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Lesson 9 Flashcards

1
Q

Gram (+) cocci arranged in pair or chains

A

Streptococcus

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2
Q

spherical to ovoid

A

Streptococcus

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3
Q

True or False: Generally non motile except few strains of Group B

A

False- should be Group D

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4
Q

True or False: Generally encapsulated but members of groups A, B, C and D are non-encapsulated

A

False- should be generally non-encapsulated but groups A, B, C and D are encapsulated

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5
Q

Non-sporeformers

A

Streptococcus

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6
Q

True or False: Streptococcus is a Facultative aerobes

A

False- should be Facultative anaerobes

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7
Q

True or False: All species have C carbohydrate in their cell wall except Viridans group and Streptococcus agalactiae

A

False- should be Viridans Group and Streptococcus pneumoniae

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8
Q

What enrichment media do we use to isolate Streptococcus bacteria?

A

Blood Agar Plate

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9
Q

Catalase (-)

A

Streptococcus

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10
Q

Reduce nitrate to nitrite

A

Streptococcus

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11
Q

Fastidious organism that need to enriched in blood

A

Streptococcus

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12
Q

True or False: On broth, organism produce translucent to milky, circular, pinpoint colonies with a shiny surface

A

False: it should be plates not broth

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13
Q

What are the hemolytic patterns on BAP of a Streptococcus?

A

Beta Hemolytic Group
Alpha Hemolytic Group
Gamma Hemolysis/Non-Hemolytic
Alpha Prime/Wide Zone

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14
Q

Complete lysis ofRBC around the colony. Claer, colorless area around the colony.

A

Beta Hemolytic Group

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15
Q

What Streptococcus species are member of Beta Hemolytic Group

A

Streptococcus pyogenes
Streptococcus agalactiae

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16
Q

Green Streptococci. Partial lysis or incomplete hemolysis of RBC around the colony. Forms long chains especially when grow in liquid media.

A

Alpha Hemolytic Group

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17
Q

What Streptococcus species are members of Alpha Hemolytic Group?

A

Streptococcus pneumoniae
Viridans Group

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18
Q

No lysis of RBC around the colony. No change observed in the agar around the colony.

A

Gamma Hemolysis/ Non-Hemolytic

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19
Q

It is also called “The Indifferent Streptococcus”

A

Gamma Hemolysis/ Non-Hemolytic

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20
Q

What Streptococcus species is the member of Gamma Hemolysis/Non-Hemolytic?

A

Streptococcus faecalis

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21
Q

Small area of intact RBC surrounded by a wider zone of complete hemolysis.

A

Alpha Prime/Wide Zone

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22
Q

According to temperature, based on physiological division of Streptococcus:

A

Pyogenic Group
Lactic Acid Group
Viridans Group
Enterococcus Group

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23
Q

Pus forming organisms. Mostly B-hemolytic and Majority of Lancefield groups.

A

Pyogenic Group

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24
Q

in what temperature did Streptococcus pyogenes grow?

A

neither 45°C nor at 10°C

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25
Q

Harmless groups of Streptococcus. Associated in dairy industry, pickles.

A

Lactic Acid Group

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26
Q

in what temperature did Streptococcus lactis grow?

A

grows at 10°C but not at 45°C

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27
Q

It is responsible for souring the milk

A

Streptococcus lactis

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28
Q

in what temperature did Streptococcus mutans and Streptococcus salivarius grow?

A

Grows at 45°C but not at 10°C

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29
Q

Normal flora of oral cavity and cause of Sub-Acute Bacterial Endocarditis (SBE)

A

Viridans Group

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30
Q

Can withstand salt high concentration. Normal fecal flora and Currently considered as a new genus.

A

Enterococcus Group

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31
Q

in what temperature did Enterococcus feacalis grow?

A

Grows at both 45°C and at 10°C

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32
Q

Used as indicator in water pollution

A

Enterococcus feacalis

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33
Q

Based on the presence of a serologically active CHO known as C-Polysaccharide group specific CHO Ag

A

Lancefield Classification

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34
Q

What species has a beta hemolytic pattern?

