B2.5 Streptococcus pneumoniae; Abiotrophia and Granulicatella

Question 1

Streptococcus pneumoniae also known as

Answer 1

PNEUMOCOCCUS and DIPLOCOCCUS

Question 2

encapsulated, characteristically lancet-shaped which occurs singly, on pairs and short chains
contains antigen referred to as C substance which reacts with CRP
facultative anaerobe requiring an increase CO2 tension (Candle Jar)

Answer 2

Streptococcus pneumoniae

Question 3

Streptococcus pneumoniae VIRULENCE FACTORS

Answer 3

1. Polysaccharide Capsule
2. Adherance
3. Enzymes
4. Pneumolysin O
5. Autolysin
6. C-substance
7. Hemolysin

Question 4

Enzymes found in Streptococcus pneumoniae

Answer 4

Neuraminidase
Protease
Hyaluronidase

Question 5

Streptococcus pneumoniae enzyme in charge of degrading surface structures of host tissue

Answer 5

Neuraminidase

Question 6

Streptococcus pneumoniae enzyme in charge of facilitating bacterial colonization on mucosal surfaces by eliminating Ig

Answer 6

Protease

Question 7

oxygen-sensitive toxin found in Streptococcus pneumoniae that is cytolytic for cells

Answer 7

Pneumolysin O

Question 8

S. pneumoniae component that facilitates the release of pneumolysin O and other toxic proteins or inflammatory substance from cells

Answer 8

Autolysin

Question 9

component of cell wall of S. pneumoniae which is teichoic acid that reacts with CRP resulting in the activation of some nonspecific host immune response

Answer 9

C-substance

Question 10

RELATED INFECTIONS AND DISEASES with S. pneumoniae

Answer 10

1. Lobar Pneumonia
2. Meningitis
3. Otitis Media
4. Endocarditis, Peritonitis, and Bacteremia
5. Secondary Atypical Hemolytic Uremic Syndrome

Question 11

characterized by the presence of voluminous fluid which hastens in the spread of bacteria in the lungs
sudden onset with chills, dyspnea, and cough
most common cause of bacterial pneumonia in elderly and immunocompromised individual

Answer 11

Lobar Pneumonia

Question 12

Microscopy of sputum from patients with Lobar Pneumonia

Answer 12

large number of S. pneumonia cells and WBC;
absence of oropharyngeal microbiota

Question 13

 follows other S. pneumonia otitis media or pneumonia
most common cause of meningitis in adults

Answer 13

Meningitis

Question 14

 most common isolate in children under 3 years old with recurrent otitis
media

Answer 14

Otitis Media

Question 15

Specimen of choice for S. pneumoniae

Answer 15

Sputum, Swabs, Pus, CSF and Blood

Question 16

Specimen characteristic that may indicate S. pneumonia

Answer 16

RUST-TINGED SPUTUM

Question 17

LABORATORY DIAGNOSIS of S. pneumoniae

Answer 17

1. Gram-Stain
2. Culture Medium
3. Biochemical Test
4. Serologic Test

Question 18

Gram-Stain observations for S. pneumoniae

Answer 18

Gram(+) cocci in pairs = DIPLOCOCCI
cells are slightly pointed = LANCET SHAPE

Question 19

Culture Medium used for S. pneumoniae

Answer 19

BHIA, TSA with 5% sheep’s RBC and CAP

Question 20

Blood agar plate results for young colonies of S. pneumoniae

Answer 20

circular, glistening, dome shaped, wet, mucoid

Question 21

Blood agar plate results for old colonies of S. pneumoniae

Answer 21

AUTOLYTIC CHANGES result in a
collapse of each colony’s center,
giving it umbilicate or doughnot
appearance, Dimple-shaped

(CHECKER or NAILHEAD COLONIES)

Question 22

BAP of S. pneumoniae

Colonies incubated aerobically produce

Answer 22

α-hemolysis.

Question 23

BAP of S. pneumoniae

Colonies incubated anaerobically produce

Answer 23

β-hemolysis due to
oxygen-labile PNEUMOLYSIN O

Question 24

BIOCHEMICAL TEST used for S, pneumoniae

Answer 24

a. Optochin Susceptibility Test/ TAXO P
b. Bile Solubility Test
c. Neufeld-Quellang Reaction/ Capsular Swelling Test
d. Francis Test
e. Mouse Virulence Test

Question 25

presumptive identification of S. pneumoniae

Answer 25

Optochin Susceptibility Test/ TAXO P

Question 26

Optochin Susceptibility Test/ TAXO P utilizes what disk

Answer 26

Optochin (ETHYLHYDROCUPREIN HYDROCHLORIDE)

Question 27

Optochin (ETHYLHYDROCUPREIN HYDROCHLORIDE) is added to what media in order to determine S. pneumoniae

