question

Which Organism is a risk for patients receiving intravenous lipid supplements?

answer

Malassezia furfur

question

Which organism that can be found in the blood infects only T lymphocytes and possibly macrophages

answer

HIV

question

What is the most common location where bacteria gain entry to the blood and cause bacteremia?

answer

Genitourinary tract

question

What bacteria are most frequently implicated in nosocomial bacteremiaIn a hospital setting, what is the most common cause of infection with these organisms?

answer

Staphylococcus epidermidis and other coagulase negative Staphylococci.
Intravascular catheters

question

Which organism is an asaccharolytic small gram-negative rod that is Oxidase positive, Catalase, Indole and Arginine dihydrolase negative, pits in the culture agar and has a bleach like odor?

answer

Eikenella corrodens

question

Which organism is a fusiform, gram-negative bacillus that exhibits yellow pigment, gliding motility, grows best at 35 degrees Celsius and requires increased CO2 for growth?

answer

Capnocytophage

question

Which organism exhibits Non-hemolytic colony growth, Oxidase positive, tends to pit agar, can be isolated on modified Thayer martin agar and can be misidentified as N. gonorrhea?

answer

Kingella dentrificans

question

Hos is Kingella dentrificans differentiated from Neisseria gonorrhea?

answer

Kingella is catalase negative and Neisseria gonorrhea is catalase positive

question

What conditions are caused by Bartonella quintana?

answer

Trench fever, bacteremia, endocarditis, bacillary angiomatosis and chronic lymphoadenopathy

question

What conditions are caused by Bartonella henselae

answer

"Cat scratch" disease, bacteremia, endocarditis, bacillary angiomatosis and peliosis hepatic

question

Malaria caused by Plasmodium species has a primary exo-erythrocytic cycle that occurs before infection of the red blood cells. Where does this cycle take place?

answer

Liver

question

Which Plasmodium species demonstrates only delicate ring forms and crescent-shaped gametocytes in peripheral blood smears?

answer

Plasmodium Falciparum

question

Name the Trypanosome that has CNS invasion early, but death may occur before CNS involvement, Inflammation of the heart is more common and severe, the disease progresses rapidly

answer

Trypanosoma brucei rhodesiense

question

The etiology of acute pneumonia's is strongly dependent on age: What is the most common etiologic agent of Community-acquired pneumonia in adults regardless of age?

answer

Streptococcus pneumoniae

question

The etiology of acute pneumonia's is strongly dependent on age: What is the most common etiologic agent of bacterial pneumonia in school aged children (5-14 years)?

answer

Mycoplasma pneumoniae and Chlamydia pneumoniae

question

The etiology of acute pneumonia's is strongly dependent on age: What is the most common etiologic agent of lower respiratory tract infection in adults younger than 30 years?

answer

Mycoplasma pneumoniae

question

The etiology of acute pneumonia is strongly dependent on age: What is the most common etiologic agent of lower respiratory tract infection in previously healthy patients 2 months to 5 years?

answer

RSV

question

What major morphological feature is first in determining the scheme to follow for identification of Streptococci?

answer

Hemolytic pattern

question

What is incomplete hemolysis and a green discoloration of the media called?

answer

Alpha hemolysis

question

What is complete hemolysis and a clearing of the medium called?

answer

Beta hemolysis

question

Identify the organism that is alpha-hemolytic, catalase negative, gram positive cocci that is susceptible to optochin or ethyl hydrocupreine with colony morphology that resembles a donut as it agesWhat other test is positive and used for definitive identificationWhat does this organism possess that is responsible for its virulence?

answer

Streptococcus pneumoniae
Bile solubility
An anti-phagocytic, polysaccharide capsule

question

What species is partially acid-fast, catalase positive, produces aerial hyphae and is lysozyme resistant?

answer

Nocardia species

question

What species is non acid-fast, catalase positive and produces aerial hyphae?

answer

Streptomyces

question

What characteristics are shared by Acinetobacter and Stenotrophomonas?

answer

Non-fermenters, oxidase negative

question

What is the gram stain morphology of Acinetobacter?

answer

Gram negative, short plum rods or cocco bacilli

question

Because of the morphology and the fact that it can resist decolorization Acinetobacter can be misidentified as Neisseria spp or Staphylococcus. Which test will differentiate it from Neisseria and Staphylococcus?

