Gram-Positive Bacilli Part Four MLAB 2434: Microbiology Keri Brophy-Martinez

Non-Spore Formers & Branching Gram positive rod Non-spore formers Pleomorphic morphology Branching Genera Actinomyces Nocardia Streptomyces

Aerobic Actinomyces Member of the normal flora of mouth, head, and neck Pathogens Human bite wounds, eye cultures Cervicitis and endometritis in women Actinomycosis

Aerobic Actinomyces Gram stain Non acid-fast Gram positive rod Filamentous, branching Can be beaded Non acid-fast

Aerobic Actinomyces Colony morphology Spider or granular center Branching filaments Takes up to 7-14 to develop Key Biochemicals Catalase negative Nonmotile Non-fermenters Produce H2S

Aerobic Actinomycetes Nocardia Streptomyces Actinomadura Gordonia Rhodococcus Tsukamurella Nocardiopsis Dermatophilus

Nocardia: Clinical Significance Pulmonary form Mostly in immunocompromised High fatality Starts as lung lesion Cutaneous Three forms Mycetoma Lymphocutaneous Superficial Sulfur granules collected from draining sinus tracts in mycetoma

Nocardia: Laboratory Diagnosis Microscopy Gram-positive branching filaments May show beading appearance Verify with acid fast stain Weakly Acid-fast Gram-stained smear of sputum showing Gram-positive branched beaded bacilli.

Nocardia: Laboratory Diagnosis Gram-positive filamentous bacilli Suspicious for actinomycetes

Nocardia: Laboratory Diagnosis Cultural characteristics Chalky, matte, dry, crumbly appearance May be pigmented Beta hemolytic Identification Urease positive Catalase positive Molecular testing

Streptomyces Habitat Disease states Soil and decaying vegetation Mycetoma- a chronic, localized, painless, subcutaneous infection Sites: head and neck Wound & Skin infections

Streptomyces: Laboratory Diagnosis Microscopic Morphology Gram positive rod Branching Spider-like Non-acid-fast

Streptomyces: Laboratory Diagnosis Morphology & Characteristics Aerobic growth in 3-30 days Waxy, bumpy or velvety rugose forms, yellow to orange Will grown on SBA, mycology media and LJ media GPR with extensive branching, chains and spores Identification Acid-fast= negative

References http://www.atsu.edu/faculty/chamberlain/golden2000/case5.htm http://chesschumpion.blogspot.com/2007/03/time-to-put-on-your-thinking-caps.html http://en.wikipedia.org/wiki/File:Bacillus_subtilis_Gram.jpg https://labs.uhstx.com/clinical_int/dols/appb.htmlhttp://www.iccb.state.il.us/pt3/mod/science/mod_bio111/mod10/p4.html http://www.flickr.com/photos/microbeworld/sets/72157625392265538/detail/http://www.uaz.edu.mx/histo/pathology/ed/ch_9b/c9b_clue.htm Kiser, K. M., Payne, W. C., & Taff, T. A. (2011). Clinical Laboratory Microbiology: A Practical Approach . Upper Saddle River, NJ: Pearson Education. Mahon, C. R., Lehman, D. C., & Manuselis, G. (2011). Textbook of Diagnostic Microbiology (4th ed.). Maryland Heights, MO: Saunders.