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All of the  cultures were done to grow colonies of bacteria that microbiologists would be able to identify, and then prescribe medications to treat. Gram staining was done because if it was Gram positive penicillin could have been a possible antibiotic used. Gram Staining also helped identify the organism.

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MacConkey Agar with mucoid colonies (Padlet Images)

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MacConkey agar is selective and differential. It was full of pink mucoid colonies. This indicates the colonies were lactose fermenting.

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Negative for common bacterial pathogens which cause diarrhea, and no growth of any bacteria found in healthy stool.

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The patient initially came in with burns covering half her body, and was put on two broad spectrum antimicrobial agents. Five days later, the patient reported abdominal pain, bloody diarrhea, and ran a fever of 103.6 degrees F.

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Stained Gram-negative rods.

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It was determined that the bacteria Klesiella oxytoca caused Antibiotic Associated Hemorrhagic Colitis (AAHC).

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-Gram-negative rod
-Associated with urinary tract, wound, or bloodstream infections
-Not a common cause of bacterial diarrhea

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The agar plates used for growing common bacterial pathogens found in stool were used to see if there was a bacterial pathogen in the patients stool causing them to have diarrhea. There was reason to suspect infection since they had bad burns over much of their body and were susceptible. The MaConkey agar just happened to grow pink mucoid colonies, an outcome nobody expected. The pink mucoid colonies greatly helped the microbiologist determine the identity of the organism, especially since they were the only colonies to grow on any culture.

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Rod shaped in mostly random arrangements. The bacteria can be single or in clusters. The bacteria was observed with Gram staining, and is Gram negative.

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- K. oxycota is encapsulated, causing the colonies to appear mucoid.
- Pink colonies indicated lactose fermentation.

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I'm interested in seeing how bacteria interact with each other. In this case when the common stool bacteria were absent, Klebsiella oxytoca quickly grew and caused diarrhea. However, given the chance to grow back, the common stool bacteria became much more prevalent than Klebsiella oxytoca leading to the patient's symptoms going away. Why did the common bacteria become dominant, and what makes it better fit to the patients stool?

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The patient's antimicrobial therapy was discontinued and the patient quickly recovered.

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The antimicrobial therapy inhibited the normal stool bacteria from growing, allowing for the K. oxytoca to grow. Once the therapy was stopped, normal stool bacteria evidently grew back preventing the growth of K. oxytoca.

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The primary difference between Gram negative and positive bacteria is that negative bacteria have a thin peptidoglycan layer while positive bacteria have a much thicker one. Gram negative bacteria also have an additional outer membrane.

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Gram stains allow microbiologists to determine wether or not an organism is Gram negative or positive. Gram positives are purple while gram negatives are pink. After doing the stain, a dichotomous key could have been used to help determine the identity of the organism.

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Riraq. Gram Stain. Wikipedia. [Accessed 2022 February 3]. https://commons.wikimedia.org/wiki/File:Klebsiella_oxytoca.jpg

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The first thing to be done was the collection of a stool sample. General causes of diarrhea found in stool include bacterial, parasitic, and viral infections. The stool sample was plated to various media to observe growth.

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There was no mention of capsule staining, but it could have been done to confirm that the bacteria was encapsulated instead of going off of just the mucoid colonies.