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Microbiology > Chapter 14: Streptococci, Enterococci and Related Genera > Flashcards

Chapter 14: Streptococci, Enterococci and Related Genera Flashcards

1
Q

How does Streptococci being classified?

A
  1. Colony morphology and hemolytic reactions on blood agar
  2. Serologic specificity of the cell wall group-specific substance
  3. Biochemical reactions and resistance to physical and chemical factors
  4. Ecologic features
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2
Q

Complete disruption of erythrocytes with clearing of the blood around the bacterial growth

A

B-hemolysis

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3
Q

Incomplete lysis of erythrocytes with reduction pf hemoglobin and the formation of green pigment

A

a-hemolysis

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4
Q

Group A pyogenic Streptococci

B hemolysis

A

Streptococcus pyogenes

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5
Q

Group B pyogenic Streptococci

B hemolysis

A

Streptococcus agalactiae

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6
Q

Group C, G pyogenic Streptococci
B hemolysis (human infections)
A hemolysis

A

Streptococcus dysgalactiae

Subspecies: Equisimilis

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7
Q

Group D Viridans Streptococci with no hemolysis

A

Streptococci bovis group

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8
Q

Group F Viridans Streptococci

a hemolysis

A

Streptococcus anginosus group

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9
Q

Group A Viridans Streptococci

A

Streptococcus anginosus

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10
Q

Group C Viridans Streptococci

A

Streptococcus intermedius

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11
Q

Group G Viridans Streptococci

A

Streptococcus constellatus

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12
Q

No group specific substance but they are a hemolytic

A

Mutans group

Streptococcus mutans

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13
Q

Mitis-Sanguinis group with a hemolysis

A

Streptococcus pneumoniae
Streptococcus mitis
Salivarius group

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14
Q

Pyogenic Streptococci that has inhibited by bacitracin

A

Streptococcus pyogenes

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15
Q

Pyogenic Streptococci that positive in hippurate hydrolysis and CAMP-factor positive

A

Streptococcus agalactiae

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16
Q

Grow in the presence of bile, hydrolyze esculin, no growth in 6.5% NaCl, degrades starch

A

Streptococcus bovis

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17
Q

Group A Viridans Streptococci that is bacitracin resistant and PYR negative

A

Streptococcus anginosus

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18
Q

All Viridans Streptococci are Voges Proskauer (VP) positive except?

A

Mitis group

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19
Q

Mitis-sanguinis group that is susceptible to optochin

A

Streptococcus pneumoniae

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20
Q

Mitis-Sanguinis group that has high-level resistance to penicillin

A

Streptococcus mitis

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21
Q

The serologic specificity of the group-specific carbohydrate is determined by?

A

An amino sugar

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22
Q

Serologic specificity sugar for group A Streptococci.

A

Rhamnose-N-acetylglucosamine

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23
Q

Serologic specificity sugar for group B Streptococci.

A

Rhamnose-glucosamine polysaccharide

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24
Q

Serologic specificity sugar for group C Streptococci.

A

Rhamnose-N-acetylgalactosamine

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25
Q

Serologic specificity sugar for group D Streptococci

A

Glycerol teichoic acid containing D-alanine and glucose

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26
Q

Serologic specificity sugar for group F Streptococci.

A

Glucopyranosyl-N-acetylgalactosamine

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27
Q

For grouping Streptococci, what are the extraction methods prepared to determine their group-specific antigen

A
  1. Centrifuged culture treated with

Hot hydrochloric acid
Nitrous acid
Formamide

  1. Enzymatic lysis with streptococcal cells with
    pepsin and trypsin
  2. Autoclaving of cell suspensions
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28
Q

Antigenic specificity of the capsular polysaccharide is used to classify

A

Streptococcus pneumoniae

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29
Q

Main human pathogen associated with local or systemic invasion and poststreptococcal immunologic disorders

A

Streptococcus pyogenes

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30
Q

Gram stain of Streptococci

A

Positive

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31
Q

Capsules of group A Streptococci are composed of?

A

Hyaluronic Acid

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32
Q

How does the capsule of S.pyogenes causes virulence?

A

By binding to hyaluronic-acid-binding protein, CD44 that are present on human epithelial cells that induce disruption of intercellular junctions

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33
Q

present in the cell wall of Streptococcus pyogenes

A

Proteins (M,T,R antigens)
Carbohydrates (group specific)
Peptidoglycans

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34
Q

Composition of pili of Streptococcus pyogenes

A

M proteins covered with lipoteichoic acid

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35
Q

Responsible for the attachment of Streptococci to the epithelial cells

A

Lipoteichoic acid

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36
Q

Most Streptococci grow in solid media as?

