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1. A urine culture from a 28 year old woman was plated on MacConkey and Blood agar. There was growth on both plates, with a colony count of 78. A Gram stain shows short Gram negative rods. What is the first identification test you should perform? 

 

 

 

 

2. If the organism described in question 1 is the most common cause of uncomplicated urinary tract infections, what color colonies would you expect to see on MacConkey agar? 

 

 

 

 

3. An isolate from a urine culture is inoculated to Triple Sugar Iron agar. After overnight incubation, the TSI reaction is: A/A gas. What ONE medium or test could you use to differentiate all the possible organisms, based on the information in the Lab Supplemental Manual?

 

 

 

 

4. A stool culture from a patient with symptoms of food poisoning grows an organism with the following test results. What is the most likely identification (genus only)?

 

SIM: the agar is almost completely black, and after adding Kovacs reagent, a yellow color appears on top of the agar

MR: a red color appears immediately after the addition of the Methyl Red reagent

VP: 30 minutes after the addition of Alpha Naphthol and Potassium Hydroxide reagents, no color change has occurred

Citrate: The entire tube, slant and butt, are a deep blue color

TSI: The slant is red, the butt is black, and there are large bubbles in the bottom of the tube

 

 

 

 

5. A stool specimen has been received by the laboratory from a different patient with symptoms of food poisoning. The IMViC and TSI test results are below. Is this isolate likely to be part of the same food-borne outbreak as the patient in #4? Why or why not?

 

SIM: Indole negative, Motility Negative, H2S Negative

MR: Positive

VP: Negative

Citrate: Negative

TSI: K/A

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Fall 2020 GRAM NEGATIVE RODS ESCHERICHIA ENTEROBACTER PROTEUS KLEBSIELLA SALMONELLA SHIGELLA PSEUDOMONAS COLI AEROGENES VULGARIS PNEUMONIAE SPECIES SPECIES AERUGINOSA Fall 2020 APPEARANCE DARK PINK LIGHT PINK CLEAR LIGHT PINK CLEAR CLEAR CLEAR 9:01 ON MAC COLONIES COLONIES COLONIES COLONIES COLONIES COLONIES COLONIES 15 of 23 LARGE, FLAT