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Final Practical
Blood, Fluid, Wound and Respiratory Cultures
61
Microbiology
Graduate
04/09/2013

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Cards

Term
Environments for blood cultures
Definition
aerobic and anaerobic
Term
Why don't you put blood cultures in fridge?
Definition
fastidious organisms may be present
Term
Incubation and temperature for blood cultures
Definition
37oC blood culture incubator for 5 days
Term
How does the incubator know if there is bacteria?
Definition
The incubator detects any metabolic activity in the bottle by changes in O2 or CO2 concentration
Term
False positives in blood cultures
Definition
respiration of white blood cells that are in high number in the culture
Term
What happens when a blood culture bottle is positive?
Definition
. A needle is aseptically inserted into the bottle and blood is
extracted to be gram stained and subbed onto blood, chocolate &
Macconkey agar.
Term
What to plates to add if GPC or GNR are seen in blood culture?
Definition
a selective plate (CNA or PEA) is added
Term
What do selective plates in blood cultures allow for?
Definition
isolation of the gram positive organism in
the event that the gram negative rod is a swarming Proteus sp
Term
What if GPC in pairs and chains are seen in a blood culture?
Definition
a blood plate with a Taxo P
optichin disc is set up to rule out S. pneumoniae at 24 hours
Term
What if yeast are seen in a blood culture?
Definition
Sabaroud’s Dextrose agar for fungus is inoculated.
Term
What do you cleanse the puncture site of the blood culture bottle with?
Definition
70% isopropyl alcohol, iodine or chlorhexidine solution
Term
How much blood is collected from an adult for a blood culture?
Definition
10-20 mL
Term
How much blood is collected from an child for a blood culture?
Definition
1-5 mL
Term
What does times 2 order blood culture mean?
Definition
For adults, an aerobic and anaerobic bottle make one set. These cultures are drawn at one site, while the other set is drawn at a different site, 10-20 minutes apart
Term
What does x2 blood culture help to determine?
Definition
bacterial findings are the true source of a blood infection or a skin contaminant.
Term
Why do children only get one blood culture bottle drawn?
Definition
lower blood volume of infants.
Term
skin contaminants in blood cultures
Definition
Diptheroids, Proprionibacterium, Bacillus sp, Coag - staph, strep viridins
Term
Bacteria that infects catheter tip?
Definition
s. epidermidis
Term
indicator of GI carcinoma
Definition
Strep bovis
Term
What can LPS in GNRs cause?
Definition
This endotoxin can cause septic shock and activate clotting factors resulting in DIC
Term
What does CSF do?
Definition
surrounds the brain and spinal cord
Term
How much CSF is collected?
Definition
5-10 mL are collected in 4 sterile tubes for laboratory analysis.
Term
Tube 1 in CSF collection
Definition
designated for chemistry testing
Term
Tube 2 or 3 in CSF collection
Definition
bacterial culture
Term
tube 3 or 4 in CSF collection
Definition
cell count in hemo
Term
Why should we not refrigerate CSF micro specimens?
Definition
presence of fastidious pathogens
Term
How do microorganisms enter the CSF?
Definition
a traumatic event, via a CNS shunt, the blood stream, oral cavity, ear, sinus or respiratory infection or through nerve transmission (rabies, herpes).
Term
What do you do if the CSF specimen is clear and more than 1 mL in volume
Definition
centrifuged at 2500 -3000 rpm for 10 minutes before being processed
Term
How do you culture CSF sediment?
Definition
to a blood, chocolate and Macconkey plate along with a thioglycollate broth and incubated in CO2. Along with a gram stain or cytospin
Term
Normal findings for CSF
Definition
sterile with ‘no organisms seen’.
Term
Clinical findings in bacterial meningitis
Definition
high white blood cell count (neutrophils), high CSF protein, low CSF glucose level
Term
Clinical findings in viral meningitis
Definition
high white blood cell count (lymphocytes)
Term
CSF Pathogens
Definition
Hemophilus influenza type B (Hib)
N. meningitis - meningococcus (military barracks & college dorms)
S. pneumonia – pneumococcus (CSF or urine EIA Ag test available)
Listeria monocytogenes
S. aureus
Enterics
Group B Strep – newborns
Term
How are sterile fluids obtained?