answer

Acinetobacter is oxidase negative, Neisseria is oxidase positive. Acinetobacter is Vancomycin resistant and Staphylococcus is Vancomycin susceptible

question

Name the organism that is known for its negative reactions and multi drug resistance, oxidase negative, motility negative, non-lactose fermenter but oxidizes lactose and can exhibit a pink to purple hue, Nicknamed "Iraqibacter" because it is the most common isolate from soldiers injured in Afghanistan and Iraq.

answer

Acinetobacter baumanii

question

For more serious infections such as pneumonia or bacteremia, what treatment may be required to be effective?

answer

Use of a beta-lactam agent in combination with an aminoglycoside antibiotic

question

Identify the organism that is most likely a colonizer, but can cause nosocomial infections, is oxidase negative, motility positive, non-lactose fermenter that oxidizes glucose and maltose, lysine decarboxylase positive:

answer

Stenotrophomonas maltophilia
If a true pathogen what is the primary drug of choice for infections? Trimethoprim-sulfamethoxazole

question

All of the gram negative cocci organisms discussed are positive for two biochemical tests. What are they

answer

Oxidase and Catalase

question

Identify the organism that is oxidase and catalase positive, butyrate esterase positive, DNase positive, glucose, maltose, lactose and sucrose negative, causes pneumonia

answer

Moraxella catarrhalis

question

What is the appearance of a Mycobacterium stained with gram stain?

answer

Poor, faintly stained, beaded, gram-positive bacilli

question

Once appropriate media is inoculated what is the optimal incubation atmosphere, temperature and time for recovery of mycobacterium species?

answer

35 degrees Celsius, dark, high humidity, 5-10% humidity, CO2 for 8 weeks

question

What is the first step always performed once there is growth on or in Mycobacterial culture media?

answer

Acid fast stain to determine whether organism is acid fast or contaminant

question

The atypical or non-tuberculosis Mycobacterium species are further classified into Runyon groups? What are the two characteristics used for the Runyon system of classification?

answer

Growth rate and pigmentation of colony

question

The most commonly isolated mycobacterium in the Untied States. It is often associated with HIV patients

answer

Mycobacterium avium-intracellulare

question

Mycobacterium of low virulence, commonly found in tap water that can be difficult to determine if a true pathogen or a laboratory contaminant

answer

Mycobacterium gordonae

question

Mycobacterium acquired from contaminated water such as aquariums. Requires incubation at 30 degrees Celsius

answer

Mycobacterium marinum

question

What are two main characteristics that separate Mycoplasma and Ureaplasma from other micro organisms?

answer

Lack of a cell wall, permanently, and are the smallest known free-living form

question

What is the method of choice for laboratory detection of Mycoplasma and Ureaplasma infections?

answer

PCR (Polymerase Chain Reaction)

question

Identify the slow growing organism from the respiratory tract that produces spherical, slightly grainy colonies of SP4 agar after 5-2 days of incubation

answer

Mycoplasma pneumoniae

question

Identify the organism isolated from urine or a congenital specimen that produces alkaline reaction after overnight incubation in broth containing urea and has relatively small grainy colonies on A8 agar

answer

Ureaplasma species

question

Most common cause of fungal infections worldwide. Called "cave disease" because it is found in bat and bird droppings. Infection from airborne conidia and hyphal fragments. Small round to oval yeast cells 2 to 5 microns, not often seen

answer

Histoplasmosis capsulatum

question

Found in Latin America, but mainly Brazil, predominantly infects males. May go to liver, spleen, lymph nodes and bone marrow. Large rod or oval yeast cell with multiple buds making it appear like a "mariner" wheel.

answer

Paracoccidioides brasiliensis

question

Found in desert regions of North America and Causes "valley fever". Infection from inhalation of arthrospores found in soil. Non-budding thick walled spherule containing endospores.

answer

Coccidioides immitis

question

Occurs worldwide but is endemic in Mississippi and Ohio river valleys. Only the conidial forms found in nature are infectious. Human or animal is a dead end in the life cycle. Large spherical thick-walled yeast cells usually with a single bud attached by a broad base.

