Non-Coryneform Gram-Positive Rods and Possible Look-Alikes

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Non-Coryneform Gram-Positive Rods and Possible Look-Alikes

Table 8. Non-Coryneform Gram-Positive Rods and Possible Look-Alikes.
OrganismGram StainPartial Acid-Fast StainColony Morphology (at 35-37°C) at 40-48hr
Aerobic ActinomycesGram-positive filamentous/branched fragment into rod-shaped or coccoid formsNegativeWhite, flat, round, smooth, or slightly granular some species may be alpha-hemolytic on blood agar
Aerotolerant BifidobacteriumGram-positive short or long rodsNegativeWhite, glistening, umbonate, and mucoid
VaribaculumGram-positive short, straight, or curved diphtheroid rodsNegativeMost are anaerobic. Small, white, glistening colonies
NocardiaBranched, Gram-positive filaments that may stain variable and can fragment into shorter bacilliPositive (may be negative first but most are positive with age)Dry, crumply, wrinkled with chalky white, orange, or tan color
TsukamurellaGram-positive short to long bacilli, can be diphtheroid no branching on routine mediaWeak positive (20-100% per oil lens field)Dry, sometimes spready with age, white to orange
ActinomaduraGram-positive short bacilli, intertwining branching with short chains of sporesNegativeWrinkled with leathery surface usually no aerial mycelium may be mucoid and “molar-tooth" with red, pink, yellow, white, orange, or tan color
RhodococcusGram-positive, some are diphtheroid (coccobacillary), some are more hyphal in appearance, and some are branchedWeak positive (10-20% per oil lens field)Non-hemolytic round often mucoid, salmon-pink/red color in 4-7 days
GordoniaGram-positive, thin, beaded coccobacillus or diphtheroidWeak PositiveSlimy, smooth, glossy to irregular and rough. Colonies may be white, yellow, tan, orange, red, or pink
DermatophilusBranched filaments fine and tapered filamentsNegativeRound, sticky white colonies that turn orange and ß-hemolytic
NocardiopsisBranching with internal sporesNegativeCoarsely wrinkled or folded orange, blue, brown, yellow, gray, or white in color
MicromonosporaGram-positive filamentous, branching with singular sporesNegativeInitially light orange, becoming orange, red, brown, or purple with the production of spores as culture ages