Gram + Bacteria Flashcards

1
Q

Gram Positive, Catalase positive, Coagulase positive, Beta hemolytic, Ferments mannitol

A

Staph aureus

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2
Q

Coagulase Positive

A

Turns fibrinogen to fibrin

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3
Q

Ferments mannitol

A

“Tall man in YELLOW”

Turn agar yellow

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4
Q

Staph aureus virulence factor

A

Protein A – prevents complement binding

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5
Q

Colonizes the nares

A

Staph aureus

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6
Q

Clinical:
Pneumonia (patchy infiltrate on XR) – post-viral bacterial PNA

A

Staph aureus

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7
Q

Clinical:
Septic arthritis

Impetigo – abscesses

Acute bacterial endocarditis – IV drug user

A

Staph aureus

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8
Q

Clinical:
Osteomyelitis (most common cause)

Scalded Skin Syndrome

Toxic Shock Syndrome

A

Staph aureus

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9
Q

Food poisoning –> vomit»> diarrhea

Rapid onset

Meat & dairy products

A

Staph aureus

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10
Q

MRSA

A

Staph aureus

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11
Q

Drugs tx Staph aureus

A

Vanco & Penicillin (Not MRSA)

Nafcillin (Naf for Staph)

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12
Q

Gram positive
Catalase positive
Coagulase NEGATIVE
Urease Positive

Novobiocin-sensitive **

A

Staph epidermidis

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13
Q

Normal flora on the skin – easy to contaminant blood cultures

A

Staph epidermidis

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14
Q

ENEMY of prosthetic joints or hardware (indolent infection)

A

Staph epidermidis

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15
Q

Indwelling catheters
Heart valves

Produces BIOFILM

A

Staph epidermidis

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16
Q

Treatment for Staph epidermidis

A

Vanco
Joint replacement

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17
Q

Gram positive
Catalase positive
Coagulase NEGATIVE
Urease Positive

Novobiocin-resistant **

A

Staph saprophyticus

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18
Q

Honeymoon cystitis

Acute bacterial prostatitis

A

Staph saprophyticus

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19
Q

Impetigo – honey crusted sores

Pharyngitis

Cellulitis
Erysipelas

Scarlet Fever (exotoxin)

A

Strep pyogenes (Group A Strep)

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20
Q

Gram Positive Coccus

Encapsulated – made of hyaluronic acid

Beta Hemolytic
Bacitracin sensitive***

A

Strep pyogenes (Group A Strep)

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21
Q

Swollen strawberry tongue

Pharyngitis

Widespread rash (except the face)

A

Scarlet fever – Strep pyogenes (Group A Strep)

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22
Q

Toxic shock-like syndrome (TSS) –super antigen

Necrotizing fasciitis

Rheumatic fever

A

Strep pyogenes (Group A Strep)

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23
Q

Rheumatic fever

A

Type II Hypersensitivity

Immune response to strep infection

M protein

Molecular mimicry (myosin in heart – mitral valve)

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24
Q

Jones criteria

A

Joints
Heart
Nodules
Erythema marginatum
Sydenham’s chorea (hand/face chorea)

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25
Q

Poststreptococcal glomerulonephritis (PSGN)

A

Immune response to strep infection

Type III hypersensitivity

Dark brown cola colored urine + facial edema

Two weeks post initial infection

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26
Q

Streptococcal pyrogenic exotoxin (SPE)

A

Scarlet fever

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27
Q

SepA

A

Superantigen (TSLS)

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28
Q

SepB

A

Protease (nec fasc)

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29
Q

SepC

A

Superantigen (TSLS)

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30
Q

Streptolysin O

A

RBC Lysis
Allows for Beta Hemolytic
ASO antibodies (can show titer had recent strep infection)

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31
Q

M Protein

A

Highly antigenic
Antiphagocytic – interferes with opsonization

Strep Pyogenes

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32
Q

Adds a phosphate
Plasminogen to plasmin
Lysis of clots

A

Streptokinase

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33
Q

Gram positive
Polysaccharide capsule
Beta hemolytic
Bacitracin RESISTANT
CAMP test positive
Positive Hippurate test

A

Streptococcus agalactiae (Group B Strep)

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34
Q

CAMP Test

A

Nothing to do with cAMP

Distinguish GBS from other Beta-hemolytic strep

GBS observed to enhance hemolysis when in close proximity to S. aureus

Synergistic effect

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35
Q

Meningitis in neonates

Sepsis in neonates

Pneumonia

A

Disease of Streptococcus Agalactiae (Group B Strep)