or APPEARANCE RAISED, GRAY - LARGE, FLAT or LARGE, FLAT or LARGE, FLAT of LARGE, FLAT or LARGE, FLAT, GRAY- GRAM STAIN MINE RAISED, GRAY - LARGE, FLAT or WHITE, METALLIC ON BAR WHITE, GAMMA or RAISED, GRAY- RAISED, GRAY - RAISED, GRAY - SHEEN, BETA or BETA WHITE, GAMMA WHITE, MUCOID RAISED, GRAY- MORPHOLOGY WHITE, GAMMA GAMMA WHITE, GAMMA WHITE, GAMMA GAMMA O-F GLUCOSE COLONY APPEARANCE (OX-FERM) Y-Y Y-Y Y-Y Y-Y Y-Y Y-Y Y-G ON BAP CATALASE POSITIVE POSITIVE POSITIVE POSITIVE POSITIVE POSITIVE POSITIVE OXIDASE NEGATIVE NEGATIVE NEGATIVE NEGATIVE NEGATIVE NEGATIVE POSITIVE HEMOLYSIS ON BAP This page intentionally blank. INDOLE POSITIVE NEGATIVE POSITIVE NEGATIVE NEGATIVE NEGATIVE NEGATIVE HYDROGEN CATALASE SULFIDE NEGATIVE NEGATIVE POSITIVE NEGATIVE POSITIVE NEGATIVE NEGATIVE 15 STREPTOCOCCUS MOTILITY POSITIVE POSITIVE POSITIVE NEGATIVE POSITIVE NEGATIVE POSITIVE 14 ANTIGEN TEST METHYL RED POSITIVE NEGATIVE POSITIVE NEGATIVE POSITIVE POSITIVE NEGATIVE NORMAL FLORA BODY VOGES- PROSKAUER NEGATIVE POSITIVE NEGATIVE POSITIVE NEGATIVE NEGATIVE NEGATIVE SITES CITRATE NEGATIVE POSITIVE NEGATIVE POSITIVE POSITIVE NEGATIVE POSITIVE A/A gas AVA gas AV/A gas, H.S AVA gas K/A gas, H.S K/ KA NORMAL FLORA INTESTINAL INTESTINAL INTESTINAL INTESTINAL NEVER NORMAL DISEASE NEVER NORMAL NEVER NORMAL BODY SITES TRACT TRACT TRACT TRACT FLORA FLORA FLORA DISEASE INFECTIONS OF INFECTIONS OF INFECTIONS OF INFECTIONS OF INFECTIONS OF THE INFECTIONS OF THE INFECTIONS OF URINARY TRACT (#1 URINARY TRACT, URINARY TRACT, URINARY TRACT, GASTROINTESTINAL GASTROINTESTINAL URINARY TRACT, BLOOD, CAUSE OF UTI'S IN "SONTOM 'COOTS BLOOD, WOUNDS, BLOOD, WOUNDS, TRACT FROM POOR TRACT FROM POOR WOUNDS, STERILE BODY Lab manual supplement.pdf HEALTHY ADULTS STERILE BODY SITES STERILE BODY SITES, STERILE BODY SITES, HYGIENE-FECAL TO HYGIENE-FECAL TO SITES, RESPIRATORY BLOOD, WOUNDS, RESPIRATORY TRACT RESPIRATORY TRACT RESPIRATORY TRACT ORAL TRANSMISSION ORAL TRANSMISSION TRACT ACQUIRED STERILE BODY SITES, CONTAMINATED NURSING HOMES RESPIRATORY TRACT FROM CONTACT WITH FOOD, NOSOCOMIAL HOSPITALS, CONTAMINATED IN NURSING HOMES, TRAVELERS DIARRHEA AQUATIC HOSPITALS, ENVIRONMENTS TRAVELERS DIARRHEA IMPORTANT NOSOCOMIAL PATHOGEN . . .