Definition
with a syringe by a physician and sent to the lab in a sterile container.
Term
environments for sterile fluids
Definition
aerobic or anaerobic
Term
Should sterile fluids be refrigerated?
Definition
no
Term
Sterile fluid plates
Definition
blood, chocolate and Macconkey plates as well as a thioglycollate broth
Term
Gram stain for sterile fluids?
Definition
Yes
Term
Clear fluids >1mL in volume for sterile fluids
Definition
centrifuged before culturing
Term
transudate
Definition
excess fluid in a tissue
Term
exudate
Definition
excess fluid resulting from inflammation.
Term
The normal finding for all blood cultures and fluids
Definition
no organisms seen. These are naturally sterile sites
Term
Fluid pathogens
Definition
S. epidermidis
S. aureus
S. pneumonia
Beta hemolytic Strep
H. influenza
N. gonorrhea
Enterobacteriaceae
P. aeruginosa
Acinetobacter spp.
Borrelia burgdorferi (Lyme disease)
Mycobacterium spp.
Anaerobes
Fungus
Term
How is skin compromised?
Definition
infection by trauma or abrasion
Term
How are wound cultures received?
Definition
swabs, in sterile containers as an abscess exudate or in the form of a tissue or bone biopsy.
Term
What do you do with large pieces of wound culture?
Definition
tissue are cut with a scalpel and ground in a tissue grinder
Term
Normal skin flora
Definition
Coagulase negative staph
Diptheroids
Proprionibactierium
Term
Wound pathogens
Definition
Staphylococcus aureus (most common)
Group A strep (Impetigo, flesh eating bacteria)
Enterococcus spp.
Enterobacteriaceae
P. aeruginosa
Eikenella corrodens (human bite)
Pasturella multocida (cat & dog bites)
Vibrio vulnificus (salt water wounds)
Bacillus anthrasis (wool sorter’s disease)
Erysipelothrix sp.
Fungus, Parasites & Viruses
Term
Bacterial isolates from deep wounds and abscesses
Definition
often anaerobic pathogens.
Term
sacral decubitus ulcers
Definition
aerobic
Term
Anaerobic pathogens
Definition
1. Actinomyces spp
2. Bacteroides spp.
3. Clostridium spp.
4. Bifidobacterium
5. Fusobacterium spp.
6. Peptococcus spp.
7. Peptostreptococcus spp.
8. Proprionibacterium spp.
9. Prevotella spp.
10. Veillonella spp.
Term
How do respiratory cultures arrive to the lab?
Definition
form of expectorated or induced sputum
Term
Aspirated sputum is in a
Definition
Lukens tube or a bronchial lavage in a sterile container.
Term
What are respiratory specimens plated to?
Definition
The specimen is plated to a blood, chocolate and Macconkey plate. Gram stains are done routinely on respiratory cultures
Term
Respiratory gram stains are assessed based on
Definition
number to epithelial and white cells present.
Term
spit
Definition
>25 squamous epithelial cells/LPF in the absence of white cells
Term
a good respiratory specimen
Definition
The presence of white cells and columnar epithelial cells
Term
Exception in respiratory specimen
Definition
no white cells because patient is neutropenic
Term
Infant respiratory specimens
Definition
sterile
Term
Normal respiratory flora
Definition
1. Coagulase negative staph
2. Micrococcus sp.
3. S. aureus
4. Diphtheroids
5. Strep viridans
6. Enteroococcus spp.
7. Neisseria spp.
8. Haemophilus spp.
Term
Respiratory pathogens
Definition
1. Streptococcus pneumonia
2. Beta hemolytic strep
3. Staphylococcus aureus
4. Haemophilus influenza
5. Neisseria meningitis
6. Moraxilla catarrhalis
7. Enterobacteiacae
8. Pseudomonas aeruginosa
9. Acinetobacter spp.
10. Burkholderia cepacia
11. Bordetella pertussis – specialized media, DFA
12. Corynebacterium diphtheria – specialized media
13. Corynebacterium jekeium
14. Legionella spp. – Urine Ag EIA test
15. Mycobacterium spp.
16. Nocardia spp.
17. Mycoplasma pneumonia - EIA
18. Fungus
19. Parasites
20. Viruses
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