Gram + Cocci

Question 1

Staph. Aureus

Answer 1

Staph. Aureus
-Gram POSITIVE
-Catalase, Coagulase, Beta hemolytic
-Ferments mannitol (yellow in agar)
-Prevent complement via Protein A in cell wall
-In nose = pneumonia, patchy infiltrates in x-ray
-Septic arthritis, abscesses
-Acute onset endocarditis in IV drug use (tricuspid valve)
-Osteomyelitis
-Scalded skin, Toxic shock syndromes + food poisoning (vomit)
-MRSA vis altered pen. binding protein (Use Vancomycin)
-IF methicillin sensitive: NAFICILLIN (naf for staph)

Question 2

Staph. Epidermis

Answer 2

Staph. Epidermis (only)
-Gram POSITIVE
-Affects art. joints/implants/catheters
-MCC of endocarditis of heart valves
-Produce biofilms = resistance = Vancomycin
-Novobiocin sensitive
-Catalase POS, Urease POS
-Coagulase NEGATIVE
(in normal skin flora, contamination of blood cultures)

Question 3

Strep. Pyogenes

Answer 3

Strep. Pyogenes (Group A)
-Encapsulated, Hylauronic Acid
-Beta hemolytic +
-Impetigo, Pharyngitis, Cellulitis/Ery

Toxins: SPE
-Scarlet fever (red tongue, throat, rash not on face)
-Toxic shock like syndrome
-Flesh eating bacteria (necrotizing)

M protein - main virulence factor (xOP, antiphago)

RF : JONES (joint, heart, erythema (rash), nodules, Sydenham’s syndrome (rapid movements of FH)

PSGN: dark brown urine, facial swelling (edema) 2 wk after inf

TX: PENICILLIN

Dog: Bacitracin sensitive

VF: Strep O (RBC lyse), Kinase (plasminogen=plasmin), DNAse

Question 4

Strep. Agalactiae

Answer 4

-In newborns
-Hippurase Positive (poly. capsulated)
-CAMP Test Positive
-Beta Hemolytic +
-Bacitracin RESISTANT (dog can’t lick baby)
-Meningitis, Pneumonia, Sepsis in neonates
(babies are PMSing)

Moms need culture at 35 weeks
IF POS: intrapartum penicillin

Question 5

Strep. Pneumoniae

Answer 5

-ALPHA Hemolytic
-Polysaccharide capsule (VF)
-Optochin Sensitive
-Bile Soluble
-Lancet shaped diplococci

= MOPS
-Meningitis
-Otitis Media
-Pneumonia (rust colored sputum)
-Sinusitis

-Cleaves IgA
-Sickle Cell pt at higher risk

TX: Macrolides or Ceftriaxone

Prevent:
-Adult: 23 Valent = IgM
-Children: 17 Valent = IgG

Question 6

Strep. Viridans

Answer 6

-No armor = No cap
-Optochin Resistant
-Bile Resistant
-Dental caries; infects damaged heart valves (mitral via dextrans)

Question 7

Enterococcus faecalis / faecium

Answer 7

Entero = Intestinal Tract

-Grow in 6.5% NaCl
-Bile Resistant

DO U HEART TREES?
-UTIs, Endo, Biliary tree INF

Vancomycin Resistant
-USE: Linezolid or Tigecycline

Question 8

Matching PICS
-Staph Aureus = ___
-Staph Epidermis = ____
-Strep Pyogenes = ___
-Strep Agalactiae = ___
-Strep Pneumoniae = ____
-Strep Viridans = ___
-Enterococcus = ___

Answer 8

= Moses / Egypt
= Plumber
= Bakery / Pies
= Space Baby
= Knight Fight (real Knight)
= Knight Fight (Joker)
= Protest (CALIS = MC / CIUM = MD)