BloodBank.MedMic.Haematology

Monday, December 10, 2007

Case 1 Posting 2

Subject: MMIC
Case: Case 1 - Khong Fay Seah
Complaints: Fever, chills, dysuria,
Diagnosis: Urinary Tract Infection

List of OrganismsTests Required to Identify Expected Test Results Treatment
Escherichia Coli
  1. Culture
  2. Gram stain and Microscopy
  3. Biochemical test test – TSI, IMViC (Indole, Methyl red, Voges-Proskauer, citrate), motility
  1. Lactose-fermenting (Yellow colonies in CLED); Flat, grey colonies on BAP
  2. Gram-negative bacilli
  3. Biochemical test
    TSI - Acid slant acid butt with gas but no H2S
    Indole – Positive (Bright red interface)
    Methy red – Positive (Red)
    Voges-Proskauer - Negative
    Citrate – Negative (Remains green)Motility – Motile (Turbidity out of line of inoculation stab)
Trimethoprim-sulfamethoxazole ampicillin
Klebsiella spp.
  1. Culture
  2. Gram stain and Microscopy
  3. Catalase test
  4. Biochemical test – IMViC (Indole, Methyl red, Voges-Proskauer, citrate), motility
  1. Lactose-fermenting (Yellow colonies in CLED); Mucoid, convex, white colonies on BAP
  2. Gram-negative bacilli
  3. Positive catalase test (Effervescence)
  4. 1) Biochemical test
    Indole – Negative (No colour change)
    Methy red – Negative (Yellow)
    Voges-Proskauer – Positive (Colour change)
    Citrate – Positive (Deep blue)Motility – Nonmotile (Growth along stab line)
Cephalosporins Aminoglycosides
Streptococcus spp.
  1. Culture
  2. Gram stain and Microscopy
  3. Catalase test
  1. Lactose-fermenting (Yellow colonies in CLED); Small, white colonies on BAP
  2. Haemolysis:

    • α-haemolytic:
      eg. Streptococcus pneumoniae
    • β-haemolytic:
      Streptococcus group A, B etc
    • Non-haemolytic:
      E.g. Enterococcus spp.(Greyer appearance)
  3. Gram-positive cocci
  4. Negative catalase test
Penicillin Eryhromycin Aminoglycoside
Staphylococcus spp. Eg. S saprophyticus, Staphylococcus aureus
  1. Culture
  2. Gram stain and Microscopy
  3. Catalase test
  1. Lactose-fermenting (Yellow colonies in CLED); Small, white colonies on BAP
    • Can be hemolytic positive or negative
  2. Gram-positive cocci
  3. Positive catalase test (effervescence)
Penicillins /with clavulanic acid
Cephalosporins Vancomycin
Pseudomonas spp.
  1. Culture
  2. Gram stain and Microscopy
  3. Oxidase test
  4. Biochemical test - TSI
  1. Non-lactose-fermenting; Swarms on BAP; Spready colonies on CLED; Pungent smell
  2. Gram-positive bacilli
  3. Positive oxidase test
  4. Biochemical testTSI - Alkaline slant acidic butt
Penicillin Aminoglycoside
Proteus spp.
  1. Culture
  2. Gram stain and Microscopy
  3. Oxidase test
    Biochemical test - TSI, Urease
  1. Non-lactose-fermenting; Swarms on BAP; Glossy colonies; Pungent smell
  2. Gram-negative bacilli
  3. Negative oxidase test
  4. 1) Biochemical test
    TSI - Alkaline slant acidic butt with H2SUrease – Positive (Purple/pink)
Aminoglycosides
Trimethoprim-sulfamethoxazole
Ampicillin Cephalosporins
Candida spp.Eg. Candida albicans
  1. Culture
  2. Gram stain and Microscopy
  1. Non-lactose-fermenting; Small, flat, white colonies on BAP and CLED; Slightly spready, not glossy
  2. Fungus; pseudohyphae
-
Enterococcus faecalis
  1. Culture
  2. Gram stain and Microscopy
  3. Catalase test
  4. Biochemical test – Motility, Indole
  1. Large white colonies; alpha-, beta-, nonhemolytic colonies
  2. Gram-positive cocci
  3. Negative catalase test
  4. Biochemical test Motility – Nonmotile (Growth along stab line)Indole – Negative (No colour change)

Penicillin Vancomycin Gentamicin

Morganella
  1. Culture
  2. Gram stain and Microscopy
  1. Large, gray, moist colonies (beta haemolytic)
  2. Gram-negative bacili
Aminoglycosides Trimethoprim-sulfamethoxazole
Serratia
  1. Culture
  2. Gram stain and Microscopy
  3. Catalase test
  4. Biochemical test – IMViC (Indole, Methyl red, Voges-Proskauer, citrate), motility
  1. Lactose-fermenting but may produce negative results; Red-pigmented colonies
  2. Gram-negative bacilli
  3. Positive catalase test (effervescence)
  4. 1) Biochemical test
    Indole – Negative
    Methy red – Variable
    Voges-Proskauer - Positive
    Citrate – PositiveMotility – Motile (Turbidity out of line of inoculation stab)
Cephalosporins Aminoglycosides


Photos of Various Microorganism on Agar Plates:
E.Coli
Klebsiella spp.
Pseudomonas & Klebsiella spp.
Proteus spp.
Candida spp.


Photos are taken by our bacteriology group to "xinjiapo"-GH (Andre,Azhar,Valerie,Boonching)

References:
1. MedlinePlus. (2007) Urinary Tract Infection. Retrieved December 02, 2007, from http://www.nlm.nih.gov/medlineplus/ency/article/000521.htm
http://www.nlm.nih.gov/medlineplus/ency/article/000521.htm > >urinary tract infection
2. MedicineNet, Inc. (2007) Definition of Dysuria. Retrieved December 02, 2007, from http://www.medterms.com/script/main/art.asp?articlekey=3163
http://www.medterms.com/script/main/hp.asp > dysuria
3. Levinson, W. (2006). Review Of Medical Microbiology and Immunology. (9th ed.). US: The McGraw-Hill Company

Boon Ching
TG01

1 Comments:

Post a Comment

Subscribe to Post Comments [Atom]

<< Home