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Microbiology Lecture Slides > Gram (+) and Gram (-) Cocci II > Flashcards

Gram (+) and Gram (-) Cocci II Flashcards

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1
Q

Beta-hemolytic Bacitracin resistant

A

GBS

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2
Q

Made up of many species of streptococci

A

Alpha-hemolytic streptococci

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3
Q

Most of the a-hemolytic streptococci are considered together as Virians, except for

A

S. pneumonia

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4
Q

Widespread residents of the oral cavity, i.e. gums and teeth

-Large complex group

A

Viridans Group Streptococci

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5
Q

Not very invasive; dental or oral surgical procedures facilitate entrance

A

Viridans Group Streptococci

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6
Q

What are the two clinical manifestations of the Viridans group streptococci?

A

Dental carries and subacute endocarditis

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7
Q

Blood-borne bacteria settle and grow on heart lining or valves. Persons with preexisting heart disease are at high risk

A

Subacute Endocarditis

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8
Q

Small, “lancet-shaped” cells arranged in pairs and short chains

-Causes 30-60% of all bacterial pneumonias

A

Streptococcus pneumoniae

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9
Q

Streptococcus pneumoniae is also referred to as

A

Pneumococci

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10
Q

There are over 85 capsule serotypes for

A

S. pneumoniae

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11
Q

Capsule is a virulence factor: heavily encapsulated forms are more frequently associated with

A

Severe invasive disease

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12
Q

Normal flora in the nasopharynx in carriers

-infections are often endogenous

A

S. pneumoniae

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13
Q

Delicate organism, does not survive long outside of its habitat

A

S. pneumoniae

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14
Q

Patients who are particularly susceptible to S. pneumoniae are those with

A

Sickle cell, or who have had a splenectomy

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15
Q

Pneumococci are aspirated into the lungs where they multiply and induce an overwhelming inflammatory response

A

Lobar pneumonia

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16
Q

Gains access to middle ear by way of eustachian tube

• Most frequent bacterial ear infection in children

A

S. pneumoniae causing Otitis Media

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17
Q

S. pneumoniae is a common cause of adult bacterial meningitis. A characteristic of this is

A

Nuchal Rigidity

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18
Q

High mortality rates in adults up to 60% in elderly

• Asplenic patients particularly susceptible

A

Bacteremia and sepsis from S. pneumoniae

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19
Q

S. pneumoniae is sensitive to

A

Optochin

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20
Q

S. pneumoniae now has an intermediate level resistance to penicillin. This resistance is mediated by altered

-acquired by genetic transmission from environmental streptococci

A

PBP

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21
Q

Resistant strains of S. pneumoniae are sensitive to 3rd generation cephalosporins such as

A

Cefotaxime and Ceftriaxone

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22
Q

Protects against 23 serotypes of S. pneumoniae, including strains that were known to be responsible for 85-90% of infections including common penicillin resistant strains

A

Pneumovax (PPV)

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23
Q

Pneumovax is recommended for high risk individuals 2 years and older and

A

Adults older than 65

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24
Q

Immune response to polysaccharide-only vaccines is limited in

A

Children

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25
Q

Is strictly a polysaccharide vaccine

A

S. pneumoniae

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26
Q

To improve on the efficacy of the S. pneumonie vaccinem the polysaccharide was conjugate to protein (nontoxic diptheria toxin). This conjugated vaccine is

A

PCV13 or Prevnar 13

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27
Q

Recommended for all children under 5, immunocompromised adults, and adults older than 65

A

PCV13 or Prevnar 13

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28
Q

Have caused a shift in most commonly clinically encountered serotypes

A

Vaccines

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29
Q

Component of normal gastrointestinal flora and can grow in 40% bile

A

Group D streptococci (S. bovis)

