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A Gram-positive coccus in clusters from a wound culture is catalase-positive and coagulase-positive. Which species is most likely?

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2026 Statistics

Key Facts: ABMM Exam

200

Total MCQ Items

Single-best-answer format

6 hrs

Total Exam Time

Single-session computer-based test

25%

Bacteriology Weight

Largest single content domain

$450 / $575

Application Fee

ASM member / non-member

12 states

CLIA Director Recognition

Direct CLIA recognition for high-complexity labs

3 yrs

Recertification Cycle

Continuing Maintenance Program

The ABMM exam (Diplomate, American Board of Medical Microbiology) is a 6-hour, 200-question single-best-answer computer-based test administered by ASM. Application is $450 (member) / $575 (non-member); a separate $400 exam registration fee applies if approved. Passing confers D(ABMM) — recognized under CLIA '88 for high-complexity clinical laboratory director qualification in 12 states. Recertification via the Continuing Maintenance Program every 3 years. Distinct from ABPath Medical Microbiology (MD-only) and ASCP M (BS-level technologist).

Sample ABMM Practice Questions

Try these sample questions to test your ABMM exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A Gram-positive coccus in clusters from a wound culture is catalase-positive and coagulase-positive. Which species is most likely?
A.Staphylococcus epidermidis
B.Staphylococcus aureus
C.Staphylococcus saprophyticus
D.Streptococcus pyogenes
Explanation: S. aureus is the catalase-positive, coagulase-positive Staphylococcus. Coagulase (clumping factor and free coagulase) reliably distinguishes S. aureus from coagulase-negative staphylococci in routine clinical workup of skin and soft tissue isolates.
2A coagulase-negative staphylococcus from a clean-catch urine in a young woman with cystitis is novobiocin-resistant. Which species is most likely?
A.Staphylococcus epidermidis
B.Staphylococcus saprophyticus
C.Staphylococcus lugdunensis
D.Staphylococcus haemolyticus
Explanation: S. saprophyticus is intrinsically resistant to novobiocin (5 µg disk zone <16 mm) and is a leading cause of uncomplicated cystitis in sexually active young women. Routine labs use the novobiocin disk to separate it from other CoNS.
3A blood culture isolate is a Gram-positive coccus in clusters, coagulase-negative, but ornithine decarboxylase positive and PYR positive. Which species should be suspected?
A.Staphylococcus epidermidis
B.Staphylococcus capitis
C.Staphylococcus lugdunensis
D.Staphylococcus warneri
Explanation: S. lugdunensis is unique among coagulase-negative staphylococci for being ornithine decarboxylase positive and PYR positive. It can cause aggressive endocarditis and abscesses similar to S. aureus and should not be dismissed as a contaminant.
4A throat culture grows beta-hemolytic colonies that are bacitracin-susceptible and PYR-positive. The most likely organism is:
A.Streptococcus agalactiae
B.Streptococcus pyogenes
C.Streptococcus dysgalactiae
D.Enterococcus faecalis
Explanation: S. pyogenes (group A Streptococcus) is bacitracin (taxo A) susceptible and PYR positive, and is the cause of acute streptococcal pharyngitis. Routine pharyngeal cultures use these markers along with Lancefield serology.
5A vaginal-rectal swab from a pregnant woman at 36 weeks grows beta-hemolytic colonies that are CAMP-positive and hippurate hydrolysis positive. Which Lancefield group does this organism belong to?
A.Group A
B.Group B
C.Group C
D.Group D
Explanation: Streptococcus agalactiae (group B Streptococcus, GBS) is CAMP-positive and hippurate-positive. Universal antenatal GBS screening at 35-37 weeks identifies colonized mothers for intrapartum penicillin prophylaxis to prevent neonatal sepsis.
6An alpha-hemolytic Gram-positive coccus from blood is optochin-susceptible and bile-soluble. The organism is:
A.Streptococcus pneumoniae
B.Streptococcus mitis
C.Streptococcus oralis
D.Enterococcus faecalis
Explanation: S. pneumoniae is optochin-susceptible (zone >=14 mm with 6 mm disk on sheep blood) and bile-soluble. Both tests are needed because some viridans streptococci can be falsely optochin-susceptible.
7A urinary isolate grows on bile-esculin agar with blackening and grows in 6.5% NaCl broth. PYR is positive. The most likely organism is:
A.Streptococcus bovis group
B.Enterococcus species
C.Group B Streptococcus
D.Aerococcus urinae
Explanation: Enterococcus species are PYR-positive, bile-esculin positive, and grow in 6.5% NaCl. The S. bovis group (now S. gallolyticus subsp.) is bile-esculin positive but does NOT grow in 6.5% NaCl and is PYR-negative.
8Which test best distinguishes Enterococcus faecium from Enterococcus faecalis in a clinical lab?
A.Bile-esculin
B.6.5% NaCl growth
C.PYR
D.Arabinose fermentation
Explanation: E. faecium ferments arabinose; E. faecalis does not. Both are PYR-positive, bile-esculin positive, and grow in 6.5% NaCl, so those tests cannot separate the two species. MALDI-TOF in modern labs replaces biochemical separation but arabinose remains a classic key.
9A urine isolate is a lactose-fermenting, indole-positive, motile Gram-negative rod that produces a green sheen on EMB. The organism is:
A.Klebsiella pneumoniae
B.Escherichia coli
C.Enterobacter cloacae
D.Citrobacter freundii
Explanation: E. coli is the classic lactose-fermenting, indole-positive Enterobacterales species and produces a metallic green sheen on EMB due to vigorous mixed-acid fermentation. IMViC for E. coli is ++--.
10A Gram-negative rod from a urine culture is urease-strongly-positive, swarms on blood agar, indole-negative, and produces H2S on TSI. The likely organism is:
A.Proteus mirabilis
B.Proteus vulgaris
C.Morganella morganii
D.Providencia stuartii
Explanation: P. mirabilis is urease-positive (rapid), swarms on non-selective agar, is indole-NEGATIVE, and produces H2S. Urease activity contributes to struvite stones in chronic UTI. P. vulgaris is the indole-positive Proteus.

About the ABMM Exam

The Diplomate, American Board of Medical Microbiology (D(ABMM)) certification validates doctoral-level expertise to direct a clinical microbiology laboratory. The 6-hour computer-based exam has 200 single-best-answer multiple-choice questions covering bacteriology, antimicrobial susceptibility testing, mycology, mycobacteriology, parasitology, virology, molecular diagnostics, and laboratory administration. Eligibility requires a doctorate (PhD, MD, DO, DVM, DDS/DMD, DrPH) plus 3 years post-doc experience, a 2-year CPEP postdoctoral fellowship, or an ACGME-accredited Medical Microbiology fellowship. CLIA recognizes D(ABMM) for high-complexity lab director qualification in 12 states.

Questions

200 scored questions

Time Limit

6 hours computer-based test (single session)

Passing Score

Criterion-referenced (modified Angoff); average item difficulty target ~0.70

Exam Fee

$450 (ASM member) / $575 (non-member) application + $400 exam registration if approved (American Society for Microbiology (ASM) — American Board of Medical Microbiology)

ABMM Exam Content Outline

25%

Bacteriology

Gram-positive cocci (Staph, Strep, Enterococcus), Enterobacterales, non-fermenters (Pseudomonas, Acinetobacter, Burkholderia, Stenotrophomonas), Neisseria/Moraxella, anaerobes, fastidious organisms (Haemophilus, Legionella, Bordetella, Brucella, Francisella, Bartonella), spirochetes (Treponema, Borrelia, Leptospira), Mycoplasma/Ureaplasma, Chlamydia, Rickettsia/Ehrlichia/Anaplasma/Coxiella. MALDI-TOF and 16S rRNA workflows.

10%

Antimicrobial Susceptibility Testing

CLSI M100 (current edition), broth microdilution, disk diffusion, gradient strip (Etest), automated systems, MIC interpretation and expert rules. ESBL (TEM/SHV/CTX-M), AmpC, carbapenemases (KPC, NDM, OXA-48-like, VIM, IMP), mecA/MRSA cefoxitin, vanA/vanB, MEF/ERM, qnr. mCIM/eCIM and CarbaNP confirmatory tests.

10%

Mycology

Yeasts including Candida auris, Cryptococcus neoformans/gattii, Trichosporon. Dimorphic fungi (Histoplasma, Blastomyces, Coccidioides, Paracoccidioides, Sporothrix, Talaromyces marneffei). Hyaline molds (Aspergillus, Fusarium, Scedosporium/Lomentospora), Mucorales, dematiaceous, dermatophytes, Pneumocystis jirovecii. CLSI M27/M38/M60 antifungal AST, galactomannan, β-D-glucan.

7%

Mycobacteriology

MTB complex, NTM (MAC, M. abscessus, M. kansasii, M. marinum, M. fortuitum), AFB stains, MGIT/Lowenstein-Jensen, MALDI-TOF mycobacteria, line probe assays, Xpert MTB/RIF and MTB/RIF Ultra, CLSI M24 AST, BSL-3 biosafety, IGRA vs TST.

7%

Parasitology

Protozoa (Giardia, Cryptosporidium, Cyclospora, Entamoeba, Plasmodium, Babesia, Trypanosoma, Leishmania, Toxoplasma, Naegleria, Acanthamoeba), helminths (Ascaris, Strongyloides, hookworm, Enterobius, Trichuris, Schistosoma, Taenia, Echinococcus, Diphyllobothrium). Stool O&P, Giemsa thick/thin smears, modified acid-fast, multiplex GI panels.

12%

Virology

Respiratory viruses (Influenza A/B, RSV, hMPV, parainfluenza, adenovirus, rhinovirus, SARS-CoV-2), GI viruses, herpes (HSV, VZV, CMV, EBV, HHV-6/7/8), hepatitis A-E, HIV diagnostic algorithm, HPV, arboviruses (West Nile, Zika, Dengue, chikungunya, EEE/WEE), VHF (BSL-4: Ebola, Lassa, Marburg).

15%

Molecular Diagnostics

PCR, real-time PCR, multiplex syndromic panels (BioFire, GenMark ePlex, NxTAG), NGS, MALDI-TOF, NAATs, isothermal amplification (LAMP, TMA, NEAR), 16S rRNA / ITS sequencing, FDA-cleared vs LDT regulations, validation/verification studies.

14%

Laboratory Administration & Consultation

CLIA '88 high-complexity testing, CAP and ISO 15189 accreditation, biosafety BSL-1 through BSL-4, HHS/USDA select agents, QA/QC and Westgard rules, proficiency testing, IQCP, LIS, billing/CPT, antimicrobial stewardship consultation, cumulative antibiograms, public health reporting.

How to Pass the ABMM Exam

What You Need to Know

  • Passing score: Criterion-referenced (modified Angoff); average item difficulty target ~0.70
  • Exam length: 200 questions
  • Time limit: 6 hours computer-based test (single session)
  • Exam fee: $450 (ASM member) / $575 (non-member) application + $400 exam registration if approved

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

ABMM Study Tips from Top Performers

1Master the CLSI M100 (current edition) breakpoint tables cold — ESBL phenotypic confirmation requires at least a 3-fold log2 dilution decrease in MIC of cefotaxime or ceftazidime when tested with vs without 4 µg/mL clavulanate. Modified carbapenem inactivation method (mCIM) detects carbapenemase activity; eCIM differentiates metallo (NDM, VIM, IMP) from serine carbapenemases (KPC, OXA)
2MRSA detection: cefoxitin disk (≤21 mm zone) or cefoxitin MIC ≥8 µg/mL is the preferred screen for mecA-mediated resistance — more sensitive than oxacillin. Vancomycin MIC creep — S. aureus isolates with MIC 1.5-2 µg/mL are at the edge of the susceptible breakpoint (≤2) and have been associated with clinical failure
3Candida auris: confirm by MALDI-TOF (with updated database) or D1/D2 28S rRNA sequencing; biochemical systems frequently misidentify it as C. haemulonii, C. famata, or Rhodotorula glutinis. Implement contact precautions and chlorhexidine bathing — environmental persistence is profound
4Mold morphology: Aspergillus shows septate hyphae with acute (~45°) dichotomous branching; Mucorales (Rhizopus, Mucor, Lichtheimia, Rhizomucor) show broad (10-20 µm) ribbon-like, pauciseptate hyphae with wide-angle (~90°) branching. Galactomannan is an Aspergillus biomarker; β-D-glucan is pan-fungal but NEGATIVE in Mucorales and Cryptococcus
5Validation vs verification (CLIA '88): an FDA-cleared assay used unmodified requires verification of accuracy, precision, reportable range, and reference intervals. An LDT or modified FDA-cleared assay requires full validation including analytical sensitivity, specificity, accuracy, precision, reportable range, reference intervals, and clinical performance

Frequently Asked Questions

What is the D(ABMM) credential?

