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Microbiology

Direct Stain Diagnosis

CSF Bacteria, gram stain

Urine Bacteria

Vagina Yeast, Trichomonas

Aspirate, abscess Bacteria, ? Rx

Urethritis (male) Gm negative diplococci

Blood smear Malaria, Borrelia

Sputum AFB

Special Media

Organism Special Medium

B. pertussis Charcoal

N. gonorrhoeae Thayer Martin, CO2

Arcanobacterium Rabbit or Human Blood

H. influenzae Chocolate, CO2

E. coli 0157 Sorbitol

Campylobacter Selective, CO2, decreased 02

C. diphtheriae Loeffier's

Legionella Buffered charcoal yeast extract

Special Media (Major Categories)

Organism Special Medium

Antibiotic Mueller-Hinton Microbiology

Anaerobes Pre-reduced

Mycoplasma

Ureaplasma

Virus

The "HACEKS" Group

Fastidious, gm- coccobacilli - require CO2, heme, neg

growth on selective media.

Associated with oral-facial infections and SBE.

Haemophilus aphrophilus

Actinobacillus actinomycetemcomitans

Cardiobacterium hominis

Eikenella corrodens

Kingella kingae (arthritis, osteo)

Suttonella indologenes

Antigen Assays in Pediatric Patients

Useful Not Recommended

B. Pertussis FA H. influenzae*

C. difficile EIA N. meningitidis*

Cryptococcus S. pneumoniae*

Giardia/Cryptosporidium Gp. B Streptococcus*

Gp A Streptococcus

Measles

RSV EIA (limited use)

Varicella-zoster FA

* limited use impartially treated

Useful Applications for

Amplification Assays in Pediatrics

· Unculturable organisms

· Fastidious, slow-growing organisms

* Dangerous organisms which should not be grown in lab

· Few viable organisms in specimen

Amplification Assays in Pediatrics

(Unculturable Organisms)

Parvovirus B I 9 Anemia in immunocompromised*

Hepatitis B

Hepatitis C Early hepatitis in seronegative

JC Virus PML in immunocompromised*

EBV Encephalitis in HIV

PTLD in transplant patients (quant)

Coxsackie A Aseptic meningitis/encephalitis

(summer)

*Becoming Standard of Care

Amplification Assays in Pediatrics

(Dangerous to try to Grow in Lab)

HIV Newborns (transplacental Ab)*

Late AIDS (poor Ab response)

*Becoming Standard of Care

Amplification Assays in Pediatrics

(Monitor or Predict Outcome of Therapy)

HIV Quantitative with CD4*

CMV Drug resistance genes

HIV Drug resistance genes

Hep B, C Monitor status

*Becoming Standard of Care

Amplification Assays in Pediatrics

(Slow Growing Organisms)

M. tuberculosis Smear positive patients*

M. pneumoniae Atypical pneumonia

C. pneumoniae Atypical pneumonia > I year of age

B. pertussis Pertussis

CMV Viremia or encephalitis in

immunocompromised*

Cat Scratch lmmunocompromised*

Enterovirus Aseptic meningitis/encephalitis

(summer)

*Becoming Standard of Care

Amplification Assays in Pediatrics

(Few Viable Organisms)

C. trachomatis STD in teens (not sexual abuse)

IV. gonorrhea STD in teens (not sexual abuse)

Herpesvirus Encephalitis*

*Becoming Standard of Care

If it looks like a duck ...........

and it flies like a duck .....

and it quacks like a duck .....

it's probably a duck!