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30
Q

Characterized as nonhemolytic (gamme-hemolysis) or alpha-hemolytic

A

S. bovis

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31
Q

Bacteremia caused by S. bovis associated with

A

GI malignancy and colon cancer

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32
Q

S. bovis is now called

A

S. gallolyticus

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33
Q

Group D antigen

-Genetically distinct from Streptococci but sometimes still referred to as “Group D Strep”

A

Enterococci

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34
Q

Non-hemolytic or alpha-hemolytic, and infrequently may be B-hemolytic

A

Enterococci

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35
Q

Most clinical relevant species (cause >90% of enterococcal infections)

A

E. faecalis and E. faecium

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36
Q

Not very virulent but have become significant nosocomial pathogens due to multidrug resistant phenotype

-Component of normal gastrointestinal flora

A

Enterococci

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37
Q

Enterococci are resistant to chemical agents and persist on

A

Fomites

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38
Q

Cause opportunistic urinary or biliary infections or intraabdominal abscesses in immune compromised individuals

A

Enterococci

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39
Q

Enterococci infections can lead to

A

Endocarditis or bacteremia/sepsis

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40
Q

Enterococcal resistance can be either

A

Intrinsic or acquired

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41
Q

An example of acquired resistance is enterococci resistance to

A

Vancomycin

42
Q

Vancomycin resistance is common in

A

E. faecium

-less so in E. faecalis

43
Q

In enterococci, genes encoding regulated resistance are present on a

A

Transposable element

44
Q

The gold standard for the laboratory identification of enterococci is

A

Bile Esculin Hydrolysis

45
Q

This test is based on the fact that enterococci has the ability to grow in

A

40% bile and hydrolyze esculin

46
Q

The ability to grow in 40% bile and hydrolyze esculin is the characteristic feature of

A

Group D streptococci and enterococci

47
Q

Enterococci are salt resistant. They can grow in

A

6.5% NaCl broth

48
Q

What differentiates group D streptococci from enterococci?

A

Enterococci’s ability to grow in salt

49
Q

What is the first line of treatment for enterococci?

A

Ampicillin + gentamycin or penicillin + streptomyci

50
Q

What is the second line of treatment for enterococci?

A

Vancomycin

51
Q

What do we use to treat multi-drug resistant enterococci?

A

Linezolid, Tigecycline, and Pristinamycin

52
Q

The Gram negative cocci are

A

Neisseria

53
Q

What are the two main types of Neisseria?

A

N. gonorrhoeae (gonococci) and N. meningitidis (meningococci)

54
Q

One of the most common causative agents for bacterial meningitis

A

N. meningitidis (meningococci)

55
Q

A Gram negative, kidney shaped diplococci

A

Neisseria spp.

56
Q

Aerobically, Neisseria spp are considered to be

A

Aerobic

57
Q

Like pneumococci, Neiserria spp. are sensitive to

A

Heat and Drying

58
Q

In a Gram stain, Neisseria spp are often seen within

A

Neutrophils (PMNs)

59
Q

Unlike meningococci, gonococci are

A

Unencapsulated

60
Q

Gene conversion and phase variation mechanisms enable heterogeneity of

A

Cell surface antigens

61
Q

Every population of Neisseria has subpopulations of bacteria that express antigenically distinct surface structures such as

-The virulence factors

A

Pili, Opa, and LOS

62
Q

Facilitate attachment to host mucosa/epithelia

A

Pili

63
Q

Opacity proteins formerly called PII proteins

A

Opa

64
Q

Endotoxin like LPS, but shorter, more branched side chains

A

LOS

65
Q

One virulence factor of N. gonorrhea is

A

IgA protease

66
Q

What are the 4 major clinical manifestations of N. Gonorrhea?

A
  1. Genitourinary tract infections
  2. ) Pharingitis and rectal infections
  3. ) Opthalmia neonatorum
  4. ) Bacteremia
67
Q

Cervicitis in women, due to gonorrhea, can lead to

A

PID or Salpingitis

68
Q

20% of women with salpingitis will experience

A

Infertility

69
Q

Routine prophylaxis with erythromycin ointment or silver nitrate

A

Opthalmia neonatorum

70
Q

Babies at high risk for opthalmia neonatorum are treated with

A

Ceftriaxone

71
Q

Rare because gonococci multiply poorly in bloodstream (unlike meningococci)

A

Bacteremia

72
Q

What are the 4 forms of N. gonorrhoeae diagnosis?

