02 GRAM POSITIVE COCCI (Streptococcus & Related Organisms) Flashcards by 3sha Ann

Streptococcus and Enterococcus are from family ___

Streptococcaceae

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based on oxygen requirement

Streptococcus and Enterococcus are ___

facultative anaerobes

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give the result

Streptococcus and Enterococcus are catalase (_)

negative

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Streptococcus and Enterococcus are susceptible to ___

Vancomycin

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Streptococcus and Enterococcus require selective media such as ___ with antibiotics

BAP

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Sherman’s classification

Grows at 37C; pus forming

Pyogenic

S. pyogenes

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Sherman’s classification

Grows at 37C and 45C

Viridans

S. salivarius, S. mutans, S. mitis, S. sanguis

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Sherman’s classification

Grows at 10C and 37C

Lactic

S. lactis

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Sherman’s classification

Grows on dairy products

Lactic

S. lactis

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Sherman’s classification

Grows at 10C, 37C, and 45C

Enterococcal

E. faecalis, E. faecium, E. durans, E. avium

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Sherman’s classification

Part of the normal flora but can be opportunistic

Enterococcal

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Rebecca Lancefield Classification

Cell wall polysaccharide

A, B, C, F, G

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Rebecca Lancefield Classification

Cell wall teichoic acids

D and enterococcus

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Not classified under Rebecca Lancefield Classification

Viridans strep
S. pneumoniae

has no carbon C carbohydrate

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Brown’s classification (based on hemolytic pattern)

Beta hemolytic

Grp A Strep
Grp B Strep
Grp C, F, G

S. pyogenes, S. agalactiae

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Brown’s classification (based on hemolytic pattern)

Alpa hemolytic

Viridans strep
S. pneumoniae

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Brown’s classification (based on hemolytic pattern)

Gamma hemolytic

Grp D Strep
Enterococcus

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The visualization of alpha-prime hemolysis is enhanced with ___

refrigeration

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Beta hemolysin

Oxygen labile and antigenic

Streptolysin O

causes subsurface hemolysis

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Beta hemolysin

Oxygen stable; surface hemolysis

Streptolysin S

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Rebecca Lancefield Classification

S. pyogenes

Grp A

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Rebecca Lancefield Classification

S. agalactiae

Grp B

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Rebecca Lancefield Classification

S. dysagalactiae

Grp C

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Rebecca Lancefield Classification

S. equi

Grp C

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# Rebecca Lancefield Classification *S. bovis*

Grp D | non-enterococcus member of viridans strep

# Rebecca Lancefield Classification *E. faecalis, E. faecium*

Grp D | Enterococcus

# Rebecca Lancefield Classification *S. pneumoniae*

Grp D | Pneumococcus

# Rebecca Lancefield Classification Anginosus group, mutans group, mitis group, salivarius group

Viridans strep

# Rebecca Lancefield Classification Causes rheumatic fever, scarlet fever, pharyngitis, glomerulonephrities, pyogenic infections

Grp A | *S. pyogenes*

# Rebecca Lancefield Classification Causes neonatal sepsis, meningitis, puerperal fever, pyogenic infections

Grp B | *S. agalactiae*

# Rebecca Lancefield Classification Causes pharyngitis, impetigo, pyogenic infections

Grp C | *S. disagalactiae, S. equi*

# Rebecca Lancefield Classification Causes endocarditis, UTIs, pyogenic infections

Grp D | *S. bovis* group

# Rebecca Lancefield Classification Causes UTIs, pyogenic infections, pneumonia, meningitis

Grp D | *E. faecalis, E. faecium, S. pneumoniae*

# Rebecca Lancefield Classification Causes pyogenic infections, endocarditis, dental caries, abscesses in various tissues

