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American Society of Microbiology ABMM Sample Questions:

1. A microbiology laboratory receives a bronchoalveolar lavage sample from a patient with suspected ventilator- associated pneumonia. Quantitative culture yields >10^5 CFU/mL of a Gram-negative rod. Identification reveals Stenotrophomonas maltophilia. The MOST significant resistance mechanism commonly associated with this organism is:

A) Ribosomal methylation leading to macrolide resistance.
B) Production of extended-spectrum beta-lactamases (ESBLs).
C) Intrinsic resistance mediated by efflux pumps and specific enzymes.
D) Target site modification in DNA gyrase.

2. A patient develops a febrile illness with a diffuse petechial rash after a camping trip. Serological testing reveals a four-fold rise in antibody titer to Rickettsia rickettsii. The vector responsible for transmitting this organism is a:

A) Flea
B) Mosquito
C) Tick
D) Louse

3. A patient with a history of recurrent Clostridioides difficile infection (CDI) is being considered for fecal microbiota transplantation (FMT). Pre-FMT screening of the donor stool sample should include comprehensive testing to exclude potential transmission of enteric pathogens. Which of the following would be the MOST critical to rule out in the donor stool?

A) Detection of common antibiotic resistance genes not currently expressed.
B) Presence of non-toxigenic C. difficile strains.
C) Evidence of asymptomatic carriage of multidrug-resistant organisms (MDROs) such as vancomycin- resistant enterococci (VRE) or carbapenem-resistant Enterobacterales (CRE).
D) Quantification of the overall microbial diversity using 16S rRNA gene sequencing.

4. A microbiology laboratory is processing a sputum sample from a patient with chronic cough and night sweats.
After Ziehl-Neelsen staining, acid-fast bacilli are observed. Culture on Lowenstein-Jensen medium is positive after several weeks. Drug susceptibility testing reveals resistance to isoniazid and rifampin. This patient is MOST likely infected with:

A) Mycobacterium avium complex
B) Actinomyces israelii
C) Nocardia asteroides
D) Multidrug-resistant Mycobacterium tuberculosis

5. The primary mechanism of action of aminoglycoside antibiotics, such as gentamicin, involves:

A) Inhibition of bacterial cell wall synthesis by binding to penicillin-binding proteins
B) Disruption of bacterial cell membrane integrity
C) Inhibition of bacterial DNA gyrase and topoisomerase IV
D) Inhibition of bacterial protein synthesis by binding to the 30S ribosomal subunit

Solutions: