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What is MicroStrep used for
- Strep pneumo
- and other species - look at the Procedures
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How do you setup MicroStep?
- Put swab on colonies
- Put in Microscan Inoculation Saline - make sure the turbidity is between 0.8-1.2
- 100 microliters in MicroStrep
- Incubate for 20-24 hours
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Coag Neg Staph
- Beta Lactamase - NEG
- Usually won't run on the Instrument and have to do manual
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Describe how Proteus can look on plates
- Swarming on Chocolate and BAP
- Can overpower the CNA plate and grow although it is Gram Negative
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Describe E. coli on plates (especially MAC)
- Can smell like vinegar
- LF or NLF
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What specimens/bacterias require contact precautions?
- MRSA
- VRE
- CDT
- Kleb pneumo (ESBLs - Extended Spectrum Beta-Lactamse, more resistant)
- MDRO (like Actinobacter)
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Is Pseudomonas Oxidase NEG or POS?
Oxidase POS
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What does Klebsiella look like on a MAC plate?
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What antibiotic can differentiate MRSA?
- Oxicillian - RESISTANT
- 18-20 mm zone is required for sensitivity
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What does Staph look like on a plate?
- White colonies
- S. aureus - massive beta hemolysis
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What does Strep look like on a plate
Very small, translucent colonies
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What does Enterococcus look like on a plate
- Alpha hemolytic
- Small translucent colonies
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What is used to ID Candida albicans?
- Germ tube (2-4 hour incubation time)
- (Male Serum in with the species in question)
- Positive will show a stem off of the bud
- POS - Candida albicans
- NEG - Setup Rapid Yeast Panel
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What fungus does Firelands report?
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What is used to see the spores of fungus?
- Tape prep
- Lactophenol blue
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What is the #1 cause of UTIs?
E. coli
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If a colony is waxy on a Choc plate, colony moves like a hockey puck when pushed, and the specimen is a sputum, What is the most likely species?
- Moraxella Catarella
- (used to be known as Branhamella)
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If a colony is sticky on a Chocolate and the species is from a sputum, what is the most likey species?
Neisseria
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Is Neisseria Oxidase NEG or POS?
Oxidase POS
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Describe Group B Beta Strep's hemolysis?
- The colony usually needs to be moved to see the beta hemolysis
- Colony tends to be more translucent
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Describe Strep pneumo on a plate
- Alpha hemolysis
- Can have a doughnut look to the colony
- Can be mucoid because of the capsule
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Describe the D-Test
- Klindamycin and Erythromycin discs are used
- Need to be 12 mm apart
- Used to eval MRSA sensitivity on Klindamycin when the instrument doesn't show sensitivity
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How do you eval the D-Test
- D zone POS - do not use Clindamycin
- D zone NEG - use the Clindamycin
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What zone needs to be clear for the P disc and what does it ID?
- 14 mm clear zone
- Strep pneumo
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How do you ID Strep pneumo?
- P disc (Optochin)
- Oxicillin disc - if POS then the doctors can use this drug
- If NEG, setup Microstrep
- Do NOT setup Oxicillin if Blood or CSF - automatically setup Microstrep
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Instead of Coagulase, what is used to ID Staph aureus?
Sureview
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What resembles Staph in Urines while looking at plates and what test result do they share?
- Corynebacterium (GPB)
- Catalase POS
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Is Serratia Oxidase Positive or Negative?
Oxidase NEG
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Why is the ONPG test used?
To test for delayed lactose fermenters
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Where is Providencia found and is it pathogenic or normal flora?
Pathogenic in normal urine
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What does Providencia look like on a plate and is it Oxidase Positive or Negative?
- Colony morphology
- Oxidase NEG
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What do you do if you are trying to prove if you have a true anaerobe?
Aerotolerance test
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Describe the Aerotolerance test
- Used to prove if you have a true anaerobe
- Sub colonies to a CDC and BAP
- CDC goes in the anaerobe bag, while the BAP goes in the aerobic CO2 incubator
- If there is growth on both plates - NEG for anaerobes
- If there is growth on just the CDC plate - POS for anaerobes
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What is the hemolysis of Group A Strep?
Beta hemolytic
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Is Morganella Oxidase Positive or Negative and is it a lactose fermenter?
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If you have a Ruptured Appendix, what bacteria would you expect?
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If you suspect Gardnerella vaginalis, what plate would you see it on and what test would you do to confirm?
- Mostly on Chocolate and CNA (doesn't grow as good on BAP - usually)
- Very small, translucent colonies (sometimes has a white center)
- Sub to Starch and V agar to confirm (it would grow on both)
- Starch - expect blue color
- V agar - expect hemolysis
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What is the normal pathogenic bacteria expected in Genital Cultures?
- Neisseria gonorrhea
- Gardnerella vaginalis
- Staph aureus
- Haemophilus
- Yeast
- GNBs
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What do you sub to for enhanced growth of bacteria in stools?
After 6-8 hours sub the GN Broth to HE to enhance growth of Salmonella and Shigella
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What is the distinctive gram stain of Campylobacter?
Seagull wings
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What are the pathogenic bacteria in the throat?
- Strep pneumo (doughnut/coin colony morphology)
- Strep A
- Yeast
- Haemophilus
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What 4 things do you look for to ID Neisseria gonorrhea?
- Growth on GC plate
- Oxidase POS
- GNDC gram stain
- ID on HNID panel
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For Strep B cultures, if there is not growth of Strep B on the CNA plate, what do you do automatically?
Sub the LIM broth to BAP
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What coded comment is added to Blood Cultures (drawn within the same 24 hrs) if the colonies look like the same species?
BC24
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