D(ABMM) — Diplomate of the American Board of Medical Microbiology — is a doctoral-level certification awarded by the American Society for Microbiology (ASM) that validates expertise to direct a clinical microbiology laboratory. CLIA '88 recognizes D(ABMM) as a qualified high-complexity laboratory director in 12 U.S. states. The credential is held primarily by PhDs but is open to MDs, DOs, DVMs, DDS/DMDs, and DrPHs who meet the eligibility pathways.

Who is eligible to take the ABMM exam?

Candidates must hold an earned doctorate (PhD, MD, DO, DVM, DDS/DMD, or DrPH) and meet one of three experience pathways: (1) at least 3 years of post-doctoral experience in medical/clinical microbiology, (2) completion of a 2-year ASM CPEP-accredited postdoctoral fellowship in medical and public health microbiology, or (3) completion of an ACGME-accredited Medical Microbiology fellowship. The ABMM credentialing committee reviews each application before exam registration is permitted.

What is the format of the ABMM exam?

The ABMM exam is a 6-hour computer-based test of 200 single-best-answer multiple-choice questions delivered in a single session. The content blueprint covers Bacteriology (~25%), Virology (~12%), Mycology (~10%), Antimicrobial Susceptibility Testing (~10%), Mycobacteriology (~7%), Parasitology (~7%), Molecular Diagnostics (~15%), and Laboratory Administration (~14%). Pass status is criterion-referenced via the modified Angoff method; the average item difficulty target is approximately 0.70.

How much does the ABMM exam cost in 2026?

The application fee is $450 for ASM members and $575 for non-members, paid at submission and nonrefundable. If the credentialing committee approves the application, candidates pay an additional $400 exam registration fee before scheduling. Total first-attempt cost is approximately $850 (member) or $975 (non-member). Continuing Maintenance Program (CMP) fees apply every 3 years to maintain the credential.

How does ABMM differ from ABPath Medical Microbiology?

ABMM (D(ABMM)) is administered by ASM and is the doctoral-level credential primarily held by PhDs (open to all earned doctorates). ABPath Medical Microbiology is a subspecialty of the American Board of Pathology and is restricted to MDs/DOs who hold ABPath AP/CP or CP primary certification plus a 12-month ACGME Medical Microbiology fellowship. Both qualify the holder to direct a clinical microbiology lab; ABMM is the more common path for non-physician scientists.

Is D(ABMM) recognized by CLIA?

Yes. CLIA '88 explicitly recognizes D(ABMM) certification as qualifying a doctoral-level scientist to serve as a high-complexity clinical laboratory director in 12 states. State-specific licensure (e.g., New York Clinical Laboratory Technology Certificate of Qualification, California Laboratory Field Services) may impose additional requirements on top of D(ABMM).

What are the highest-yield topics?

Bacteriology (~25%) and Molecular Diagnostics (~15%) together cover 40% of the exam — master CLSI M100 breakpoint interpretation, ESBL/AmpC/carbapenemase detection (mCIM, CarbaNP), MRSA cefoxitin screen, vanA/vanB VRE, MALDI-TOF identification, multiplex syndromic panels (BioFire FilmArray), 16S rRNA sequencing applications, and FDA-cleared vs LDT validation. Lab Administration (~14%) is heavily weighted — know CLIA, CAP, ISO 15189, biosafety levels, and antimicrobial stewardship deeply.

How should I prepare for the ABMM exam?

Plan a 6-12 month focused review during or immediately after a CPEP/ACGME fellowship or ABMM-eligible directed practice. Work through the ASM Manual of Clinical Microbiology cover-to-cover, study the current CLSI M100/M24/M27/M38/M60 standards, complete thousands of board-style questions, and take at least two timed full-length 200-question mock exams. The ASM ABMM/CPEP study guide and the ASM Press 'Clinical Microbiology Procedures Handbook' are core references.