INTERPRETATION OF THE GRAM STAIN
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1 INTERPRETATION OF THE GRAM STAIN
2 DISCLOSURE Relevant relationships with commercial entities none Potential for conflicts of interest within this presentation none Steps taken to review and mitigate potential bias N/A
3 LEARNING OBJECTIVES This lecture is designed to meet the following end-of-week learning objective: 1. Apply the knowledge of the classification of bacteria to determine the likely etiologic agent of disease based on a Gram stain result
4 MODULE OBJECTIVES By the end of this module, you should be able to: 1. Classify the following organisms with regard to Gram reaction, microscopic morphology and aerobic tolerance: Staphylococcus spp. Streptococcus spp. Enterococcus spp. Corynebacterium spp. Bacillus spp. Escherichia coli Pseudomonas aeruginosa Haemophilus spp. Neisseria spp. Bacteroides spp. Clostridium spp.
5 RECOMMENDED READING Engleberg et al (eds.) Schaechter s Mechanisms of Microbial Disease (5th Edition), Lippincott Williams & Wilkins Chapters 10
6 BACTERIAL CLASSIFICATION Bacteria are prokaryotic cells that can be classified according to their: 1. Gram reaction Gram-positive vs. Gram-negative 2. Microscopic morphology Cocci (clusters, chains) vs. Bacilli Diplococci 3. Aerobic tolerance Aerobic vs. anaerobic
7 BACTERIA - EXAMPLES O 2 Staphylococcus spp. Listeria spp. Neisseria spp. E. coli Streptococcus spp. Corynebacterium spp. Moraxella spp. P. aeruginosa Enterococcus spp. Bacillus spp. [Haemophilus spp. (coccobacilli)] AnO 2 Peptostrepto- Clostridium spp. Veillonella spp. Bacteroides spp. coccus spp.
8 BACTERIA - EXAMPLES O 2 Staphylococcus spp. Listeria spp. Neisseria spp. E. coli Streptococcus spp. Corynebacterium spp. Moraxella spp. P. aeruginosa Enterococcus spp. Bacillus spp. [Haemophilus spp. (coccobacilli)] AnO 2 Peptostrepto- Clostridium spp. Veillonella spp. Bacteroides spp. coccus spp.
9 BACTERIA - EXAMPLES O 2 Staphylococcus spp. Listeria spp. Neisseria spp. E. coli Streptococcus spp. Corynebacterium spp. Moraxella spp. P. aeruginosa Enterococcus spp. Bacillus spp. [Haemophilus spp. (coccobacilli)] AnO 2 Peptostrepto- Clostridium spp. Veillonella spp. Bacteroides spp. coccus spp.
10 Staphylococcus spp. Gram-Positive Cocci in Clusters S. aureus Methicillin-resistant S. aureus (MRSA) Coagulase-negative staphylococci S. epidermidis S. lugdunensis S. saprophyticus
11
12 Streptococcus spp. Gram-Positive Cocci in Chains Beta-hemolytic streptococci S. pyogenes (Group A Streptococci) S. agalactiae (Group B Streptococci) Alpha-hemolytic streptococci Viridans group streptococci S. pneumoniae ( Gram-positive diplococci )
13 Streptococcus spp. Gram-Positive Cocci in Chains Beta-hemolytic streptococci S. pyogenes (Group A Streptococci) S. agalactiae (Group B Streptococci) Alpha-hemolytic streptococci Viridans group streptococci S. pneumoniae ( Gram-positive diplococci )
14 Streptococcus spp. Gram-Positive Cocci in Chains Beta-hemolytic streptococci S. pyogenes (Group A Streptococci) S. agalactiae (Group B Streptococci) Alpha-hemolytic streptococci Viridans group streptococci S. pneumoniae ( Gram-positive diplococci )
15 Streptococcus spp. Gram-Positive Cocci in Chains Beta-hemolytic streptococci S. pyogenes (Group A Streptococci) S. agalactiae (Group B Streptococci) Alpha-hemolytic streptococci Viridans group streptococci S. pneumoniae ( Gram-positive diplococci )
16 Enterococcus spp. Gram-Positive Cocci in Chains E. faecium E. faecalis Vancomycin-resistant E. faecium (VRE) Vancomycin-resistant E. faecalis (VRE)
17 BACTERIA - EXAMPLES O 2 Staphylococcus spp. Listeria spp. Neisseria spp. E. coli Streptococcus spp. Corynebacterium spp. Moraxella spp. P. aeruginosa Enterococcus spp. Bacillus spp. [Haemophilus spp. (coccobacilli)] AnO 2 Peptostrepto- Clostridium spp. Veillonella spp. Bacteroides spp. coccus spp.
18 C. jeikeium Corynebacterium spp. Gram-Positive Bacilli C. urealyticum C. diphtheriae (not common) Other species typically normal skin flora often referred to as diphtheroids
19 Bacillus spp. Gram-Positive Bacilli B. anthracis (not common) Other species typically normal skin flora
20 BACTERIA - EXAMPLES O 2 Staphylococcus spp. Listeria spp. Neisseria spp. E. coli Streptococcus spp. Corynebacterium spp. Moraxella spp. P. aeruginosa Enterococcus spp. Bacillus spp. [Haemophilus spp. (coccobacilli)] AnO 2 Peptostrepto- Clostridium spp. Veillonella spp. Bacteroides spp. coccus spp.