answer

Blastomyces dermatitidis

question

Rose handler's or rose gardener's disease, worldwide in soil, plants and decaying vegetation (peat moss). Spores infectious and enter the body through cuts or punctures to the skin. Causes cutaneous lesions and may spread along the lymph nodes. Cigar-shaped yeast cells

answer

Sporothix schenckii

question

Found in Southeast Asia, third most common infection in HIV patient in Indochina. Considered an AIDS defining illness. Etiologic niche uncertain but has been isolated from bamboo rats. Small yeast-like cells that have internal cross walls but no budding.

answer

Penicillum marnefei

question

Pneumocystis jiroveci, based on molecular sequencing, has been placed within the fungal kingdom. However the type of sterol found in the cell membrane differs from fungi What is the sterol found in Pneumocystis and in Fungus?

answer

Pneumocystis: Cholesterol Fungi: Ergosterol

question

Which form of Pneumocystis jiroveci is considered diagnostic?

answer

Cyst form

question

Which patient population suffers from pneumocystis jiroveci infection?

answer

HIV or HIV/AIDS patients

question

Infection of the epiglottis and other soft tissues above the vocal cord. Presents with fever, difficult painful swallowing, drooling, respiratory obstruction which may have complete blockage

answer

Epiglottitis

question

What is the most common agent of Epiglottitis

answer

Haemophilus influenzae type B

question

Infection of the pharynx called "sore throat". Presents with erythematous and swollen tissue, possible inflammatory exudates, vesicles and mucosal ulceration or nasopharyngeal lymphoid hyperplasia:

answer

Pharyngitis

question

Most common agent of pharyngitis

answer

Viruses
Most common bacterial agent
Streptococcus pyogenes

question

Infection of the buccal (cheek) mucosa, tongue or oropharynx resulting in creamy patches

answer

Thrush
Most common agent: Candida species
Usually Candida albicans

question

Which media should be used to plate specimens from suspected cases of epiglottitis?

answer

Sheep blood agar and Chocolate agar

question

Why is chocolate agar required for the recovery of Haemophilus species?

answer

For the recovery of Haemophilus influenzae factor X (heme) and factor V (NAD) are required for growth and are present in chocolate agar. Haemophilus Parainfluenzae only requires factor X, not factor V

question

Identify the organism that is beta hemolytic, catalase negative, PYR negative, gram positive cocci in pairs or chains and is bacitracin susceptible:

answer

Streptococcus pyogenes
Which Lancefield group is it inGroup A

question

Name four diseases Streptococcus pyogenes can cause:

answer

Rheumatic fever, Exudative pharyngitis, Glomerulonephritis, Necrotizing fasciitis

question

What are two selective and differential medias used for the isolation of Corynebacterium diphtheriae?

answer

Cystein-Tellurite blood agar and Modified Tinsdale agar.

question

What is the morphology of Corynebacterium diphtheriae on Tinsdale agar that allows for presumptive identification?

answer

Brown-black colonies with a gray-brown halo

question

What is required for Corynebacterium diphtheriae to be pathogenic and how does it acquire this ability?

answer

Toxin, exotoxin production. The toxin is acquired through viral transduction

question

What media is used for the isolation of Corynebacterium, fastidious organisms?

answer

Bordet-Gengou and charcoal containing media such as Regan-Lowe

question

What highly contagious disease of the upper respiratory tract does this Bordetella cause?

answer

Pertussis (whooping cough)

question

What is the colony appearance of Bordetella pertussis and parapertussis?

answer

Small, shiny colonies resembling mercury droplets

question

Name the toxin that contributes to the virulence of Bordetella pertussis and describe how this toxin works.

answer

Adenylate cyclase toxin, causes hemolysis of red cells, activates cyclic adenosine monophosphate. The cell is unable to inhibit adenyl cyclase activity. It interferes with cellular communication causing inactivation of several types of host immune cells. Azithromycin is used for treatment

question

What is the proper storage of cerebral spinal fluid for bacterial culture?

answer

Incubation at 35 degrees Celsius

question

What is the most common source of central nervous system infections?

answer

Hematogenous; originated in or spread through the blood

question

Define meningitis

answer

Infection within the subarachnoid space or throughout the pia mater and arachnoid membrane

question

What is the condition that presents with pleocytosis in the CSF and negative bacterial and fungal cultures?

