Gram (+) cocci - Sketchy Copy Flashcards by h h

Staphylococcus aureus

lab tests

The golden staff of moses

gram (+) cocci

ß hemolytic

Ferments Mannitol Salt Agar (turns yellow)

catalase (+)

coagulase (+)

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Staphylococcus aureus

Biochemical Properties

The golden staff of moses

Catalase - 2H2O2 to 2H2O + O2

Cougulase - Fibrinogen to Fibrin

Hyaluronidase, Staphylokinase, Lipase, Nuclease

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Staphylococcus aureus

Cytotoxins

The golden staff of moses

Hemolysin - Destruction of RBC and Some WBCs

Panton Valentine Leukocidin (PVL) - Destruction of WBCs

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Staphylococcus aureus

Protein A

Exofoliative Toxin

Enterotoxin

The golden staff of moses

Protein A: component of cell wall that binds to FC region of antibodies - Evading Phagocytosis

Exofoliative Superantigen A-B - Intercellular adhesion of Keratinocytes leading to Scalded Skin Syndrom

Enterotoxin Superantigen A-R - Gastroenteritis, Vomiting and Diarrhea

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Staphylococcus aureus

signs and symptoms

The golden staff of moses

Pneumonia -patchy infiltrate on x-ray

Septic arthritis

Large erythematous abcesses, Imptego

Tricuspid valve endocaritis -IV drug users

Scalded skin syndrom

Toxic shock syndrome

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Staphylococcus aureus

Toxis Shock Syndrome (TSS) MOA

The golden staff of moses

Toxic Shock Syndrome (TSS) by -TSST superantigen

commonly caused by leaving in a bandage or tampon
causes nonspecific binding of MHC II to T cell receptors causing over reaction and cytokine storm

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Staphylococcus aureus

Food poisoning MOA

The golden staff of moses

-due to preformed toxins

(not the actual organisms)

-usually from meats and mayonnaise

(also salad and creme filled pastries)

-usually sick in 6 hours

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Staphylococcus aureus

Treatment

The golden staff of moses

For MARSA:

Vancomycin

For methicillin sensitive S. aureus use:

Nafcillin

(“Naf for staph”)

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Staphylococcus epidermidis

lab tests

Beauty and the Plumber

gram (+) cocci

catalase (+)

coagulase (-)

urease (+)

S. epidermidis = Novobiocin sensitive

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Staphylococcus saprophyticus

Treatment

Beauty and the Plumber

Ciprofloxacin (Fluroquinalone)

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Staphylococcus saprophyticus

lab tests

Beauty and the Plumber

gram (+) cocci

S. Saprophyticus = Novobiocin resistance

catalase (+)

coagulase (-)

urease (+)

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Staphylococcus epidermidis

signs and symptoms

Beauty and the Plumber

Normal skin flora

Infects hardware, orthopedic joints, catheter tubes, heart implants (endocarditis)

Uses biofilms (polysaccharides)

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Staphylococcus saprophyticus

signs and symptoms

Beauty and the Plumber

UTI’s

Sexually Active Females

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Staphylococcus epidermidis

Treatment

Beauty and the Plumber

Vancomycin

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Strep pyogenes (Group A strep)

lab tests

The Pie Genies’ Bakery

gram (+) cocci

catalase (-)

ß hemolytic

Bacitracin sensitive

encapsulated (hyaluronic acid)

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Strep pyogenes (Group A strep)

signs and symptoms

The Pie Genies’ Bakery

SpeB - Necrotizing Fascitis

SpeA/C: Pharyngitis, Scarlet fever, Toxic Shock Like Syn, Impetigo

Erysipelas (Red lesion with well demarcated border; S. Pyogenes is the most common cause)

Rheumatic fever

Post Strep Glomerulonephritis

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Strep pyogenes (Group A strep)

Scarlett Fever

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The Pie Genies’ Bakery

Strawberry tongue

pharyngitis

widespread rash that spares the face

Toxic Shock Like Syndrome (TSLS)

-mediated by super antigen SpeA, SpeC

Necrotizing Fasciitis

-mediated by super antigen SpeB

Strep pyogenes (Group A strep)

Rheumatic Fever

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The Pie Genies’ Bakery

VF = M protein

-interferes with opsonization, antiphagocytic

Mimics antibodies in heart causing problems with Mitral Valve.

(molecular mimicry, elicits humoral response)

Pharyngitis precipitates RF (if not treated promptly) but NOT IMPETIGO

JONES symptoms

Strep pyogenes (Group A strep)

Post Strep Glomerulonephritis

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The Pie Genies’ Bakery

Type III hypersensitivity reaction

(deposition of antibodies in glomerulus)

Puffy cheeks w/ nephritis

Cola colored urine

Occurs two weeks after strep infection

Can occur after pharyngitis AND impetigo

Strep pyogenes (Group A strep)

Rheumatic Fever J♥NES signs

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The Pie Genies’ Bakery

J = Joints

♥ = Heart problems

N = Nodules on extensor surfaces

(often forearms, elbows, knees)

E = Erythema marginatum

(pink rings)a

S =Sydenham’s Chorea

(rapid involuntary movements of hands, feet, face)

