Clinical Significant Strep And Strep-like Organisms Flashcards
What is the essential virulence factor of S. pyogenes?
M protein
This protein is encoded of emm gene.
M proteins
How many serotypes of M protein thus S. pyogenes have?
80 serotypes
Roles of M protein.
Evades phagocytosis
Adhesion to the mucosal cells
The most common serotype of M protein found in pharyngitis.
M1
Which of the following is/are not virulence factors of S. pyogenes
A. Fibronectin-binding protein (Protein F)
B. Neuraminidase
C. Streptolysin O
D. Streptokinase
B
What are the virulence factors of S. pyogenes?
M protein
Lipotechoic acid
Hyaluronic acid capsule
Protein F
Extracellular products
(Enzymes, hemolysin, exotoxins)
What are the extracellular products of S. pyogenes ?
Extracellular products
- Streptolysin O
- Streptolysin S
- DNase
-streptokinase
-hyaluronidase
-streptococcal pyrogenic exotoxin
(Erythrogenic toxins)
Four immunologically distinct exotoxins types found in S. pyogenes?
SpeA
SpeB
SpeC
SpeF
Which virulence factors of S. pyogenes is not for adhesion?
A. M protein
B. protein F
C. Lipotechoic acid
D. Hyaluronic acid capsule
D.
- Hyaluronic acid capsule:
- Streptolysin S:
- Streptolysin O:
A. Weakly immunogenic
B. Highly immunogenic
C. Nonimmunogenic
- A
- C
- B
Virulence factor that mask the antigen to avoid phagocytosis.
Hyaluronic acid capsule
What is the common DNase in S. pyogenes?
DNase B
It is responsible for hemolysis in the SBA plate incubated ANAEROBICALLY.
Streptolysin O
The SLO leaves antibodies in hemolysin that can be measured in what test?
Antistreptolysin O (ASO) test
It is an oxygen stable type of Streptolysin and resposibel for hemolysis incubated AEROBICALLY.
Streptolysin S
This virulence factor of S. pyogenes cause lysis of fibrin clots.
Streptokinase
T or F
Group C and G alse have streptokinase.
True
It is the spreading factor of S. pyogenes.
Hyaluronidase
Some strain of S. pyogenes cause red spreading rash called ____ and cause by what virulence factor?
- Scarlet fever
- streptococcal pyrogenic exotixins
This virulence factors of S. pyogenes is superantigen.
Steptococcal pyrogenic toxins
Clinical infections of S. pyogenes
- Bacterial pharyngitis
- pyodermal infection
- necrotizing fasciitis
-streptococcal toxic shock syndrome
Poststreptococcal sequelae
Mos common clinical manifestation of GAS infection
Bacterial pharyngitis
T or F
Strep throat is usually seen in children between 3-4 yrs. Old.
False- 5-15 yrs old
Bacterial pharyngitis could be spread through___.
Droplets or close contact
Which is not a pyodermal infection of S. pyogenes?
A. Folliculitis
B. Impetigo
C. Erysipelas
D. Cellulitis
A.
This skin infection begins in small vesicles that progress to weeping lesions. Occurs through minor abrasion and isect bites bites.
Impetigo
A rare infection of the skin and subcutaneous tissues is observed frequently in elderly patients.
Erysipelas
Can develop following deeper invasion by strep.
Cellulitis
An invasive infection characterized by rapid progressing inflammation and necrosis of the skin, Subcutaneous fat, and fascia.
Necrotizing fasciitis
What type of NF cause by polymicrobial infection?
Type 1
NF cause only by GAS.
Type 2
Type of NF that is a gas gangrene/ clostridial myonecrosis
Type 3
This infection of S. pyogenes cause the entire organ system to collapse.
Streptococcal Toxic Shock Syndrome
GAS associated with TSS produce what type of streptoccal pyrogenic exotoxins?
SpeA
Two serious complications of Postreptococcal sequelae infection.
Rheumatic Fever (RF)
Acute glomerulonephritis
Characterized by fever, an inflammation of the heart, joints, blood vessels, and subcutaneous tissues.
Rheumatic fever
Circulating immune complexes found in the serum of patients with___.
Acute glomerulonephritis
What causes acute glomerulonephritis?
Ag-Ab complexes deposits in glomeruli. The complement is fixed, and the inflammatory response cause damage to glomeruli that further damage the kidneys function.
What antibiotics is good for S. pyogenes, and what is the alternative?
Penicillin
Alternative:
Erythromycin
What other components of selective agar for the growth of S. pyogenes?
-SMZ (sulfamethoxazole)/ colistin
-polymixin B
Key test of S. pyogenes
Bacitracin susceptibility (S)
PYR hydrolysis (S)
What group of strep. has an acid-stable polysaccharide in cell wall.
Group B (S. agalactiae)
What is the significant component of Group B strep in their capsule?
Sialic acid
Other virulence factors of S. Agalactiae.
CAMP factor
Hemolysin
DNase
Hyaluronidase
Protease
Neuraminidase
This strep. spp. Cause invasive disease in newborn.