A

1-2 mm discoid colonies

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37
Q

Growth of Streptococci are poor on solid media or broth unless enriched with?

A

Blood or Tissue fluids

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38
Q

Growth and hemolysis of Streptococci are aided by

A

incubation in 10% CO

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39
Q

Pathogenic hemolytic streptococci grow best at temperature

A

37 degrees Celcius

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40
Q

Most Streptococci are __________ anaerobes

A

Facultative

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41
Q

Colonies of Streptococci pyogenes that has many M proteins and are virulent

A

Matte colonies

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42
Q

Colonies of Streptococci pyogenes that produce little M protein and not virulent.

A

Glossy colonies

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43
Q

Major virulence factor of S. pyogenes

A

M protein

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44
Q

How does M protein contributes to the virulence of S. pyogenes?

A

Resist phagocytosis

Inhibits activation of alternate C pathway

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45
Q

Class of M protein of S.pyogenes that react with human cardiac muscle and the virulence determinant for rheumatic fever

A

Class 1 M protein

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46
Q

Toxins and enzymes exhibited by S.pyogenes

A 
Streptokinase
Deoxyribonucleases
Hyaluronidase
Hemolysins
Erythrogenic Toxin
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47
Q

Enzyme of S.pyogenes that transforms plasminogen to plasmin allowing them to escape from blood clots

A

Streptokinase (Fibrolysin)

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48
Q

Enzymes that facilitate the spread of Streptococci in tissue by liquefying pus

A

Deoxyribonucleases (A,B,C,D) degrade DNAses

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49
Q

How does the enzymatic activity of DNAses can be measured in DNA solutions?

A

Decrease in viscosity

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50
Q

Enzymes used in enzymatic debridement that liquefies exudates and facilitates removal of pus and necrotic tissue

A

Streptokinase & DNAses

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51
Q

Enzyme that aid in spreading infecting microorganism (spreading factor)

A

Hyaluronidase

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52
Q

Pyrogenic exotoxin of S.pyogenes that carry lysogenic phage

A

Spe A (most widely studied)

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53
Q

Pyrogenic exotoxin of S.pyogenes that contributes to the streptococcal toxic shock syndrome and encoded in phage

A

Spe C

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54
Q

Pyrogenic exotoxin of S.pyogenes that is a potent protease that interferes with phagocytosis

A

Spe B

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55
Q

The group A Streptococci associated with toxic shock syndrome are primarily of M protien types?

A

Types 1 & 3

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56
Q

How does pyrogenic exotoxins causes toxic shock syndrome?

A

They act as superantigens that binds to MHC II in the Vb region of T-cell and activates them and release of cytokines mediates the shock

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57
Q

Hemolysins that is hemolytically active in reduced state and inactivated in the presence of oxygen

A

Streptolysin O

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58
Q

Antibody that appears in human after infection of any Streptococci that produce streptolysin O

A

Anti-streptolysin O (ASO)

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59
Q

Units in ASO titer that indicates recent infection of S.pyogenes

A

160-200 units

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60
Q

Hemolysin of S.pyogenes that is responsible for the hemolytic zones around streptococcal colonies growing on blood agar plates

A

Streptolysin S

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61
Q

Diseases attributable to invasion by S.pyogenes

A 
Erysipelas
Cellulitis
Necrotizing fasciitis (streptococcal gangrene)
Puerperal fever
Bacteremia or Sepsis
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62
Q

S.pyogenes portal of entry is the skin, that leads to raised,red lesion with edema and sharply demarcated margin of infection

A

Erysipelas

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63
Q

rapidly spreading infection of the skin and subcutaneous tissue caused by S.pyogenes with mild trauma, burns, wounds or surgical incisions. Not raised lesion and line between the involved and uninvolved tissue is indistinct

A

Cellulitis

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64
Q

Extensive and very rapidly spreading necrosis of the skin, tissues and fascia.

A

Necrotizing fasciitis (streptococcal gangrene)

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65
Q

S.pyogenes enter the uterus after delivery that leads to septicemia originating in the infected wound (endometritis)

A

Puerperal fever

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66
Q

Most common infection caused by B-hemolytic S.pyogenes

A

Streptococcal sore throat or pharyngitis

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67
Q

In streptococcal pharyngitis, this glycoprotein serves as lipoteichoic acid ligand.