answer

Aseptic meningitis

question

Identify the organism that is catalase positive, small gram positive bacilli that is CAMP factor positive and able to hydrolyze hippurate:

answer

Listeria monocytogenes

question

Identify the organism that is catalase negative, gram positive cocci in pairs and/or chains, that is CAMP factor positive and able to hydrolyze hippurate:

answer

Streptococcus agalactiae

question

Name the types of infection Listeria monocytogenes and streptococcus agalactiae can cause:

answer

Listeria: blood stream and CNS in all patients and neonatal infection in-utero are systemic, leading to bacteremia
Streptococcus: blood stream and CNS in neonates

question

Name two rapid methods that will differentiate Listeria monocytogenes and Streptococcus agalactiae

answer

Catalase negative and gram stain morphology

question

Name the two types of motility Listeria exhibits at 25 degrees Celsius

answer

End over End motility in nutrient broth and Umbrella motility in semi-solid media

question

What two rapid biochemical tests are positive for gram negative cocci

answer

Oxidase and Catalase

question

What is the best method to differentiate the gram negative diplococcus

answer

Carbohydrate utilization

question

Identify the following organism: glucose and maltose positive, lactose and sucrose negative, group B serotypes highly virulent, invasive strains usually encapsulate, causes rapid fetal bacterial meningitis

answer

Neisseria meningitidis

question

Cryptococcus neoformans isolated from cerebrospinal fluid exhibits extreme variation in size and polysaccharide capsule. What common stain or reagent is used to detect this encapsulated yeast?

answer

India ink

question

Which bacteria is the most common cause of otitis media in children

answer

Haemophilus influenzae

question

What atmosphere is recommended for the isolation of Haemophilus species?

answer

5 to 10% CO2

question

Which organism is the causative agent of Trachoma?

answer

Chlamydia trachomatis

question

Describe the infective cycle for Chlamydia trachomatis

answer

An inert, infective extracellular body (EB) enters the body, EB differentiates into reticulocyte body (RB), RB replicates by binary fission within vacuoles, RB reverts to EB 48-72 hours post infection, EB released from cell

question

What type of Hyphae do the mucorales (zygomycetes) exhibit?

answer

Hyaline aseptate hyphae

question

Identification of mucorales is based in part on presence of absence and position of rhizoids. Name the organism with unbranched sporangiophores with round sporangium. Rhizoids are nodal or opposite the sporangiophores where stolons start:

answer

Rhizopus species

question

Identification of mucorales is based in part on presence of absence and position of rhizoids. Name the organism with sporangiophores singular or branched with round sporangium. No rhizoids or stolons:

answer

Mucor species

question

Identification of mucorales is based in part on presence of absence and position of rhizoids. Name the organism with sporangiophores branched with pyriform or pear shaped sporangium. Have funnel shapes apophysis. Rhizoids intranodal or between groups of sporangiophores:

answer

Lichtheimia (syn. Absidia) species

question

Which mold is the most frequently isolated opportunistic fungus and has been implicated in cases of pulmonary or sinus fungus balls, external otomycosis, mycotic keratitis and onychomycosis?

answer

Aspergillus species

question

Identify the follow mold: most commonly recovered species. Growth white to blue-green colony in 2 to 6 days. Uniserate with phialides covering upper half to two thirds of the dome-shaped vesicle:

answer

Aspergillus fumigatus

question

Identify the following mold growth of colonies most commonly shades of green to blue-green. Brush like conidiophores produced. Rarely associated with invasive disease

answer

Penicillum species

question

What is the most frequent cause of uncomplicated community-acquired urinary tract infection?

answer

Escherichia coli

question

Name the illness that features dysuria, frequency and urgency, but a specimen yielding fewer organisms that 10 to the 5th CFU/mL urine on the culture

answer

Acute urethral syndrome

question

Name the illness that features isolation of a specified quantitative count of bacteria in an appropriately collected urine specimen obtained from a person without symptoms or signs of urinary infection

answer

Asymptomatic bacteriuria

question

Name the organism that is catalase positive, coagulase negative, gram positive cocci in clusters that causes uncomplicated urinary tract infections in sexually active young women:

answer

Staphylococcus saprophyticus

question

What can be used to presumptively identify Staphylococcus saprophyticus?

answer

Novobiocin resistance

question

Name three characteristics that are common to all the Enterobacteriaecae

answer

Ferment glucose with production of acid, reduces nitrates to nitrites, catalase positive (also oxidase neg)

question

What is the typical colony morphology of Escherichia coli on blood agar and MacConkey agar?

