Infectious Endocarditis

Question 0

Staphylococcus epidermidis

Answer 0

-Gr+ cocci
-found in skin, mucous membrane
-*loose slime layer
-G-hemolysis
-Coag-/mannitol-
-very salt/desiccation tolerant
Disease
-PVE early
-major cause HAI
Virulence
-adhesins (collagen, fibronectin, fibrinogen, elastin)
-slime layer
-biofilms

Question 1

Staphylococcus Aureus

Answer 1

-Gr+ cocci
-found in nares, skin, mucous membranes, throat, perineum, vagina
-B-hemolysis
-coag+/mannitol+
-very salt/desiccation tolerant
Disease
-acute endocarditis, NVE (leader), PVE (early & late)
-IE in IVDA (tricuspid valve)
Virulence
-fibronectin-binding protein
-protein A
-coagulase
-capsule (polysacc)

Question 2

Viridans steptococci

Answer 2

-Gr+ cocci
-found in mouth, nasopharynx, GI, GU
-dental carries
-optochin resistant
-bile resistant
-cat-
-some capnophilic
-a-hemolytic (green)
-**S. salvarius, Smutans, Smitis, S. sanguinis (<–most common viridans in endocarditis)
Disease
-subacute endocarditis
Virulence
- produce dextrans (carb polymer used to make makes biofilms)

Question 3

Streptococcus bovis

Answer 3

-Gr+ cocci
-found in GI
-Lancefield group D antigen (*GDS)
-G-hemolytic (nonhemolytic)
-bile resistant
-salt sensitive/PYR-
Disease
-bacteremia
-endocarditis
-found in pts w/ ulcerative lesions of colon due to colon cancer or IBD

Question 4

Enterococcus

Answer 4

-Gr+ cocci
-found in GI, GU
-cat-
-G-hemolytic
-bile tolerant, high temp/salt tolerant
-PYR+
Disease
-HAIs
-endocarditis
Types
-E. faecalis (more common 85-90% Enterococcal infection)
-E. faecium (MDR super strong, more problems)
Virulence
-antibiotic resistance (innate and acquired)(MDR)
-pili
-biofilms

Question 5

Coxiella burnetti

Answer 5

-Gr- rod
-found in sheep and goats
-resistant to drying and heat
-survives and replicates in MACs
-wont grow on petri, grows on embryo eggs (serology needed)
-PCR
Disease
-Q fever
-acute- flu-like symptoms, pneumonia, granulomatous hepatitis
-chronic- Endocarditis (aortic>mitral)
Virulence
-LPS
-obligate intracellular parasite (in MACs)
-2 stages
-small cell variant (SCV)-Stable, resistant
-large cell variant (LCV)-replicates like crazy

Question 6

Eikenella corrodens

Answer 6

-Gr- rod
-HACEK group
-found in mouth, GU, bowel
-human bite & clenched fist injury infections
-ox+
-pits agar/bleach like odor
Disease
-Infectious endocarditis

Question 7

Kingella kingae

Answer 7

-Gr- coccobacillus
-found in oropharynx (mostly kids)
-B-hemolytic
-Ox+
-some pit agar/no odor
Disease
-Endocarditis in older kids, adults
Virulence
-pili
-*B-hemolysin