2.2 Gram positive, Catalase Negative bac Flashcards
What family of bacteria can be seen in Gram positive, Catalase negative?
Streptococcaceae
What are the genus for Streptococcaceae?
Streptococcus
Enterococcus
What are the general characteristic of streptococcaceae?
Gram positive
Catalase Negative
Aerotolerant anaerobes
Non-motile
Capnophilic (some)
What bacteria in Streptococcaceae family have capnophilic characteristics?
Streptococcus pneumoniae
What are the 3 Classification of Streptococcaceae
Smith and Brown
Lancefield
Academic/Bergey’s
A classification of Streptococcaceae that is based on hemolytic pattern?
Smith and Brown
A classification of Streptococcaceae that is base on cell wall antigen or sero grouping
Lancefield
In Lancefield classification what is the indicator for positive in a certain group?
Agglutination
How many drop of antisera in lance field?
3-5
In lancefield, What bacteria can be seen in Group A?
Streptococcus pyogenes
In lancefield, What bacteria can be seen in Group b?
Streptococcus agalactiae
In lancefield, What bacteria can be seen in Group C?
Streptococcus dysagalactiae / equisimilis
In lancefield, What bacteria can be seen in Group D (Non-enterococcus)
Streptococcus bovis
In lancefield, What bacteria can be seen in Group D (Enterococcus)
Enterococcus faecalis / faecium
In lancefield, What bacteria can be seen in pneumococcus
Streptococcus pneumoniae
In lancefield, What bacteria can be seen in Viridans strep?
Anginosus, mutans, mitis
In smith and brown classification, It shows partial lysis/discoloration of RBC?
Alpha hemolytic
In smith and brown classification, it shows complete lysis of rbc
Beta hemolytic
What is the result for Beta hemolytic?
Yellow discoloration
What is the result for Alpha hemolytic?
Green discoloration
What bacteria can produce beta hemolytic from lancefield?
A - S. pyogenes
B - S. agalactiae
C - S. dysagalactiae/equisimilis
What bacteria can produce alpha hemolytic from Lancefield?
Pneumococcus
Viridans - Anginosus, mutans, mitis
What bacteria are nonhemolytic (gamma-hemolytic)
Group D
Non-enterococcus (S. bovis)
Enterococcus (E. faecalis/faecium)
What are the virulence factors for Streptococcus pyogenes
M protein
Protein F
Lipoteichoic acid
Hyaluronic acid capsule
Hyaluronic acid
Streptodornase
Streptolysin O
Streptolysin S
Streptokinase (Fibrinolysin)
Exotoxin (A, B, C)
A virulence factor for S. pyogenes that is an antiphagocytic and it adheres to mucosal cells
M protein
What is the gene for M protein?
emm genes
A virulence factor for S. pyogenes that MEDIATES the attachment to the epithelial cells
Protein F (Fibrinolytic binding protein)
A virulence factor for S. pyogenes that MEDIATES that attachment to the mucosal cells
Lipoteichoic acid
A virulence factor for S. pyogenes that is responsible for oral infection
Lipoteichoic acid
A virulence factor for S. pyogenes that prevents opsonization of phagocytosis which also masked the bacterial antigen
Hyaluronic acid capsule
What is the most common serotype of M protein that can cause pharyngitis
M1 serotype
A virulence factor for S. pyogenes that degrade host DNA and RNA
Streptodornase
What is the most common DNase in streptodornase?
DNase B
A virulence factor for S. pyogenes that is HIGHLY immunogenic and can lyse cell.
It is also responsible for hemolysis in BAP
Streptolysin O
Streptolysin O hemolysis can only be seen in what gaseous composition?
Anaerobic environment
What is the test for streptolysin O?
Anti-streptolysin O test
A virulence factor for S. pyogenes that is NON-IMMUNOGENIC that only lyse WBC
Also responsible for lysis in BAP
Streptolysin S
Streptolysin O is Oxygen labile
True
Streptolysin S is Oxygen stable
True
Streptolysin S hemolysis can only be seen in what gaseous
Aerobic environment
A virulence factor for S. pyogenes that converts plasminogen to plasmin that causes lysis of fibrin clots
Streptokinase
A virulence factor for S. pyogenes that solubilizes hyaluronic acid in connective tissue
Hyaluronidase / Hyaluronic Acid (PPT)
A virulence factor for S. pyogenes that is associated with scarlet fever and TSS?