answer

Moist, gray, beta-hemolytic colonies on blood agar and lactose fermenting on MacConkey agar

question

Name the three genera that produce phenylalanine deaminase (PPA/TDA)

answer

Proteus, Providencia and Morganella

question

Flora from the female vaginal tract will vary with age. Name the predominant organisms that will grow from normal vaginal cultures from normal women of reproductive age

answer

Lactobacilli

question

Name the infective agent for an organism that many women carry as part of their normal genital flora that may be transmitted to the neonate during childbirth

answer

Streptococcus agalactiae

question

Name the infective agent that is the number one cause of non-gonococcal urethritis (STD)

answer

Chlamydia trachomatis

question

Name the infective agent that is the major cause of cervicitis and urethritis (STD)

answer

Neisseria gonorrhoeae

question

Name the infective agent that is the cause of bacterial vaginosis characterized by large numbers of epithelial cells, many of which are covered by tiny gram variable rods and coccobacilli and the absence of inflammatory cells:

answer

Garderella vaginalis
What is the name given to these particular epithelial cells? Clue cells

question

How would you report the presence of gram negative diplococci on a genital smear from a female patient:

answer

Presence of gram-negative diplococci, follow up with culture

question

How would you report the presence of gram negative diplococci on a genital smear from a male patient:

answer

Neisseria gonorrhoeae

question

Why is the reporting different for female genital specimens than male genital specimens?

answer

Female genital tract features normal colonizing gram negative diplococci that cannot be differentiated from Neisseria gonorrhoeae by gram stain morphology

question

Identify the organism that is oxidase and catalase positive, must be cultured promptly, glucose positive, strict pathogen, requires factor X for growth, maltose, lactose and sucrose negative

answer

Neisseria gonorrhoease

question

Which organism is the common bacterial sexually transmitted disease (SDT) and a major cause of pelvic inflammatory disease (PID)

answer

Chlamydia trachomatis

question

Name the organism that is a motile troph, measures 7 to 23 microns long and 5 to 15 microns wide, no cyst stage in life cycle, undulating membrane ends halfway down the side of the trophozoite, treatment of choice for urogenital infection is mentronidazole:

answer

Trichomonas vaginalis

question

Which disease is the primary non-viral sexually transmitted disease worldwide and which parasite causes this disease?

answer

Trichomoniasis

question

Cornmeal agar is used to aid in identification of Candida species based on the microscopic features produced. What are the unique features of each of the following:

answer

Candida albicans: Spherical clusters at regular intervals on pseudohyphae. Chlamydoconidia
Candida glabrata: only small spherical blastoconidia in compact clusters. No hyphae or pseudohyphae

question

Routine stool cultures screen for aerobic enteric pathogens. At the minimum in the United States, there are at least three pathogens that should be included in the laboratory screening. Name these pathogens:

answer

Salmonella, Shigella and Campylobacter

question

Campylobacter has two significant species. What are the two species and the incubation conditions necessary for the their recovery?

answer

Campylobacter jejuni and Campylobacter coli, microaerophilic atmosphere at 42 degrees Celsius and cultures examined at 24 and 48 hours

question

Which rapid test will differentiate Bacillus and Clostridium species and what is the reaction for each?

answer

Catalase; Bacillus is positive and Clostridium is negative

question

Of the Enterobacteriaecae, all but three genera are considered only opportunistic. Name the three genera that are always considered enteric pathogens

answer

Yersinia, Salmonella and Shigella

question

Although considered normal flora of the gastrointestinal tract, which organism also contains agents of important diseases such as urinary tract infections, bacteremia, dysentery and hemorrhagic colitis?

answer

Escherichia coli

question

Which type of pathogenic E. coli can cause hemolytic uremic syndrome (HUS) and contains the serotypes O157, O126 and O111?

answer

Enterohemorrhagic Escherichia coli
(VTEC/STEC/EHEC)

question

Identify the selective media for Vibrio species

answer

TCBS. Colonies of Vibrio will produce either yellow or green colonies based on their ability to ferment sucrose

question

Vibrio cholera pathogenesis is related to its production of

answer

A powerful cholera toxin (CT)

question

What is the primary habitat of most Vibrios?

