SEMR: Gram (+) cocci Flashcards

1
Q

peptidoglycan layer:
gram +=
gram -= single layered

A

multilayered

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2
Q

peptidoglycan layer:
gram += multilayered
gram -=

A

single layered

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3
Q

teichoic acids:
gram +=
gram -= absent

A

present in many

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4
Q

teichoic acids:
gram += present in many
gram -=

A

absent

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5
Q

GRAM +
peptidoglycan layer:
teichoic acids:
periplasmic space:
outer membrane:
LPS content:
lipid and lipoprotein:

A

multilayered
present in many
absent
absent
none
low

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6
Q

GRAM -
peptidoglycan layer:
teichoic acids:
periplasmic space:
outer membrane:
LPS content:
lipid and lipoprotein:

A

single layered
absent
present
present
high
high

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7
Q

gram +
catalase +
2 families

A
  1. micrococcaceae
  2. staphylococcaceae
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8
Q

gram +
catalase -
2 families

A
  1. streptococcaceae
  2. enterococcus
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9
Q

determinant in development of staphylococcal infections (3)

A
  1. virulence
  2. size of inoculum
  3. status of host’s immune system
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10
Q

Gram (+) cocci arranged in tetrads or clusters
Facultative anaerobes
Catalase positive
Oxidase Negative
Non-motile
Grows in 7.5-10% NaCl

A

Staphylococci

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11
Q

only Staphylococci that is obligate anaerobe

A

s. saccharolyticus

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12
Q

Test the ability of the organism to breakdown of H2O2(3%) into oxygen and water.

A

Catalase Test

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13
Q

result of test: Copious bubble formation

A

catalase test

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14
Q

-Most clinically significant specie of Staphylococci
-Present in various skin surfaces
-Cause of nosocomial or hospital-acquired infections

A

Staphylococcus aureus

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15
Q

Virulence Factor: S. aureus

Enterotoxins that are associated to food poisoning
(diarhea, vomiting); reheating contaminated food
will not prevent disease

A

A, B, D

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16
Q

Virulence Factor: S. aureus

heat stable exotoxins: include

A

A-E
G-J

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17
Q

Virulence Factor: S. aureus

Formerly known as Enterotoxin F (superantigen-activate aggressive immune response)

A

TSST-1

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18
Q

Virulence Factor: S. aureus

Causes menstruating-associated TSS (Tampon use)
absorbed through vaginal mucosa

A

TSST-1

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19
Q

Virulence Factor: S. aureus

-Also known as epidermolytic toxin
-Causes SSS (Scalded Skin Syndrome or Ritter
disease) and bullous impetigo (large pustules
with erythema

A

Exfoliative Toxin

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20
Q

large pustules with erythema

A

bullous impetigo

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21
Q

Virulence Factor: S. aureus

Cytolytic Toxins
Destruction of neutrophils and macrophages

A

Panton-Valentine Leukocidin(γ-Hemolysin)

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22
Q

Virulence Factor: S. aureus

Cytolytic Toxins
Lyse erythrocytes

A

Hemolysins (α, β, δ)

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23
Q

Virulence Factor: S. aureus

Enzymes
Conversion of fibrinogen to fibrin
Bound Coagulase & Free Coagulase

A

Coagulase (Staphylocoagulase)

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24
Q

Virulence Factor: S. aureus

Enzymes
Dissolve fibrin clots and may enable spread of
infection.

A

Fibrinolysin (Staphylokinase)

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25
Q

Virulence Factor: S. aureus

Enzymes
Cleaves protein

A

Protease

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26
Q

Virulence Factor: S. aureus

Enzymes
Hydrolyzes hyaluronic acid in connective tissues

A

Hyaluronidase

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27
Q

Virulence Factor: S. aureus

Enzymes
Hydrolyzes lipids in the skin

A

Lipase

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28
Q

Virulence Factor: S. aureus

Enzymes
Binds to the Fcportion of IgG, neutralizes it and
block phagocytosis

A

Protein A

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29
Q

Virulence Factor: S. aureus

Enzymes
Breakdown of beta-lactamring in penicillin
molecule

A

Beta lactamase (Penicillinase)

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30
Q

infections or Associated Disease

mild inflammation of hair follicle

A

Folliculitis
Staphylococcus aureus

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31
Q

infections or Associated Disease

large, raised, superficial abscess

A

Furuncles (boils)
Staphylococcus aureus

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32
Q

infections or Associated Disease

invasive lesions develop from multiple furuncles, may progress into deeper tissues

A

Carbuncles
Staphylococcus aureus

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33
Q

infections or Associated Disease

pustules are larger and surrounded by a small zone of erythema

A

Bullous Impetigo
Staphylococcus aureus

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34
Q

infections or Associated Disease

extensive exfoliative (profuse peeling) dermatitis caused by staphylococcal exfoliative or epidermolytic toxin.