Galactic Baby

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36
Q

Alpha hemolytic – partial (green hew)

Encapsulated (polysaccharide)

OptoCHIN sensitive

Lancet shaped diplococci

Bile soluble**

A

Streptococcus Pneumonia

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37
Q

Streptococcus Pneumonia

Virulence factor

A

Polysaccharide capsule

IgA protease – reduce host defenses

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38
Q

1 cause PNA (lobar, lower first, rust colored sputum)

A

Streptococcus Pneumonia

39
Q

Splenectomy
Sickle cell disease

A

Greatest risk of encapsulated infection

40
Q

1 cause MOPS

A

Meningitis
Otitis media
PNA
Sinusitis

41
Q

Treatment of Streptococcus Pneumonia

A

Macrolides
3rd Generation Ceph (CephTRIaxone)

Vaccine

42
Q

Alpha hemolytic

NO CAP

OptoCHIN resistant

Bile resistant** insoluble

A

Streptococcus viridans

43
Q

Dental carries

Subacute endocarditis effect previously damaged heart valves

A

Mitral most common

Streptococcus viridans

44
Q

Dextrans – glue to platelets

A

Streptococcus viridans

45
Q

Gram Positive Cocci – pairs and chains

Encapsulated – polysaccharide cap

Gamma-hemolytic – doesn’t cause hemolysis

Biofilms – esp on collagen rich surfaces

Normal flora of GI tract

Grows in bile salt media

A

Streptococcus gallolyticus – group D strep (Strep Bovis/Equinus Complex SBSEC)

46
Q

Clinical:
Endocarditis (heart valve)
Hepatobiliary disease
Septic arthritis
Osteomyelitis
UTI
Meningitis
Mastitis
Colorectal neoplasia (require colonoscopy)

A

Streptococcus gallolyticus – group D

47
Q

Treatment of Streptococcus gallolyticus – group D

A

3rd Gen Ceph
Vanco
Penicillin

48
Q

Enterococcus genus

A

Inhabit human GI

Can grow in 6.5% sodium chloride

E.faecalis»>E.faecium (super bug DANGER)

49
Q

Enterococcus faecium

A

More dangerous
Bile resistant
Nosocomial infection VRE – Vanc Resistant

50
Q

Treatment of Enterococcus faecium

A

Linezolid (EXPENSIVE/big gun)

Tigecycline

51
Q

Enterococcus faecium Disease

A

UTI
Endocarditis
Biliary Tree Infections

52
Q

Large gram positive

Rod-shaped – forms chain

Poly-D-glutamate – protein

Spore forming

Obligate aerobe

A

Bacillus anthracis

53
Q

Black eschar surrounded by erythematous ring

A

Cutaneous anthrax

Bacillus anthracis

54
Q

Widened mediastinum on XR

Can progress to pulmonary hemorrhage

A

Pulmonary anthrax (wool sorter’s dx)

Bacillus anthracis

55
Q

Bacillus anthracis
Virulence factor

A

Edema factor (EF)
Lethal factor (LF)

56
Q

Bacillus anthracis
Edema factor (EF)

A

Adenylate cyclase increases cAMP intracellular –> edema

57
Q

Bacillus anthracis
Lethal factor (EF)

A

Exotoxin act as a protease and cleaves mitogen-activated protein kinase (MAPK) –> Tissue Necrosis

58
Q

Aerobic
Spore forming
Associated with food poisoning (reheated rice)

A

Bacillus cereus

59
Q

Gram positive

Obligate anaerobes

Spore forming – found in soil

Classic associated with puncture wound closed to air

A

Clostridium tetani

60
Q

Clostridium tetani

Virulence factor

A

Tetanus toxin (retrograde) acts as protease cleaving SNARE protein

Inhibits exocytosis of neurotransmitters like GABA and glycine

61
Q

Diagnosis of Clostridium tetani

A

Tetanus – spastic paralysis
Risus sardonicus (evil grin)
Lockjaw

62
Q

Treatment of Clostridium tetani

A

Toxoid vaccine

63
Q

Gram-positive

Spore forming

Obligate anaerobe

Transmitted by improper canning of food

A

Clostridium botulinum

64
Q

Diagnosis Clostridium botulinum

A

Descending flaccid paralysis
Diplopia/ptosis

Floppy baby syndrome (honey)
Adult (ingest preformed toxin)

Flaccid paralysis

65
Q

Clostridium botulinum virulence factor

A

Bolulinum toxin targets motor neurons (ACh)