A

Fibronectin

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68
Q

Local infection of superficial layers of skin in children, consists if superficial vesicles and crusty lesion

A

Streptococcal pyoderma

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69
Q

Invasive S. pyogenes infections characterized by shock, bacteremia, respiratory failure and multiorgan failure.

A

Streptococcal toxic shock syndrome

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70
Q

Group A streptococcal skin infection are often attributable to M types?

A

49, 57, 59, 60, 61

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71
Q

The S.pyogenes of the M types_________ make pyrogenic exotoxin A or B.

A

M types 1 & 3 (12 & 28)

72
Q

Exotoxin of S. pyogenes that causes scarlet fever

A

Pyrogenic exotoxins A-C

73
Q

Poststreptococcal diseases includes

A

Rheumatic fever

Glomerulonephritis

74
Q

Nephritis and rheumatic fever appears after infections of S.pyogenes during?

A

1-4 weeks (mean 7 days)

75
Q

Nephritis is preceded by infection of S.pyogenes in the?

76
Q

Rheumatic fever is preceded by infection of S.pyogenes in the?

A

Respiratory tract

77
Q

How many days (mean) does acute glomerulonephritis appears after infection of S.pyogenes?

78
Q

Strains of S. pyogenes that are nephritogenic (skin)

A

M types 2, 42, 49, 56, 57, 60

79
Q

Strains of S. pyogenes that are nephritogenic (throat infections and glomerulonephritis)

A

M types 1, 4, 23 and 25

80
Q

Important antigens in the glomerulonephritis

A

Spe B and nephritis-associated plasmin receptor

81
Q

Most serious sequela of S.pyogenes because it results to heart muscle and valves damage.

A

Rheumatic fever

82
Q

Onset of rheumatic fever preceded by S.pyogenes pharyngitis is ______

A

19 days earlier

83
Q

Strains of S.pyogenes associated with rheumatic fever

A

M types 1, 3, 5, 6, 18

84
Q

What are the poststreptococcal autoimmune, neuropsychiatric disorders associated with streptococci (PANDAS)

A 
Fever 
Malaise
Migratory nonsuppurative polyarthritis
Carditis
Sydenham’s chorea
85
Q

Manifestation of acute rheumatic fever characterized by involuntary, uncoordinated movements and associated muscle weakness

A

Sydenham’s chorea

86
Q

Test used to estimate rheumatic activity

A

Erythrocyte sedimentation rates
Serum transaminase levels
Electrocardiograms

87
Q

Poststreptococcal that can be reactivated by recurrent streptococcal infection

A

Rheumatic fever

88
Q

Patients are protected by recurrent S.pyogenes infections by what drug?

A

Prophylactic penicillin

89
Q

Specimens that can be used for lab test for S.pyogenes

A 
Throat swab
Pus
CSF
Sterile body fluid
Blood
Serum (antibody determinations)
90
Q

S.pyogenes can be identified by rapid tests like

A

Test for the presence of the group A-specific antigen

PYR Test

91
Q

Group that has a positive result to bacitracin

A

Group A Streptococci (B hemolysis)

92
Q

Antigen detection test for S.pyogenes includes

A

Enzyme immunoassay

Agglutination Tests

93
Q

More sensitive assays for detection of S.pyogenes

A

DNA probes

Nucleic acid amplification

94
Q

Most widely used serologic test for S.pyogenes, used particularly in respiratory diseases

A

Anti-ASO titer

95
Q

Serologic test for skin infection caused by S.pyogenes

A

Anti-DNAse B
Anti-hyaluronidase

(Others include antistreptokinase, anti-M type specific antibodies)

96
Q

Resistance against streptococcal diseases is _________ type specific.

A

M type specific

( A host who recovered from infection by one group A streptococcal M type is immune to reinfection by the same type but fully susceptible to infection by another M type)

97
Q

All S. Pyogenes are susceptible to

98
Q

these drugs are for penicillin-allergic patients with necrotizing fasciitis

A

Macrolides, Erythromycin, Clindamycin

99
Q

How many days does penicillin erythromycin results in effective tissue

100
Q

Mode of transmission of S.pyogenes

A

clinical infection
subclinical infection
droplets from the respiratory tract
skin

101
Q

Early antimicrobial therapy of respiratory and skin infections with Group A streptococci

A

Benzathine penicillin G (intramuscular)