Viridans strep

# Identify the *Streptococcus spp.* Colonizes skin and throat

*S. pyogenes*

Virulence factor of *S. pyogenes*; associated with sequelae

M protein | present in the cell wall

Virulence factor that causes rheumatic heart disease and glomerulonephritis

M protein

M protein is coded by ___

EMM gene

# Identify the *Streptococcus spp.* Most common manifestation includes tonsilitis and pharyngitis

*S. pyogenes*

# Identify the *Streptococcus spp.* Causes "strep throat"

*S. pyogenes*

# Identify the *Streptococcus spp.* Associated with lymphadenopathy

*S. pyogenes*

The pyodermal infection caused by *S. pyogenes* produces ___ toxin

Erythogenic

The Erythogenic toxin is also known as ___

Scarlatina toxin/ Streptococcal pyogenic exotoxin

Pyodermal infection characterized by erythema and edema

Erysipelas | different from Erysipeloid caused by *E. rhusiopathiae*

# Identify the *Streptococcus spp.* Causes necrotizing fascitis; necrosis of skin, subcutaneous fat, and fascia

*S. pyogenes*

Streptococcal toxic shock syndrome is caused by ___

Pyogenic exotoxin A

Poststreptococcal sequelae include ___ and ___

* Acute rheumatic fever * Acute glomerulonephritis

# Postreptococcal sequelae Characterized by fever, arthralgia, cardiac valvular disease

Acute rheumatic fever, Rheumatic heart disease

# Postreptococcal sequelae Characterized by edema, hypertension, hematuria, proteinuria, and RBC casts

Acute glomerulonephritis

DOC for Grp A *Streptococcus* infection

Penicilin or Erythromycin

# Pathogenic determinant of Grp A *Streptococcus* (extracellular) Antigenic; O2 labile

Streptolysin O

# Pathogenic determinant of Grp A *Streptococcus* (extracellular) Non-antigenic; O2 stable

Streptolysin S

# Pathogenic determinant of Grp A *Streptococcus* (extracellular) Causes fever, skin rash or scarlet fever, blood brain alteration, organ damage

Erythrogenic/ Pyogenic toxins A, B, C

# Pathogenic determinant of Grp A *Streptococcus* (extracellular) Protease implicated in flesh eating streptococci

Exotoxin B

# Pathogenic determinant of Grp A *Streptococcus* (extracellular) Lysis of blood clots; spread of infection

Streptokinase

# Pathogenic determinant of Grp A *Streptococcus* (extracellular) DNAse

Streptodornase | most common: DNAse B

# Pathogenic determinant of Grp A *Streptococcus* (extracellular) Induce proliferation of host T-lymphocytes

Superantigens

# Pathogenic determinant of Grp A *Streptococcus* (cell surface antigen) Mucoid colonies; antiphagocytic

* M protein * Hyaluronidase

# Pathogenic determinant of Grp A *Streptococcus* (cell surface antigen) Spreading factor

Hyaluronidase

# Pathogenic determinant of Grp A *Streptococcus* (cell surface antigen) Mediates epithelial cell attachment

Protein F | Fibronectin binding protein

# Identify the *Streptococcus spp.* Cause of mastitis in cattle and invasive disease in newborns

*S. agalactiae* | Grp B Strep

# Identify the *Streptococcus spp.* Normal flora of GI tract, pharynx, and vaginal tract

*S. agalactiae* | Grp B Strep

DOC for Grp B Strep infections

Penicillin

# Pathogenic determinant of Grp B *Streptococcus* Sialic Acid

Capsule

# Pathogenic determinant of Grp B *Streptococcus* Promote/ enhance hemolysis

CAMP factors | Christie Atkins Munch-Petersen

# Identify the *Streptococcus* Rebecca Lancefield Classification Ability to grow in 40% bile and hydrolyze esculine

Grp D strep & Enterococcus

# Identify the *Streptococcus* Rebecca Lancefield Classification Gr (+) cocci that are nomal flora of GI tract of animals and humans; produce Grp D antigen and is able to grow under extreme conditions

Enterococcus | *E. faecalis, E. faecium, E. durans, E. avium*

Most common *Enterococcus* that causes nosocomial UTI and wound infections

*E. faecalis*

# Identify the *Streptococcus* Rebecca Lancefield Classification Causes UTI, wound infections; intraabdominal abscesses, endocarditis, bacteremia

