Bacteria: Gram-Positive Flashcards
Streptococci vs. Staphylococci
Which would be lined up like a strip in a gram stain?
Which would be lined up in clusters in a gram stain?
Which would be lined up like a strip in a gram stain?
Streptococci
Which would be lined up in clusters in a gram stain?
Staphylococci
Strep sounds like strip
In order to determine the identity of the gram positive bacterium. The tech wraps a wire containing H2O2 is rubbed across the slide containing a colony of gram positive bacteria. The tech notes the formation of bubbles on the slide. What is the most likely bacterium present on the slide?
A. Streptocci due to its superoxide dimutase activity
B. Streptococci due to its catalase activity
C. Staphylococci due to its superoxide dimutase activity
D. Staphylococci due to its catalase activity
Staphylococci due to its catalase activity
Streptococci can be classified into 3 groups based on their ability to lyse RBCs. They go alpha-, beta-, and gamma- hemolytic strep. For the image below, indicate which group has been plated for 1-3.
- alpha-hemolytic strep
- beta-hemolytic strep
- gamma-hemolytic strep
NOTE: gamma-hemolytic strep is also called non-hemolytic step
Which of the following is a major virulence factor found in the cell wall of Group A beta-hemolytic streptococci that inhibits complement activation and protects it from phagocytosis?
A. C carbohydrate
B. M protein
C. Streptolysin S
D. Streptolysin O
E. Pyrogenic exotoxin
M protein
NOTE:
We defend against M protein by forming Ab against M protein that bind and opsonizing the cell wall
Which of the following is an enzyme that destroys RBCs and WBCs, and it’s antigenicity allows us to test for Abs we produce against it to confirm recent infection by Group A beta-hemolytic strep? Bonus: Which enzyme does the same thing but is NOT antigenic?
A. M protein
B. Streptolysin S
C. Streptolysin O
D. Pyrogenic exotoxin
E. B and C
Streptolysin O
Steptolysin S is not antigenic, but is hemolytic
NOTE:
ASO is the test used to find anti-streptolysin O Abs in our system
Pyrogenic exotoxin is only found in a few strains of Group A beta-hemolytic strep that upon invasion of the enzyme produces what disease?
Pyrogenic exotoxin also is a superantigen that leads to the superstimulation of T cells which produce a cytokine overload that leads to what syndrome?
Pyrogenic exotoxin is only found in a few strains of Group A beta-hemolytic strep that upon invasion of the enzyme produces what disease?
Scarlett Fever
fire burns scarplet like a fire that a pyro might start
Pyrogenic exotoxin also is a superantigen that leads to the superstimulation of T cells which produce a cytokine overload that leads to what syndrome?
Toxic Shock Syndrome
Local invasion and exotoxin release by Group A beta-hemolytic strep causes 4 types of disease, EXCEPt which of the following that is caused by delayed Ab-mediated disease?
A. Streptoccocal pharyngitis and skin infections
B. Streptoccocal pharyngitis and Scarlet fever
C. Rheumatic fever and Glomerulonephritis
D. Toxic Shock syndrome and Scarlett fever
Rheumatic fever and Glomerulonephritis
NOTe:
technically called acute post-streptococcal glomerulonephritis
What are the 4 disease associated with local invasion and exotoxin release by Streptoccocus Pyogenes?
What are the 2 diseases associated with delayed Ab-mediated diseases caused by Streptoccocus Pyogenes?
What are the 4 disease associated with local invasion and exotoxin release by Streptoccocus Pyogenes?
Pharyngitis, Skin infections, Scarlet fever, Toxic Shock syndrome
What are the 2 diseases associated with delayed Ab-mediated diseases caused by Streptoccocus Pyogenes?
Rheumatic fever
Acute post-strep Glomerulonephritis
When Strep Pyrogenes get PSST they come back later and like an acute punch to the kidneys cause a fever room.
What is the genus and species name of Group A Beta-hemolytic streptococci?