Answer 27

surface of an SBA plate inoculated with an α-hemolytic Streptococcus

Question 28

Optochin Susceptibility Test/ TAXO P positive result for S. pneumoniae

Answer 28

 ZOI >14 mm with a 6-mm disk = SUSCEPTIBLE  ZOI >16 mm with a 10-mm disk = SUSCEPTIBLE

Question 29

Test based on the presence of autocatalytic enzyme AMIDASE in S. pneumoniae Under the influence of BILE SALT OR DETERGENT, bacteria’s cell wall lyses during cell division

Answer 29

Bile Solubility Test

Question 30

Bile Solubility Test detects the presence of what enzyme in order to determine S. pneumoniae

Answer 30

AMIDASE

Question 31

Bile Solubility Test Reagent used for S. pneumoniae identification

Answer 31

SODIUM DEOXYCHOLATE

Question 32

Bile Solubility Test Result interpretation

Answer 32

 S. pneumoniae = solution becomes CLEAR (+)  Other α-hemolytic = solution remains CLOUDY (-)  Negative control: Suspensions made in saline

Question 33

most useful, specific and rapid method for the identification of S. pneumonia (+) and allows serotyping of isolates performed by mixing on a slide loopful of emulsified sputum or CSF with a loopful of ANTICAPSULAR SERUM and METHYLENE BLUE

Answer 33

Neufeld-Quellang Reaction/ Capsular Swelling Test

Question 34

Neufeld-Quellang Reaction/ Capsular Swelling Test (+) reaction for S. pneumoniae

Answer 34

capsule appears swollen due to change in refractive index which in turn due to serologic reaction (OIL IMMERSION OBJECTIVE)

Question 35

SKIN TEST for determining the presence of ANTIBODIES against pneumococci

Answer 35

Francis Test

Question 36

Based on the sensitivity of mouse to even small inoculum of pneumococci Sputum containing pneumococci is injected intraperitoneally to a mouse which eventually dies within 16-48 hours Heart blood of the mouse contain pure culture of pneumococci

Answer 36

Mouse Virulence Test

Question 37

uses particle-bound antibody to enhance the visibility of the agglutination reaction between Antigen and Antibody

Answer 37

Coagglutination Test

Question 38

Pneumococci reaction with these test Bile Solubility Test Inulin Fermentation Test Capsular Swelling Test Quinidine Test Optochin Test Mouse Virulence Test

Answer 38

Bile Solubility Test = Bile Soluble Inulin Fermentation Test = Fermenter Capsular Swelling Test = Swelling of Capsule Quinidine Test = Susceptible Optochin Test = Susceptible Mouse Virulence Test = Mouse dies within 16-48 hours

Question 39

Streptococci reaction with these test Bile Solubility Test Inulin Fermentation Test Capsular Swelling Test Quinidine Test Optochin Test Mouse Virulence Test

Answer 39

Bile Solubility Test = Insoluble Inulin Fermentation Test = Non-fermenter Capsular Swelling Test = No Swelling Quinidine Test = Resistant Optochin Test = Resistant Mouse Virulence Test = Won’t die

Question 40

SEROLOGIC TEST FOR STREPTOCOCCI

Answer 40

Lancefield Precipitin Test Direct Fluorescent Antibody Test Coagglutiantion (Phadebact) Enzyme-linked Immunosorbent Assay (ELISA) Latex Agglutination Test ASO Titer for Group A Streptococcal Infection

Question 41

confirmatory test wherein cell wall antigens are extracted either physically by heating or chemical or enzymatic extraction of cell suspension grown overnight in Todd-Hewitt Broth

Answer 41

Lancefield Precipitin Test

Question 42

formerly known as the NUTRITIONALLY VARIANT STREPTOCOCCI

Answer 42

Abiotrophia and Granulicatella

Question 43

Abiotrophia and Granulicatella also known as

Answer 43

pyridoxal-dependent or vitamin B6-dependent, thiol-dependent and symbiotic streptococci

Question 44

grow as “satellite colonies” around other bacteria and require sulfhydryl compounds for growth part of the human oral and gastrointestinal microbiota

Answer 44

Abiotrophia and Granulicatella

Question 45

Abiotrophia and Granulicatella Related Infections

Answer 45

Bacteremia, endocarditis, otitis media, osteomyelitis, endophthalmitis after cataract extraction, brain abscess, chronic sinusitis, septic arthritis, meningitis, and breast implant– associated infections

Question 46

Microscopy phenotype of Abiotrophia and Granulicatella

Answer 46

Gram-variable and Pleomorphic forms

Question 47

Abiotrophia and Granulicatella Species

Answer 47

Granulicatella adiacens, Granulicatella elegans, and Granulicatella balaenopterae, Abiotrophia defective, and Abiotrophia adjacens

Question 48

Biochemical Characteristics of Abiotrophia and Granulicatella

Answer 48

α-galactosidase β-galactosidase β-glucuronidase, Hippurate hydrolysis Arginine hydrolysis Acid production from trehalose and starch