102
Q

Antistreptococcal chemophylaxis in persons who have suffered an attack of rheumatic fever

A
  1. One injection of benzathine Pen G intramuscularly every 3-4 weeks or
  2. Daily oral penicillin or oral sulfonamide
103
Q

3rd step in the control procedures for S.pyogenes

A

Eradication of S. pyogenes from carriers

104
Q

Streptococcus agalactiae are group B streptococci found normally in

A

Vagina

Lower respiratory tract

105
Q

Group B streptococcal infection during 1st month of life are

A

Sepsis
Meningitis
Respiratory distress syndrome

106
Q

For those mothers who are colonized by group B streptococci, prior to labor they are given ______ (drug)

A

Intravenous ampicillin

107
Q

Streptococcal groups that has hemolysins and M proteins analogous to group streptococci

A

Groups C & G

108
Q

Group D streptococci that is more recently important to human disease

A

Streptococcus bovis

109
Q

Group D streptococcus that has DNA Cluster I

A

Streptococcus equinus

110
Q

Group D streptococcus that has biotype 1 (DNA Cluster II) where isolates ferment mannitol

A

Streptococcus gallolyticus

111
Q

Biotype II, DNA cluster III group D streptococci

A

Streptococcus infantarius

112
Q

Group D streptococcus biotype _____ bacteremias are associated with biliary sources.

A

Biotype II

113
Q

Group D streptococcus that is DNA Cluster IV

A

Streptococcus alactolyticus

114
Q

What group of streptococci that is non-hemolytic, PYR negative and grows in bile and hydrolyze esculin

A

Group D streptococci

115
Q

Streptococcus that are normal in throat, colon and urogenital tract

A

Streptococcal anginosus group

S. consellatus & S. intermedius

116
Q

Streptococcus that has butterscotch or caramel odor

A

Streptococcus anginosus group

117
Q

Streptococcus that causes infection in dogs

A

Streptococcus canis

118
Q

Viridans streptococci is consists of

A 
S. mitis group
S. anginosus group
S. mutans group
S. salivarus group
S. bovis group
119
Q

Viridans streptococci are normal microbiota most prevalent in?

A

Upper respiratory tract

120
Q

Viridans streptococci that synthesize dextrans & levans (large polysaccharides) present in dental caries

121
Q

Nutritionally variant, deficient streptococci are

A

Abiotrophia

Granulicatella

122
Q

Requires pyridoxal or cysteine for growth on blood agar

123
Q

Streptococci that grows only under anaerobic or microaerophilic conditions and variably produce hemolysins

A

Peptostreptococcus

124
Q

Peptostreptococcus are normal microbiota in?

A

Mouth
Upper respiratory tract
Bowel
Female genital tract

125
Q

gram-positive diplococci, often lancet shaped or arranged in chains with polysaccharide capsule

A

Streptococcus pneumococci

126
Q

Pneumococci are normal inhabitants in?

A

Upper respiratory tract

can cause pneumonia, sinusitis, otitis, bronchitis, bacteremia, meningitis, peritonitis

127
Q

Autolysis of pneumococci is enhanced by

A

surface-active agents

128
Q

On solid media, the growth of pneumococci is inhibited around a disk of?

129
Q

Hemolysis of pneumococci on blood agar

A

a-hemolysis

130
Q

Growth of pneumococci is enhanced by

A

5-10% CO2.

131
Q

Polysaccharide present in the cell wall of S.pneumoniae that can be detected in the urine and CSF

A

C-polysaccharide

132
Q

Antiserum used in determination of pneumococci in fresh sputum

A

Polyvalent antiserum

133
Q

Pneumococcal types responsible for adult pneumonia

134
Q

Pneumococcal types responsible for children pneumonia

A

Types 6, 14, 19, 23

135
Q

Virulence of pneumococci

A

Capsule (prevents/delays ingestion by phagocytosis)

136
Q

Circumstances that lowers the resistance to pneumococci

A
  1. Viral and other respiratory tract infection
  2. Alcohol/Drug Intoxication
  3. Abnormal circulatory dynamics
  4. Malnutrition, General Debility, Sickle-cell anemia, hyposplenism, nephrosis, complement deficiency
137
Q

Significant complication of pneumococcal infections

A

Empyema (pus in the pleural space)

138
Q

Specimen used in lab tests for pneumococci

A

Blood
CSF
Sputum

139
Q

Positive stained smear of pneumococci

A

gram-stained film with rusty red sputum with PMN and RBCs

140
Q

Pneumococci remain susceptible to?