*Enterococcus*

T/F: *Enterococcus* are penicillin resistant

T | DOC: cell wall inhibitor (vanco/ampi) + aminoglycoside (genta/strep)

Pathogenic type of Grp D Non-Enterococci

*Streptococcus bovis* group | No longer a valid species

# Group D Non-Enterococci Non-pathogenic but opportunistic

*S. equinus*

# Group D Non-Enterococci High association with colon cancer

*S. bovis*

*Streptococcus bovis* group include ___ and ___

* *S. equinus* * *S. gallolyticus*

# Identify the *Streptococcus* Rebecca Lancefield Classification Causes severe pharyngitis; pneumonia, cellulitis, abscess

Grp C *Streptococcus* | *S. equi, S. equsimilis, S. zooepidemicus, S. dysagalactiae*

Grp C *Streptococcus* that causes strangles among horses

*S. equi*

# Identify the *Streptococcus* Rebecca Lancefield Classification Miscellaneous lancefield groups

Grp F & G | *S. anginosus*

# Identify the *Streptococcus* Rebecca Lancefield Classification Cultures have honeysuckle odor

Group F & G

# Identify the *Streptococcus* Rebecca Lancefield Classification Normal flora of the GI tract, vaginal tract, and oropharynx

Group G

Viridans *Streptococci* means "___"

Green

T/F: Viridans *Streptococci* has no polysaccharide component

Most common subacute bacterial endocarditis

Viridans *Streptococci*

Causes gingivitis & dental caries

Viridans *Streptococci*

Most common Viridans *Streptococci*

*S. mutans*

# Viridans *Steptococci* Causes dental caries

*S. mutans*

# Viridans *Steptococci* Causes endocarditis

*S. salivarius*

# Viridans *Steptococci* Causes bacteremia and abscess

*S. constellatus*

*S. pneumoniae* is under the ___ group, but is more virulent

*S. mitis*

Leading cause of community-acquired pneumonia

*S. pneumoniae*

DOC for *S. pneumoniae*

Erythromycin & Chloramphenicol

Number 1 cause of bacterial pneumonia

*S. pneumoniae*

Most important virulent factor of *S. pneumoniae* that plays a role in the occurence of disease

Polysaccharide capsule

Nutritionally variant *Streptococci*

* *Abiotrophia* * *Granulicatella*

Nutritionally variant *Streptococci* requires the growth of which spp. as they produce pyridoxal or thiol needed for growth?

* *S. aureus* * *K. pneumoniae* * *E. coli*

These genus resemble Viridans *Streptococci* and cause diseases similar to those caused by enterococci and streptococci

* *Abiotrophia* * *Aerococcus* * *Gemella* * *Lactococcus* * *Leuconostoc* * *Pediococcus*

# Identify the strep-like organism Common airborns organism

*Aerococcus*

# Identify the strep-like organism Vancomycin-resistant organism that causes endocarditis, wounds, and abscesses

*Gemella*

# Identify the strep-like organism Vancomycin-resistant organism that is previously part of Group N and causes UTI and endocarditis

*Lactococcus*

# Identify the strep-like organism Present in plant surfaces, vegetables, and milk products; opportunistic pathogen

*Leuconostoc*

# Identify the strep-like organism Can grow at 45C and causes bacteremia, asbcess, meningitis among patients who underwent surgery