A

S. pyogenes
S. agalactiae
S. equisimils
S. equi

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35
Q

What species has an alpha or gamma hemolytic pattern?

A

S. bovis
S. equines

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36
Q

What species has an alpha, beta or gamma hemolytic pattern?

A

E. feacalis
E. faecium
E. durans

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37
Q

What species has an alpha hemolytic pattern?

A

S. pneumoniae

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38
Q

What species has an alpha, alpha-prime or gamma hemolytic pattern?

A

(Viridans Streptococci) (None-lancefield group)
S. anginosus
S. sanguis
S. mitis
S. mutans

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39
Q

Group A Streptococci.
Predominantly pathogenic to man. Almost always ß-hemolytic

A

Streptococcus pyogenes

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40
Q

What are the virulence factors of Streptococcus pyogenes?

A

M Protein
Streptolysin O
Streptolysin S
Streptodornase
Streptokinase
Hyaluronidase
Erythrogenic Toxin/Pyrogenic Toxin

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41
Q

It is resistant to phagocytosis and adherence to mucosal cells and the principal virulence factor.

A

M Protein

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42
Q

It is Oxygen labile; active only in reduced form or anaerobic conditions. Responsible for sub-surface hemolysis o Highly antigenic; Anti-Streptolysisn O (ASO) indicates recent infection with S. pyogenes. Lyses leukocytes, platelets, and RBC

A

Streptolysin O

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43
Q

It is Oxygen stable; responsible for hemolysis when incubated aerobically, Surface hemolysis and Non-antigenic.

A

Streptolysin S

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44
Q

Used to liquefy exudates

A

Streptodornase

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45
Q

It is responsible for redness and the spreading rash in scarlet fever .

A

EYTHROGENIC TOXIN/ PYROGENIC TOXIN

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46
Q

What are the three types of toxins in EYTHROGENIC TOXIN/ PYROGENIC TOXIN

A

A, B, and C

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47
Q

What are the clinical infections of Streptococcus pyogenes?

A

Pharyngitis and tonsilitis
Pyodermal infections
Streptococcal Toxic shock syndrome

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48
Q

What are the pyodermal infections?

A

Impetigo
Erysipelas
Cellulitis
Scarlet Fever

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49
Q

“Strep Throat” o Usually in children 5-15 years old; IP: 1-4 days; MOT: droplets and close contact. Manifest as sore throat, malaise, fever, headache, inflamed tonsils and pharynx, swollen and tender cervical lymph nodes.

A

pharyngitis and tonsilitis

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50
Q

Definitive Dx relies on a throat culture and 1/3 of those with sore throat have a throat culture (+) for
_________?

A

S. pyogenes

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51
Q

Localized skin disease, small vesicles that progress to weeping lesions.

A

Impetigo

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52
Q

Impetigo are seen in what age of children?

A

2-5 years old

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53
Q

Infection of the skin & subcutaneous tissue and it is erythematous lesion.

A

Erysipelas

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54
Q

Erysipelas is seen in what type of patient?

A

Elderly Patients

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55
Q

Develops following deeper invasion by Streptococci. Life-threatening. With bacteremia or sepsis present.

A

Cellulitis

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56
Q

What are the two type of susceptibility test used in Scarlet fever?

A

Dick’s Test and Schultz-Charlton RXN/ Neutralization RXN/ Blanching Phenomenon

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57
Q

What are the two type of susceptibility test used in Scarlet fever?

A

Dick’s Test and Schultz-Charlton RXN/ Neutralization RXN/ Blanching Phenomenon

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58
Q

Uses 0.1 mL Dick’s Toxin and 0.1 mL Dick’s Toxoid

A

DICK’S TEST

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59
Q

what is the result of the dick’s test if: area of erythema/ redness and edema

A

(+) result

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60
Q

Red rash appear on the upper chest, spreads on the trunk & extremities associated with erythrogenic toxin

A

Scarlet Fever

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61
Q

Based on the neutralization of erythrogenic toxin when an antitoxin is injected into the skin of patient with a scarlet fever and it is used to diagnose skin rashes whether skin rashes are due to scarlet fever.

