GRAM-POSITIVE ALGORITHM

Actinomyces
Anaerobic, Not acid fast

Gram Stain

Branching Filaments

Gram (+) purple/blue

Nocardia
Aerobic, Acid Fast

S. pneumonia
Cocci

Bacilli

Capsule
Optochin sensitive
Bile Soluble (lysed in bile)

Clostridium (anaerobe)
Corynebacterium
Listeria
Bacillus (aerobe)

Catalase (+): clusters

Staphylococcus spp.

Catalase (-): chains

Streptococcus spp.

Partial Hemolysis
(green)

Viridans
streptococci
No Capsule
Optochin resistant
Bile Soluble (lysed in bile)

Hemolysis

Group A
Complete Hemolysis
(clear)

S. pyogenes
Bacitracin sensitive

Group B

Coagulase (+)
S. aureus

S. agalactiae

Coagulase (-)
Novobiocin sensitive
S. epidermidis

Bacitracin resistant

Novobiocin resistant
S. saprophyticus

Group D, Growth in:

Bile, AND 6.5% NaCl

Enterococcus
E. faecium

No Hemolysis

Group D, Growth in:

Bile, But NOT 6.5% NaCl

Non-enterococcus
S. bovis

GRAM-NEGATIVE ALGORITHM

Gram Stain

Camplylobacter
Grows at 42 C

Gram (-) Pink

Oxidase (+)
CommaShaped

Vibrio
Grows in Alkaline Media
Produces Urease:
Urease Breath Test

Helicobacter
Diplococci
Coccoid Rods

Rods

Neisseria
Haemophilus
spp. influenza
Pasteurella-Animal bites
Brucella-brucellosis
Bordetella pertussis
Lactose
Maltose

Maltose
Fermenter

Maltose
Non-Fermenter

N. meningitidis

N. gonorrhoeae

Lactose Fermenter:
White on MacConkey

Lactose NonFermenter:
Pink on MacConkey

Fast Lactose
Fermenter

Slow Lactose
Fermenter

Klebsiella
E. Coli
Enterobacter

Citrobacter
Serratia
Others

Oxidase
Produce H2S
Black on Hektoen
Agar

Salmonella
Proteus
Yersinia

Black on TSI or
Hektoen Agar

Oxidase (+)

Does NOT Produce

H2S
Black on Hektoen
Agar

No Change on TSI or
Green on Hektoen Agar

Oxidase (-)

Pseudomona
s

Salmonella
Proteus
Yersinia

Encapsulated Bacteria: SHiNE SKiS

Streptococcus pneumoniae

Catalase (+) Bacteria: Cats Need

PLACESS to hide

Haemophilis
influenzae type B
Neisseria meningitidis
Escherichia coli
Salmonella
Klebsiella pneumoniae
iGroup B Strep (S. agalactiae)
Inc. Risk for Infection: Asplenics

Catalase: H2O2 H2O + O-(Fe Complex)

Nocardia spp.
Pseudomonas
Listeria
Aspergillus
Candida
Escherichia coli
Staphylococcus spp.
Serratia
Inc. Risk for Infection: Chronic
Granulomatous Disease (CGD): NADPH
oxidase deficiency

Transplacental Transmission:
ToRCHHeS
Toxoplasma gondii
Other: S. agalactiae
Listeria
E. coli
Parvovirus B19
Rubella
CMV
HIV
Herpes Simplex Virus-2
Syphillis

Metronizdazole: GET GAP on the Metro

Anaerobes below the diaphragm

Tetracyclines: GET GAP on the Metro

Bind 30S subunit: prevent attachment

 Toxic Free radicals DNA Damage

Giardia
Entamaeba
Trichomonas
Gardnerella vaginalis
Anaeobes
H. Pylori
Toxicities:
Disulfiram-like reaction, headache,
metallic taste

of aminoacyl-tRNA
VACUuM THe BedRoom
Vibrio cholera
Acne
Chlamydia
Ureaplama urealyticum
u
Mycoplasma pneumonia
Tularemia
H. pylori
e
Borrelia burgdorferi
e
d
Rickettsia
Toxicities:
GI Distress, discoloration of teeth and
inhibition of bone growth in children,
photosensitivity*, teratogen

Aminopenicillins: Amoxicillin, Ampicillin

Cephalosporins
1st Gen:

PEcK

 Extended-Spectrum: HHELPSS
H. influenzea
H. pylori
E. coli
Listeria monocytogenes
Proteus mirabilis
Salmonella
Shigella

1. Cefazolin
2. Cephalexin

and Gram (+) cocci

Proteus mirabilis
Escherichia
coli
Klebsiella

2nd Gen:
1. Cefoxitin
2. Cefaclor
3. Cefuroxime

HENS PEcK
and Gram (+) cocci
H. influenzae
Enterobacter
Neisseria spp.*
Serratia
marcescens
Proteus mirabilis
Escherichia
coli
Klebsiella
*growing resistance

3rd Gen:
1. Ceftriaxone
2. Cefotaxime
3. Ceftazidine

Ceftriaxone
Meningitis
Gonorrhea
Disseminated Lyme
Disease
Ceftazidimine
Pseudomonas

4th Gen: Cefepime

Pseudomas
aeruginosa
Gram (+) organisms

5th Gen: Ceftaroline

MRSA
No Pseudomonas
Coverage