A. Streptococcus agalactiae
B. Streptococcus pyogenes
C. Enterococci or Non-enterococci
D. Viridians group streptoccocus
Streptococcus pyogenes
Rheumatic fever is a delayed-Antibody mediated disease caused by an infection of Strep Pyogenes when which of the following goes untreated?
A. Necrotizing facitis
B. Pharyngitis
C. Pyroderma
D. Erypspelas
Pharyngitis
NOTE:
Rheumatic fever does not show up after skin infections
Erythema marginatum is a rash that spreads out from the center and is 1/6 major manifestations of what disease caused by Strep Pyogenes?
Rheumatic fever
What is the genus and species name of Group B strep, which is also a B-hemolytic strep?
A. Streptococcus agalactiae
B. Streptococcus pyogenes
C. Enterococci or Non-enterococci
D. Viridians group streptoccocus
Streptococcus agalactiae
Strep Agalactiae is also called Group B strep, and we can use the “B” in Group B to remeber BABY. Why is it good to remember BABY?
What are the 3 common diseases Group B strep is associated with?
Strep Agalactiae is also called Group B strep, and we can use the “B” in Group B to remeber BABY. Why is it good to remember BABY?
Babies are the common group affected
What are the 3 common diseases Group B strep is associated with?
Neonatal Meningitis, Pnumonia, and Sepsis
Group B strep makes baby MaPS
Group B strep (strep agalactiae), Listeria, and E. Coli are the 3 most common pathogens associated with what disease?
A. Meningitis in neonates and infants <3 months
B. Pneumonia in neonates and infants <3 months
C. Sepsis in neonates and infants <3 months
D. All of the above
Meningitis in neonates and infants <3 months
NOTE:
in adults, the most common pathogens for meningitis are Neisseria meningitides and Haemophilus influenzae
All of the following are classic signs of meningitis seen in neonates infected by Strep Agalactiae, EXCEPT?
A. Fever
B. Stiff neck
C. Vomiting and poor feeding
D. Irritability
Stiff neck
NOTE:
Stiff neck is a symptom seen in adults, NOT neonates which instead have non-specific signs like A, C, and D
T/F: Streptococcus agalactiae can cause bacteremia and sepsis in pregnant and secondary infection of the fetus results in still birth or spontaneous abortion in about 80% of cases
False;
True in 30% of cases
Viridians group streptococcus represents about 30% of the culturable bacteria of the gingiva, tongue, salvia and dental plaque; and is indigenous to which of the following locations?
A. Heart
B. Brain
C. Lungs
D. GI tract
GI tract
NOTE:
Viridians group are the normal human flora of the GI tract frequently found in the nasopharynx and gingival crevices
Viridians Group Strep is associated with what 3 main types of infection?
Dental infection
Endocarditis
Abscesses
Viridians sound like verde which means green. Think of green foliage between the teeth, that can fly off and enter the blood stream to deposit on your heart to cause infection.
Finding which of the following Viridians Group Strep subspecies in a blood culture liekly indicates an abscess hiding in an organ, and should be ImMEDIately ASsessed by a CT scan with contrast?
A. S. Anginosus and S. multans
B. S. Intermedius and S. multans
C. S. Anginosus and S. Intermedius
D. S. salivarius and S. criceti
E. None of the above
S. Anginosus and S. Intermedius
Viridian AI: Investigate Abscesses
T/F: Viridians Group of Strep causes “subacute” bacterial endocarditis (SBE), while Staphylococcus causes acute infective endocarditis
True
NOTE:
Strep -> endocarditis: slow developing low grade fever, fatigue, anemia, murmurs
Staph –> endocarditis: rapid onset of high fever, chilld, valve destruction
Which of the following groups of streptocci that we’ve been over can be alpha or gamma hemolytic?
A. Group A
B. Group B
C. Viridian
D. Group D
Group D
Which of the following is unique to enterococci (faecalis and faecium), members of Group D strep?
A. Grow well in 40% NaCl and 6.5% bile
B. Grow well in 40% bile and 6.5% NaCl
C. Grow well in 4% bile and 65% NaCl
D. Grow poorly in 40% NaCl and 6.5% bile
Grow well in 40% bile and 6.5% NaCl
Enterococci (faecalis and faecium) are common infecting agents associated with the development of what 3 infections?
