13. Streptococci Flashcards
Development of post streptococcal glomerulonephritis is due to what mechanism?
Cross-reaction of host antibodies against Streptococcus pyogenes
Which streptococci is a recognised cause of disease in neonates?
Agalactiae
Which streptococci is commonly associated with abscess formation?
Aginosus
Which streptococci is identified in the microbiology lab by its susceptibility to optochin?
Pneumoniae
What is the appearance of streptococci with gram staining?
Gram positive cocci in chains or pairs
What agar is optimal for streptococci?
Blood supplemented
How are streptococci grouped based on blood haemolysis?
a= partial haemolysis, turns blood agar green b= total lysis y= no lysis
Which Lancefield group is the only one which is not beta haemolytic?
Group D
How are streptococci differentiated from staphylococci?
Strep are catalase negative
What decides the Lancefield group of a strep?
Antigen present on the cell wall
Name the b haemolytic streps
Pyogenes
Agalactiae
Group C and G
What Lancefield group is strep pyogenes?
A
Where do pyogenes colonise?
Oropharynx of children and young adults
How is pyogenes transmitted?
Droplets
What are the main virulence factors of strep pyogenes?
M proteins M-like proteins Capsule Hyaluronidase Streptolysin Pyogenic exotoxin Haemolysins Streptokinase
What is the function of M proteins?
Attach to cells
Prevent phagocytosis
What is the function of M-like proteins?
Prevent oponisation
What is the function of streptolysin?
Lysis of neutrophils, platelets and organelles
What is the function of pyogenic exotoxin?
superantigen which causes rash and fever
Name the infections that can be caused by strep pyogenes
Pharyngitis Scarlet fever Impetigo Erysipelas cellulitis Necrotising fasciitis TSS BSI Puerperal sepsis Burns infections
Describe the rash present in scarlet fever
Blanches
Sandpaper feel
What is the difference between erysipelas and cellulitis?
Erysipelas involves upper dermis and superficial lymphatics
Cellulitis involves deeper dermis and subcutaneous fat
What are the 2 post infectious immune-mediated complications caused by a strep pyogenes infection?
Rheumatic fever
Glomerulonephritis
What type of hypersensitivity reaction causes rheumatic fever?
Type 2
Antibodies cross-react with cardiac tissue
What is the name of the criteria used to diagnose rheumatic fever?
Jones criteria
What type of hypersensitivity reaction causes glomerulonephritis?
Type 3
Immune complexes are deposited on glomerular basement membrane
What Lancefield group is strep agalactiae?
B
Where does strep agalactiae colonise?
Lower GI and genitourinary tract
What infection is caused by strep agalactiae?
Neonatal sepsis
What infections are caused by group C b haemolytic strep?
Tonsilitis
Wound sepsis
What infections are caused by group G b haemolytic strep?
Upper RTI
Endocarditis
Name the a haemolytic strep
Viridans
Pneumoniae
Where does strep viridans colonise?
Oropharynx
GIT
Genitourinary tract
What diseases are caused by strep viridans?
Dental carries
Endocarditis
Brain lesions
How is spread of strep pneumoniae prevented?
Vaccine is available
Where does strep pneumoniae colonise?
Oropharynx
How does strep pneumoniae spread?
Droplet
What infections are caused by strep pneumoniae?
Pneumonia
Sinusitis and otitis media
Meningitis
BSI
What are the main virulence factors of strep pneumoniae?
Pneumolysin
Capsule
What are the risk factors for strep pneumoniae infection?
Influenza Splenectomy COPD, asthma Immunocompromised Smoking and alcohol
What class of drugs is pneumoniae becoming resistant to?
Penicillins
Can alter the structure of penicillin binding protein
Where are enterococci found?
Bowel flora
What are the lab results for enterococci?
Faculative anaerobes
a or b haemolytic
Grow on MacConkey agar
What does VRE stand for?
Vancomycin resistant enterococci
What infections are caused by enterococci?
UTI
Wound and intra-abdominal
Endocarditis
BSI
What class of antibiotics are enterococci intrinsically resistant to?
Cephalosporins
What are the antibiotics of choice for enterococci?
Amoxicillin
Vancomycin
Linezolid
How is a past group A strep infection detected?
ASO (antibodies to streptolysin O) titre serology test
What susceptibility test is used to show a bacteria is strep pneumoniae?
Optochin: pneumoniae are susceptible
How do enterococci appear on MacConkey agar?
Small, magenta coloured colonies