A

SCHULTZ-CHARLTON RXN/
NEUTRALIZATION RXN/ BLANCHING PHENOMENON

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62
Q

if there is
a rashes fade/ blanch, the result would be?

A

(+) result

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63
Q

Same toxin associated with scarlet fever

A

STREPTOCOCCAL TOXIC SHOCK SYNDROME

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64
Q

What are the complications associated with S. pyogenes?

A

Rheumatic fever and Acute glomerulonephritis (AGN)

65
Q

Complications of S. pyogenes pharyngitis. Fever, inflammation of the heart, joints, blood vessels; most serious result is a progressive damage to the heart valves.

A

rheumatic fever

66
Q

Rheumatic fever:
Attacks begin within a ___________ infection; repeated infections may produce further valve damage

A

month after

67
Q

May occur after a cutaneous or pharyngeal infection

A

ACUTE GLOMERULONEPHRITIS (AGN)

68
Q

True or False: ACUTE GLOMERULONEPHRITIS (AGN) are more common in adults than children.

A

False- should be more common in children than in adults

69
Q

What are the laboratory diagnosis of S. pyogenes?

A

gram stain
culture
biochemical tests
Definitive ID
Immunologic tests to detect past infection with s. pyogenes

70
Q

What culture media is use in S. pyogenes?

A

Blood Agar Plate with SXT

71
Q

What are the biochemical tests of S. pyogenes?

A

Catalase (-)
Bacitracin (S)
CAMP(-)
Hippurate Hydrolysis (-)
PYR (+)

72
Q

It is gram (+) cocci in chains, pairs, singly

A

Gram stain of S. pyogenes, S. agalactiae and Group D Streptococcus

73
Q

What is the definitive ID for S. pyogenes and S. agalactiae?

A

Serologic Typing (Lancefield Typing)

74
Q

What are the Immunologic tests to detect past infection with s. pyogenes?

A

Anti-Streptolysin O (ASO)
Anti-DNAse
Anti-Streptokinase
Anti-Hyaluronidase

75
Q

Treatment of choice for S. pyogenes

A

Penicillin

76
Q

For those allergy to Penicillin this is the alternative.

A

Erythromycin

77
Q

What are the groups for antimicrobial susceptibility testing of S. pyogenes and S. agalactiae?

A

Group A
Group B
Group C
Group O

78
Q

What antimicrobial susceptibility testing are belong to Group A of S. pyogenes and S. agalactiae?

A

Penicillin
Ampicillin
Erythromycin
Clindamycin

79
Q

What antimicrobial susceptibility testing are belong to Group B of S. pyogenes and S. agalactiae?

A

Cefepime
Cefotaxime or Ceftriaxone
Vancomycin

80
Q

What antimicrobial susceptibility testing are belong to Group C of S. pyogenes and S. agalactiae?

A

Levofloxacin
Ofloxacin
Linezolid

81
Q

What antimicrobial susceptibility testing are belong to Group O?

A

Meropenem
Azithromycin
Clarithromycin
Tetracycline
Gatifloxacin

82
Q

Group B Streptococci. Three (3) Serotypes based on capsular polysaccharides: I, II, and III. Etiologic agent of bovine mastitis in animals. In human, normal flora in the URT, GIT, GUT

A

STREPTOCOCCUS AGALACTIAE

83
Q

What are the VIRULENCE FACTORS of S. agalactiae?

A

Capsule with sialic acid
CAMP Factor
Hyaluronidase
Hemolysin
DNase
Neuraminidase
Protease

84
Q

What virulence factor of S. agalactiae that prevents phagocytyosis?

A

Caosule with sialic acid

85
Q

What are the clinical infection neonates?

A

Early Onset Infection
Late Onset Infection

86
Q

Within 3 days after birth
and usually manifests pneumonia or meningitis with bacteremia

A

Early Onset Infection

87
Q

Between 1 week and 3 months after birth and Usually meningitis

A

Late Onset Infection

88
Q

Women after childbirth or abortion and Elderly with serious underlying disease or
immunodeficiency

89
Q

Grayish white mucoid colonies surrounded by a small zone of ß-hemolysis on BAP

A

Culture of S. agalactiae

90
Q

What are the BIOCHEMICAL TESTS for S. agalactiae?

