Clinical Bacteriology: Gram Positive Bacteria - Staphylococci and Streptococci Flashcards
What color are gram positive bacteria on the gram stain?
Gram negative?
Gram positive bacteria are purple/blue.
Gram negative bacteria will be pink.
What differentiates staphylococcus from streptococcus by initial testing?
Staphylococcus is catalase + (in clusters)
Streptococcus is catalase - (in chains)
(Catalase catalyzes the reaction 2H2O2 -> 2H20 + O2)
What is the major differentiation between staph aureus and the other staphylococci?
S. Aureus is coagulase positive.
The other staphylocicci (S. epidermidis and S. saprophyticus) are coagulase negative.
How can you differentiate staph epidermidis from staph saprophyticus?
NOvobiocin - Saprophyticus is Resistant
Epidermidis is Sensitive
“On the office’s “staph” retreat, there was NO StRESs”
How are the major divisions of streptococci formed by lab testing?
What does each category mean?
Their behavior by hemolysis.
Partial hemolysis AKA α-hemolysis: (green ring)
Complete hemolysis AKA β-hemolysis (clear)
No hemolysis AKA γ-hemolysis (no change in surrounding agar)
What are the α-hemolytic streptococci?
How are they differentiated?
Streptococcus pneumoniae: Capsule. Optochin sensitive, bile soluble (lysed by bile)
Viridans streptococci (e.g., S. mutans): No capsule, optochin resistant, bile insoluble (not lysed by bile)
Optochin - Viridans is Resistant; Pneumoniae is Sensitive: OVRPS (overpass)
What are the β-hemolytic streptococci?
How are they differentiated?
Group A: Streptococcus Pyogenes, bacitracin sensitive
Group B: Streptococcus Agalactiae, bacitracin resistant
Bacitracin - group B strep are Resistant; group A strep are sensitive: B-BRAS
What are all the β-hemolytic bacteria?
How to differentiate?
Staphylococcus Aureus: Catalase and coagulase positive
Streptococcus pyogenes - Group A Strep (catalase negative, bacitracin sensitive)
Streptococcus agalactiae - Group B strep (catalase negative, bacitracin resistant)
Listeria monocytogenes: Tumbling motility, meningitis in newborns, unpasteurized milk
An unknown organism is gram stained. It is coagulase positive. What organism is this?
What would you predict about catalase activity?
What is its most common virulence factor?
What does it commonly colonize?
Staphylococcus aureus - gram-positive (purple) cocci in clusters.
Catalase (staph) and coagulase (S. aureus) positive.
Protein A exotoxin: Binds Fc-IgG, inhibiting complement activation and phagocytosis.
Colonizes the nose.
What are some inflammatory diseases caused by Staph aureus?
Skin infections, organ abscesses, pneumonia (often after influenza virus infection), endocarditis, and osteomyelitis.
What are some toxin-mediated diseases caused by Staph Aureus?
What is the toxin that causes each?
Toxic Shock Syndrome: Toxic Shock Syndrome Toxin (TSST-1)
Scalded skin syndrome: Exfoliative toxin
Rapid-onset food poisoning: Enterotoxins
What predisposes to toxic shock syndrome, caused by S. Aureus?
What is its major exotoxin, and how does it work?
Toxic shock syndrome predisposed by vaginal or nasal tampons
Toxic shock syndrome toxin (TSST-1): Superantigen that binds MHC II and T-cell receptor, resulting in polyclonal T-cell activation.
Presents with fever, vomiting, rash, desquamation, shock, end-organ failure.
What causes S. aureus food poisoning?
What is special about the toxin?
Ingestion of preformed enterotoxins.
Short incubation period (2-6 hours)
Enterotoxin is heat stable -> not destroyed by cooking. Unique among exotoxins for heat stability.
What types of infections are characteristic of Staphylococcus epidermidis?
What antibiotic is it sensitive/resistant to?
Staphylococcus epidermidis: Infects prosthetic devices and intravenous catheters by producing adherent biofilms. Component of normal skin flora.
S. epidermidis is Novobiocin sensitive.
What types of infections are characteristic of Staphylococcus saprophyticus?
What antibiotic is it resistant/sensitive to?
Second most common cause of uncomplicated UTI in young women (first is E. coli)
S. saprophyticus is Novobiocin resistant.