Micro 8.5 Gram-Positive and Gram-Negative Cocci Flashcards
- The test used most often to separate Staphylococcus and Micrococcus spp. from Streptococcus spp. is:
A. Bacitracin
B. Catalase
C. Hemolysis pattern
D. All of these options
B. Catalase
- Micrococcus and Staphylococcus spp. are differentiated by which test(s)?
A. Fermentation of glucose (OF tube)
B. Catalase test
C. Gram stain
D. All of these options
A. Fermentation of glucose (OF tube)
Both micrococci and staphylococci are catalase-positive and gram-positive cocci. On direct smears, they both appear as pairs, short chains (resembling Streptococcus spp.), or clusters. However, the micrococci fail to produce acid from glucose under anaerobic conditions. For OF tube reactions:
Staphylococcus spp. is positive for both open tube (oxidation) and closed tube (fermentation)
Micrococcus spp. is positive for open tube but negative for closed tube
- Lysostaphin is used to differentiate Staphylococcus from which other gram-positive, catalase-positive organisms?
A. Streptococcus
B. Aerococcus
C. Micrococcus
D. Enterococcus
C. Micrococcus
Lysostaphin is an endopeptidase that cleaves the glycine-rich pentapeptide cross-bridges in the staphylococcal cell wall peptidoglycan. The susceptibility of the staphylococci to lysostaphin (less than 200 μg/mL) is used to differentiate them from the micrococci. Staphylococci are susceptible and show a 10- to 16-mm zone of inhibition, whereas micrococci are not inhibited and will grow up to the disk.
- Which of the following tests is used routinely to identify S. aureus?
A. Slide coagulase test
B. Tube coagulase test
C. Latex agglutination
D. All of these options
D. All of these options
- Which of the following enzymes contribute to the virulence of S. aureus?
A. Urease and lecithinase
B. Hyaluronidase and β-lactamase
C. Lecithinase and catalase
D. Cytochrome oxidase
B. Hyaluronidase and β-lactamase
- Toxic shock syndrome is attributed to infection with:
A. Staphylococcus epidermidis
B. Staphylococcus hominis
C. Staphylococcus aureus
D. Staphylococcus saprophyticus
C. Staphylococcus aureus
- Which Staphylococcus species, in addition to S. aureus, also produces coagulase using the tube coagulase test?
A. Staphylococcus intermedius
B. Staphylococcus saprophyticus
C. Staphylococcus hominis
D. Staphylococcus haemolyticus
A. Staphylococcus intermedius
S. epidermidis (coagulase negative) is recovered from which of the following sources?
A. Prosthetic heart valves
B. Intravenous catheters
C. Urinary tract
D. All of the above
D. All of the above
- Slime production is associated with which Staphylococcus species?
A. Staphylococcus aureus
B. Staphylococcus epidermidis
C. Staphylococcus intermedius
D. Staphylococcus saprophyticus
B. Staphylococcus epidermidis
- Strains of Staphylococcus species resistant to the β-lactam antibiotics by standardized disk diffusion and broth microdilution susceptibility methods are called:
A. Heteroresistant
B. Bacteriophage group 52A
C. Cross-resistant
D. Plasmid-altered
A. Heteroresistant
Methicillin-resistant S. aureus (MRSA) and methicillin-resistant S. epidermidis (MRSE) are called heteroresistant.
- S. saprophyticus is best differentiated from S. epidermidis by its resistance to:
A. 5 µg of lysostaphin
B. 5 µg of novobiocin
C. 10 units of penicillin
D. 0.04 unit of bacitracin
B. 5 µg of novobiocin
S. saprophyticus is coagulase negative and resistant to 5 µg of novobiocin. When using the standardized Kirby-Bauer sensitivity procedure, a 6- to 12-mm zone of growth inhibition is considered resistant. Susceptible strains measure 16 to 27 mm (inhibition) zones.
- The following results were observed by using a tube coagulase test:
Coagulase at 4 hours = +
Coagulase at 18 hours = Neg
DNase = +
Novobiocin = Sensitive (16-mm zone)
Hemolysis on blood agar = β
Mannitol salt plate = + (acid production)
What is the most probable identification?
A. Staphylococcus saprophyticus
B. Staphylococcus epidermidis
C. Staphylococcus aureus
D. Staphylococcus hominis
C. Staphylococcus aureus
- S. aureus recovered from a wound culture gave the following antibiotic sensitivity pattern by the standardized Kirby-Bauer method (S = sensitive; R = resistant):
Penicillin = R
Cephalothin = R
Vancomycin = S
Ampicillin = S
Cefoxitin = R
Methicillin = R
Which is the drug of choice for treating this infection?
A. Penicillin
B. Ampicillin
C. Cephalothin
D. Vancomycin
D. Vancomycin
Vancomycin, along with rifampin, is used for strains of S. aureus that are resistant to the β-lactams. MRSA strains pose problems when reading the zone sizes for these strains. Their heteroresistance results in a film of growth consisting of very small colonies formed within the defined inhibition zone surrounding the antibiotic disk. Initially, this appears as a mixed culture or contaminant.