A

Catalase (-)
Bacitracin (R)
CAMP (+)
Hippurate Hydrolysis (+)
PYR (-)

91
Q

What are the treatment for S. agalactiae?

A

Penicillin and Ampicillin + Aminoglycoside

92
Q

Previously subdivided into two groups

A

GROUP D STREPTOCOCCUS

93
Q

What are the 2 group of GROUP D STREPTOCOCCUS?

A

ENTEROCOCCAL GROUP and
NON-ENTEROCOCCAL GROUP

94
Q

It is now placed in a new genus Enterococcus

A

ENTEROCOCCAL GROUP

95
Q

Non-enterococcal isolate but is found in the intestinal tract
and Bacteremia has been associated with gastrointestinal tumors

A

NON-ENTEROCOCCAL GROUP

96
Q

Remained part of the Group D Streptococci

A

S. equines and S. bovis

97
Q

What are the CLINICAL INFECTION of Group D Streptococcus?

A

Bacterial Endocarditis
UTI
Abscesses
Wound Infections

98
Q

It is Susceptible to Penicillin

A

Treatment for Group D Streptococcus

99
Q

CULTURE for Group D Streptococcus

A

Alpha or Beta or non-hemolytic on BAP

100
Q

BIOCHEMICAL TEST
for Group D Streptococcus

A

Catalase (-)
Bile Esculin (+)
PYR (-)
6.5% NaCl (-)

101
Q

DEFINITIVE ID for Group D Streptococcus

A

Serologic Typing for Streptococcus bovis

102
Q

ANTIMICROBIAL SUSCEPTIBILITY TESTING
GROUP A

A

Penicillin
Ampicillin

103
Q

GROUP B

A

Cefepime
Cefotaxime
Ceftriaxone
Vancomycin

104
Q

GROUP C

A

Erythromycin
Chloramphenicol
Clindamycin
Linezolid

105
Q

GROUP O

A

Meropenem
Azithromycin
Clarithromycin
Tetracycline
Levofloxacin
Ofloxacin
Gatifloxacin

106
Q

Previously known as Group D Streptococcus Enterococcus and Found in intestinal tract

A

ENTEROCOCCUS

107
Q

Enterococcus Species

A

Enterococcus faecalis
Enterococcus faecium
Enterococcus durans

108
Q

Gram (+) cocci in pairs, singly, short chains

A

GRAM STAIN for Enterococcus

109
Q

Alpha, Beta, non-hemolytic on BAP

A

CULTURE for Enterococcus

110
Q

BIOCHEMICAL TEST
for Enterococcus

A

Catalase (-)
Bile Esculin (+)
6.5% NaCl (+)
PYR (+)

111
Q

GROUP A
Antimicrobial for Enterococcus

A

Penicillin
Ampicillin

112
Q

GROUP B
Antimicrobial for Enterococcus

A

Vancomycin
Linezolid

113
Q

GROUP C
Antimicrobial for Enterococcus

A

Gentamicin (High level resistace screen only)
Sreptomycin (High level resistace screen only)

114
Q

GROUP O Antimicrobial for Enterococcus

A

Erythromycin
Doxycycline
Minocycline
Gatifloxacin
Rifampicin
Chloramphenicol

115
Q

GROUP U Antimicrobial for Enterococcus

A

Ciprofloxacin
Levofloxacin
Norfloxacin
Nitrofurantoin
Tetracycline – MIC testing; disk diffusion unreliable

116
Q

What are the ANTIGENIC STRUCTURES of the STREPTOCOCCUS PNEUMONIAE?

A

C SUBSTANCE IN THE CELL WALL
CAPSULAR ATIGENS

117
Q

Similar to C CHO of Lancefield Group

A

C SUBSTANCE IN THE CELL WALL

118
Q

With 72 different capsular types. Capsular antigen identified with appropriate antiserum
and Capsule swells in the presence of specific anticapsular serum

A

CAPSULAR ATIGENS

119
Q

What are the VIRULENCE FACTORS of S. pneumoniae?

