Bacterial Identification

There are many differents ways to identify a bacterial unknown and many different situations where identification would be beneficial. One way to identify bacterial unknowns is to perform biochemical tests. In this experiment multiple biochemical tests were done, by performing these tests on the bacterial unknown received the two different bacteria were then identified. The citrate test is done to test the ability of organisms to use citrate as a carbon source. This test uses Simmons citrate agar, the agar contains sodium citrate as the only carbon source and has bromothymol blue as the pH indicator. The organisms that use citrate as a carbon source use the enzyme to transport the citrate into the cell. The cells converts ammonium dihydrogen

The purpose of this lab was to identify two unknown bacteria from a mixed culture. The reason for identification of unknown bacteria was to help students recognize different bacteria through different biochemical tests and characteristics. This is important in the medical field because identification of unknown bacteria can help treat a patient by knowing the contributing source of a disease. Also knowledge of different bacteria helped others make antibiotics used today. This lab was completed by using the methods learned thus far in identification of bacteria.

The first result of importance was the result of the Gram stain. The observations of the unknown bacteria from the slant culture after Gram staining showed that the unknown bacteria were Gram negative bacilli (Image 1). After determining the unknown bacteria was Gram negative, an oxidase test was conducted on a sample from the slant culture. The cotton swap with the sample of bacteria did not change color when the oxidase reagent was applied, thus providing a negative result. With a negative oxidase test, further tests were conducted to determine various characteristics of the unknown bacteria. A MR-VP broth was inoculated with a sample from a slant culture of unknown bacteria. After incubation, the methyl red reagent was added to the broth, and the broth turned red, providing a positive result (Image 2). An EMB agar streak plate was inoculated with a sample from a slant culture of the unknown bacteria, and after incubation, growth was found on the plate, providing a positive result (Image 3). A Citrate agar slant was inoculated, and after incubation, growth was found on the media, providing a positive result (Image 4). A Urea agar slant was inoculated, and after incubation, the agar had changed from a peach color to a bright pink color, providing a positive result (Image 5). Using the flowchart (Figure 1) developed from the Table of Expected Results, the lab partners started at the oxidase test. Given the negative result of the oxidase test, the flowchart is

For many years the identification of microorganisms has been important in the world of medicine. It is essential or correct disease diagnosis in patients and for proper treatment. Knowing the correct identity and characteristics of microorganism is crucial when disease outbreaks occur in populations, also knowing how humans can benefit from microorganisms is important; many can be used in making certain foods or antibiotics.

Unknown bacteria determined to be Alcaligenes faecalis because of its morphological, physiological and metabolic properties.

The number of documented cases has been rising every year. “This may be due to the aging population, the increased longevity of people with chronic disease, the spread of antibiotic-resistant organisms, an upsurge in invasive procedures and broader use of immunosuppressive and chemotherapeutic agents” (National Institute of General Medical Sciences, 2014). The mortality rate for sepsis ranges from about thirty percent for patients with sepsis to fifty percent in patients who develop septic shock. Mortality rate varies as to how many organs have been affected. Twenty percent mortality for one organ failure, forty percent for two organs failing, sixty-five to seventy percent for three failed organs, and seventy-five to eighty-five percent when four or more organs have failed. The cost related to sepsis is about seventeen billion dollars per year (about twenty-two thousand dollars per patient), which is six times greater than the cost of patients without sepsis.

The first step toward identifying this unknown organism was to perform a Gram Stain to differentiate between gram positive and gram negative bacteria. This is an important step because it directs what the next tests will be. My Gram Stain on sample #12 showed that the bacteria was gram negative, however, after receiving the results of the OF glucose, H2S, Citrate, Urease and Motility tests, it was apparent that my Gram Stain was contaminated. I then performed a catalase test which came back negative, so I ordered a Bacitracin disc, Optochin disc and a CAMP test which had to be incubated overnight. After receipt of those test results,

Sepsis is a very serious condition with a high mortality rate that ranges from 28-50%. 9

The ASP/IC team continues to review specifically targeted drugs hospital-wide to determine trends in antibiotic utilization and Proton Pump Inhibitors (PPI) for CDI cases. Increased awareness monitoring of antibiotics, particularly broad-spectrum antibiotics, can result in the early de-escalation of therapies, thereby reducing risk factors for CDIs. EVS continues to use the Dazo monitoring device to monitor staffs cleaning efforts. Efforts have improved from previously reported. C diff algorithm implemented in May 2017.

The purpose of this study was to identify the unknown bacterium #305. This sample was collected from the urine of a 64 year old hospital patient named “Doris”. Several tests were conducted to determine the morphological and physiological characteristics of the unknown. These tests included but were not limited to: motility, gram staining, salinity tolerance, and fermentation of different substances. After assessing the observed results, the identity of unknown bacterium #305 was suggested to be Citrobacter freundii. The test results, with the exception of the urea test, were very consistent with the expected results.

Knapp (2012) describes sepsis as the systemic inflammatory response to a pathogen. Sepsis can be a fatal condition which occurs when the body retaliates to an infection by attacking the body’s own tissues and organs. Sepsis has many symptoms that can be attributed to other illness such as flu, which can make it difficult to recognise and treat in time (CDC Sepsis 2016). Due to this every year in the UK there are 150,000 cases of sepsis, which leads to 44,000 deaths, in perspective sepsis results in more deaths than bowel, breast and prostate cancer collectively (Sepsis Trust, 2016). Sepsis costs the NHS £15.6 billion a year (Sepsis Trust 2016). As the NMC code of conduct describes, healthcare professionals have a ‘duty of condor’ to preserve the safety of patients, reducing the potentials of harm and mistakes to the service users (NMC Code of Conduct 2015), thus with improved management and early detection of sepsis e.g. beginning a course of antibiotics within the hour of detection, will not only save the NHS £2.8 billion a year but thousands of lives (Sepsis Trust 2016).

In Cleveland Clinic, trained pharmacists could monitor patients’ labs and adjust medication dosages based on the lab under the consent. One of the medications was antibiotics, especially vancomycin. The center tried to expand the existed service to home care setting. Therefore, my preceptor and I were talking with the person in the legislative field.

Effective sepsis management not only reduces patient morbidity and mortality, but it can substantially impact the financial status of the hospital by reducing the cost of care, length of stay, readmissions and ultimately increase reimbursement. By lowering

Future studies should concentrate on introducing intravenous antibiotics to pre-hospital setting, which would dramatically decrease the time interval to administration of antibiotics. However, safety, efficacy and cost-effectiveness would need to be taken into account through conducting randomized controlled trials to find out the effect on reducing delay, infection and occurrence of adverse effects

Multi use of single dose vials are the leading cause of life threatening infection. It may cause wide spread infections such as hepatitis ,STD’s or hospital acquired infections and can even lead to death. The Nursing staff must follow safe injection and infection control practices to prevent bacterial growth by the use of strict aseptic method each time. The use of storage, preparation, administration, and discard on medication in safe manner. The use of sterile alcohol or approved aseptic swab will control bacterial growth. Do not reuse vials once open. Discard the vials properly after single use even if medication is left in vials. Using a teach back style educate the patient on improved safety and controlled environment will prevent diseases.