Term
What is the normal cut-off time for specimen collections? |
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Definition
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Term
What should be indicated on the label of specimens? |
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Definition
- Name
- Date and time of collection
- Patien ID number/ or hospital number
- Source
- Type of collection
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Term
What is the transport media Carey-Blair typically used for? |
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Definition
| good for stool cultures or specimens that need to be held for extended period of time (mailing etc..) |
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Term
What is the transport media Amies typically used for? |
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Definition
| Good for Neisseria gonorrhea |
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Term
What is the transport media Stuarts typically used for ? |
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Definition
| supports transport of almost all pathogens |
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Term
What is the transport media JEMBEC typically used for? |
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Definition
for genital cultures that cant get to the lab in a timely fashion
Specifically looking for N. gonorrhoeaa |
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Term
Mouth cultures are not routinely processed-will grow URF, what is the exception? |
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Definition
Mycology cultures may be performed to rule out THRUSH (Candida albicans) |
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Term
What are you looking for in throat cultures? |
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Definition
| Primarily used for the detection of Group A beta-hemolytic streptococci (cause of strep throat) |
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Term
If group A strep is left untreated...sequelae include... |
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Definition
| Rheumatic Fever and Glomerulonephritis |
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Term
| What do type of agar do you plant throat cultures on? |
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Definition
BAP - streak for isolation |
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Term
Group A rapid tests are commonly performed for throat cultures, but what is the problem with them? |
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Definition
| Rapid tests are specific, but not sensitive...A Negative rapid test MUST be confirmed by culture |
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Term
Nasopharyngeal cultures are not routinely done, if performed they are by request and only to screen for carriers of..... |
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Definition
S. aureus
N. meningitidis
H. influenzae |
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Term
| What are the steps to Nasopharyngeal cultures? |
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Definition
- Plant on BAP (STAX)/ Choc
- Incubate in increased CO2
- Special Circumstances- use Calcium alginate swab on thin nichrome wire (C. diptheriae B. pertussis)
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Term
What is a Nares culture usually used for? |
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Definition
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Term
| What are the types of Lower Respiratory Specimens? |
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Definition
Expectorated Sputum
Suctioned Sputum (leukens tube)
Bronchoscopy specimen or bronchial washing (BAL)
Bronchial Brushing
Transtracheal Aspirate
Lung Aspirate
Lung Biopsy |
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Term
| LRT specimen processing begins with... |
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Definition
Gram Stain
Calulate Q-Score
If acceptable quality..process specimen |
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Term
| For the Q-score, sputum is evaluated at low power (10x) and neutrophils and squamous cells are graded...how many cells for a score of 0, 1, 2, or 3? |
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Definition
- No cells= 0
- 1-9= 1
- 10-24= 2
- >25= 3
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Term
What plates do you innoculate when you have an acceptable quality Lower resp specimen?? |
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Definition
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Term
After BAP and MAC cultures of Lower Resp specimens have grown....whats next? |
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Definition
Add STAX to BAP
If both GN and GP appear in significant numbers...add CNA or PEA |
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Term
For Lower Resp Specimens...when do you report "Pneumo" |
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Definition
when you see pairs of GP diplococci, sometimes lancet shaped, encapsulated, or with blotchy appearence,
>25 pairs/oil immersion field (OIF) |
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Term
| For Lower Resp Specimens...when do you report "Staph" |
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Definition
GP cocci in clusters
>25/Oil immersion field |
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Term
| For Lower Resp Specimens....when do you report "yeasts" |
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Definition
| at least one yeast cell with pseudohyphae/OIF |
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Term
| For Lower Resp Specimens..when do you report "Enteric/Psuedomonas" |
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Definition
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Term
| For Lower Resp Specimens...when do you report "Bacteriodes/ Hemophilus" (B/H) |
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Definition
| GN coccobacilli/pleomorphic > 10 /OIF |
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Term
| For Lower Resp Specimens...when do you report "Branhamella/Acinetobacter" |
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Definition
| Plump GN diplococci >25/OIF |
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Term
| What are the most common pathogens of the Upper and Lower Respiratory Tract? |
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Definition
Strep pneumoniae
Haemophilus influenzae
Klebsiella pneumoniae and other Enterobacteriaceae
Pseudomonas aeruginosa and other "Pseudomonads"
Legionella pneumophila
Candida albicans (Thrush)
Acinetobacter spp.
Moraxella (Branhamella) catarrhalis
Beta-hemolytic streptococci |
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Term
What are the "other" respiratory pathogens which require specialized media for isolation? |
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Definition
Corynebacterium diphtheriae
Mycobacterium tuberculosis and other Mycobacterium spp.
Bordetella pertussis
Nocardia asteriods
Mycoplasma pneumoniae
Chlamydia pneumoniae and other spp
Pneumoncystis carinii
Viruses ( CMV, HSV, Adeno, Influenza, etc)
Fungi including Histoplasma capsulatum and others
Anaerobes (Prevotella melaninogenicus, Fusobacterium nucleatum etc.) |
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Term
What are the organisms considered normal upper respiratory flora? (URF) |
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Definition
Alpha and gamma hemolytic Streptococcus
Staphylococcus spp (NOT aureus)
Neisseria spp (NOT meingiditis)
Corynebacterium spp (NOT diphtheriae)
Many anaerobes
Candida spp. |
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Term
What organisms are isolated in the URT of hospitalized patients and is usually not reported unless its a chemo patients? |
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Definition
Klebs. pneumoniae
Ps. aeruginosa
Other Enterobacteriaceae |
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Term
What are the causative organisms of Vincents Angina (Trench Mouth) |
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Definition
Borrelia vincentii (a.k.a. Bacteriodes denticola/Prevotella)
Fusobacterium nucleatum (now Fusobacterium necrophorum) |
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Term
In Vincents Angina (Trench mouth) what organisms predominate in the acute cases? Chronic cases? |
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Definition
Acute: Spirochetes
Chronic: Fusiform |
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Term
How are samples of Trench mouth tested in lab? |
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Definition
Direct smear with Z/N or crystal violet
ALOT of Spirochetes and Fusiforms will be seen |
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Term
| What are the most likely organisms in otitis media infections? |
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Definition
Stp pneumoniae (25-50%)
Hem. influenzae (15-30%)
Mor. cararralis (3-20%)
Stp. pyogenes (2%)
Sth. aureus (1%)
Enterobacteriaceae (1%) |
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Term
| What are the most likely organisms in Otitis Externa infections? |
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Definition
Ps. aeruginosa
Sth. aureus
Other aerobic bacteria |
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Term
What skin contaminants are not significant in otitis media samples? |
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Definition
Sth. epidermidis
Diphtheroids |
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Term
| A Nasopharyngeal swab is used in suscpected cases of... |
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Definition
Neisseria meningitidis
Bordetella pertussis |
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Term
| Chronic Granulomatus infection of nasal passages is due to the infection of what organism? |
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Definition
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Term
| chronic mucopurulent nasal discharge, foul smelling, due to secondary low grade anaerobic infection of what organism? |
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Definition
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Term
| What is the expected flora of the nasopharyngeal? |
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Definition
Neisseria spp
alpha/gamma strep
Haemophilus spp
Diphtheroids
Anaerobic Bacteria
Strep pneumoniae
Staph
small amounts of GNB (as hospitlization increase..so does GNB)
small number of yeasts |
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