A

Capsular Polysaccharide
Hemolysin
IgA Protease
Neuraminidase
Hyaluronidase
Pneumolysin O
Purpura Producing Factor

120
Q

It is Similar to Streptolysin O

A

Pneumolysin O

121
Q

Dermal purpura. Thermal hemorrhages in experimental animal

A

Purpura Producing Factor

122
Q

What are the CLINICAL INFECTIONS
of S. pneumoniae?

A

PNEUMONIA

OTITIS MEDIA
MENINGITIS

ENDOCARDITIS
PERITONITIS
BACTEREMIA

123
Q

Predisposing factors of S. pneumoniae

A

Alcoholism
Malnutrition
Anesthesia
Viral infections of the RT

124
Q

Lobar pneumonia (rusty-brown sputum). Caused by types 1, 2, and 3. Usually in elderly and patients with underlying disease. High mortality rate

125
Q

Most common cause of bacterial meningitis in adults and Also affects all age groups

A

MENINGITIS

126
Q

What are the SUBSTANCES RESPONSIBLE FOR SEROLOGICAL REACTION of S. pneumoniae?

A

SPECIFIC SOLUBLE SUBSTANCE (SSS)

SOMATIC Ag/ O Ag

127
Q

Polysaccharide capsular substance which determines both the virulence and capsular type

A

SPECIFIC SOLUBLE SUBSTANCE (SSS)

128
Q

Present in the cell wall. Binds with C-Reactive CHON (CRP). CRP: increase in patients with acute inflammatory disease

A

SOMATIC Ag/ O Ag

129
Q

Gram (+) cocci in pairs, lancet-shaped

A

Streptococcus lanceolatus

130
Q

On BAP aerobic: α-hemolytic
On BAP anaerobic: ß-hemolytic due to presence of toxin pneumolysin O
Culture are most often aerobic
Young colonies: circular, glistening and dome-shaped On aging, autolytic changes results in te collapse of the center of colonies appearing as nail-head or checker

A

Culture of S. pneumoniae

131
Q

What are the BIOCHEMICAL TEST for S. pneumoniae?

A

Catalase (-)
Bile Solubility Test (+)
Optochin Sensitivity Test/ TAXO P (S)
Quellung Capsular Swelling (+)
Inulin Fermentation (+)
Quinidine Test (S)

132
Q

What are the SEROLOGICAL TEST
in S. pneumoniae?

A

NUEFELD QUELLUNG REACTION

FRANCIS TEST

133
Q

Capsular Precipitation Rxn/ Capsular Swelling Test o In glass slide, mix a loopful of sputum and antipneumococcal serum + methylene blue
(+) result = capsules appear swollen due to a change in refractive index

A

NUEFELD QUELLUNG REACTION

134
Q

Skin test done to determine the presence or absence of Ab against Pneumococcal Ag

A

FRANCIS TEST

135
Q

ANIMAL INOCULATION TEST

A

Mouse Virulence Test

136
Q

Animal dies within 16-48 hours (+). Pure culture of pneumococci can be grown

A

Mouse Virulence Test

137
Q

TREATMENT for S. pneumoniae

A

Penicillin
Erythromycin

138
Q

ANTIMICROBIAL SUSCEPTIBILITY TESTING:
GROUP A

A

Erythromycin
Penicillin
Trimetoprim-Sulfamethoxazole

139
Q

ANTIMICROBIAL SUSCEPTIBILITY TESTING: GROUP B

A

Cefepime
Cefotaxime
Ceftriaxone
Meropenem
Vancomycin
Tetracycline
Doxycline
Levofloxacin
Ofloxacin
Clindamycin

140
Q

ANTIMICROBIAL SUSCEPTIBILITY TESTING: GROUP C

A

Amoxicillin
Amoxicillin-Clavulanate
Cefuroxime
Chloramphenicol
Rifampicin
Linezolid

141
Q

ANTIMICROBIAL SUSCEPTIBILITY TESTING: GROUP O

A

Cefaclor
Ceffpodoxime
Azithromycin
Clarithromycin
Gatifloxacin

142
Q
  • Lack Lancefield Group Ag
  • Does not meet the criteria for S. pneumonia
  • Identification for _____________ to the species level is difficult
  • Oropharyngeal commensal but opportunistic pathogen
A