A

Scalded Skin Syndrome (Ritter disease)
Staphylococcus aureus

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35
Q

infections or Associated Disease

fatal disease characterized by sudden onset of fever, chills, vomiting, diarrhea, muscle aches, and rash, w/c could lead to hypotension and shock.

A

Toxic Shock Syndrome
Staphylococcus aureus

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36
Q

infections or Associated Disease

clinical manifestation w/ multiple causes; it is most commonly drug induced, but some cases may have been linked to infections and vaccines.

A

Toxic Epidermal Necrolysis (TEN)
Staphylococcus aureus

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37
Q

Virulence Factor: S. epidermidis

Enhances organisms adhesion to implanted
medical devices and provides refractoriness
to host defense.

A

Exopolysaccharide “slime” or biofilm

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38
Q

Staphylococci
infection and associated disease: Hospital acquired UTI and prosthetic valve
endocarditis

A

Staphylococcus epidermidis

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39
Q

-Adheres to the epithelial cells lining the
urogenital tract
-Causes UTI in sexually active, young females
and in older women with indwelling catheters

A

Staphylococcus saprophyticus

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40
Q

Coagulase negative (can give (+) slide, but tube
negative)

A

Staphylococcus lugdunensis

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41
Q

Virulence Factor

  • encodes for oxacillin resistance
A

Gene mecA
Staphylococcus lugdunensis

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42
Q

Virulence Factor

Vancomycin resistance

A

Staphylococcus haemolyticus

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43
Q

Culture Media

Enriched isolation of Staphylococci

A

Blood Agar

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44
Q

Culture Media

Selective medium for Gram-positive cocci

A

Colistin-nalidixic acid or PEA agar

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45
Q

Culture Media

Selective and differential for Staphylococcus

A

Mannitol Salt Agar

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46
Q

catalase +
microdase -
aerobic growth +
anaerobic growth +

A

staphylococcus

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47
Q

catalase +
microdase +
aerobic growth +
anaerobic growth -

A

micrococcus

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48
Q

bacitracin, furazolidone, lysostaphin: RESISTANT

A

staphylococcus

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49
Q

bacitracin, furazolidone, lysostaphin: SENSITIVE

A

micrococcus

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50
Q

coagulase +
DNAse +
MSA +

A

s. aureus

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51
Q

coagulase -
DNAse -
MSA -
novobiocin- SENSITIVE

A

s. epidermidis

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52
Q

coagulase -
DNAse -
MSA -
novobiocin- RESISTANT

A

s. saprophyticus

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53
Q

lab test to differentiate s. epidermidis from s. saprophyticus

A

novobiocin

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54
Q

Bacitracin Susceptibility (Taxo A)

Test for the susceptibility to –U Bacitracin.

A

0.04

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55
Q

Test for the ability of bacteria to convert fibrinogen into fibrin

A

Coagulase Test

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56
Q

Differentiate Staphylococcus aureusfrom coagulase negative
staphylococci

A

Coagulase Test

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57
Q

Detects bound coagulase “clumping factor”.

A

Coagulase Slide Test

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58
Q

Coagulase Slide Test

S. aureus
S. lugdunensis
S. schleiferi

A

Positive

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59
Q

Coagulase Slide Test

S. epidermidis
S. saprophyticus

A

negative

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60
Q

Detects free coagulase (staphylocoagulase)

A

Coagulase Tube Test

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61
Q

-Selective for gram-positive bacteria
-inhibit
Gram (-) Bacteria.

A

Colistin-Nalidixic Agar (CNA)/
Phenylethyl Alcohol Agar (PEA)

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62
Q

Colistin-Nalidixic Agar (CNA)/
Phenylethyl Alcohol Agar (PEA)

No growth:
total inhibition –

A

E. coli

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63
Q

Colistin-Nalidixic Agar (CNA)/
Phenylethyl Alcohol Agar (PEA)

No growth:
partial inhibition –

A

P. mirabilis

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64
Q

-Selective and differential Medium
-Contains NaCl (7.5%), D-mannitol, phenol red

A

Mannitol Salt Agar

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65
Q

Test for the position of cytochrome to produce a dark-
blue end product when reacted with Microdase
Reagent

A

Microdase Test (Modified oxidase)

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66
Q

Microdase test:+

A

micrococcus

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67
Q

Microdase test:-

A

staphylococcus

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68
Q

Novobiocin Susceptability

test for susceptibility to – μg novobiocin.

