemical tests to differentiate from other enterobacteriaceae
    • treat with hydration antibioitcs unless EHEC
    • avoid raw veggies and fruits, unpasteurized dairy products, undercooked food, tap water for ETEC
    • EHEC avoid undercooked meat/unpasteurized milk and juices for EHEC
  27. Shigella spp
    • Gram-negative
    • facultative anaerobic
    • bacilli
    • colon flora
    • shigella flexneri, shigella boydii, shigella sonnei
    • shigella dysenteriae causes dysentery
  28. Salmonela enterica
    • Gram-negative
    • facultative anaerobic
    • bacilli
    • more common in developed countries
    • chicken and reptile reservoirs
    • foodborne illness
    • SPI-1 type III secretion system causes inflammatory response and diarrhea
    • SPI-2 type III secretion system causes bacteremia in 8%
    • most killed by stomach acid
    • diarrhea, nausea vomiting 1-2 days after ingestion
    • fever in 50%
    • typhoid fever
    • grow on agar from stool or blood for typhoid fever
    • treat only immunocompromised or sever infections with antibiotics because treatment might lead to carrier state
  29. Yersinia spp.
    • Yersinia enterocolitica and Yersinia pseudotuberculosis can cause infectious diarrhea
    • Yersinia pestis causes the black plague
  30. Yersinia pestis
    • Gram-negative
    • bacilli
    • bubonic plague by rats/fleas
    • pneumonic plague by human to human aerosols
    • primary septicemic plague by contact with infected animal tissues
    • SW US wild animals like rabbits and squirrels
    • lysis releases LPS causing septic shock and disseminated intravascular
    • bacteria go to macrophages of lungs causing pneumonia and aerosol
    • Ail adhesin to stick to cells
    • Type III secretion system secretes Yersinia outer proteins (Yops) infecting phagocytes
    • Fra1 forms part of antiphagocytotic capsule
    • plasminogen activator, Pla, cleaves fibrin to prevent walling off in an abscess
    • Grow from blood, bubo aspirate (bubonic), sputum sample (pneumonic) on sheep blood agar cultures looking for closed safety pin with giemsa stain
    • treat with antibiotics
    • also antibiotic prophylaxis and avoiding sick/dead animals in SW US
    • whole cell vaccine is of unclear efficacy
    • bio warfare
  31. Other medically important enterobacteriaceae
    • Klebsiella pneumoniae
    • Klebsiella oxytoca
    • Proteus mirabilis
    • Proteus vulgaris
    • Enterobacter spp.
    • Citrobacter spp.
    • Serratia marcescens
    • You can get these from hospitals and they have become resistant to all antibiotics
  32. Psuedomonas aeruginosa
    • Gram-negative
    • bacilli
    • aerobic
    • oxidase positive
    • inhabits soil, water, hospitals, moist environments including disinfectant, any organic compound
    • pili help adhere
    • exotoxin A causes ADP-ribosylation of EF-2
    • alginate causes mucoidy antiphagocytic in cystic fibrosis patients
    • Las A and LasB act together to degrade elastin
    • type III secretion kills cells and disrupts actin
    • quorum sensing
    • sometimes opportunistic especiallly with CF, who can’t erradicate
    • nosocomial pneumonia (hospital acquired), necrotizing, especially with ventilators
    • urinary tract infection with catheters
    • bacteremia and sepsis in cancer patients (decreased neutrophils)
    • ecthyma gangrenosum (skin lesions)
    • hot tub folliculitis (self limited)
    • grows on various media, smelling like grapes sometimes fluorescing pyocyanin or pyoverdin
    • good at acquiring resistance, treat with 2 drugs initially
  33. Legionella pneumophila
    • Gram-negative (does not stain)
    • thin bacilli
    • aerobic
    • facultative intracellular
    • legionairre’s disease
    • water and cooling towers where they parasitize amoebae
    • aspiration of water or inhalation of aerosol, veggie misters (no human to human)
    • can be nosocomial and immunocompromised are at higher risk (smokers, alcoholics, elderly, COPD)
    • coiling phagocytosis into macrophage (thinking it’s an amoeba)
    • prevents lysosome fusion, recruiting ER to phagosome via defect in organelle trafficking (dot locus) type IV secretion system also encoded at dot locus
    • multiplies and lyses host cell via phospholipase C
    • pneumonia, fever
    • headache, nausea, vomiting, diarrhea, mental status changes, hyponatremia
    • hard to grow, only on buffered charcoal yeast extract agar (BCYE) which contains L cysteine, visualized by Dieterle silver, but we normally don’t do this
    • direct fluorescent antibody test (DFA) is not very sensitive
    • urinary antigen test is sensitive and specific to legionella pneumophila serogroup 1
