Case Studies in Clinical Microbiology (Online CE Course)

(based on 1025 customer ratings)

Elmer W. Koneman, MD; Christie A. Grueser MSS, MT

Do you want to challenge your knowledge of those classic clinical microbiology topics? Do your collegues always look to you as the local expert on bacteria? Then, Case Studies in Clinical Microbiology is the course for you! This newly revised and updated interactive microbiology course contains classic case studies and covers 10 common but important topics topics, including ESBL- producing strains, MRSA, neonatal meningitis, and much more. Whether you are a student or practicing clinical microbiologist, this is a great way to earn a full 6.5 hours of P.A.C.E. approved CE credits that are sure to satisfy your need for all things microbiology. Subscribe today!

Continuing Education Credits

• P.A.C.E.® Contact Hours (acceptable for AMT, ACSP / NCA, and state recertification): 6.5 hour(s)
• Florida Board of Clinical Laboratory Science CE - General (Microbiology/Mycology/Parasitology): 6.5 hour(s)

Objectives

• Overall Objective 1: To provide home access to on-line clinical microbiology case studies.
• Overall Objective 2: To correlate the clinical histories of select bacterial infectious diseases with laboratory culture results.
• Overall Objective 3: To provide home-base, on-line opportunities to acquire continuing education credits.
• Learning Objectives: At the completion of this case study review, the student will be able to:
• 1. Correlate presenting clinical signs and symptoms with the organism identifications for the cases being presented.
• 2. Outline the presumptive and definitive characteristics for the laboratory identification of the bacterial species being presented.
• 3. Discuss the diagnostic and therapeutic implications of making a correct organism identification.
• 4. Recommend key current literature citations for each of the infectious diseases and bacterial species included in the program.

Customer Ratings

(based on 1025 customer ratings)

