Case Study 3: Answer the following questions based upon the following clinical microbiology report: DATE: 10/25/2008  21:22:13                                          bioMerieux Vitek 2 Lab Report PATIENT NAME: HARRIET MORGAN PATIENT ID00000000 SEX: F DOB: 01/01/1931 AGE: 81Y ROUTINE CULTURE  SPECIMEN: URINE  COLONY COUNT= >100,000 CFU/ML ISOLATE: STAPHYLOCOCCUS AUREUS SUSCEPTIBILITY TEST DRUG MIC(mcg/ml) INTERPRETATION ROUTE/DOSAGE AMPICILLIN  >=16 R PO/IV250-500MGQ6H CIPROFLOXACIN >=4 R IM/IV0.5-1.0GMQ8H ERYTHROMYCIN >=8 R PO250-500MGQ6H GENTAMICIN =8 R PO400MGQ12H PENICILLIN G >=16 R IV2.0-3.0GMQ4-6H RIFAMPIN

Mycoplasmas are resistant to penicillins because:

Case Study 1:  The patient was a 37-year-old male with hemophilia.  He was HIV positive and had progressed to full-blown AIDS in the past 3 months.  His current medications included factor VIII treatments, suppressive treatment with the antimicrobial agents trimethoprim/sulfamethoxazole, and azidothymidine (AZT).  He presented with a 3-day history of voluminous bloody diarrhea, 10-lb (ca. 4.5-kg) weight loss, and profound dehydration.  Tests for ova and parasites and culture for Salmonella, Shigella, Yersinia, and Campylobacter were negative three times.  He gave no recent travel history, nor had he recently consumed shellfish. Case Study 1.2:  What role do suppressive antimicrobial agents have in predisposing this patient to his current infection?

Bacillus cereus has been most closely implicated in which of the following diseases?

Neurotoxin is produced by which anaerobic bacteria? Check all which apply.

Ixodes scapularis, the deer tick, is best known as the vector for:

Answer the next three questions (A, B, C) concerning Enterobacteriaceae: Question A:   List one organism in the Enterobacteriaceae family that can only be classified as a definitive pathogen.

You have a set of plates from a urine culture, one SBAP and one MacConkey, both have greater than 100,000 colonies.  A gram stain indicates the presence of gram-negative bacilli.  You suspect it could either be from the Enterobacteriaceae family or is a Non-fermenter.  Outline two ways you could determine which group the organism is from and how that determination was made.

Which body site)s) might contain anaerobes as normal flora? Check all which apply.

Case Study 3: A 3-year old girl presents at the emergency room with bloody diarrhea, fever and vomiting. The child’s mother reports that the day-care center called yesterday morning because she started having a watery diffuse diarrhea.  That night she began to complain of severe cramps and her diarrhea became bloody and pus-filled.  The family has no recent travel history and while they are vegetarians, they only consume pasteurized milk, cheese, and egg products.  The gram stain showed many white blood cells and many gram-negative bacilli.  The culture resulted in many yellowish-clear colonies on the MacConkey’s agar that were oxidase negative and fermented glucose.   She was admitted to the hospital to treat her dehydration and for observation.  Case Study 3 Question 1: What was the most likely etiologic agent of infection in this patient?