bluestar
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is it motile? why?
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| mash
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yeah, it has a polar flagellum
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| bluestar
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and what other bacteria also have flagella?
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| mash
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treponema pallidum(periplasmic flagellum)
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| rida
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what about listeria??
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| bluestar
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yeah, Listeria, too. and E. coli, Salmonella, Proteus, vibrio, enterobacter. what else?
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| Sakaki-
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Heh--we'd be here all day trying to compile a list of all motile bacteria. :
Campylobacter is another, as well as Helicobacter.
Oh yeah--Listeria is supposed to show an "umbrella" pattern of motility; you'll see it in any diagnostic microbiology book. In practice, I've heard that it's almost never seen at all. ^^
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| rida
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true, and they usually describe it as tumbling motility....just an extra point to sakaki....
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| Sakaki-
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Yep. Forgot about that...thanks!
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| bluestar
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thank you guys!
and what's the diff b/t Listeria's tumbling motion and Proteus's swarming motion?
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| Sakaki-
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Proteus' swarming is seen on a macroscopic level; if you've ever seen the BAP, it has a sheen that covers the entire surface (or nearly so) due to the swarming or spreading. Why it does that--I don't know. But anyways, we usually inoculate it into a motility tube, so we don't examine it on a microscopic level.
Listeria's tumbling motility is seen on the microscopic level; it's an end-over-end kind of movement.
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| bluestar
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Sakaki, do you happen to know where I can find microbiology images?
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| Sakaki-
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I wish I could help, but I really don't know any good sites on the web...
I do sometimes use Koneman's "Color Atlas and Textbook of Diagnostic Microbiology" (there are color pages in there with some nice pictures--you might find something useful in there.
Sorry, bluestar.
Here's a picture of Proteus swarming:
http://helios.bto.ed.ac.uk/bto/microbes/proteus.h...
(mind me, that's not a BAP though...but it should give you an idea)
BTW, I forgot to mention that there are strains of Proteus that do not swarm.
It's just that I've done some lab work, so I know what some things look like. 
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| bluestar
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thank you very much, Sakaki, you've been very helpful.
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| bactitech
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I have seen the umbrella motility in a tube of SIM medium. It was a demo set up by our Ph.D. It was pretty cool. (SIM medium is for H2S, motility, and indole. It is semisolid, which allows the motility to be visualized along the stab line. With Listeria, you can see a little umbrella over the stab line).
Unfortunately, these organisms are now mostly ID'd via automated methods, so you don't get to see the cool reactions any more. I learned all my bugs on conventional media, which still comes in very helpful 29 years later. Young kids learn on the Microscan or Vitek, and the ID's are just a line of numbers.
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| bactitech
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The big problem with Proteus mirabilis/vulgaris (the two swarmers - P. mirabilis is by far the more common) is that they cover up other organisms on the plates. It can delay a culture result by a day or more, just to get the other organisms isolated from the swarming. It also stinks! Proteus is not the favorite bug of microbiologists.
The biggest problem with anaerobic specimens is that the Proteus will also swarm anaerobically. This covers up the anaerobes as well, and they're not as easily reisolated.
When you are all doctors, please understand that when there's Proteus on a culture result, it can and does delay the REST of the culture result.
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| Malaysian
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bactitech......I must tell you I just love reading your posts.....please keep them coming.I really like reading your anecdotes and expereinces.I guess its got to do with the fact that you are in a lab. and I just love working in the lab. and the people working in the labs. Thanks once again for your comments and interesting stories.....it makes microbiology 'alive'!!
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| bactitech
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Why thank you! Please remember, when you are all docs, that microbiology is just a phone call away. We never hear enough from the docs about the patients. The more we know about the patient, the better we can tell you what is significant in a culture. Believe me, when doctors order "dumb" stuff (we had a request for a glucose on a sputum the other night - it was from the med school that sends us their micro, and I would be willing to bet Las Vegas money that a resident wrote the order for THAT one - we all just rolled our eyes and had a good chuckle) too many times, the word gets around.
Good rules of thumb - in a surgical situation, tissues and aspirates are ALWAYS better specimens than a swab. A friend of mine works in a hospital that has practically outlawed swab specimens from the OR. We'd like to do that, but our pathologists are kind of wimpy about stuff like that, I guess.
DON'T order anaerobic cultures on surface skin stuff - it's a total waste of time. Tissues should ALWAYS be ordered for anaerobes. DON'T order anaerobic cultures for genital or sputum specimens - they will be rejected.
ALWAYS LABEL YOUR SPECIMENS IMMEDIATELY AFTER COLLECTION!!!!! Our policy now is to reject any mislabelled or unlabelled specimen, unless it is something like a tissue or CSF (yes, we get unlabelled CSF's - amazing!). Then a huge rigamarole must be gone through before acceptance of the specimen by the laboratory because of legal issues.
If you're not sure how to collect something, CALL THE MICRO LAB. If you want to rule out a certain organism, like Nocardia, LET THE MICRO LAB KNOW so they can set up special media. Communication is the key here.
DON'T EVER SEND A SYRINGE TO THE LAB WITH A NEEDLE ATTACHED! We write all these up as incidents and people get in big trouble for this stuff.