Biliary tract infection
UTI
Subacute bacterial endocarditis (SBE)
Enterococci are D-listers that have to take the BUS
Which of the following is true of Enterococci (faecalis and faecium)?
A. Use of infectious disease specialist is not necessary when treating Enterococci as they are not known to be very anti-biotic resistant yet
B. Enterococci are significantly more virulent than Strep Pyogenes
C. Enterococci are the 2nd and 3rd most common cause of hospital acquired (nosocomial) infection
D. All the above are true
E. All the above are false
Enterococci are the 2nd and 3rd most common cause of hospital acquired (nosocomial) infection
S. bovis vs. S. equinous:
Which of these non-enterococci of Group D strep, is most like enterococci as it is good at growing in 40% bile (NOT 6.5% NaCl), lives in the GI and causes similar disease?
Bacteremia with which is found to have a remarkable association with colon cancer?
S. bovis
S. bovis
Streptococcus pneumoniae is also referred to as pneumococcus. Pneumococcus is the major cause of what 2 diseases in adults?
Pneumococcus is the major cause of what disease in children?
It is the major cause of what 2 diseases in adults?
Bacterial Pneumonia
Bacterial Menigitis
Pneumococcus is the major cause of what disease in children?
Otitis media
- A child with Strep pneumoniae has an ear infection, that his parents can treat in the PM*
- “Pnemococcus is to Parents what group B streptococcus is to Babies”*
Which of the following is the major virulence factor of Streptococcus Pneumoniae (Pneumococcus), which allows it protection from phagocytosis? Bonus: is this factor antigenic?
A. M protein
B. C carbohydrate
C. Polysaccharide capsule
D. Bile resistance
Polysaccharide capsule
yes; polysaccharide capsule is antigenic
NOTE about it’s antigenicity and immunity:
there are 84 different capsuel types, so surviving infection only results in immunity against 1 capsule type.
basically you can get infected by pneumoccocus 84 times should the pathogen have a different capsule
Which 2 of the following streptococcal groups is alpha-hemolytic only, and thus only able to partially lyse RBCs and produce a greenish area around the colony?
A. Group A
B. Group B
C. Viridian group
D. Group D
E. Streptoccus Pneumoniae
Viridian group
Streptoccus Pneumoniae
What are the two lab tests used to identify pneumococcus?
If a disc coated in optochin is placed on an agar dish, between Viridian group and Pneumococcus, which of these is LEAST likely to grow?
What are the two lab tests used to identify pneumococcus?
Quelleng reaction
Optochin Sensitivity
If a disc coated in optochin is placed on an agar dish, between Viridian group and Pneumococcus, which of these is LEAST likely to grow?
Pneumococcus
What pathogen is the most common cause of pneumonia in adults?
This same pathogen is the most common cause of what disease in children?
What pathogen is the most common cause of pneumonia in adults?
Pneumococcus (Streptococcus Pneumoniae)
This same pathogen is the most common cause of what disease in children?
Otitis Media
Pneumovax is a vaccine that has 23 of the most common capsular polysaccharides and is given to those who’s infection of pneumococcal pneumonia would be the most lethal. All of the following are included in this group EXCEPT?
A. AIDS patients
B. Asplenic people (people without spleens)
C. Immunocompromised individuals
D. Elderly
E. Children
Children
What are the 3 major pathogenic species of Staphylococcus?
Aureus
Epidermis
Saprophyticus
Which of the following species of Staphylococcus is beta-hemolytic and produces a gold pigment when plated on sheep blood agar?
A. Staph aureus
B. Staph epidermidis
C. Staph saprophyticus
Staph aureus
The lab sends a report that the clustered, gram positive cocci have been confirmed to be coagulase negative. To you this means the pathogen could be any of the following EXCEPT?
A. Staph saprophyticus
B. Staph epidermidis
C. Staph aureus
Staph aureus
NOTE:
- Staph aureus is coagulase positive
- Coagulase activates prothrombin to promote blood clot formation