Exotoxin A
(Streptococcal Pyrogenic Exotoxins)
Exotoxins A, B, and C are formally known as?
Super antigen
Streptococcal Pyrogenic Exotoxins is also known as?
Erythrogenic toxic
Clinical infections cause by S. pyogenes
Strep throat (Tonsilitis/pharyngitis)
Pyodermal infections
- Impetigo
- Erysipelas
- Cellulitis
- Scarlet fever
- Necrotizing fasciitis
- Rheumatic heart fever
- Acute glomerulonephritis
Strep throat usually targets what age?
3 years and 6 and below
Frequent bacterial pharyngitis will lead to?
Rheumatic heart fever
Most common clinical manifestation of S. pyogenes?
Pharyngitis and toncilitis
What is the incubation period of strep throat?
1-4 days
When will the symptoms subside in Strep throat?
3-5 days
A Pyodermal infections that is superficial and localized flat type of lesion that begins as small vesicles that progress to weeping lesions
Impetigo
A Pyodermal infection that has acute spreading erythematous lesion in subcutaneous tissues that is frequently seen among elderly
Erysipelas
A Pyodermal infection that involves deeper tissue invasion
Cellulitis
What happens if Cellulitis is left untreated?
Necrotizing fasciitis
Gangrene (patients with peripheral vascular diseases or diabetes)
Produce by streptococcal pyrogenic toxins that can cause rash (DIFFUSE red rashsed)
Scarlet fever
How scarlet fever symptoms travel?
Chest to extremities and tongue
What happens to the tongue in scarlet fever?
Strawberry tongue
An invasive infection characterized by inflammation and necrosis of skin, subcutaneous fat and fascia
Also known as flesh-eating disease
Necrotizing fasciitis
What group type of NF for S.pyogenes?
Type 2
What are the bacteria for type 1 NF?
Saltwater bacteria
Aerobic and anaerobic bacteria
Vibrio species
What are the bacteria for Type 3 NF?
Gas gangrene
Clostridial myonecrosis
A condition where the organ system is shut down which leads to death
Streptococcal Toxic shock syndrome
What are the symptoms /caused of Streptococcal TSS?
Untreated pharyngitis and pyodermal infections
which leads to:
- Sepsis
- Bacteremia
- Hypotension and highfever -> organ shut down
What are the 2 post streptococcal sequelae?
Rheumatic heart fever
Acute glomerulonephritis
What are the cause and symptoms of Rheumatic heart fever
- Occurs after pharyngitis
COMMON IN CHILDREN
Symptoms:
- Fever
- Inflammation of heart, joint, Subcutaneous tissue
What is the most important Pathogenesis in Rheumatic heart fever?
Cross reactive antibodies
(The antibodies presume that the heart valve is the same as invading streptococcus.)
What are the cause and symptoms of Acute glomerulonephritis
- Occurs after pharyngitis or cutaneous infection
COMMON IN CHILDREN ???
- Untreated pharyngitis or pyodermal infection
- Produces antibodies to act against antigens
In acute glomerulonephritis, the production of antibodies will act against the antigen will lead to?
Deposition of antibody-antigen complexes in glomeruli
The deposition of Ab-Ag is now a body? what is the effect?
waste
The kidney will not be able to filter all due to overproduced Ab-Ag leading to glomeruli damage
When will Rheumatic heart fever attack?
1 month
GAS is susceptible to what antimicrobial and remains as the drug of choice?
Penicillin
What drug can be use to treat GAS if he/she is allergic to penicillin?
Erythromycin
What is the characteristics of Streptococcus agalactiae?
Group B
Beta hemolytic
What is the normal flora for Streptococcus agalactiae?
Female genital tract and lower gastro intestinal tract
Is S. agalactiae the only group B?
Yes
What are the virulence factor for Streptococcus agalactiae?
Capsular antigen (Capsule)
Sialic acid
CAMP factor
Hyaluronidase
DNase
Protease
Hemolysin (Beta)
What is the most significant component of the capsular antigen and critical virulence determination for S. agalactiae
Sialic acid
What is the most important toxin produced by S. agalactiae
CAMP factor
How Streptococcus agalactiae transmit?
