Ch. 15 - Streptococcus Flashcards
Catalase reaction of Streptococcus
Catalase negative
Gram reaction of Streptococcus
Gram positive
Test that differentiates Streptococcus and Enterococcus from Staphylococcus
Catalase Test
Streptococcus and Enterococcus are Catalase negative
Description of colonies of Streptococcus
Pinpoint colonies (small & transparent)
Type of hemolysis where there is partial lysis and greenish coloration
Alpha hemolysis
Type of hemolysis where there is complete lysis; there is a clear area
Beta hemolysis
Type of hemolysis where there is no lysis; there is no change in the agar
Nonhemolytic/gamma hemolysis
Type of hemolysis where there is a small area of intact RBCs; there is wider zone of complete hemolysis
Alpha-prime
Lancefield group of Streptococcus pyogenes
Lancefield Group A
Virulence factor of S. pyogenes; attached to the peptidoglycan of the cell wall; part of antigenic structure of S. pyogenes
M protein
Substance in S. pyogenes that makes it resistant to phagocytosis; it is used for adherence of the bacterial cell to mucosal cells
M protein
2 virulence factors of S. pyogenes that mediate adherence to host epithelial cells
- Lipoteichoic acid
- Protein F
Virulence factor of S. pyogenes that prevents opsonized phagocytosis; masks its antigens to remain unrecognized
Hyaluronic Acid Capsule
Virulence factor of S. pyogenes that is antigenic
Deoxyribonucleases (A, B, C, and D)
2 hemolysins produced by S. pyogenes; virulence factors
- Streptolysin O
- Streptolysin S
Hemolysin of S. pyogenes that is oxygen-labile
Streptolysin O
Hemolysin of S. pyogenes that is highly immunogenic/antigenic
Streptolysin O
Antibody that is tested for recent infection of S. pyogenes
Antistreptolysin-O (ASO) antigen
3 cells lysed by the hemolysins of S. pyogenes
- erythrocytes
- leukocytes
- platelets
Hemolysin of S. pyogenes that is oxygen stable
Streptolysin S
Hemolysin of S. pyogenes that is non-immunogenic/non-antigenic
Streptolysin S
3 enzymes that are S. pyogenes virulence factors
- Streptokinase
- Hyaluronidase
- Streptodornase
Enzyme by S. pyogenes that lyses fibrin clots
Streptokinase
Enzyme by S. pyogenes that is a spreading factor; contributes to its invasiveness
Hyaluronidase
Enzyme by S. pyogenes that dissolves purulent or fibrinous secretions
Streptodornase
Toxin produced by S. pyogenes
Erythrogenic toxin
Disease caused by erythrogenic toxin
Scarlet fever (red spreading rash)
3 superantigens of erythrogenic toxin
- SpeA
- SpeB
- SpeC
Produced by erythrogenic toxins that are highly mitogenic proteins; they stimulate T-lymphocyte proliferation which induces production of IL-1, tumor necrotizing factor and other cytokines
Superantigens (SpeA, SpeB, and SpeC)
Infection by S. pyogenes; “Strep throat”; characterized by sore throat, malaise, fever, and headache
Bacterial pharyngitis amd tonsilitis
2 methods for diagnosis of S. pyogenes bacterial pharyngitis and tonsilitis
- Throat culture
- Direct Antigen Detection
2 MOTs of S. pyogenes in bacterial pharyngitis and tonsilitis
- droplet
- close contact
Pyodermal infection by S. pyogenes associated with young children (2-5 yrs old); affects exposed areas of skin; inoculation through minor abrasions or insect bites
Impetigo
Pyodermal infection by S. pyogenes in elderly patients; acute spreading skin lesion; erythematous with plain demarcation but irregular edge
Erysipelas
Pyodermal infection by S. pyogenes with deeper invasion; may be life threatening; with bacteremia or sepsis; patients with peripheral vascular disease or diabetes may have gangrene
Cellulitis
2 tests for diagnosis of Scarlet fever
- Dick’s test
- Schultz-Charlton Reaction
Susceptibility test for scarlet fever; erythrogenic toxin is injected; positive when there is redness or swelling
Dick’s test
Diagnostic test for scarlet fever; used to differentiate scarlet fever from measles; antierythrogenic toxin is injected; rash will blanch then fade
Schultz-Charlton Reaction
Substance that is injected in Dick’s Test
Erythrogenic toxin
Substance that is injected in Schultz-Charlton Reaction
Antierythrogenic toxin
