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Normal Bacterial Flora (Skin (staphylococci, streptococci, corynebacterium…

- - - - staphylococci
        
        form grape like clusters
        
        can cause abscesses and pneumonia
        
        coagulase +
        
        S. aureus
        
        highly virulent
        
        S. aureus from a blood culture should never be considered a contaminant or colonizer
        
        coagulase -
        
        S. epidermidis
        
        low virulence- colonizers/contaminants
        
        Infections
        
        Skin/soft tissue
        
        abscesses
        cellulitis
        wound infections
        
        Bacteremia
        
        catheter related blood stream infections
        
        endocarditis
        
        osteomyelitis
        
        in adults due to diabetic foot infections or bed bound ptx
        
        pneumonia [esp hospital acquired}
      - streptococci
        
        often seen in pairs or chains [lancet shaped diplococci = pneumonia]
        
        Brown
        
        beta
        
        Lancefield
        
        C,G,F all cause similar types of infections
        
        group A
        S.pyogenes
        
        pharyngitis
        cellulitis
        necrotizing fascitis
        strep throat
        
        group B
        S. agalactiae
        
        Neonatal sepsis
        
        soft tissue infections
        
        how they hemolyzed agar
        
        alpha
        
        S. mutans
        Enterococcus faecium
        
        Viridans strep
        
        normal oral and GI flora
        
        can be contaminants
        
        Infections
        
        dental
        subacute endocarditis
        
        S. Pneumoniae
        
        the most important cause of respiratory tract infections
        
        sinusitis/otitis
        community acquired pneumonia
        meningitis
        
        gamma
        
        Enterococcus faecalis
        [most common non hemolytic strep we give]
      - enterococci
        
        E. faecalis
        
        more common
        Less resistant
        typically non hemolytic
        only certain antibiotics are effective
        
        infections
        
        UTI
        bacteremia
        endocarditis
        
        E. faecium
        
        less common
        more resistant (vanc)
        
        infections
        
        UTI
        bacteremia
        especially in immunocompromised patients
    - - peptostreptococcus
        
        normal mouth flora (when overgrown they cause infections
        
        dental infections
        
        putrid lung abscesses
      - clostridium spp
      - c. difficile
        
        antibiotic associated diarrhea
      - C. perfringens
        
        sepsis
  - - - listeria
      - bacillus spp
        (usually not pathogenic)
      - diptheroids
    - - clostridium spp
        (antibiotic diarrhea)
      - actinomyces
- - - - non lactose fermenting
        
        oxidase +
        
        Pseudomonas aeruginosa
        
        major cause of hospital acquired infections
        
        multi drug resistant
        
        green pigment
        
        multiplies in water [humidifiers, aerosols]
        
        Stenotrophomonas maltophilia
        
        helicobacter pylori
        
        peptic ulcer disease
        
        Pseudomonas cepacia
        
        infections in cystic fibrosis patients
        
        oxidase -
        
        Proteus
        Serratia
        Morganella
        Acinetobacter
      - lactose fermenting
        
        oxidase -
        
        E coli
        
        most common cause of UTI
        
        normal intestinal flora
        
        Klebsiella
        
        K. pneumoniae
        (most common)
        
        K oxytoca
        (more resistant)
        
        Enterobacter
        
        E. aerogenes
        
        E cloaecae
        
        NOT enterococcus
        
        Serratia
        
        S. marscesens
        
        Common Infections **
        UTI
        Pneumonia
        Intra abdominal infections
        Diabetic foot
        
        oxidase +
        
        Aeromonas
        Vibrio
    - - Morazella Catarrhalis
        
        third most common cause for respiratory infections
      - Neisseria gonorrhoeae
        
        gonorrhea
      - Neisseria meningitidis
        
        Meningitis
    - - Bordetella pertussis
        
        pertussis
      - Haemophilus influenza
        
        flu
  - - - B fragilis
        [most common]
      - intra abdominal infections
      - normal flora
    - - Normal oral flora
      - bite wounds
    - - cat oral flora
- - - - iodine
        
        decolorize
        
        counter stain (safranin)
- - - - has colistin and nalidixic acid to inhibit gram negative organisms
    - - alpha
        
        green- incomplete
      - beta
        
        complete (clear)
      - Gamma
        
        none