DON'T submit specimens on wooden swabs broken off about one inch long and tossed in a urine cup. That is a terrible specimen and it will be dry when it reaches the lab. Take the time to get a proper collection device. Also, don't submit anything perched on a wooden applicator stick. If it's liquid, it will soak into the stick and be worthless, and the stick is not sterile.
I didn't mean to get on my soap box, but I have a captive audience so I thought I'd go for it. Hope you guys don't mind :-).
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| Malaysian
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Thanks bactitech....and no I don't mind reading it all as its educational and very practical advice you're giving.I will surely try to be more communicative with the microbiologist when the time arises......but in the hospital where I used to work we had to communicate with the lab. technicians and they were awfully rude(but I'm sure you've come across rude doctors yourself).Assuming you got a specimen.....how does a microbiologist know that the bacteria grown is a probable cause of the infection or its just contamination that has occured??
Also why did you say its pointless to request for anerobic cultures for skin and also in sputum and genital swabs?As there are anerobic organisms causing pneumonia/lung abscess.
I'm sure the reguest for glucose in sputum must have caused a riot in the micro. lab!!
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| bactitech
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I'm sorry you dealt with rude micro people. Our place has required everyone to go through customer service training and things are definitely improving on our end. However, the floor and ER staff have a long way to go....
A microbiologist DOESN'T know what is contamination and what isn't. That is why the specimen must be collected carefully - to minimize skin contamination. This is why tissue and aspirates are so much better than swabs. We try to interpret the specimens as best as we can within guidelines set by the lab. Each lab's guidelines are a bit different, depending on patient population, who is the lab manager, politics (!), etc. Always call and speak to whoever sets policy if you're not sure. You can make a case for anything if you do your homework. ID docs demand workups on things a lot but they have their reasons (which are sometimes nebulous to the tech :-)).
Expectorated sputum specimens are probably the worst specimens as far as predictability of getting a decent pathogen. All sputum specimens are screened by gram stain nowadays at most facilities. If there are more than 25 epithelials/LPF (some places go down to 10/LPF) on a smear, the whole specimen is rejected as being contaminated with saliva. The ONLY respiratory specimen we accept for anaerobes is a protected brush specimen taken during bronchoscopy. We don't even accept bronchoscopy specimens for anaerobes, because of possible contaminants from the URT. The only true pathogens of the female genital tract are GC, yeasts, trichomonas, Group B beta strep (not particularly pathogenic for the woman, but deadly for the newborn), Chlamydia. We work up Gardnerella vaginalis as it has been implicated in BV (bacterial vaginosis) but the jury is out on that one, and a lot of labs don't work it up.
With a lung abscess, the best specimen would be an aspirate directly from the abscess (not so easily obtained).
As far as skin, it is an open area. Anaerobes live in closed conditions. Many labs reject specimens for anaerobes if ANY epithelials appear on the gram stain. This indicates improper collection. Don't forget - anaerobic workups take a LOT of time and money. It's not money well spent if the specimen is bad or inappropriate in the first place.
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| Alina T
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bactitech, it is really amazing that you share your time and experience with us!! I'm impressed by the fact that you do this exclusively to our bennefit. thank you very much, your posts are useful for our close exam and future practice also and you have the gift to make them interesting at the same time.
We appreciate it!! 
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| bactitech
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Thanks so much for your support, Alina. I do enjoy this. There are many questions on the forum that I don't have a clue as to what the answer might be. I am trying to stick with what I know. We teach pathology residents in the micro lab, and also take telephone calls from residents quite frequently. When it comes to microbiology, I know that most of them are quite lost, unless they are doing ID.
I took a call from a resident this evening. A urine culture went out with >100,000 E. coli, 10-50,000 Group D strep, and 10-50,000 yeast not Candida albicans. I'm not sure why all this was worked up but it was. Anyway, the resident wanted to put the patient on an oral antibiotic and discharge her to home. The poor guy didn't know how to look up results on the computer. I tried reading them to him, but he was unsure of the names of the antibiotics (except for Cipro - the EC was resistant, naturally [what is it with Cipro - I think these drug salesmen have pushed this drug as the be-all and end-all for everything]). I tried to give him the MIC of Nitrofurantoin, as we report out both the MIC AND the interpretation (sensitive) and I lost him. He obviously didn't know what he was going to do. I knew he really needed to see the result in front of him on the screen so he could ponder it before prescribing, so I told him that the result was in the computer and he could look it up. We ended the call. I felt kind of bad, but he really couldn't understand what I was trying to tell him, and without the Cipro crutch he was lost.
I think I would have gone to a superior or ID doc at that point, since the EC was pretty resistant to most of the common drugs. I think he was trying to get a one-drug-fits-all, but when you throw the yeast in there, it complicates things. Of course, we as techs cannot recommend any antibiotics as we are not physicians. This is made very clear to us in our training. We can make suggestions as to recollection, etc. but when it comes to prescribing things, that's a big no-no. I really feel for you guys as there's SO much to learn out there, and only 24 hours in the day. I have the luxury of doing just micro and have been doing it so long that it comes easily to me.
I'll help you as much as I am able, but I will surely tell you when the answer is beyond my limited scope.
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