answer

Brackish or marine water

question

Campylobacter has a unique gram stain morphology; describe it

answer

Small curved "S" shaped gram negative bacilli. Similar to seagull wings

question

How can Campylobacter species be presumptively identified?

answer

Gram stain characteristics, Oxidase positive and catalase positive

question

Which test will differentiate Campylobacter jejuni and Campylobacter coli

answer

Hippurate hydrolysis: C. jejuni positive, C. coli negative

question

What rapid test can be used to presumptively identify Helicobacter pylori from culture or gastric biopsy?

answer

Rapid urease test

question

Name the most common etiologic agents involved in Bulbous impetigo

answer

Staphylococcus aureus

question

Name the most common etiologic agents involved in aerobic isolates from animal bites

answer

Pasteruella species (multicida), Staphylococcus, Streptococcus

question

Name the most common etiologic agents involved in anaerobic isolates from animal bites

answer

Fusobacteremia, Bacteroides, Porphorymonas

question

Name the most common etiologic agents involved in lumpy jaw

answer

Actinomyces

question

What superficial mycoses is lipophilic and causes skin lesions to reveal a golden yellow fluorescence when observed under a Wood's lamp?

answer

Malassezia furfur

question

Which organism is associated with gas gangrene in the skin as a result of bullous lesions associated with sepsis

answer

Clostridium perfringens

question

Identify the organism that is Lemon yellow pigmented, non-hemolytic, gram-positive cocci in clusters, catalase positive of low virulence most often considered a contaminant

answer

Micrococcus species
Name the rapid test that will differentiate this organism from Staphylococcus species: Microdase (oxidase modified)positive

question

Identify the organism that is gray to white, generally non-hemolytic, gram-positive cocci in clusters, catalase positive, coagulase negative, Novobiocin susceptible, part of the human skin flora, most likely cause of infections in compromised hosts:

answer

Staphylococcus epidermidis

question

Identify the organism that is yellow pigmented, beta hemolytic gram-positive cocci in clusters, catalase positive, coagulase positive, one of the most important human pathogens

answer

Staphylococcus aureus

question

What are two toxin-mediated diseases caused by Staphylococcus aureus

answer

Scalded skin syndrome and Toxic shock syndrome

question

Identify the organism that is alpha or non-hemolytic gram colonies, catalase negative, gram-positive cocci that are able to hydrolyze esculin, grow in 6% NaCl and are PYR positive:

answer

Enterococcus species

question

Describe the unique reaction that Erysipelothrix has in triple sugar iron agar

answer

H2S production along inoculum line

question

Erysipelothrix usually causes infection through puncture wound or skin abrasion

answer

Red, diamond like patter on hands or fingers called erysipeloid

question

What are the gram stain, oxidase, and motility results of Pasteruella

answer

Small gram-negative, cocco-bacillus, oxidase positive, non-motile

question

Which species of Pasteurella is most commonly isolated in the laboratory

answer

Pasteurella multocida

question

Catalase positive, indole positive and nitrate positive organism related to acne

answer

Propionibacterium acnes

question

Catalase negative, indole negative, nitrate positive, sulfur granule presence organism similar to Prionibacterium acnes

answer

Actinomyces israelii

question

What is the gram stain and colony morphology of C. perfringens?

answer

Anaerobic gram positive rod that produces spores, features a double zone of beta hemolysis on blood agar

question

What is the life threatening illness caused by C. perfringens?

answer

Gas gangrene

question

Produce brick-red fluorescence under long wavelength ultraviolet light organism

answer

Prevotella and Porphyomonas species

question

An anaerobic gram-positive bacillus that fluoresces a chartreuse (yellow-green) color

answer

Fusobacterium

question

Which Mycobacterium species causes chronic disease of the skin, mucous membranes and nerve tissue

answer

M. leprae

question

As a fastidious organism, what special requirements does Legionella need for in vitro growth?

answer

BCYE & BCYES Legionella requires high humidity, L-cysteine and iron for growth

question

What is the gram stain morphology of Brucella species

answer

Gram negative cocco-bacilli organism

question

Name 3 occupations that put individuals at greatest risk of contracting brucellosis

answer

Dairy farming, veterinary practice and laboratory professionals

question

Because of Francisells growth requirements, name another media that will support the growth of this organism

answer

BCYE, presumptive identification should be performed under BSL2 conditions

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