Strep pyogenes (Group A strep)

Habitat and Transmission

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The Pie Genies’ Bakery

Human Skin, Throat

Direct contact or Respiratory Droplet

Strep pyogenes (Group A strep)

Treatment

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The Pie Genies’ Bakery

Penicillin

Strep pyogenes (Group A strep)

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The Pie Genies’ Bakery

Scarlet Fever: super antigen SpeA, SpeC**

Necrotizing Fasciitis: SpeB**

Rheumatic Fever: M protein

Other VF:

-Streptolysin O (allows ß hemolysis; we generate ASO antibodies to this)

-Streptokinase (converts plasminogen to plasmin; plasmin is fibrinolytic)

-DNA’ases (depolymerize DNA)

Strep agalactiae (Group B strep)

Habitat

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Galactic Baby

Hauman Vagina and GI

_**Strep agalactiae** (Group **B** strep)_ lab tests

**_Galactic Baby_** gram (**+**) cocci **ß** hemolytic (⬆ zone when plated w/ S. aureus) hippurate (+) **_Bacitracin_** **resistant** **CAMP test (+)** (ddx S. agalactiae from all other strep) **encapsulated** (polysaccharide)

_**Strep agalactiae** (Group **B** strep)_ signs and symptoms

**_Galactic Baby_** Major infection in **_newborns_** Most likely to cause **_meningitis_** in **neonates** **_Sepsis_** in **neonates** **Pneumonia**

_**Strep agalactiae** (Group **B** strep)_ Treatment

**_Galactic Baby_** **Mother** is **cultured** at **35 weeks** **Penicillin** given to mother **intrapartum** to prevent Group B Strep

**_Strep pneumonia_** lab tests

**_The alpha knight tournament_** gram (**+**) cocci catalase (**-**) **α** hemolytic (surrounding zone is a **green hue**) **_Optochin_** **Sensitive** **_Lancet**_ shaped _****diplo**_cocci** **Bile soluble** (does not grow in bile) Polysaccharide **Capsule** (Major VF!)

**_Strep pneumonia_** signs and symptoms

**_The alpha knight tournament_** **_Rust_** collored **sputum** **_lobar_ pneumonia** #1 cause of **MOPS** (**Meningitides**, **Otitis Media**, **Pneumonia**, **Sinusitis)**

**_Strep pneumonia_** VF

**_The alpha knight tournament_** ## Footnote **Polysaccharide Capsule**

**_Strep pneumonia_** MOA

**_The alpha knight tournament_** **Protease** that **cleaves _IgA_** Allows **invasion of mucosa** reducing host defenses **Removal of spleen** leads to **susceptibilty** of infection by **encapsulated organisms** like in sickle cell anemia.

**_Strep pneumonia_** Treatment

**_The alpha knight tournament_** **Azithromycin Macrolides** **Ceftriaxone**

**_Strep pneumonia_** Vaccines

**_The alpha knight tournament_** **_Adult_****:** **23** valiant polysaccharide (**T-cell** independent response creates **_IgM_**) **_Children_****:** **7** valent **_conjugated to a protein_** (more robust, leads to **production of _IgG_** in children)

**_Strep viridians_** lab tests

**_The alpha knight tournament_** gram (**+**) cocci catalase (**-**) **_Optochin_** **Resistant** **Bile resistant** (grows in bile) **_NOT_** **encapsulated** (ddx from S. Pneumonia)

**_Strep viridians_** MOA

**_The alpha knight tournament_** **Synthesizes** **Dextran's** from glucose Allows **_Strep viridians_** to **adhere to** any **fibrin** from **platlets** that have been damaged **in _heart_**. **_Strep Sanguineous_** adheres to **fibrin platelet aggregates** in damaged **_heart valves_**, most common in **_mitral_** valve.

**_Strep viridians_** signs and symptoms

**_The alpha knight tournament_** associated with **_dental carries_** (**cavities!**)

**_Enterococcus_** General Properties

**_Protest at the Caucus_** **_Group D Sterp_** **_Gram+ in Short chains or Pairs_** **_Habitat_** - Normal Intestinal flora, Urethra and Female Genital tract

**_Enterococcus_** lab tests

**_Protest at the Caucus_** gram (**+**) cocci PYR+ and Catalase (-) **_6.5% NaCl_** **Resistant -** grows in 6.5% NaCl **Bile resistant -** grows in bile Esculin Agar - Black **_NOT_** **encapsulated** (ddx from S. Pneumonia)

**_Enterococcus_** Pathogenesis

**_Protest at the Caucus_** **Nosocomial Infection:** 1) Easily grown and Resistance developing 2) Bile and Salt resistance 3) Biofilm Formation

**_Enterococcus_** signs and symptoms

**_Protest at the Caucus_** **UTI's** **Endocarditis and Sepsis** **Infection** of **biliary tree**

**_Enterococcus_** Treatment

**_Protest at the Caucus_** **Nosocomial infection** resisant to almost every antibiotic we have. _Vancomycin_ **_resistant_** **_Linezolid_** **_Tigacycline_**

Gram (+) cocci - Sketchy Copy Flashcards

Staph, Strep, and Enterococcus (41 cards)