Review of Bacterial infection specimen

For OSCE examination

To Find more
Mycobacterium TB S. aureus Klebsiella Cell wall differences - +ve, -ve, Mycolic acid AFB MAFB Burkhloderia pseudomellei

Gram Stain

Bacterial Cell Wall

The cell wall of a bacteria (1) is found externally to the plasma membrane. (2) is semirigid. (3) protecting bacteria against osmotic lysis. (4) consists of peptidoglycan.

Lactobacillus spp..

Gram positive bacilli

Typical Gram stains

Gram-positive bacilli:
Thick: Clostridium

Thin :

Listeria.

Branched: Nocardia, Actinomycetes

Clostridium perfringens

No surrounded RBC (Cell lysis)

Clostridium with subterminal spores

Susan D. Caston

Diphtheroids (Propionibacterium and

Corynebacterium spp)

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The orientation of the bacteria in the clumps, at variable and random angles, sometimes called "Chinese letters" Many other bacteria also have this appearance, including Rothia spp,

Listeria monocytogenes

Lactobacillus

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Chains of Gram-variable, but mostly Gram-positive, nonsporing, regular small bacilli. This is characteristic of Lactobacillus, especially in genital tract specimens.

Nocardia

Actinomyces

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Mycobacterium

Susan D Coston

Mycobacterium species ,especially the rapidly growing mycobacteria, such as M. fortuitum and M. chelonae can sometimes be seen in Gram stains as beaded gram-positive

Mycobacterium marinum "ghosts"

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Hyphae

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Bacillus anthracis in CSF

Jernigan JA: EID 2001;7:933-944

Bacillus cereus

Gram positive cocci

Typical Gram stains

Gram-positive cocci:
Cluster: Staph. Aureus

Tetrad: Micrococcus spp.

Chain:

Streptococcus

Staph. Vs. Pneumococcus

Pneumococcus

Lancet-shaped, diplococci with capsule

S.pneumoniae

Streptococcus

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Viridans Streptococcus

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Usually forms short to long chains. The individual cells are often elongated.

Streptococcus pyogenes

Gram negative cocci

Typical Gram stains

Gram-negative cocci :

Diplococci: usually characteristic of Neiseria spp., such as N gonorrhea or N meningitides. In addition, Moraxella spp. and Acinetobacter spp.are often diplococcal in morphology. Acinetobacter can be pleomorphic, and sometimes appear as Gram-positive cocci.

N. gonorrheae

Acinetobacter spp.

Acinetobacter- A major characteristic of this species is its gram stain morphology: they appear as gram-negative coccobacilli but are frequently confused with gramnegative diplococci characteristic of Neisseria spp.

Susan D. Caston

Acinetobacter spp.

Acinetobacter often stains as Gram-variable cocci or coccobacilli. It is not unusual for this bacterium to stain as a Gram-positive coccus in blood cultures positive for the bacterium. If flattening of the "cocci" at their apposing surfaces is observed, then acinteobacter should be high on the list. Too short a period of destaining with acetone-alcohol can also present this picture, but in this case the red color of the proteinaceous background suggests that this was not the case here Susan D. Caston

Acinetobacter spp.

Susan D. Caston

Gram negative bacilli

Typical Gram stains

Gram-negative coccobacilli :
H influenzae

Typical Gram stains

Gram-negative bacilli : Thin rods: E coli

An advancing colony of Klebsiella bacteria is halted when it encounters an antibiotic. Source: : Gary Carlson, www.gcarlson.com/microbial_krebsiella.htm

Typical Gram stains

Gram-negative bacilli : Curved rods: Vibrio Campylobacter
Thin needle shape: Fusobacterium

Campylobacter

Seagull-wings appearance

Susan D. Caston

Fusobacterium

The needle-like tapering ends of the bacilli are specific for this species. The only other commonly encountered Fusobacterium species, F. necrophorum, does not possess the tapering ends and tends to be much more pleomorphic. Susan D. Caston

Candida

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Cryptococcus neoformans

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\Cryptococcus neoformans

in spinal fluid. These yeast can be easily mistaken for blood monocytes, especially when they are present in low numbers.