SALMONELLA SHIGELLA PSEUDOMONAS SPECIES Fall 2020 GRAM POSITIVE COCCI (round to oval) SPECIES AERUGINOSA CATALASE NEGATIVE CLEAR CLEAR CLEAR STREPTOCOCCUS STREPTOCOCCUS ENTEROCOCCUS STREPTOCOCCUS COLONIES COLONIES COLONIES PYOGENES AGALACTIAE FAECALIS PNEUMONIAE 14 of 23 9:01 LARGE, FLAT or LARGE, FLAT or LARGE, FLAT, GRAY - GRAM STAIN AND RAISED, GRAY- WHITE, METALLIC MORPHOLOGY GPC IN PAIRS AND CHAINS GPC IN PAIRS AND CHAINS GPC IN PAIRS AND CHAINS GPC IN PAIRS AND CHAINS GRAM RAISED, GRAY - MORE WHITE, GAMMA WHITE, GAMMA SHEEN, BETA or GAMMA COLONY APPEARANCE COL Y-Y Y-Y Y-G ON BAP WHITE-GRAY, SMALL SIZE WHITE-GRAY WHITE-GRAY GREENISH-GRAY, FLAT ON BA POSITIVE POSITIVE POSITIVE 100% are BETA WITH 85% are BETA WITH A 90% are SLIGHTLY ALPHA, NEGATIVE NEGATIVE POSITIVE HEMOLYSIS ON BAP LARGE ZONE SMALL ZONE, 15% are 10% GAMMA OR SLIGHTLY 100% are ALPHA HEMO GAMMA BETA NEGATIVE NEGATIVE NEGATIVE CATAL CATALASE NEGATIVE NEGATIVE NEGATIVE NEGATIVE POSITIVE NEGATIVE NEGATIVE MAN POSITIVE NEGATIVE POSITIVE 14 STREPTOCOCCUS ANTIGEN TEST POSITIVE FOR A ANTIGEN POSITIVE FOR B ANTIGEN POSITIVE FOR D ANTIGEN NOT APPLICABLE 13 POSITIVE POSITIVE NEGATIVE NORMAL FLORA BODY NEVER NORMAL FLORA IN COLONIZES MUCUS NORMAL FLORA OF UPPER RESPIRATORY TRACT PLASN NEGATIVE NEGATIVE NEGATIVE SITES THE BODY--ALWAYS A MEMBRANES OF THE GASTROINTESTINAL TRACT PATHOGEN GENITOURINARY AND COAG LATEX POSITIVE NEGATIVE POSITIVE GASTROINTESTINAL TEST TRACTS K/A gas, H.S NEVER NORMAL DISEASE NEVER NORMAL NEVER NORMAL INFECTIONS OF UPPER INFECTIONS IN NEWBORNS INFECTIONS OF THE URINARY #1 CAUSE OF COMMUNITY NORM WHEN PREGNANT MOTHER IS BODY FLORA FLORA FLORA RESPIRATORY TRACT TRACT, BLOOD, WOUNDS, ACQUIRED BACTERIAL (PHARYNGITIS, TONSILITIS, NOT TREATED WITH IMPORTANT NOSOCOMIAL PNEUMONIA, CAN BECOME INFECTIONS OF THE INFECTIONS OF THE INFECTIONS OF GASTROINTESTINAL GASTROINTESTINAL URINARY TRACT, BLOOD, OTITIS MEDIA), CAN BECOME ANTIBIOTICS (MENINGITIS, PATHOGEN--ESPECIALLY THE INVASIVE AND ENTER BLOOD, TRACT FROM POOR TRACT FROM POOR ACCE 3718315'SONTOM INVASIVE AND INFECT SKIN BLOOD), POST PARTUM VANCOMYCIN RESISTANT CAUSE MENINIGITIS, OTITS DISEA Lab manual supplement.pdf HYGIENE-FECAL TO HYGIENE-FECAL TO SITES, RESPIRATORY AND SOFT TISSUE INFECTIONS, URINARY TRACT (VRE) STRAINS MEDIA, SINUSITIS AND ORAL TRANSMISSION ORAL TRANSMISSION TRACT ACQUIRED CONTAMINATED NURSING HOMES FROM CONTACT WITH (NECROTIZING FACIITIS) INFECTIONS, AND WOUNDS ENDOCARDITIS FOOD, NOSOCOMIAL HOSPITALS, CONTAMINATED BLOOD, BONE, STERILE BODY IMMUNOCOMPROMISED IN NURSING HOMES, TRAVELERS DIARRHEA AQUATIC SITES AND FLUIDS AND PATIENTS ARE AT RISK OF HOSPITALS, ENVIRONMENTS WOUNDS INFECTION TRAVELERS DIARRHEA IMPORTANT NOSOCOMIAL PATHOGEN . . .