VIRIDANS STREPTOCOCCI

143
Q

CLINICAL INFECTIONS of Viridans Streptococci

A

Sub-Acute Bacterial Endocarditis (SBE)
Meningitis
Dental Caries
Abscess
Osteomyelitis
Empyema

144
Q

Gram (+) cocci in pairs

A

Gram Stain of Viridans Streptococci

145
Q

α-hemolytic or non-hemolytic on BAP

A

Culture of Viridans Streptococci

146
Q

Biochemical Test of Viridans Streptococci

A

Catalase (-)
Bile Esculin (-)
Optochin (R)
6.5% NaCl (-)
Bile Solubility Test (-)
PYR (-)

147
Q

TREATMENT of choice for Viridans Streptococci

A

Penicillin

148
Q

Other Viridans Streptococci

A
  • Streptococcus anginosus (formerly S. milleri)
  • Streptococcus mitis
  • Streptococcus oralis
  • Streptococcus sanguis
  • Streptococcus salivarius
  • Streptococcus constellatus
  • Streptococcus mutans
  • Streptococcus intermedius
149
Q

Primary animal pathogens

A

GROUP C STREPTOCOCCI

150
Q

pathogen in humans

A

Streptococcus equisimilis

151
Q

pathogen in horses

A

Streptococcus equi

152
Q

Used in thrombolytic therapy in humans
Hydrolyzes thrombus (clot)

A

Sources of Streptokinase

153
Q
  • Formerly known as Nutritionally Variant Streptococci/ Pyridoxaldependent/ Vitamin B6-dependent/ Thiol-dependent/ Symbiotic Streptococci
  • They satellite around the colonies of organism that produces pyridoxal: Staphylocci, E. coli, Klebsiella spp., Enterobacter, and Yeasts
  • Gram (+) cocci
  • Maybe gram (-), variable and pleomorphic
  • Part of the normal flora but can cause endocarditis, otitis media, wound infections
A

GENUS ABIOTROPHIA

154
Q

➢ Use of pyridoxal (Vitamin B6 supplemented medium)
➢ Plated with a Staphylococcal streak (cross-streaking)
➢ PYR (+)
➢ Bile Esculin (-)
➢ 6.5% NaCl (-)

A

Laboratory diagnosis for GENUS ABIOTROPHIA

155
Q

Other Streptococcus

A
  • Streptococcus acidominimus
  • Streptococcus crista
  • Streptococcus gordonii
  • Streptococcus parasanguis
  • Streptococcus sobrinus
  • Streptococcus uberis
  • Streptococcus vestibularis
  • Streptococcus cricetus
  • Streptococcus pornicus
156
Q
  • Gram (+) cocci in tetrads
  • Aerobic
  • Catalase (+)
  • Non-motile
  • Often yellow orange or red in color
  • Easily confured with Staphylococci
  • Widespread in soil, water, and mammalian skin
  • Non-pathogenic
  • Skin colonizers
  • Occasionally associated with skin lesions
  • More commonly isolated from immunocompromised patients
  • Unknown virulence factor; probably of extremely low virulence
  • Usually considered contaminants of clinical specimens
  • Rarely implicated as cause of infections in humans
  • Similar organism: Kocuria spp., Kytococcus spp., and Alloiococcus spp.
A

MICROCOCCUS

157
Q

In contrast to Staphylococci:

A

➢ Not lysed with Lysostaphin
➢ Resistant to furazolidone
➢ Bacitracin (S)
➢ Microdase (+) - Micrococcus luteus

158
Q

Other Micrococcus

A
  • Micrococcus kristinae
  • Micrococcus lylae
  • Micrococcus roseus
  • Micrococcus sedentarius
159
Q
  • Facklamia
  • Dolosigranulum pigrum
  • Ignavigranum ruoffiae
  • Rothia (formerly Stomatococcus mucilaginosa)
  • Gemella
  • Pediacoccus
  • Tetragenococcus
  • Leuconostoc
  • Vagococcus
  • Aerococcus
  • Helcoccus
A

MISCELLANEOUS GRAM (+) COCCI

Bacteriology (7 decks)

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