    • treat with antibioitics
    • disinfect water systems in hospitals
  34. Vibrio spp.
    • Gram-negative
    • comma shaped bacilli
    • foundin salt and fresh water
    • Vibrio cholerae causes diarrhea
    • Vibrio vulnificus causes wound infections and fatal bacteremia if you have liver disease or iron overload
  35. Helicobacter pylori
    • Gram-negative
    • spiral shaped bacilli
    • microaerophilic (likes a little bit of oxygen)
    • peptic ulcer disease
    • grows in the mucus with flagella and curved shape
    • urease (splits to ammonia) to alkaline it
    • type IV secretion
    • VacA (cytotoxin) causes vacuolation of epithelial cells
    • usually asymptomatic (30% have it)
    • risk for adenocarcinoma, non-hodgkin’s lymphoma, and low-grade B cell mucosa-associated lymphoid tissue lymphoma of the stomach, which regresses with antibiotics
    • difficult to culture (giemsa/silver stain)
    • endoscopy with tissue biopsy and urease test
    • urea breath test with radio labeled urea drink
    • serological IgG test (IgG stays high 6 months post clearance)
    • antibody stool test
    • proton pump inhibitor plus antibiotics
    • no vaccine
  36. Campylobacter spp.
    • Gram-negative
    • spiral shaped bacilli
    • gastroenteritis leading to diarrhea
    • originally what they mistook helicobacter to be
  37. Haemophilus spp.
    • Gram-negative
    • small coccobacilli
    • facultative anaerobe
    • Haemophilus influenzae is respiratory
    • Haemophilus ducreyi is sexually transmitted, similar to syphilis
  38. Bordetella pertussis
    • Gram-negative
    • tiny coccobacilli
    • strict aerobe
    • whooping cough
    • pili, filamentous hemagglutinin (FHA) bind to ciliated cells via galactose residues and polymorphic neutrophils via CR3
    • pertussis toxin increasing cAMP and inhibiting luekocyte function
    • capsulated
    • >90% of nonimmune household contract it
    • transmission by droplets
    • 2 week incubation stage, catarrhal stage of very infectious with mild coughing and sneezing, paroxysmal stage with whooping cough can lead to hemorrhage in eye, cyanosis, exhaustion, vomiting, convulsions
    • slow resolution
    • recently adults contract because of waning vaccine effect
    • hard to grow sample collected from nasopharynx with Bordet-Gengou or charcoal-containing medium
    • PCR is best
    • treat with antibiotic although ineffective, macrolides or TMP/SMX
    • Whole-cell killed vaccine with tetanus and diptheria (no protection after 12 years) CNS side effects that increase with age in old vaccine, newer has less side effects
  39. Brucella spp.
    • Gram-negative
    • small coccobacilli
    • aerobic
    • farm animals
    • contact with mucous membrane, cuts, inhalation, unpasteruized dairy
    • veterinarians and meat inspectors at risk
    • survives inside macrophage
    • Brucella abortus, Brucella melitensis, Brucella suis
    • brucellosis
    • fever, chills, malaise, drenching sweats for weeks/months
    • isolation from blood or biopsy (2-4 weeks to grow)
    • serological tests
    • treat with antibiotics
    • only animal vaccine
  40. Francisella tularensis
    • Gram-negative
    • small coccobacillus
    • metabolically facultative
    • woods animals
    • contact with animal, tiny break in skin
    • exposure of mucous membranes, ingestion, inhalation, tick bite
    • classic example is skinning rabbits
    • bio warfare concern
    • multiplies in macrophages
    • lymphadenopathy
    • ulcerated inoculation site
    • fevers, chills, pneumonia, multiple organ dissemination
    • difficult to grow, requiring special media
    • serological assay is best
    • treat with antibiotics
    • vaccine exists
  41. Pasteurella multocida
    • Gram-negative
    • small coccobacillus
    • cat and dog mouth flora
    • via cat or dog bite
  42. Neisseria spp.
    • Gram-negative
    • diplococci
    • Neisseria meningitis
    • Neisseria gonorrhoeae
    • Moraxella catarrhalis is similar and is respiratory
  43. Other Gram-Negative Anaerobes
    • flora of GI, respiratory and female genital
    • opportunistic
    • common gram negative rods include Bacteroides spp., Prevotella spp., Fusobacterium
  44. Rickettsiaceae family
    • Gram-negative
    • coccobacilli
    • intracellular
    • often insect vector
    • Rickettsie, Coxiella, Ehrlichia, Anaplasma
  45. Ricketsia rickettsi
    • Gram-negative
    • cocobacilli
    • intracellular
    • Rocky Mountian spotted fever
  46. Coxiella burnetii
    • Gram-negative
    • cocobacilli
    • intracellular
    • Q fever
    • fever with pulmonary infiltrates
    • no rash
    • sheep resevoir in placenta, aerosolized at birth or in milk
  47. Ehrlichia chaffeensis
    • Gram-negative
    • cocobacilli
    • intracellular
    • tick transmitted
    • infect monocytes and macrophages
    • ehrlichiosis
  48. Anaplasma phagocytophilum
    • Gram-negative
    • cocobacilli
    • intracellular
    • tick transmitted
    • infects neutrophils
  49. Bartonella spp.
    • once thought to be obligate intracellular?
