Gram + Micro Flashcards
Alpha hemolytic bacteria
Streptococcus pneumoniae Viridans streptococci (S. mutans, S. mitis)
Beta hemolytic bacteria
Staphylococcus aureus Streptococcus pyogenes (group A strep) Streptococcus agalactiae (group B strep)
Gram +, beta hemolytic, catalase +, coagulase + cocci in clusters
Staphylococcus aureus
Protein A
Staph aureus. Binds Fc-IgG, inhibiting complement activation and phagocytosis
TSST-1
Superantigen that binds to MHC II and T cell receptor, resulting in polyclonal T-cell activation
Staph aureus food poisoning
Due to ingestion of preformed toxin (2-6 hr)
Diseases caused by staph aureus
Inflammatory disease - skin infections, pneumonia (often after influenza), organ abscesses, endocarditis, septic arthritis, osteomyelitis.
Toxin mediated disease - toxic shock syndrome, scalded skin syndrome, rapid onset food poisoning.
MRSA
Gram +, catalase +, coagulase -, urease + cocci in clusters. Novobiocin sensitive. Does not ferment mannitol.
Staphylococcus epidermidis
Gram +, catalase +, coagulase -, urease + cocci in clusters. Novobiocin resistant.
Staphylococcus saprophyticus
Gram +, catalase -, alpha hemolytic, lancet shaped diplococci. Encapsulated. IgA protease. Optochin sensitive
Streptococcus pneumonia
Strep pneumo is the most common cause of which conditions?
Meningitis
Otitis media (in children)
Pneumonia
Sinusitis
Gram +, catalase -, alpha hemolytic cocci. Resistant to optochin.
Viridans group streptococci
Where are viridans group streptococci located? What can they cause?
Normal flora of the oropharynx. Streptococcus mutans and S mitis cause dental caries. S. sanguinis causes subacute bacterial endocarditis.
Gram +, catalase -, beta hemolytic cocci in chains. Bacitracin sensitive. PYR +.
Streptococcus pyogenes (group A streptococci)
What kind of infections are caused by group A strep?
Pyogenic - pharyngitis, cellulitis, impetigo, erysipelas
Toxigenic - scarlet fever, toxic shock-like syndrome, necrotizing fasciitis
Immunologic - rheumatic fever, glomerulonephritis
Virulence factors for group A strep
Hyaluronic acid capsule and M protein inhibit phagocytosis
Blanching, sandpaper like body rash, strawberry tongue, and circumoral pallor in setting of group A strep pharyngitis (Erythrogenic toxin +)
Scarlet fever
Gram + cocci, beta hemolytic, bacitracin resistant. Produces CAMP factor, which enlarges the area of hemolysis by S. aureus. Hippurate test +. PYR -
Streptococcus agalactiae (group B strep)
What infections does group B strep cause?
Colonizes vagina. Causes pneumonia, meningitis, and sepsis, mainly in babies
When are pregnant women screen for group B strep? What is done if they are positive?
Screen at 35-37 weeks gestation. Pts with + culture receive intrapartum penicillin prophylaxis
Gram + cocci, catalase -, no hemolysis, does not grow in 6.5% NaCl
Streptococcus bovis
S. bovis is associated with?
Colon cancer
Gram + cocci, catalase -, grows in 6.5% NaCl, PYR+, variable hemolysis
Enterococci
What infections do enterococci cause?
Normal colonic flora. Penicillin G resistant and cause UTI, biliary tract infections, and subacute endocarditis (following GI/GU procedures). VRE are an important cause of nosocomial infection
Gram + spore forming rod. Produces anthrax toxin. Aerobic
Bacillus anthracis
Only bacterium with a polypeptide capsule (contains D-glutamate)
Bacillus anthracis
Bacillus cereus
Causes food poisoning. Emetic type usually seen with rice and pasta, nausea and vomiting within 1-5 hr, caused by cereulide (preformed toxin). Diarrheal type - watery, nonbloody diarrhea and GI pain within 8-18 hrs.
Gram + facultative intracellular rod. Aerobic.
Listeria monocytogenes
How is listeria acquired
Ingestion of unpasteurized dairy products and cold deli meats, via transplacental transmission, or by vaginal transmission during birth
What conditions can listeria cause?
Amnionitis, septicemia, and spontaneous abortion in pregnant women; granulomatosis infantiseptica; neonatal meningitis; meningitis in immunocompromised; mild, self limited gastroenteiritis in healthy individuals
How is infection with listeria treated?
Ampicillin
Gram +, spore forming, obligate anaerobic rods
Clostridia
Tetanospasmin
An exotoxin causing tetanus
Tetanus toxin mechanism
Protease that cleaves SNARE proteins for neurotransmitters. Blocks release of inhibitory neurotransmitters, GABA and glycine, from Renshaw cells in spinal cord
Spastic paralysis, trismus, risus sardonicus, opisthotonus
Tetanus
How is tetanus treated?
Antitoxin +/- vaccine booster, antibiotics, diazepam (for muscle spasms), and wound debridement
Heat labile toxin that inhibits ACh release at the neuromuscular junction
C botulinum
Diplopia, dysarthria, dysphagia, dyspnea
Botulism
alpha toxin
Lecithinase, a phospholipase. Toxin produced by C perfringens that can cause myonecrosis and hemolysis.
Toxins produced by C difficile
Toxin A, an enterotoxin, binds to brush border of gut and alters fluid secretion. Toxin B, a cytotoxin, disrupts cytoskeleton via actin depolymerization. Both toxins lead to diarrhea and pseudomembranous colitis.
Which antibiotics commonly cause C difficile?
Clindamycin or ampicillin
How is C difficile treated?
Metronidazole or oral vancomycin
Gram + rod; transmitted via respiratory droplets
Corynebacterium diphtheriae
How does C. diphtheriae cause diphtheria
Via exotoxin encoded by beta-prophage. Inhibits protein synthesis via ADP-ribosylation of EF-2.
Symptoms of diphtheria
Pseudomembranous pharnygitis, with lymphadenopathy, myocarditis, and arrhytmias
Gram + long branching filaments, weakly acid fast, aerobe
Nocardia
What does nocardia cause?
Pulmonary infections in immunocompromised; cutaneous infections after trauma in immunocompetent; can spread to CNS
How is infection with Nocardia treated?
Sulfonimides (TMP-SMX)
Where is Nocardia found?
Soil
Gram + long branching filaments, anaerobe, not acid fast
Actinomyces
Where is Actinomyces found?
Normal oral, reproductive, and GI flora
What can Actinomyces cause?
Oral/facial abscesses that drain through sinus tracts; often associated with dental caries/extraction and other maxillofacial trauma. Can cause PID with IUDs
How is Actinomyces treated?
Penicillin
Mycobacterium avium
Causes disseminated, non-TB disease in AIDS. Often resistant to multiple drugs
Prophylaxis for M avium
Azithromycin when CD4+ count <50 cells/mm3
Mycobacteria scrofulaceum
Cervical lymphadenitis in children
Mycobacteria marinum
Hand infection in aquarium handlers
Cord factor
Virulence factor in M tuberculosis strains; activates macrophages (promoting granuloma formation) and induces release of TNF-alpha
Sulfatides
Surface glycolipids. Inhibit phagolysosomal fusion. Present in M tuberculosis
Yellow sulfur granules
Actinomyces