A

Vancomycin

141
Q

Pneumococci are resistant against

A

Pen G
Tetracycline
Erythromycin
Flouroquinolones

142
Q

Prevention and control of pneumococci is thru

143
Q

Current conjugate vaccine of pneumococci with diphtheria

A

PCV 13, Prevnar 23 (Wyeth Pharmaceuticals)

144
Q

When does children receive pneumococcal conjugate vaccine?

A

Four-dose series 2,4, 6, 12, 15 months of age

145
Q

Pneumococcal vaccine for adults 19 yrs older with immunocompromised conditions

A

PPSV23 & PCV13

146
Q

group D group specific-substance, non-hemolytic, PYR positive, bile esculin positive, grew well in 6.5 NaCl

A

Enterococci

147
Q

Most common cause of enterococcal infection

A

Enterococcus faecalis (85-90%)

148
Q

Least common cause of enterococcal infections

A

Enterococcus faecium (5-10%)

149
Q

Most frequent causes of health-care associated infections, transmitted on medical devices

A

Enterococcal infections

150
Q

Most common sites of Enterococcal infections

A

Urinary tract
Wounds
Biliary tract
Blood

151
Q

Enterococcus that is more antibiotic-resistant

A

Enterococcus faecium

152
Q

Enterococci are resistant to?

A 
Cephalosporins 
Penicillinase-resistant penicillins 
Monobactams
Fluoroquinolones
Aminoglycosides
153
Q

Enterococci are inhibited by

A

B-lactams (ampicillin)

154
Q

Treatment for severe enterococcal infections (endocarditis)

A

Penicillin/Vancomycin + Aminoglycoside (streptomycin/gentamicin)

155
Q

Reason for high level aminoglycoside resistant of the enterococci

A

because they have aminoglycoside-modifying enzymes

156
Q

Gene that codes aminoglycoside-modifying enzymes

A

conjugative plasmids

transposons

157
Q

Enterococci: Resistance to _____ predict resistance to other aminoglycosides EXCEPT streptomycin

A

Gentamicin

158
Q

Alternative drug to a penicillin (+ aminoglycosides) for enterococcal infections

A

Vancomycin

159
Q

Vancomycin resistance phenotypes: inducible high-level resistance to vancomycin and teicoplanin

A

Van A phenotype

160
Q

Vancomycin resistance phenotypes: inducibly resistant to vancomycin but susceptible to teicoplanin

161
Q

Vancomycin resistance phenotypes: intermediate to moderate resistance to vancomycin

162
Q

Vancomycin resistance phenotypes: moderate resistance to vancomycin and low-level resistance or susceptibility to teicoplanin

163
Q

Vancomycin resistance phenotypes: low-level resistance to vancomycin and susceptibility to teicoplanin

164
Q

Vancomycin resistance phenotypes: isolates usually E.faecalis have low-level resistance to vancomycin and are susceptible to teicoplanin

165
Q

Vancomycin and Teicoplanin interfere cell wall synthesis in gram positive by interacting with the?

A

D-alanyl-D-alanine

166
Q

The best studied vancomycin resistance determinant

A

Van A operon (packed of genes in plasmid-containing transposon)

167
Q

Genes for regulatory system and is sensitive to the presence of vancomycin/teicoplanin in the environment

A

Van R and Van S

168
Q

Genes that are required for glycopeptide resistance

A

Van H
Van A
Van X

169
Q

Gene that encodes dehydrogenase

170
Q

Gene that encodes ligase

171
Q

Gene that encodes dipeptidase that depletes the normal d-Ala-d-Ala dipeptide

172
Q

Gene that encodes carboxypeptide that cleaves the terminal d-Ala from the pentapeptide, depleting the environment of any functional pentapeptide

173
Q

Treatment for vancomycin-resistant enterococci

A

Daptomycin
Linezolid
Quinupritis-dalfopristin
Tigecycline

174
Q

genera that catalase-negative, gram-positive cocci that is vancomycin resistant

A

Pediococcus

Leuconostoc

175
Q

Lactobacilli are _____ resistant

A

Vancomycin-resistant

176
Q

Catalase-negative, gram positive cocci that are vancomycin-susceptible

A

Lactococcus
Aerococcus
Gemella

177
Q

Catalase-negative that is previously considered as Staphylococcus

A

Rothia mucilaginosa

Microbiology (7 decks)

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