A

Specimins, smears, culture, and NAATs

73
Q

Pus secretions from mucosal surfaces

-Samples must be plated promptly

A

Specimens

74
Q

Intracellular Gram negative diplococci are diagnosed via

A

Smears

75
Q

Requires modified Thayer-Martin medium contains antimicrobial agents to suppress normal flora (TM media = VPN media = VCN media)

A

N. gonorrhoeae culture

76
Q

What is the oxidase classification of N. gonorrhoeae?

A

Oxidase positive

77
Q

The primary method for diagnosing gonococci infection

A

NAATs

78
Q

Antibiotic resistance in gonococci is a significant problem. There is widespread resistance to

A

Penicillin, tetracycline, and quinolones

79
Q

What are the three commonly resistant strains of N. gonorrhoeae?

A

PPNG, TRNG, and QRNG

80
Q

What are the current guidelines for the first line of therapy for N. gonorrhoeae?

A

IM Ceftriaxone along with azithromycin or doxycycline for chlamydia

81
Q

What is the one virulent factor that is present in N. menenditidis that is absent in N. gonorrhoeae?

A

Antigenic capsule

82
Q

13 serogroups, with serogroups A, B (most common), C, Y and W-135 causing most infections

A

Antigenic capsule

83
Q

We see epidemic waves in closed communities like dorms and military barracks of which bacteria?

A

N. meningitidis

84
Q

Found in nasopharynx of carriers

-Infants 6 months to 2 years are particularly susceptible to infection

A

N. meningitidis

85
Q

Rapid onset and progression within 12-24 hours to a lifethreatening condition

A

Meningitis

86
Q

What are the three characteristic clinical manifestations of meningococci?

A

Meningococcemia, meningitis, and fulminant septicemia/meningococcemia

87
Q

Meningococcemia is rapidly multiplying N. mengitidis in the bloodstream. It is accompanied by fever, chills, and joint and muscle pain. What is a characteristic feature?

A

Meningococcemia

88
Q

An inflammatory immune response in meninges

-Purulent CSF

A

Meningitis

89
Q

What are three characteristic symptoms of meningitis?

A

Severe headache, stiff neck, and sensitivity to light

90
Q

LOS-mediated septic shock

• Frequently seen in infants

A

Fulminant septicemia/meningococcemia

91
Q

What is a characteristic feature of Fulminant Septicemia/ Meningococcemia

A

Large purplish blotchy hemorrhages

92
Q

Bacterial Meningitis is a medical emergency. Therefore, even before a definitive diagnosis, we typically start

A

Antibiotics

93
Q

Third generation cephalosporin – ceftriaxone or cefotaxime – are used to treat

A

Meningitis

94
Q

To treat meningitis, we can also give large doses of

A

Penicillin G or ampicillin

95
Q

We prophylactically treat family members and medical personnel in contact with a patient who has meningitis with

A

Rifampin

96
Q

Gram stain CSF, blood, skin or nasopharyngeal samples are used to make a clinical diagnosis of

A

Meningitis

97
Q

What is the oxidase classification of Meningitis?

A

Oxidase positive

98
Q

A major difference between N. meningitidis and N. gonorrhoeae, is that N. meningitidis can utilize

A

Glucose AND Maltose

-Gonorrhoeae can only utilize Glucose

99
Q

We can also use the rapid latex agglutination tests for

A

Capsular antigen

100
Q

To vaccinate for meningitis, we use a tetravalent conjugate vaccine called

-polysaccharides conjugated with diptheria toxoid

A

Menactra® and Menveo®

Microbiology Lecture Slides (24 decks)

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