Gram positive bacteria: Difference between revisions
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==Cocci==
==Cocci==
#Clusters ([[Staph Species]])
===Clusters ([[Staph Species]])===
##Coagulase Positive: [[Staph aureus]]
#Coagulase Positive: [[Staph aureus]]
###Always consider as true bacteremia (and not a [[Bacteremia Versus Contaminated Blood Cultures‎|contaminant]]) due to the danger of delaying treatment<ref>Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp</ref>
##Always consider as true bacteremia (and not a [[Bacteremia Versus Contaminated Blood Cultures‎|contaminant]]) due to the danger of delaying treatment<ref>Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp</ref>
##Coagulase Negative:  
#Coagulase Negative:  
###[[Staph epidermidis]]
##[[Staph epidermidis]]
####Most common cause of catheter-related bacteremia<ref>Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp</ref>
###Most common cause of catheter-related bacteremia<ref>Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp</ref>
####Most common skin [[Bacteremia Versus Contaminated Blood Cultures‎|contaminant]] found in blood cultures<ref>Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp</ref>
###Most common skin [[Bacteremia Versus Contaminated Blood Cultures‎|contaminant]] found in blood cultures<ref>Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp</ref>
###[[Staph saprophyticus]]
##[[Staph saprophyticus]]
####[[UTI]]s in women
###[[UTI]]s in women
###[[Staph lugdunensis]]
##[[Staph lugdunensis]]
####Rare cause of [[endocarditis]], [[meningitis]], and [[Skin and Soft Tissue Infections]]  
###Rare cause of [[endocarditis]], [[meningitis]], and [[Skin and Soft Tissue Infections]]  
###[[Staph haemolyticus]]
##[[Staph haemolyticus]]
####Rare cause of [[endocarditis]], [[meningitis]]  
###Rare cause of [[endocarditis]], [[meningitis]]  
#Chains or Pairs ([[Strep]] and Related)
===Chains or Pairs ([[Strep]] and Related)===
##Enterococcus (e.g. Enterococcus faecalis, Enterococcus faecium)  
#Enterococcus (e.g. [[Enterococcus faecalis]], [[Enterococcus faecium]])  
###May cause bacteremia in the proper clinical setting ([[UTI]], intra-abdominal infections, infected vascular catheters, and [[endocarditis]])<ref>Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp</ref>
##May cause bacteremia in the proper clinical setting ([[UTI]], intra-abdominal infections, infected vascular catheters, and [[endocarditis]])<ref>Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp</ref>
##[[Strep viridans]]
#[[Strep viridans]]
####In general are low virulence pathogens and likely contaminants (21-50% of positive blood cultures are clinically significant)
###In general are low virulence pathogens and likely contaminants (21-50% of positive blood cultures are clinically significant)
####Risk factors for VGS bacteremia include: neutropenia, oral mucositis, irradiation to the oral cavity, antibiotic prophylaxis with trimethoprim-sulfamethoxazole and fluoroquinolones, intravenous hyperalimentation, high dose chemotherapy
###Risk factors for VGS bacteremia include: neutropenia, oral mucositis, irradiation to the oral cavity, antibiotic prophylaxis with trimethoprim-sulfamethoxazole and fluoroquinolones, intravenous hyperalimentation, high dose chemotherapy
##[[Streptococcus pneumoniae]] (Pairs only)
#[[Streptococcus pneumoniae]] (Pairs only)
###Asociated with [[pneumonia]], [[meningitis]], [[peritonitis]] and other severe infections
##Asociated with [[pneumonia]], [[meningitis]], [[peritonitis]] and other severe infections
###Isolation of this organism is always significant and should be treated<ref>Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp</ref>
##Isolation of this organism is always significant and should be treated<ref>Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp</ref>
##Other [[Strep Species]]
#Other [[Strep Species]]
####ß-hemolytic streptococcus (Group A Streptococcus, Group B Streptococcus, etc)
###ß-hemolytic streptococcus (Group A Streptococcus, Group B Streptococcus, etc)


==Rods (Bacilli)==
==Rods (Bacilli)==

Revision as of 02:55, 24 April 2014

Cocci

Clusters (Staph Species)

  1. Coagulase Positive: Staph aureus
    1. Always consider as true bacteremia (and not a contaminant) due to the danger of delaying treatment[1]
  2. Coagulase Negative:
    1. Staph epidermidis
      1. Most common cause of catheter-related bacteremia[2]
      2. Most common skin contaminant found in blood cultures[3]
    2. Staph saprophyticus
      1. UTIs in women
    3. Staph lugdunensis
      1. Rare cause of endocarditis, meningitis, and Skin and Soft Tissue Infections
    4. Staph haemolyticus
      1. Rare cause of endocarditis, meningitis

Chains or Pairs (Strep and Related)

  1. Enterococcus (e.g. Enterococcus faecalis, Enterococcus faecium)
    1. May cause bacteremia in the proper clinical setting (UTI, intra-abdominal infections, infected vascular catheters, and endocarditis)[4]
  2. Strep viridans
      1. In general are low virulence pathogens and likely contaminants (21-50% of positive blood cultures are clinically significant)
      2. Risk factors for VGS bacteremia include: neutropenia, oral mucositis, irradiation to the oral cavity, antibiotic prophylaxis with trimethoprim-sulfamethoxazole and fluoroquinolones, intravenous hyperalimentation, high dose chemotherapy
  3. Streptococcus pneumoniae (Pairs only)
    1. Asociated with pneumonia, meningitis, peritonitis and other severe infections
    2. Isolation of this organism is always significant and should be treated[5]
  4. Other Strep Species
      1. ß-hemolytic streptococcus (Group A Streptococcus, Group B Streptococcus, etc)

Rods (Bacilli)

Organism
Cult Morphology

Listeria monocytogenes

Small

Aero
 tumbling
Diphtheroids
 Small Anaero
 pallisades
Actinomyces
 Small Anaero
 Branching
Propionibac
 Small Anaero
 clumps/pleo
Lactobacillus
 Variable Both
 may chain
Clostridium
 Large Anaero
 Spores
Bacillus Large Aero Spores

Clinical Identification Chart

Gram-Positive Classification.png

Table Overview

Gram Positives
Cocci
Clusters
Pairs/Chains
Other
Rods
Gram Negatives
Cocci
Rods
Lactose Fermenters
Lactose Non-Fermenters
Other
Rods/Cocci
Anaerobes

See Also

Source

  1. ↑ Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp
  2. ↑ Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp
  3. ↑ Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp
  4. ↑ Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp
  5. ↑ Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp
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