Fall 2020 GRAM POSITIVE COCCI (round shape) CATALASE POSITIVE Fall 2020 ENTEROCOCCUS STREPTOCOCCUS STAPHYLOCOCCUS STAPHYLOCOCCUS STAPHYLOCOCCUS MICROCOCCUS FAECALIS PNEUMONIAE AUREUS SAPROPHYTICUS LUTEUS 13 of 23 9:01 EPIDERMIDIS IN PAIRS AND CHAINS GPC IN PAIRS AND CHAINS GRAM STAIN AND MORPHOLOGY GPC IN CLUSTERS GPC IN CLUSTERS GPC IN CLUSTERS LARGE GPC IN TETRADS YELLOW-WHITE OR BRIGHT WHITE-GRAY GREENISH-GRAY, FLAT COLONY APPEARANCE WHITE, CREAMY-WHITE OR WHITE, CREAMY-WHITE OR WHITE, CREAMY-WHITE OR ON BAP SLIGHTLY YELLOW SLIGHTLY YELLOW SLIGHTLY YELLOW YELLOW SLIGHTLY ALPHA, HEMOLYSIS ON BAP 90% are BETA, 90% are GAMMA, MMA OR SLIGHTLY 100% are ALPHA 10% GAMMA 10% BETA 100% GAMMA 100% GAMMA BETA CATALASE POSTIVE POSTIVE POSTIVE POSTIVE NEGATIVE NEGATIVE MANNITOL SALT AGAR GROWTH, POSITIVE MANNITOL GROWTH, NEGATIVE GROWTH, NEGATIVE GROWTH, NEGATIVE POSITIVE SIT E FOR D ANTIGEN NOT APPLICABLE FERMENTATION MANNITOL FERMENTATION MANNITOL FERMENTATION MANNITOL FERMENTATION 13 12 MAL FLORA OF UPPER RESPIRATORY TRACT PLASMA STAPHYLOCOC INTESTINAL TRACT COAGULASE/STAPH MICROCOCCUS LATEX AGGLUTINATION POSITIVE/POSITIVE NEGATIVE/NEGATIVE NEGATIVE/NEGATIVE NEGATIVE/NEGATIVE TEST CTIONS OF THE URINARY #1 CAUSE OF COMMUNITY NORMAL FLORA UPPER RESPIRATORY UPPER RESPIRATORY SKIN AND MUCOSA OF UPPER RESPIRATORY ACT, BLOOD, WOUNDS, ACQUIRED BACTERIAL BODY SITES TRACT, NARES, AXILLA, TRACT, ALL OVER SKIN UROGENITAL TRACT TRACT, ALL OVER SKIN ORTANT NOSOCOMIAL PNEUMONIA, CAN BECOME GROIN, PERINEUM, SKIN SURFACE SURFACE HOGEN--ESPECIALLY THE INVASIVE AND ENTER BLOOD, SURFACE USE THIS FLO COMYCIN RESISTANT CAUSE MENINIGITIS, OTITS DISEASE INFECTIONS OF SKIN AND BIOFILMS-INFECTIONS OF INFECTIONS OF THE GENERALLY HARMLESS, BUT Lab manual supplement.pdf (VRE) STRAINS MEDIA, SINUSITIS AND SOFT TISSUE, BLOOD, BONE, INDWELLING PROSTHETIC URINARY TRACT--ESPECIALLY CAN BE OPPORTUNISTIC ENDOCARDITIS STERILE BODY SITES AND DEVICES--INTRAVASCULAR IN SEXUALLY ACTIVE PATHOGEN IN THE FLUIDS, SURGICAL WOUNDS CATHETERS, CARDIAC WOMEN, PROSTATITIS IN IMMUNOCOMPROMISED UTIs, IMPORTANT VALVES, JOINTS, CEREBRAL MEN NOSOCOMIAL PATHOGEN-. SHUNTS, BLOOD, UTIs, ESPECIALLY THE METHICILLIN WOUNDS, NOSOCOMIAL RESISTANT (MRSA) STRAINS PATHOGEN . . .

Fall 2020 GPC AND GNR IDENTIFICATION Fall 2020 ROCOCCUS LUTEUS 12 of 23 9:01 PC IN TETRADS GRAM POSITIVE GRAM NEGATIVE COCCI HITE OR BRIGHT RODS ELLOW AMMA CATALASE TEST OXIDASE TEST NEGATIVE POSITIVE NEGATIVE MENTATION POSITIVE NEGATIVE 12 11 STAPHYLOCOCCUS STREPTOCOCCUS PSEUDOMONAS ENTEROBACTERIACIAE IVE NEGATIVE MICROCOCCUS ENTEROCOCCUS (e.g. ESCHERICHIA COLI) RESPIRATORY ALL OVER SKIN URFACE USE THIS FLOW CHART TO IDENTIFY BACTERIA TO THE GENUS LEVEL, THEN PERFORM TEST METHODS TO CONFIRM HARMLESS, BUT THE IDENTIFICATION TO SPECIES LEVEL OPPORTUNISTIC Lab manual supplement.pdf OGEN IN THE COMPROMISED . . .

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