    • Bartonella henselae and Bartonella quintana
    • cat scratch disease
    • vacillary angiomatosis
  50. Chlamydia spp.
    • intracellular (see below)
    • Chlamydia trachomatis causes STDs
    • Chlamydia pneumoniae and Chlamydia psittaci cause pneumonia
    • elementary body outside of cell (spore like) and reticulate body in cell
  51. Mycoplasma
    • smallest possible free living and self replicating organism
    • common cause of pneumonia
  52. Borrelia spp.
    • spirochetes
    • Borrelia burdgorferia causes lyme disease
    • Borrelia recurrentis causes relapsing fever through ticks and lice
  53. Treponema pallidum
    • spirochete
    • causes syphilis
  54. Leptospira iterrogans
    • aerobic
    • spirochete
    • through drinking, cuts, or contact with conjuctiva to animal urine contaminated water
    • biphasal illness
    • primary phase is fever, chills, headache, muscle pains (blood stream dissemination)
    • symptoms reside after a week as cleared from blood
    • secondary phase in 15% is meningitis
    • use antibiotics
  55. Mycobacterium tuberculosis
    • Gram-positive but doesn’t stain
    • acid fast
    • facultative intracellular
    • strict aerobe
    • mycolic acid 60% cell envelope means hydrophobic
    • exposure is when you are near someone with TB who is coughing
    • infection is when the bacteria are taken up, survive, and multiply in alveolar macrophages
    • prevents phagosome lysosome fusion
    • usually the immune system takes care of it
    • if not the disease “primary TB” occurs 10% (5% in first 2 years post infection “reactivation”)
    • can infect lymph nodes with visible scaring on skin
    • in rare cases “miliary TB” occurs when it disseminates to distant sites
    • primary TB is fever, night sweats, weight loss, upper lobe pulmonary lesions, productive cough with blood tinged sputum
    • miliary TB is spleno/hepatomegaly and lymphadenopathy, snowstorm, AFB and skin PPD often negative, with or without cough
    • granulomas/caseating granulomas
    • pulmonary TB
    • extrapulmonary TB especially common in HIV patients
    • pott’s disease (spinal TB)
    • mycolic acid and lipids
    • 12-24 hour doubling time
    • Native americans and eskimos have heightened risk of mortality
    • Interferon-gamma release assays works well (IGRA)
    • 3-6 week growth (definitive diagnosis) inhibit other bacteria growth (Lowenstein, Jensen media)
    • radio label pamitic acid, check CO2 for growing culture pre colony
    • nucleic acid probe for speciating growing cultures
    • treatment with many antibiotics for a long time
    • multiple drug resistant (MDR TB)
    • extensively drug resistant (XDR TB)
    • require more antibiotics and directly observed therapy
    • prevention with Bacillus Calmett Guerin vaccine (BCG) from M. bovis, not in US
  56. Mycobacterium bovis
    • Gram-positive but doesn’t stain
    • acid fast
    • mycolic acid 60% cell envelope means hydrophobic
    • rare, but through unpasteruized milk
    • causes tuberculosis
  57. Mycobacterium leprae
    • Gram-positive but doesn’t stain
    • acid fast
    • obligate intracellular
    • mycolic acid 60% cell envelope means hydrophobic
    • 11-13 day replication
    • no known toxins but it kills schwann cells
    • tuberculosis leprosy, few bacteria, intense cell-mediated response (Th1)
    • lepromatous leprosy, many bacteria, no immune response (th2)
    • human to human controversy
    • tuberculous leprosy with hypopigmentedn skin lesions raised edges and depressed middle enlarged peripheral nerves
    • lepromatous leprosy mainly lesions on face, wrists, elbows, buttocks, knees
    • boderline leprosy is between tuberculoid and lepromatous
    • infection to hands and feet can cause loss of digits
    • diagnose by biopsy
    • can culture in armadillos or cuter catas?
    • Some needs lot of therapy
    • Bacillus Calmet is somewhat effective
  58. Mycobacterium avium
    • Gram-positive but doesn’t stain
    • acid fast
    • mycolic acid 60% cell envelope means hydrophobic
    • gastrointestinal
  59. Mycobacterium intracellulare
    • Gram-positive but doesn’t stain
    • acid fast
    • mycolic acid 60% cell envelope means hydrophobic
    • gastrointestinal
  60. Mycobacterium Kansasii
    • Gram-positive but doesn’t stain
    • acid fast
    • mycolic acid 60% cell envelope means hydrophobic
    • pulmonary infections
  61. Mycobacterium abscessus
    • Gram-positive but doesn’t stain
    • acid fast
    • mycolic acid 60% cell envelope means hydrophobic
    • rapid grower
    • post operative
  62. Mycobaterium fortuitum
    • Gram-positive but doesn’t stain
    • acid fast
    • mycolic acid 60% cell envelope means hydrophobic
    • rapid grower
    • post operative
  63. Mycobacteria marinum
    • Gram-positive but doesn’t stain
    • acid fast
    • mycolic acid 60% cell envelope means hydrophobic
    • from fresh or saltwater aquariums

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