Family STREPTOCOCCACEAE Flashcards
Gram positive cocci,occurring in pairs or in chains Non-motile, Non Spore Forming, CATALASE NEGATIVE, Facultative Anaerobes,
Capnophilic 5 to 10%
Streptococcaceae
S.pneumoniae, Viridans streptococcus
A. Alpha
B. Beta
C. Gamma
A. Alpha
Group A (large zone), Group B (small zone), Group C Streptococcus
A. Alpha
B. Beta
C. Gamma
B. Beta
Group D (Non-Hemolytic)
A. Alpha
B. Beta
C. Gamma
C. Gamma
S. agalactiae
A. Group A strep.
B. Group B strep
C. Group C strep
D. Group D Non Enterococcus
E. Group D Enterococcus
F. Pneumococcus
G. Viridans streptococcus
B. Group B strep
Note:
Beta hemolysis
S.dysagalactiae, S.equi
A. Group A strep.
B. Group B strep
C. Group C strep
D. Group D Non Enterococcus
E. Group D Enterococcus
F. Pneumococcus
G. Viridans streptococcus
C. Group C strep
Note:
Beta hemolysis
S.pyogenes
A. Group A strep.
B. Group B strep
C. Group C strep
D. Group D Non Enterococcus
E. Group D Enterococcus
F. Pneumococcus
G. Viridans streptococcus
A. Group A strep.
Note:
Beta hemolysis
Anginosus, mutans, mitis, salivarius
A. Group A strep.
B. Group B strep
C. Group C strep
D. Group D Non Enterococcus
E. Group D Enterococcus
F. Pneumococcus
G. Viridans streptococcus
G. Viridans streptococcus
Note:
Mostly Alpha, Beta, Gamma hemolysis
S.bovis group
A. Group A strep.
B. Group B strep
C. Group C strep
D. Group D Non Enterococcus
E. Group D Enterococcus
F. Pneumococcus
G. Viridans streptococcus
D. Group D Non Enterococcus
Note:
Alpha, Gamma hemolysis
E.faecalis, E.faecium
A. Group A strep.
B. Group B strep
C. Group C strep
D. Group D Non Enterococcus
E. Group D Enterococcus
F. Pneumococcus
G. Viridans streptococcus
E. Group D Enterococcus
Note:
Alpha, Beta, and Mostly Gamma hemolysis
S.pneumoniae
A. Group A strep.
B. Group B strep
C. Group C strep
D. Group D Non Enterococcus
E. Group D Enterococcus
F. Pneumococcus
G. Viridans streptococcus
F. Pneumococcus
Note: alpha hemolysis
VIRULENCE FACTOR OF GROUP A S.pyogenes
Antiphagocytic for ADHERENCE to mucosal cells
M protein
Able to bind beta globulin Factor H, also binds to Fibrinogen Blocking Complement Alternate Pathway activation:
M PROTEIN
A serine protease capable of inactivating the Chemotactic Factor for Neutrophils And Monocytes:
C5a Peptidase (anapylatoxin)
Mediates ADHERENCE to host epithelial cells:
Protein F (fibronectin-binding protein)
Prevents opsonized phagocytosis, Mask Bacterial Antigens
Hyaluronic acid capsule
Degrades host DNA (DNase) and RNA
Streptodornase or DNases
Causes lysis of fibrin clots
Streptokinase (Fibrinolysin).
Solubilizes hyaluronic acid in connective tissue or Duran Reynal
Hyaluronidase
Subsurface hemolysin (Oxygen Labile)
Toxic to RBC’s WBCs and platelets
Induces antibody response
A. Streptolysin S
B. Streptolysin O
B. Streptolysin O
Surface hemolysin (oxygen stable)
Lysis WBCs and is non immunogenic
A. Streptolysin S
B. Streptolysin O
A. Streptolysin S
Associated with Scarlet Fever and Streptococcal Toxic Shock-like syndrome:
A. Exotoxin A
B. Endotoxin B
A. Exotoxin A
Acute Spreading Erythematous lesion
A. Impetigo
B. Erysipilas
C. Cellulitis
D. Scarlet fever
B.Erysipilas
Diffuse red rashes from chest to extremities
A. Impetigo
B. Erysipilas
C. Cellulitis
D. Scarlet fever
D. Scarlet fever
Superficial and localized
A. Impetigo
B. Erysipilas
C. Cellulitis
D. Scarlet fever
A. Impetigo
Involves deeper tissue invasion
A. Impetigo
B. Erysipilas
C. Cellulitis
D. Scarlet fever
C. Cellulitis
ASO:
Elevated (children)
A.<166 todd units
B. >240 todd units
C. >320 todd units
C. >320 todd units
ASO:
Normal
A.<166 todd units
B. >240 todd units
C. >320 todd units
A.<166 todd units
ASO Moderately Elevated in Adults:
A.<166 todd units
B. >240 todd units
C. >320 todd units
B. >240 todd units
Test for SCARLET FEVER:
+ Redness/erythema
Susceptibility to Scarlet fever
A. Dick’s test
B. Schultz-Charlton test
A. Dick’s test