“Flesh-eating” disease by S. pyogenes; rapidly progressing inflammation of the skin, subcutaneous fat, and fascia; life threatening; occurs when one has suffered trauma to the skin (portal of entry)
Necrotizing fasciitis
Disease by S. pyogenes that causes an entire organ to shut down leading to death
Streptococcal Toxic Shock Syndrome
2 conditions under Post-Streptococcal Sequelae caused by S. pyogenes
- Rheumatic fever
- Acute glomerulonephritis
Post-streptococcal sequelae characterized by fever and inflammation of the heart, joints, blood vessels and subcutaneous tissue; associated with Class I M protein
Rheumatic fever
Post-Streptococcal Sequelae characterized by damage to the glomeruli and impairment of kidney function; associated with Class I & II M protein
Acute glomerulonephritis
2 drugs for the treatment of post-streptococcal sequelae
- Penicillin
- Erythromycin (for patients allergic to penicillin)
M protein associated with Rheumatic fever
Class I M protein
M protein associated with acute glomerulonephritis
Class I & II M protein
Specimen for S. pyogenes laboratory diagnosis
Swab over the posterior pharynx
Plate used for isolation of S. pyogenes
SBA plate containing SXT
Antibiotic in SBA plates
Sulfamethoxazole-Trimethoprim (SXT)
2 key tests in laboratory diagnosis of S. pyogenes infections
- Bacitracin susceptibility
- PYR hydrolysis
Lancefueld group of Streptococcus agalactiae
Lancefield group B
Test used to detect capsular polysaccharide serotypes of S. agalactiae
Precipitin test
2 virulence factors of S. agalactiae
- capsule
- sialic acid
Virulence factor of S. agalactiae that prevents phagocytosis; ineffective after opsonisation
Capsule
Virulence factor of S. agalactiae which is a critical virulence determinant; most significant component of the capsule
Sialic acid
Streptococcus spp. that causes neonatal sepsis
S. agalactiae
Disease caused by S. agalactiae
Neonatal sepsis
2 type of neonatal sepsis
- early-onset infection (less than 7 days old)
- late-onset infection (at least 7 days old)
Type of neonatal sepsis; vertical transmission from the mother; pneumonia/meningitis with bacteremia; presence of group B streptococci in the vagina of the mother
Early-onset infection
Type of neonatal sepsis; meningitis; uncommonly associated with obstetric complications
Late-onset infection
Treatment for S. agalactiae infections
Ampicillin + aminoglycoside
Colony description of S. pyogenes
Small, transparent and smooth with a well-defined area of ß-hemolysis
Plate used for the growth of S. agalactiae
SBA
Colony description of S. agalactiae
Grayish-white, mucoid, surrounded by a small zone of ß-hemolysis
2 useful tests for laboratory diagnosis of S. agalactiae
- Hippurate hydrolysis
- CAMP test
Streptococcus spp. that has C substance
Streptococcus pneumoniae
Virulence factor of S. pneumoaniae
Cbpsular polysaccharide
Type of pneumonia caused by alcoholism, anesthesia, malnutrition and viral infections
Lobar pneumonia
2 vaccinations for S. pneumoniae infections
- PCV7 (children)
- PS23 (adults)
2 drugs for the treatment of S. pneumoniae infections
- erythromycin
- chloramphenicol
Colony description of S. pneumoniae young cultures
Round, glistening, wet, mucoid, dome-shaped appearance
Colony description of S. pneumoniae old cultures
Collapse of colony’s center; appearance of a coin with a raised rim
2 tests used to differentiate S. pneumoniae from Viridans streptococci
- optochin susceptibility
- bile solubility
Hemolytic pattern of Viridans streptococci
Alpha hemolytic
5 groups under Viridans Streptococci
- S. bovis
- S. anginosus
- S. mitis
- S. mutans
- S. salivarius
2 divisions of the Group D streptococci (Bile esculin positive)
- Enterococcal
- Nonenterococcal
Group D streptococci division found in the intestinal tract; has the ability to grow in 6.5% NaCl
Enterococcal
Group D streptococci division that will not grow in a nutrient broth with 6.5% NaCl
Nonenterococcal
2 infections caused by S. mutans
- gingivitis
- dental carries
Disease caused by S. mitis
Bacterial endocarditis in native valves
Viridans streptococci associated with gingivitis and dental carries
S. mutans
Viridans streptococci associated with bacterimic patients with the tendency to form abscesses
