FastidiousGramNegativeRodsUNMCHome挑剔的革兰阴性杆菌内布拉斯加大学医学中心的家庭_第1页
FastidiousGramNegativeRodsUNMCHome挑剔的革兰阴性杆菌内布拉斯加大学医学中心的家庭_第2页
FastidiousGramNegativeRodsUNMCHome挑剔的革兰阴性杆菌内布拉斯加大学医学中心的家庭_第3页
FastidiousGramNegativeRodsUNMCHome挑剔的革兰阴性杆菌内布拉斯加大学医学中心的家庭_第4页
FastidiousGramNegativeRodsUNMCHome挑剔的革兰阴性杆菌内布拉斯加大学医学中心的家庭_第5页
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FastidiousGramNegativeRodsUNMCHome挑剔的革兰阴性杆菌内布拉斯加大学医学中心的家庭第1页/共21页FastidiousComplex/extensivenutrientrequirementsFaintstainingGramNegativeRodsSafranincounterstainfor>2minutesSubstitutecarbolfuschinforsafraninSerologicaltestingusefulClickiconforaudioGeneralInformation第2页/共21页Brucellaspecies

ClinicalSignificanceCausesBrucellosis/Undulantfever/MaltafeverTransmissionvia:DirectcontactwithinfectedanimalsIngestionofcontaminatedmeatordairyproductsInhalationoftheaerosolizedorganismFacultativeintracellularorganismClickiconforaudio第3页/共21页Blood,bonemarrowortissueRiskoflabacquiredinfectionSpecifyonrequisitionwhensuspectingBrucellaBAP,CHOC,BCYE,BloodCulturebrothClickiconforaudioBrucellaspecies

SpecimenCollection第4页/共21页35C,5-10%CO2for21daysColonymorphologyGrowthat7daysBAP=smooth

glistening,

translucentcolonies

thatbecomebrown

withageClickiconforaudioBrucellaspecies

GrowthCharacteristics第5页/共21页Gramstain:tiny,faintstaining

gramnegativecoccobacilliOxidase+,Catalase+Nitrate+GlucoseoxidizerNonmotileAdditionalteststospeciateClickiconforaudioBrucellaspecies

Identification第6页/共21页TubeagglutinationtestSingletiterof>=1:160FourfoldriseintiterbetweenacuteandconvalescentspecimensDoesnotdetectBrucellacanisClickiconforaudioBrucellaspecies

SerologicalTesting第7页/共21页Doxycyclineandrifampinfor6weeksClickiconforaudioBrucellaspecies

TreatmentandPrevention第8页/共21页HowlongmustculturesbeheldwhenBrucellaissuspected?Cultureplatesandmediamustbeheldforatleast21daysbecauseBrucellaisaslowgrower.第9页/共21页Normalfloraofmouth,respiratory&GItractsOpportunisticpathogenAssociatedwith:Dental/periodontalandhead/neckinfections/abscessesHumanbitewoundsSepticemiafollowingtoothextractionEndocarditisClickiconforaudioEikenellacorrodens

ClinicalSignificance第10页/共21页Eikenellacorrodens

SpecimenCollectionAerobicRequiresheminBAP,CHOCClickiconforaudio第11页/共21页Tinycoloniesat48hrsColonymorphologyBAP“Pits"theagarPaleyellowpigmentGreeningaroundcolonyBleachodorMAC–nogrowthClickiconforaudioEikenellacorrodens

GrowthCharacteristics第12页/共21页Eikenellacorrodens

IdentificationSmall,slenderGramNegativeBacilliOxidase+Catalase–Glucosenon-oxidizer(asaccharolytic)Nitrate+NonmotileClickiconforaudio第13页/共21页SusceptibilitytestingnotroutinelydoneTreatwith:Penicillins3rdgenerationcephalosporinsTetracyclineQuinolonesClickiconforaudioEikenellacorrodens

TreatmentandPrevention第14页/共21页WhatarethekeyidentifyingcharacteristicsforEikenellacorrodens?ItpitstheagarandhasableachsmellonBAPat48hours,itwillnotgrowonMAC,itisoxidasepositive,catalasenegative,glucoseN“F”/N“O”,andnitratepositive.第15页/共21页HaemophilusaphrophilusActinobacillusactinomycetemcomitansCardiobacteriumhominisEikenellacorrodensKingellakingaeClickiconforaudioHACEKGroup

Organisms第16页/共21页SubacutebacterialendocarditisBloodCulturesSubculturetovariousenrichedmediaandholdforextendedtimebeyond1weekBCYEClickiconforaudioHACEKGroup

ClinicalSignificance第17页/共21页WhatorganismsareincludedintheHACEKgroup?HaemophilusaphrophilusActinobacillusactinomycetemcomitansCardiobacteriumhominisEikenellacorrodensKingellakingae第18页/共21页LookedatseveralorganismsClinicalsignificanceSpecimencollection,transport&processingGrowthcharacteristics&identificationSerologicaltestingTreatmentandp

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