A patient specimen was Gram-stained upon arrival in the clinical laboratory and revealed both Gram-positive cocci and Gram-negative bacilli. The specimen was cultured on sheep blood agar and chocolate agar, and after incubation, the culture grew only the Gram-negative bacilli. Which of the following is/are a likely explanation(s) for the failure of the Gram-positive cocci to grow?
A. The Gram-negative bacilli may have grown very quickly and overgrew the slower growing Gram-positive cocci.
B. The growth temperature may have enabled the growth of the Gram-negative bacilli but not the growth of the Gram-positive cocci.
C. The Gram-positive cocci may be an obligate anaerobe and was unable to grow in an ambient air incubator.
D. The media used may not support the growth of the Gram-positive cocci.
E. All of the choices are possible explanations.
Answer: E
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