A

5 μg novobiocin.

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69
Q

Test for the ability of the organism to hydrolyze
the substrate L-pyrrolidonyl-β-naphthylamide

A

Miscellaneous (PYR Test)

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70
Q

Positive: Bright color within 5
minutes (pink to cherry-red color
after addition of color developer)

A

Miscellaneous (PYR Test)

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71
Q

Miscellaneous (PYR Test)
S. epidermidis
S. saprophyticus

A

+

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72
Q

Miscellaneous (PYR Test)
S. haemolyticus
S. lugdunensis

A

-

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73
Q

Most – isolates produce Beta-lactamases (penicillinases)
therefore are resisitantto penicillin

A

S. aureus

74
Q

Isolates that
are resistant to nafcillinor oxacillin

A

MRSA/MRSE (methicillin-resistant staphylococci)

75
Q

gold standard for MRSA
detection (detection of mecA gene)

A

Nucleic acid probes/ PCR amplification

76
Q

(borderline oxacillin-resistant S. aureus)

A

BORSA

77
Q

(vancomycin-intermediate S. aureus)

A

VISA

78
Q

(vancomycin-resistant S.aureus)

A

VRSA

79
Q

Gram (+) cocci arranged in pairs or chains
Aerotolerant anaerobes
Catalase negative
Some are capnophilic
Non-motile

A

Streptococci

80
Q

stretococci based on Cell Wall Structure

A

Lancefield grouping

81
Q

Lancefield: A
Common term: group A strep

A

s. pyogenes

82
Q

Lancefield: B
Common term: group B strep

A

s. agalactiae

83
Q

Lancefield: C
Common term: group C strep

A

s. dysagalactiae, s. equi

84
Q

Lancefield: D
Common term: group D NONenterococcus

A

s, bovis

85
Q

Lancefield: D
Common term: group D ENTEROcoccus

A

e. faecalis, e. faecium

86
Q

Common term: pneumococcus

A

s. pneumoniae

87
Q

Lancefield: A,C,F,G,N
Common term: viridans strep

A

anginosus, mutans, mitis

88
Q

streptococci based on Pattern of hemolysis

A

Brown’s Classification

89
Q

Syreptococci
hemolysis: beta

A

group a,b,c

s. pyogenes
s. agalactiae
s. dysagalactiae, s. equi

90
Q

Syreptococci
hemolysis: alpha

A

pneumococcus/ s. pneumoniae

91
Q

Syreptococci
hemolysis: alpha, beta, gamma

A

group D enterococcus
e. faecalis, e. faecium

92
Q

Syreptococci
hemolysis: alpha, gamma

A

group D nonenterococcus
s. bovis

93
Q

Syreptococci
hemolysis: beta, alpha, gamma

A

viridans strep
anginosus, mutans, mitis

94
Q

Pattern of hemolysis (Brown’s Classification)

Partial lysis of RBC’s around colony
Greenish discoloration of area around colony

A

Alpha (α)

95
Q

Pattern of hemolysis (Brown’s Classification)

Complete lysis of RBC’s around colony
Clear area around colony

A

Beta (β)

96
Q

Pattern of hemolysis (Brown’s Classification)

No lysis of RBC’s around colony. No change in agar

A

Gamma(γ)

97
Q

Pattern of hemolysis (Brown’s Classification)

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

A

Alpha-prime (α’)

98
Q

Virulence Factor: Streptococcus pyogenes

-Antiphagocytic
-For adherence to mucosal cells

A

M Protein

99
Q

Virulence Factor: Streptococcus pyogenes

Mediates adherence to host epithelial cells

A

Protein F (Fibronectin-binding protein)

100
Q

Virulence Factor: Streptococcus pyogenes

Mediates attachment to mucosal cells

A

Lipoteichoic acid

101
Q

Virulence Factor: Streptococcus pyogenes

-Prevents opsonized phagocytosis
-Mask bacterial antigens

A

Hyaluronic acid Capsule

102
Q

Virulence Factor: Streptococcus pyogenes

-Group of four enzymes with nuclease activity
-Degrade host DNA (DNase) and RNA

A

Streptodornase (DNases)

103
Q

Virulence Factor: Streptococcus pyogenes

-Subsurface hemolysin (Oxygen labile)
-Toxic to RBC’s, WBC’s and platelets
-Induces antibody response -anti-streptolysinO