Course Outline

• Acute urethral discharge
• Clinical history
• A 25-year-old female presented in the emergency room with an acute urethral discharge of two days duration. The image to the right shows the Gram stai...
• Lab ID presumptive
• The positive oxidase reaction as shown in the image (yellow arrow) rules out which of the following two look-alike organisms of N. gonorrhoeae? (...
• The Superoxol Test
• Lab ID definitive
• The carbohydrate utilization reaction seen in the QuadFerm system shown in the image provides a definitive identification of N. gonorrhoeae.
• Literature Reviews and Queries
• Review 1
• Acute gonorrhea is the most common cause of septic arthritis in patients under 30 years of age.
• The recovery of an oxidase-positive, gram-negative diplococcus that tests direct flourescent antibody (DFA) non-reactive should be tested by alternati...
• Acute onset pneumonia
• Clinical History
• Acute Onset Pneumonia
• The Gram stain report to be issued based on the microscopic characteristics seen in the image on the right would most correctly be, "many WBC wit...
• Based on the Gram stain morphology observed in the previous image, the possible presumptive identifications might include "gram-positive cocci consist...
• Laboratory Identification
• The patient was admitted to the hospital. The sputum specimen was inoculated to sheep blood agar. Based on the colony morphology and the alpha hemolys...
• The name of the rapid test seen in the image, often used to differentiate S. pneumoniae from viridans streptococci, in which a drop of 10% deoxycholat...
• The zone of inhibition around the disk shown in the image has been measured at 23 mm. Based on this result, you should:
• The oxacillin screen test alone is not sufficient for determining the susceptibility to penicillin for S. pneumoniae isolates recovered from cerebrosp...
• Minimum inhibitory concentration (MIC) susceptibility tests should also be performed against other select beta lactam antibiotics on important S. pneu...
• Pneumococcal Resistance
• Literature Reviews and Queries
• Review 1
• Streptococcus pnemoniae is the most common cause of fatal community-acquired pneumonia.
• Middle ear damage in cases of S. pneumoniae infections are caused primarily by the: (Choose all that apply)
• Pneumococcal vaccine is particularly effective in children less than two years of age.
• Gram-negative sepsis
• Clinical History
• Clinical History
• Laboratory Identification
• The colonies shown in the blood (BAP) agar (upper) and MacConkey (MAC) agar (lower) biplate are a 24 hour growth from an aerobic blood culture bottle ...
• The reactions seen in the portion of the API strip shown in the photograph, effectively rules out Escherichia coli.
• Isolates of Escherichia coli, Klebsiella pneumoniae, K. oxytoca and clinically significant isolates of Proteus mirabilis may possess extended-spectrum...
• Extended-Spectrum Beta-Lactamases (ESBLs) Review
• Extended-Spectrum Beta-Lactamases (ESBLs)
• Extended-Spectrum Beta-Lactamase (ESBL) Screening by Disk Diffusion
• ESBL Screeing by Broth Microdilution
• Phenotypic Confirmation by Disk Diffusion and Reporting
• Extended-Spectrum Beta-Lactamase (ESBL) Activity
• Phenotypic Confirmation by Broth Microdilution and Reporting
• Literature Reviews and Queries
• Review 1
• The prevalence of extended-spectrum beta-lactamases (ESBLs) may be underestimated because the Clinical and Laboratory Standards Institute (CLSI) had s...
• The hands of hospital personnel represents one of the major reservoirs for the persistence and potential spread of extended-spectrum beta-lactamase (E...
• Recurrent urinary tract infection
• Clinical History
• Clinical History
• The bacterial species shown growing on 5% sheep blood agar was recovered from the spun sediment of a midstream urine specimen after 24 hours incubatio...
• Laboratory Identification
• Pyrrolidonyl Arylamidase (PYR) Differential
• The spot test that is helpful in separating Enterococcus species (positive as shown in the image) from the viridans streptococci and S. pneumoniae (bo...
• Enterococcus Identification
• Enterococcus faecium Identification
• Vancomycin Resistance
• In this image is a quadrant plate containing brain heart infusion agar supplemented with 6 ug/mL of vancomycin. The right upper quadrant was inoculate...
• Literature Reviews and Queries
• Review 1
• Review 2
• What is the most important modifiable risk factor for enteric colonization with vancomycin-resistant Enterococcus faecium (VREF)?
• Acute enteritis with sepsis
• Clinical History
• Case History
• Gas gangrene may be seen in infections with all the following clostridia EXCEPT:
• Laboratory Identification
• The Gram stain shown in the image was prepared from a positive anaerobic blood culture bottle after 36 hours incubation. Based on the morphology of th...
• Colony Morphology
• Clostridium Quad Plate
• Clostridium septicum RapID ANA
• It is important to establish a species identification of C. septicum in blood culture isolates because of its close association with carcinoma of the ...
• Literature Reviews and Queries
• Review 1
• Review 2
• Review 3
• Match the species of anaerobes and frequently associated conditions.