Test for SCARLET FEVER:
Neutralization test, Diagnostic test
+ Rash fades/”Blanching phenomenon”
A. Dick’s test
B. Schultz-Charlton test
B. Schultz-Charlton test
Most common cause of neonatal meningitis:
Group B S. agalactiae
NOTE:
1. Transmission occurs vertically or during delivery
2. Causes Pneumonia and Neonatal Meningitis
3. In adult, causes Endometritis and wound infections
Large-colony forming Beta hemolytic isolates
Resembles S. pyogenes infections
A. Group C Strep (S. dysagalactiae subsp. equisimilis)
B. S. anginosus group
A. Group C Strep (S. dysagalactiae subsp. equisimilis)
Small colony forming beta hemolytic isolates resembles S.pyogenes infection
A. Group C Strep (S. dysagalactiae subsp. equisimilis)
B. S. anginosus group
B. S. anginosus group
VIRULENCE FACTOR:
-Extracellular surface protein, serine protease and gelatinase for adhesion
-Cytolysins and resistance to antimicrobial agent
(MDR- MULTI DRUG RESISTANT) = HOSPITAL ACQUIRED OR NOSOCOMIAL INFECTION
ASSOCIATED DISEASE:
Nosocomial Infection, UTI (catheterization) Bacteremia (hemodialysis, surgery)
Endocarditis (Prosthetic Heart Valves)
Group D Enterococcus
VIRULENCE FACTOR: (Oral Flora URT)
-Enhance attachment to host cell surfaces
-Polysaccharide capsule, Extracellular Dextran and cell surface associated proteins (adhesins)
ASSOCIATED DISEASE:
-Subacute bacterial endocarditis from patients with damage heart valves
-Bacteremia, Septicemia and Cavities
-Dental Infection
Viridians streptococci Group A, C, F, G, N)
NOTE:
CAUSATIVE ORAL FLORA:
GRAM POSITIVE=VIRIDIANS
GRAM NEGATIVE= HACEK
Common cause of bacterial meningitis in adults
VIRULENCE FACTOR:
✓Capsular polysaccharide
✓Antigenic polysaccharide resulting to 80 serogroups
✓Antiphagocytic
Streptococcus pneumoniae
>29 yrs old age group
1 cause of “MOPS”
Streptococcus pneumoniae
Note: MOPS
MENINGITIS
OTITIS MEDIA
PNEUMONIA
SINUSITIS
MORPHOLOGY AND OTHER CHARACTERISTICS:
✓Gram positive diplococci (lancet, flame or bullet shape)
✓ Growth on BAP : WHITE “PINPOINT”
✓CATALASE NEGATIVE
✓Capnophilic
✓neufeld reaction (Quellung, capsular swelling) POSITIVE
Streptococcus pneumoniae
Note:
Neufeld reaction is replaced by MOLECULAR TECHNIQUES
Sputum:
Rust colored sputum
A. S.pneumoniae
B. K.pneumoniae
C. P.aeruginosa
A. S.pneumoniae
Sputum:
Currant jelly
A. S.pneumoniae
B. K.pneumoniae
C. P.aeruginosa
B. K.pneumoniae
Sputum:
Blue-green
A. S.pneumoniae
B. K.pneumoniae
C. P.aeruginosa
C. P.aeruginosa
Growth in 6.5% NaCl +
PYR+
Bile Esculin hydrolysis +
A. D Enterococcus
B. D non-Enterococcus
A. D Enterococcus
Note:
+BILE ESCULIN: Brown-Black precipitate
Growth in 6.5% NaCl -
PYR-
Bile Esculin hydrolysis+
A. D Enterococcus
B. D non-Enterococcus
B. D non-Enterococcus
Note:
+BILE ESCULIN: Brown-Black precipitate
Skin test for Pneumococcal antibodies
FRANCIS test
PYRase test POSITIVE:
A. Group A strep
B. Group B strep
C. Group C strep
A. Group A Strep (S. pyogenes)
CAMP test :
Enhanced hemolysis, Arrowhead Pattern:
A. Group A strep
B. Group B strep
C. Group C strep
B. Group B strep (S. agalactiae)
CAMP test :
Rectangular or Block Shape or Pattern:
A. S.aureus
B. Listeria
C. S. agalactiae
B. Listeria
Hippurate hydrolysis +
Deep blue /purple color
A. S.pyogenes
B. S.agalactiae
B. S.agalactiae (Group B strep)
Reagent: PDAC
+ BLUE
A. Spot Indole test
B. Indole test
A. Spot Indole test
PDAB
+CHERRY RED
A. Spot Indole test
B. Indole test
B. Indole test
Test for: pyrrolidinyl aylamidase
Substrate: L-pyrrolidonyl-B-naphthylamide
Color Developer: PDAC + CHERRY RED
Positive result: RED
POSITIVE FOR GROUP A AND ENTEROCOCCI
PYRase
✓Alpha hemolytic
✓Bile solubility + (soluble)
✓ Optochin Sensitive( >14mm)
✓Neufeld Quellung: Positive (+) capsular swelling
A. S. pneumoniae
B. Viridians
A. S. pneumoniae
✓Alpha hemolytic
✓Bile solubility(-) (insoluble)
✓ Optochin: Resistant
✓Neufeld Quellung: Negative (-)
A. S. pneumoniae
B. Viridians