Cleaves SNARE protein – prevent fusion of vesicles at presynaptic nerve terminal

66
Q

Gram positive

Spore-forming

Obligate anaerobe

Found in dirt/soil

Blood agar forms DOUBLE zone of hemolysis

A

Clostridium perfringens

67
Q

Clostridium perfringens virulence factors

A

Alpha toxins – lyse red blood cells

Disrupt cell membrane – necrosis

68
Q

Diagnosis of Clostridium perfringens

A

Gas gangrene
Food poisoning

69
Q

Gas gangrene

A

Gas production
Tissue necrosis
Crepitus

70
Q

Clostridium perfringens

Food poisoning

A

LATE Onset

Large ingestion of spores

Delayed 2/2 spore germination & toxin formation

71
Q

Treatment of Clostridium perfringens

A

IV Penicillin G

72
Q

Gram positive

Obligate anaerobes

Spore forming

Can colonize gut of normal flora

Transmission of spores – oral–fecal route

Nosocomial and some community infection

A

Clostridioides difficile

73
Q

Clostridioides difficile virulence factors

A

Toxin A
Toxin B

74
Q

C. diff colitis

A

Exposure to toxogenic strain (A&B toxin) – destroy cytoskeleton & disrupt intracellular tight junctions –> watery stool

Can result in toxic mega colon

75
Q

Increased risk for C. Diff

A

Recent ABX use (Clindamycin, Penicillin, Fluoroquinolongs, Cephalosporin)

Proton pump inhibitors

76
Q

C. Diff Testing

A

PCR for toxin producing strain of c. diff

Enzyme immunoassay (EIA)

Glutamate dehydrogenase (nonspecific)

77
Q

Tx of c. diff

A

Oral vancomycin
Oral fidaxomicin

IV mentronidazole + oral Vanco

Fecal microbiota transplant (FMBT)

78
Q

Gram-positive rod

Non-spore-forming bacillus

Club shape (maraca shaped) –> Y or V formation

Metachromatic granules – staining gran red and cell blue

A

Coryne diptheriae

79
Q

Virulence factor Coryne diptheriae

A

Exotoxin – 2 subunits A/B

Causes ADP-ribosylation of elongation factor-2 (EF-2)

Inhibiting ribosome function & protein synthesis – cell death & formation of pseudomembranous

80
Q

Clinical Coryne diptheriae

A

Bull neck – lymphadenopathy

Respiratory droplet transmission

Cardio toxic effects

CNS damage

81
Q

Tests for Coryne diptheriae

A

Tellurite media (culture)

Loeffler’s media (culture)

Elek’s test – test for toxic/non-toxic strains

82
Q

Treatment of Coryne diptheriae

A

Toxoid vaccine

83
Q

Gram-positive bacillus

Beta hemolytic

Tumbling motility with flagella outside the cell and “actin rocket” propulsion when intracellular

Catalase positive
Can survive/multiple in cold environments – can contaminate even refrigerated food (unpasteurized milk, soft cheeses, packaged meat

A

Listeria Monocytogenes

84
Q

Diagnosis of Listeria monocytogenes

A

Primary infection in pregnant women

Meningitis in newborns & adults >60

85
Q

Treatment of Listeria monocytogenes

A

Ampicillin

86
Q

Gram positive

Obligate anaerobic

Branching rod

Normal flora of oral cavity

A

Actinomyces israelii

87
Q

Diagnosis of Actinomyces israelii

A

Infection 2/2 jaw trauma – cervicofacial actinomycosis – slow progression

Begins with non-tender jaw lump – forms abscess

Forms sinus tracts that drain infection through skin

Thick yellow pus containing yellow sulfur granules

88
Q

Treatment of Actinomyces israelii

A

Penicillin G OR
surgical drainage

89
Q

Obligate aerobe

Gram positive – stains weakly acid-fast 2/2 mycolic acids (cell wall)

Catalase positive

Urease positive

Branching rod

Found in soil

A

Nocardia asteroides

90
Q

Diagnosis of Nocardia asteroides

A

Primarily affects immunocompromised patients

Pulmonary, CNS, cutaneous

91
Q

Pulmonary nocardiosis

A

Pneumonia w/ lung abscess formation – cavitary lesions

92
Q

Can disseminate leading to brain abscesses

A

Neural tissue (CNS)

93
Q

Cutaneous nocardiosis

A

Open wounds are exposed to dirt –> pyogenic response +++ production of indurated lesions

94
Q

Treatment of Nocardia asteroides

A

Sulfonamides TMP-SMX