21 Escherichia coli Gram-Negative Bacilli Other Important Enteric Gram-Negative Bacilli (Enterobacteriaceae): Klebsiella pneumoniae Enterobacter spp. Citrobacter spp. Proteus spp. Salmonella spp. Shigella spp.
22 Pseudomonas aeruginosa Gram-Negative Bacilli Intrinsically more resistant compared to Enterobacteriaceae
23 BACTERIA - EXAMPLES O 2 Staphylococcus spp. Listeria spp. Neisseria spp. E. coli Streptococcus spp. Corynebacterium spp. Moraxella spp. P. aeruginosa Enterococcus spp. Bacillus spp. [Haemophilus spp. (coccobacilli)] AnO 2 Peptostrepto- Clostridium spp. Veillonella spp. Bacteroides spp. coccus spp.
24 Haemophilus spp. Gram-Negative Coccobacilli H. influenzae
25 BACTERIA - EXAMPLES O 2 Staphylococcus spp. Listeria spp. Neisseria spp. E. coli Streptococcus spp. Corynebacterium spp. Moraxella spp. P. aeruginosa Enterococcus spp. Bacillus spp. [Haemophilus spp. (coccobacilli)] AnO 2 Peptostrepto- Clostridium spp. Veillonella spp. Bacteroides spp. coccus spp.
26 Neisseria spp. Gram-Negative Diplococci Neisseria meningitidis Neisseria gonorrhoeae non-pathogenic Neisseria spp.
27 BACTERIA - EXAMPLES O 2 Staphylococcus spp. Listeria spp. Neisseria spp. E. coli Streptococcus spp. Corynebacterium spp. Moraxella spp. P. aeruginosa Enterococcus spp. Bacillus spp. [Haemophilus spp. (coccobacilli)] AnO 2 Peptostrepto- Clostridium spp. Veillonella spp. Bacteroides spp. coccus spp.
28 Clostridium spp. Gram-Positive Bacilli C. tetani C. botulinum C. perfringens C. difficile
29 Bacteroides spp. Gram-Negative Bacilli B. fragilis group is the most common Bacteroides isolated
30 QUIZ A Gram stain of a skin abscess aspirate shows many pus cells and Grampositive cocci in clusters. What organism is consistent with this result? A. Staphylococcus aureus B. Streptococcus pyogenes C. Escherichia coli D. Clostridium perfringens
31 QUIZ A Gram stain of a skin abscess aspirate shows many pus cells and Grampositive cocci in clusters. What organism is consistent with this result? A. Staphylococcus aureus B. Streptococcus pyogenes C. Escherichia coli D. Clostridium perfringens
32 QUIZ A Gram stain of a knee aspirate shows many pus cells and Gram-negative diplococci. What organism is consistent with this result? A. Escherichia coli B. Neisseria gonorrhoeae C. Haemophilus influenzae D. Bacteroides fragilis
33 QUIZ A Gram stain of a knee aspirate shows many pus cells and Gram-negative diplococci. What organism is consistent with this result? A. Escherichia coli B. Neisseria gonorrhoeae C. Haemophilus influenzae D. Bacteroides fragilis
34 KEY MESSAGES Bacteria are prokaryotic cells that can be classified according to their: 1. Gram reaction Gram-positive vs. Gram-negative 2. Microscopic morphology Cocci (clusters, chains) vs. Bacilli Diplococci 3. Aerobic tolerance Aerobic vs. anaerobic
35 KEY MESSAGES O 2 Staphylococcus spp. Listeria spp. Neisseria spp. E. coli Streptococcus spp. Corynebacterium spp. Moraxella spp. P. aeruginosa Enterococcus spp. Bacillus spp. [Haemophilus spp. (coccobacilli)] AnO 2 Peptostrepto- Clostridium spp. Veillonella spp. Bacteroides spp. coccus spp.
36 KEY MESSAGES O 2 Staphylococcus spp. Listeria spp. Neisseria spp. E. coli Streptococcus spp. Corynebacterium spp. Moraxella spp. P. aeruginosa Enterococcus spp. Bacillus spp. [Haemophilus spp. (coccobacilli)] AnO 2 Peptostrepto- Clostridium spp. Veillonella spp. Bacteroides spp. coccus spp.
37 MODULE OBJECTIVES By now you should be able to: 1. Classify the following organisms with regard to Gram reaction, microscopic morphology and aerobic tolerance Staphylococcus spp. Streptococcus spp. Enterococcus spp. Corynebacterium spp. Bacillus spp. Escherichia coli Pseudomonas aeruginosa Haemophilus spp. Neisseria spp. Bacteroides spp. Clostridium spp.
CLASSIFICATION OF BACTERIA
CLASSIFICATION OF BACTERIA DISCLOSURE Relevant relationships with commercial entities none Potential for conflicts of interest within this presentation none Steps taken to review and mitigate potential
CLASSIFICATION OF MICROORGANISMS
CLASSIFICATION OF MICROORGANISMS DISCLOSURE Relevant relationships with commercial entities none Potential for conflicts of interest within this presentation none Steps taken to review and mitigate potential
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