• Each of the following statements is true concerning Clostridium septicum infections EXCEPT:
• Post Traumatic Wound Infection
• Clinical History
• Clinical History
• A Gram stain of the serous exudate is shown in the image. The appropriate report would read:
• Laboratory Identification
• Staph on Blood Agar
• The bacterial cells shown in the image were observed in a smear prepared from the colony shown before. Which of the following tests will help to affir...
• The tube coagulase test, shown in this image (upper tube positive), should be performed on all S. aureus-suspicious isolates giving a negative slide c...
• Staph aureus Mannitol
• Testing for Methicillin Resistance
• Methicillin-Resistant Staphylococcus aureus (MRSA) Screen
• Methicillin-Resistant Staphylococcus aureus (MRSA) Disk Test
• Literature Reviews and Queries
• Review 1
• Review 2
• Review 3
• Factors predisposing to infections with methicillin resistant Staphylococcus aureus (MRSA) include: (choose all that apply)
• Decreasing the risk of staphylococcal colonization of indwelling catheters in the future may involve:
• Patients with infections with MRSA have uniformly poorer outcomes than those infected with sensitive strains.
• The staphylococcal toxins causing the scalded skin syndrome (SSSS) have as their site of action in w
• Splenic abscess
• Clinical History
• Spleen Specimen
• Laboratory Identification
• Illustrated in the upper image are tiny pinpoint 24-hour colonies recovered from one of the splenic abscesses. The wide zones of beta hemolysis are be...
• Most strains of S. anginosus (milleri) carry the F antigen (see image). Rare strains that carry the group A antigen can be differentiated from S. pyog...
• S. anginosus ("milleri") CO2
• S. anginosus ("milleri") Biochemicals
• Literature Reviews and Queries
• Review 1
• Review 2
• Most infections caused by S. anginosus can be effectively treated with penicillin or a first generation cephalosporin.
• The epidural and subdural abscesses in the two patients reported by Gelfand, et al, are clinical manifestations uncommon for S. anginosus ("milleri").
• A clinical condition often associated with Streptococcus anginosus ("milleri") is:
• Cellulitis
• Clinical History
• Cellulitis Skin
• Laboratory Identification
• The image shows the Gram stain prepared from the positive blood culture. What is the appropriate report?
• Beta hemolytic colonies grew from the blood culture bottle after 18 hours incubation (see image). Which of following tests would be helpful in ma...
• Group A Strep A Disk/SXT
• Thus, in follow-up to the previous discussion, the reaction shown in the image establishes the identification of a group A, beta hemolytic streptococc...
• Literature Reviews and Queries
• Review 1
• Review 2
• What is a major complication of toxic shock syndrome related to group A streptococci, leading to 50% mortality?
• What are the factors related to the strong resistance of certain strains of group A streptococci to phagocytosis? (Choose all that apply) 
• Neonatal meningitis
• Clinical History
• Clinical History
• Histology of Brain Biopsy
• A Brown and Brenn gram stain was performed on one of the tissue biopsy specimens. Organisms were seen as shown in the image. Based on the history and ...
• Laboratory Identification
• Colony Morphology
• Shown in the image is a close-in view of the colony growth after 48 hours incubation. What are the possible presumptive identifications  sug...
• What test(s) which may be performed to establish a presumptive differential identification between group B streptococci and L. monocytogenes?
• Listeria Gram stain
• Shown in theimage are three tubes: (1) motility agar (note subsurface flare shown by arrows); (2) esculin hydrolysis (+), and (3) VP (+). The reaction...
• Listeria motility
• Literature Reviews and Queries
• Review 1
• Review 2
• Review 3
• Which of the following is NOT related to the virulence of Listeria monocytogenes? 
• Which of the following factors has NOT led to the current increase in incidence of listeriosis? 
• A characteristic of the virulence of L. monocytogenes is its unique ability to invade peripheral nerves and rapidly enter into the brain.
• Cellulitis of the arm
• Clinical History
• Cellulitis Lesion
• Laboratory Identification
• Eikenella BAP
• A bacterial isolate that produces pitting of the agar and has a bleach-like odor is probably E. corrodens. What are the closely related species that m...
• Eikenella - Catalase & Oxidase
• Eikenella Biochemicals
• Which of the following result in most Eikenella cellulitis infections? 
• In view of the feedback to the previous question, what is the most likely reason that the clinical correlation does not seem to fit in this case? ...
• Literature Reviews and Queries
• Review 1
• Review 2
• Review 3
• Human bite wound infections are categorically more severe and more often lead to complications than infected bites from other animals.
• To avoid infection with E. corrodens, what are patients with insulin-dependent diabetes mellitis (IDDM) advised NOT to do? (Choose all that apply)
• We can conclude from Robinson & Kourtis' "Tale of the Toothpick", that, "it is unwise to place a used toothpick in your pocket."
• References
• References

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