- Which of the following tests should be used to following a coagulase-positive tube test (free coagulase) to separate S. aureus from S. intermedius? The culture specimen was obtained from a patient who suffered a dog-bite wound.
A. Acetoin
B. Catalase
C. Slide coagulase
D. Urease
A. Acetoin
The production of acetoin by S. aureus from glucose or pyruvate differentiates it from S. intermedius, which is also coagulase positive (positive for clumping factor and free coagulase or tube test). This test is the Voges-Proskauer (VP) test. Acetoin production is detected by addition of 40% KOH and 1% α-naphthol to the VP test broth after 48 hours of incubation. A distinct pink color within 10 minutes denotes a positive test result.
- A gram-positive coccus recovered from a wound ulcer from a 31-year-old patient with
diabetes showed pale yellow, creamy, β-hemolytic colonies on blood agar. Given the
following test results, what is the most likely identification?
Catalase = +
Glucose OF: Positive open tube, negative sealed tube
Mannitol salt = Neg
Slide coagulase = Neg
A. Staphylococcus aureus
B. Staphylococcus epidermidis
C. Micrococcus spp.
D. Streptococcus spp.
C. Micrococcus spp.
Micrococcus spp. utilize glucose oxidatively but not under anaerobic conditions (sealed tube). Staphylococcus spp. utilize glucose oxidatively and anaerobically. The catalase differentiates the Micrococcaceae family (positive) from the Streptococcaceae family (negative).
- Urine cultured from the catheter of an 18-year-old female patient produced more than 100,000 col/mL on a CNA plate. Colonies were catalase positive, coagulase negative by the latex agglutination slide method as well as the tube coagulase test. The best single test for identification is:
A. Lactose fermentation
B. Urease
C. Catalase
D. Novobiocin susceptibility
D. Novobiocin susceptibility
S. epidermidis and S. saprophyticus are the two possibilities because they are both catalase positive, coagulase negative, urease positive, and ferment lactose. Novobiocin susceptibility is the test of choice for differentiating these two species. S. epidermidis is sensitive, but S. saprophyticus is resistant to 5 μg of novobiocin. UTIs caused by S. saprophyticus are often seen in cultures from sexually active young females.
- A Staphylococcus spp. recovered from a wound (cellulitis) was negative for the slide coagulase test (clumping factor) and negative for novobiocin resistance. The next test(s) needed for identification is (are):
A. Tube coagulase test
B. β-Hemolysis on blood agar
C. Mannitol salt agar plate
D. All of these options
D. All of these options
S. aureus is novobiocin sensitive and cannot be ruled out by a negative clumping factor test. Most S. aureus produce β-hemolysis on sheep blood agar plates and are mannitol salt positive (produce acid and are not inhibited by the high salt concentration). The tube test (to detect free coagulase) should be performed because the slide test was negative.
- Furazolidone (Furoxone) susceptibility is a test used to differentiate:
A. Staphylococcus spp. from Micrococcus spp.
B. Streptococcus spp. from Staphylococcus spp.
C. Staphylococcus spp. from Pseudomonas spp.
D. Streptococcus spp. from Micrococcus spp.
A. Staphylococcus spp. from Micrococcus spp.
Staphylococci are susceptible to furazolidone, giving zones of inhibition that are 15mm or greater. Micrococcus spp. are resistant to furazolidone, giving zones of 6 to 9mm. The test is performed as a disk susceptibility procedure using a blood agar plate.
- Bacitracin resistance (0.04 unit) is used to differentiate:
A. Micrococcus spp. from Staphylococcus spp.
B. Staphylococcus spp. from Neisseria spp.
C. Planococcus spp. from Micrococcus spp.
D. Staphylococcus spp. from Streptococcus spp.
A. Micrococcus spp. from Staphylococcus spp.
- Which of the following tests will rapidly differentiate micrococci from staphylococci?
A. Catalase
B. Coagulase
C. Modified oxidase
D. Novobiocin susceptibility
C. Modified oxidase
- Streptococcus species exhibit which of the following properties?
A. Aerobic, oxidase positive, and catalase positive
B. Facultative anaerobic, oxidase negative, catalase negative
C. Facultative anaerobic, β-hemolytic, catalase positive
D. May be α-, β-, or γ-hemolytic, catalase positive
B. Facultative anaerobic, oxidase negative, catalase negative
- Which group of β-hemolytic streptococci is associated with erythrogenic toxin production?
A. Group A
B. Group B
C. Group C
D. Group G
A. Group A
Group A β-hemolytic streptococci are the cause of scarlet fever, and some strains produce toxins (pyrogenic exotoxins A, B, and C) that cause a scarlatiniform rash. Streptococcus pyogenes is the cause of puerperal fever, streptococcal toxic shock, rheumatic fever, and a severe “flesh-eating” bacterial infection.