S. anginosus
Viridans streptococci associated with bacterial endocarditis in native valves
S. mitis
Viridans streptococci associated with blood cultures of patients wi bacteremia, septicemia and endocarditis
S. bovis
Viridans streptococci associated with abscesses bactermia
S. constellatus
4 virulence factors for Viridans streptococci
- polysaccharide capsule
- cytolysin
- extracellular dextran
- cell surface-associated proteins
PYR reaction of Viridans streptococci
PYR negative
LAP reaction of Viridans streptococci
LAP positive
Colony description of Viridans streptococci
Small, surrounded by a zone of alpha hemolysis; some are beta or nonhemolytic
Viridans streptococci spp. with sweet odor of honeysuckle or butterscotch when growing in pure culture or high concentation
S. anginosus
4 classifications of Streptococci based on physiologic characteristics
- pyogenic
- viridans
- lactic acid
- enterococci
Physiologic characteristic of Streptococci; pus producing, ß hemolytic, Lancefield grouping
Pyogenic
Physiologic characteristic of Streptococci; alpha or nonhemolytic, opportunistic pathogens, not part of Lancefield grouping, normal flora in the upper respiratory tract
Viridans
Physiologic characteristic of Streptococci; nonhemolytic, in dairy products, Lancefield group N
Lactic Acid
Physiologic characteristic of Streptococci; flora of the intestine, resistant to Vancomycin
Enterococci
Classification of Streptococci based on extraction of C-carbohydrate
Lancefield Classification Scheme
Test used to identify Group A Streptococci in throat cultures
Bacitracin Susceptibility (susceptible)
Streptococci group that is susceptible to Bacitracin and resistant to SXT
Group A Streptococci
Streptococci group that is resistant to Bacitracin and SXT
Group B streptococci
Test used to identify Group B streptococci
CAMP test (Christie, Atkins, and Munch-Petersen)
Used to differentiate Group B and ß-hemolytic streptococci
Hippurate Hydrolysis
Organism which is positive in Hippurate Hydrolysis
Group B: S. agalactiae (purple color)
Test used to differentiate Enterococcus from non-enterococcus
PYR Test
Organism that is positive for PYR test
Enterococcus
Tgst used to differentiate Aerococcus and Leuconostoc from other gram positive cocci
Leucine Aminopeptidase Test (LAP)
2 organisms that are LAP negative
- Aerococcus
- Leuconostoc
Test that detects acetoin production from glucose
Voges-Poskauer Test
Organism that is bile soluble
S. pneumoniae
2 strep-like organisms; grows as satellite colonies around other bacteria; has cysteine or pyridoxal (Vit B6); requires thiol- or pyridoxal for growth; nutritionally-variant strep
S. adjacens
S. defectivus
2 strep-like organisms; causes endocarditis, bacteremia, and otitis media
- S. adjacens
- S. defectivus
Bile esculin reaction of S. adjacens and S. defectivus
Bile esculin negative
PYR reaction of S. adjacens and S. defectivus
PYR positive
Strep-like organism; airborne; occurs as tetrads in broth media; grows in the presence of 6.5% NaCl; alpha hemolytic; LAP negative
Aerococcus
Aerococcus spp. that is bile esculin and PYR positive
A. viridians
Aerococcus spp. that is bile esculin and PYR negative
A. urinae
Strep-like organism that is similar to Viridans strep in colony morphology and habitat; involved with endocarditis, wounds and abscesses
Gemella
Strep-like organism found on plant surfaces, vegetables and milk products; grows in 6.5% NaCl; hydrolyzes esculin; associated with meningitis, bacteremia, UTI and pulmonary infection; PYR and LAP negative
Leuconostoc
Strep-like organism; in tetrads; bile esculin and LAP positive; PYR negative; grows at 42 degrees Celsius
Pediococcus
Organisms that are PYR negative
Group D (E. faecalis, E. faecium, S. bovis)
Organisms that are Bile esculin negative
- Nonhemolytic streptococcus
- ß-hemolytic strep (not Group A, B or D)
- Viridans strep
Lancefield group of Enterococcus
Lancefield group D
Quorum-sensing mechanism of Enterococcus
Cytolysin
2 culture media for Enterococcus
- Trypticase soy
- Brain-heart infusion agar
Supplemented by 5% sheep blood
Enterococcus sp. that grows in thesence of tellurite
Enterococcus faecalis