Vertical transmission or during delivery
What bacteria is the leading cause of neonatal meningitis
Streptococcus agalactiae
What are the clinical manifestation for S. agalactiae?
Pneumonia
Endometritis
Endocarditis
Wound infection
Neonatal meningitis
(PEEWN)
What procedure/media to use in order to determine/transport S. agalactiae?
Todd-Hewitt Broth
What are the sample use for meningitis?
CSF
Vaginal discharge
What type of media is Todd-Hewitt broth?
Transport media
Endometritis and wound infection are most common in ?
Young, previously healthy woman who becomes ill after child birth or abortion
What is the characteristics of Streptococcus pneumoniae?
- Capsule (No lancefield classification)
- Known as pneumococcus
- Diplococci
- Capnophilic
What is the test use to identify capsule in S. pneumoniae?
Neufeld or Quelling reaction
What is the positive reaction for Neufeld?
Capsular swelling
What do you call the cell wall of S. pneumoniae?
C substance
What are the virulence factor for S. pneumoniae?
Capsular polysaccharide
(Anti phagocytosis)
Toxins:
Hemolysis
Hyaluronidase
Immunoglobulin I (Protease)
Neuraminidase
How many capsular type in capsular polysaccharide of S. pneumoniae?
90
What are the associated disease for S. pneumoniae?
- Lobar pneumonia
- Bacteremia
- Bacterial meningitis
- Otitis media
- Sinusitis
What are the leading cause of diseases in S. Pnemoniae?
- Bacterial meningitis (Adults)
- Otitis media
What are the bacteria that also cause Otitis media?
S. pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
(SHAM)
It is the infection on eardrums
Otitis media
In lobar pneumonia, what is the characteristics of sputum?
Rusty or anchovy
What are the Group C streptococcus?
S. dysagalactiae subspp. equisimilis
What is the the characteristics of S. dysagalactiae subspp. equisimilis
Large-colony forming beta-hemolytic isolates
- Resembles S. pyogenes
A Large colony forming Beta hemolytic isolates?
S. dysagalactiae subsp. equisimilis
What is the group F streptococcus bacteria?
Streptococcus anginosus
A small colony forming Beta hemolytic isolates
Streptococcus anginosus
What are the associated diseases in Group F?
- Pharyngitis
- Pneumonia
- Abscess and bacteremia
- Cellulitis
(BACAPP)
What are the characteristics of viridans?
- Fastidious
- Normal flora (URT, GIT, Female genital tract)
- viridans = green
- Alpha hemolytic
What are the virulence factor for Viridans?
- Polysaccharide capsule
- Extracellular dextran
- Adhesins
(PEA)
What does C and G have similarities on A streptococci?
M protein
What are the diseases associated with viridans?
- Subacute bacterial endocarditis
- Bacteremia
- Septicemia
- Cavities
(SuBaCaSe)
The disease associated with Viridans that has damaged heart valves
Subacute bacterial endocarditis
The disease associated with viridans that is more common in children than in adults
Bacteremia
What are the characteristics of Group D?
2 types
- non-enterococcus
- Enterococcus
What is the natural inhabitant of Group D?
Intestinal tract
What are the commonly identified spp in enterococcus
- Faecalis
- Faecium
What are the virulence factor for group D
Adhesion:
- Extracellular surface protein
- Serine protease
- gelatinase
Cytolysins
Resistance to antimicrobial agents (Vancomycin)
What are the associated diseases for Group D
- Nosocomial infections
- UTI (Catheterization)
- Bacteremia
- endocarditis
(NUBE)
Streptococcus like organisms that is vancomycin resistant?
- Pediococcus (Intrinsically)
Streptococcus like organism that is an opportunistic pathogens in patients who are immunocompromised or for underlying disease with vancomycin
- Susceptible to vancomycin
Leuconostoc
Previously known as N. streptococci that causes UTI and endocarditis
Lactococcus
An opportunistic pathogens that is airborne that crease bacteremia, endocarditis and UTI in immunocompromised patients
Aerococcus
Streptococcus like organism that is Destain easily may appear as gram negative cocci
Easily washed out primary stain
Gemella