*Pediococcus*

# Identify the media Selective for Gr (+) cocci

PEA, CNA

# Identify the media Used for Group B Strep, for vaginal or rectal swab/discharge

Granada Agar

# Identify the media Produces orange coloration in Group B Strep growth

Carrot broth

# Identify the media Selective broth for Group B Strep

Todd Hewitt Broth

Additionaly antibiotics for Todd Hewitt Broth | 2 pairs

* Gentamicin & Nalidixic Acid * Colistin & Nalidixic Acid

Additional requirement of nutritionally variant Strep

Pyridoxal

Antibiotics added to BAP to grow Group A Strep

TMP SXT | GAS are B-hemolytic

Preferred sample for *S. pyogenes* diagnosis and culture

Throat swab

# Identify the Grp of Strep based on BAP growth Pinpoint, opalescent or gray, smooth and glossy, mucoid; b-hemolytic

Grp A

# Identify the Grp of Strep based on BAP growth Pinpoint, grayish, white mucoid colonies, b-hemolytic (small zone)

Grp B

# Identify the Grp of Strep based on BAP growth Pinpoint colonies; alpha or gamma hemolytic colonies

Grp D *Enterococcus*

# Identify the Grp of Strep based on BAP growth Tend to dip down in the center and resemble a doughnut as they age

*S. pneumoniae*

# Identify the Grp of Strep based on BAP growth Minute to small, gray, domed, smooth or matte; alpha-hemolytic or nonhemolytic

Viridans

# Identify the Grp of Strep based on BAP growth Penny coin with raised rim

*S. pneumoniae*

# Identify the Grp of Strep based on BAP growth a-hemolytic

* *S. pneumoniae* * Viridans

# Laboratory dx. Presumptive test for *S. pyogenes*

* Taxo A * Sulfamethoxazole | Taxo A (S), Sxt (R)

# Laboratory dx. Presumptive test for Grp B Strep

CAMP Test | Christie, Atkins, Munch-Petersen (+): Arrow head hemolysis pattern

# Laboratory dx. Used to differentiate b-hemolytic *Streptococcus*

PYR Test

# Laboratory dx. Used to identify Group D *Enterococcus*

PYR Test | (+): Red

# Laboratory dx. The only *Streptococcus* that is PYR Test (+)

*S. pyogenes*

# Laboratory dx. Used to differentiate *S. agalactiae* from other B-hemolytic Strep

Hippurate Hyrdolysis w/ Ninhydrin Reagent | (+): GBS, Violet; presence of hippuricase enzyme

# Laboratory dx. Test to differentiate Viridans

Voges Proskauer | *S. mitis* (-) Anginosus Grp. (+)

# Laboratory dx. Differentiates *Aerococcus* and *Leuconostoc*

LAP Test | Leucine Aminopeptidase Test; (+): Red

# Laboratory dx. Result of *Aerococcus* and *Leuconostoc* in LAP test

Negative | *Streptococcus, Enterococcus, Pediococcus* (+)

# Identify the Grp of Strep. Taxo B (S) Taxo P (S)

*S. pneumoniae*

# Identify the Grp of Strep. Taxo A (S) SMZ (R)

Grp A

# Identify the Grp of Strep. Taxo A (R) SMZ (R)

Grp B

# Laboratory dx. The production of clear solution in Bile Solubility Test is indicative of the presence of what enzyme?

S. pneumonial autocatalytic enzyme

# Laboratory dx. Susceptibility test for Scarlet Fever

Dick's test | (+): redness

# Laboratory dx. The Dick's Test detects what toxin?

Scarlatina toxin

# Laboratory dx. Confirmatory test for Scarlet Fever

Schultz Charlton | (+): Blanching, neutralized phenomenon Injected w/ antitoxin

# Laboratory dx. Detects antibody against streptolysin coat and increased sequelae risk

ASO Test

# Identify the Grp of Strep. Taxo A (R) SMZ (S)

Grp C

# Sherman's Classification 10C (-) 37C (+) 42-45C (-) 6.5% NaCl (-) Skim Milk w/ MB (-)

Pyogenic

# Sherman's Classification 10C (+) 37C (+) 42-45C (+) 6.5% NaCl (+) Skim Milk w/ MB (+)

*Enterococcus*

# Sherman's Classification 10C (+) 37C (+) 42-45C (-) 6.5% NaCl (-) Skim Milk w/ MB (+)

Lactic

# Sherman's Classification 10C (-) 37C (+) 42-45C (+) 6.5% NaCl (-) Skim Milk w/ MB (-)