Group B strep. (S. agalactiae)
Two clinical syndromes associated with neonatal GBS.
Early-onset infection(<7 days)
Late-onset infection (7days-3months)
Manifestation of Early-onset infection.
Pneumonia and sepsis
Manifestation of late-onset infection
Meningitis and sepsis
In adult, S. agalactiae affects two type of patients. What are they?
- Young, previously healthy woman who become ill after childbirth or abortion.
- Elder person with serious underlying disease or immunodeficiency.
Drug of choice for GBS is__.
Penicillin
Biochemical test of GBS.
-Hippurate hydrolysis (+)
- CAMP test (+)
What broth is recommended for detection of GBS in pregnant women?
Todd-Hewitt broth
Type of broth used in identification of GBS that turns orange/red if positive.
StrepB Carrot Broth
Large colony forming beta hemolysis belongs to___.
S. dysagalactiae subsp. equisimilis
Small-colony-forming beta hemolytic is ___.
Strep. anginosus
What antigen does S. pneumoniae contains?
C substance
A B-globulin in human serum called ___, reacts with C substance to produce precipitate.
C-reactive protein (CRP)
How many capsular types does S. pneumoniae have?
90 capsular types
What test can identify S. pneumoniae?
the presence of this antisera makes the capsule swell called ___ rxn.
- Neufield test
- Quellung rxn.
Significant virulence factor of S. pneumoniae.
Capsular polysaccharide
All are toxins produced by S. pneumoniae except __.
A. IgA protease
B. Nueraminidase
C. Streptokinase
D. Hyaluronidase
C.
T or F
S. pneumoniae is the major cause of bacterial pneumonia.
True
T or F
Bacterial pneumonia is usually in children.
False- elderly persons with underlying disease.
Which is not a clin. Infections of S. pneumoniae?
A. Mrnigitis
B. Otitis media
C. Sinusitis
D. Cellulitis
D
What are the 3 pneumococcal vaccines?
- Heptavalent pneumococcal conjugate vacccine (PCV7)
- (PCV13)
- 23-valent vaccine (PS23)
Pneumococcal vaccine for children.
PCV7
Pneumococcal vaccine for adults.
PS23
Characteristics of S. pneumoniae
- The end of the cell is slightly pointed (lancet shape or oval)
- diplococci
All are media for S. pneumoniae except what?
A. Brain-heart infusion agar
B. MAC
C. TSA with 5% SRBCs
D. CHOC
B.
Characteristics of young and old culture of S. pneumoniae.
Young= round, glistering, wet, mucoid, doomed shaped
Old= appearanc off a coin with a raised rim (collapse of each colony’s center)
The colonies are closely resemble to viridans strep.
S. pneumoniae
Biochem test for Identifying S. pneumoniae.
- Optochin susceptibility (S)
- Bile solubility test (soluble)
Drug of choice for S. pneumoniae.
Penicillin
If resistant to Penicillin used:
Erythromycin or chloramphenicol
Aside from penicillin, what other classes of drugs is S. pneumoniae resistant?
B-lactams
Macrolides
Tetracyclines
What are the different groups of Strep. vridans?
S. mitis group
S. mutans group
S. salivarius group
S. bovis group
S. anginosus group
What are the possible lancefield group of S. anginosus group
Group A, C, F, G, N
T or F
both S. bovis and Enterococcus are positive bile esculin
True
T or F
Enterococcal organisms can not grow in nutrient media with 6.5% NaCl.
False- nonenterococcal
They are the common cause of subacute bacterial endocarditis
Viridans streptococci
What oral infection is cause by Viridans streptococci?
Gingivitis
Dental caries (cavities)
____ is the most commonly isolated among viridans strep. They are the primary contributor to dental cavities.
S. mutans
Most significant virulence factor of Viridans strep.
Polysaccharide capsule and cytolysin
T or F
Group C and G posses M protein
True
T or F
All Viridans strep. are PYR (+) and LAP (-)
False
PYR(-)
LAP(+)
The common identified species of Enterococcus in clinical specimens are___.
E. faecalis
E. faecium
T or F
Enterococci has the ability to grow in extreme environment
True
T or F
1. Enterococcus are susceptible to most multiple antibiotics.
False- they are resistant
Which is/are not virulence factors of Enterococcus faecalis?
A. Extracellular surface adhesin protein
B. Extracellular serine protease
C. Gelatinase
D. Cytolisin
E. Hyaluronidase
E.
The most common infection by Enterococcus.
-UTI
- (2nd) Bacteremia
Which is not true about the identification of Enterococcus?
A. Identify through the production of acid.
B. Ability to hydrolyze argine
C. Ability to release enzyme
D. Motility
C
E. faecalis is easily identified because of their ability to grow in the presence of ___
Tellurite
Which drugs is/are Enterococcus are resistant?
A. B-lactams
B. Aminoglycosides
C. Glycopeptides
D. Vancomycin
All of the above
They are formly know as the nutritional variant of strep.
Abiotrophia and Granulicatella
Abiotrophia and Granulicatella require ___ to grow
Sulhydryl compounds
Classified as Group N in Lancefield system
Lactococcus