A

Streptolysin O

104
Q

Virulence Factor: Streptococcus pyogenes

-Surface hemolysin (Oxygen stable)
-Lysis WBC’s and is non immunogenic

A

Streptolysin S

105
Q

Virulence Factor: Streptococcus pyogenes

Causes lysis of fibrin clots

A

Streptokinase (Fibrinolysin)

106
Q

Virulence Factor: Streptococcus pyogenes

Solubilizes hyaluronic acid in connective tissues

A

Hyaluronic acid

107
Q

Virulence Factor: Streptococcus pyogenes

Exotoxin A is associated with Scarlet Feverand
Streptococcal Toxic shock-like syndrome

A

Streptococcal pyrogenic exotoxins A, B, C (SPE)

108
Q

Clinical Infections:
Bacterial Pharyngitis and Tonsilitis

A

streptococcus pyogenes

109
Q

Clinical Infections:
Pyodermal Infections

superficial and localized

A

Impetigo
streptococcus pyogenes

110
Q

Clinical Infections:
Pyodermal Infections

acute spreading erythematous lesion

A

Erysipelas
Streptococcus pyogenes

111
Q

Clinical Infections:
Pyodermal Infections

involves deeper tissue invasion

A

Cellulitis
Streptococcus pyogenes

112
Q

Clinical Infections:
Pyodermal Infections

diffuse red rashes (chest to extremities)

A

Scarlet Fever

113
Q

Clinical Infections

Necrotizing Fasciitis
Streptococcal Toxic Shock Syndrome

A

streptococcus pyogenes

114
Q

Clinical Infections

Post-Streptococcal Sequelae
a. Rheumatic Heart
b. Acute glomerulonephrits (AGN)

A

Streptococcus pyogenes

115
Q

-Capsular material interferes with phagocyticactivity
and complement cascade activation.
-Transmission occurs vertically or during
delivery (associated with obstetric complications)
-

A
116
Q

-Transmission occurs VERTICALLY or during
delivery (associated with obstetric complications)
-Causes pneumonia and meningitis

A

Streptococcus agalactiae

117
Q

-In adult, causes endometritis and wound infections
-Capsular material interferes with phagocytic activity
and complement cascade activation.

A

Streptococcus agalactiae

118
Q

-Large-colony forming β-hemolytic isolates
-Resembles S. pyogenes infections

A

Groups C and G Streptococci
S. dysgalactiae subsp. equisimilis

119
Q

-small-colony forming β-hemolytic isolates
-resembles S. pyogenes infections

A

Groups C and G Streptococci
S. anginosus group

120
Q

Virulence Factor
-Capsular polysaccharide
-Antigenic polysaccharide resulting to 80 serogroup
-Antiphagocytic

-Pneumonia (lobar and community acquired)
-Sinusitis, Otitis Media, Bacteremia, Meningitis

A

streptococcus pneumoniae

121
Q

Gram-positive diplococci (lancet or bullet shape)

A

streptococcus pneumoniae

122
Q

Neufeld reaction (Quellung, capsular swelling) positive

A

streptococcus pneumoniae

123
Q

Associated Disease
1. SUBACUTE BACTERIAL ENDOCARDITIS from patients
with damaged heart valves.
2. Bacteremia, septicemia and cavities

A

Viridans Streptococci (A,C,F, G,N)

124
Q

Associated Disease
1. Nosocomial infection
2. UTI (catheterization), bacteremia (hemodialysis,
surgery), endocarditis (prosthetic heart valves)

A

Enterococcus

125
Q

Streptococci
Disease Associations

Pharyngitis, PYODERMAL infections, NECROTIZING FASCIITIS, STREPTOCOCCAL TOXIC SHOCK SYNDROME,
POST SEPSIS SYNDROME (Rheumatic fever, AGN)

A

S. pyogenes

126
Q

Streptococci
Disease Associations

NEONATAL SEPSIS (pneumonia, meningitis) PUERPERAL
fever, pyogenic infections

A

S. agalactiae

127
Q

Streptococci
Disease Associations

Pharyngitis, IMPETIGO, pyogenic infections

A

S. dysgalactiae, S. equi

128
Q

Streptococci
Disease Associations

UTI, endocarditis, pyogenic infections, BACTEREMIA

A

E. faecalis, E. faecium

129
Q

Streptococci
Disease Associations

PNEUMONIA, MENINGITIS, pyogenic infections

A

S. pneumoniae

130
Q

Streptococci
Disease Associations

Pyogenic infections, endocarditis, DENTAL CARIES

A

Anginosus, mutans, mitis

131
Q

Colony Characteristics

Grayish white (pinpoint), transparent to translucent,
matte or glossy; large zone of βhemolysis

A

Group A strep

132
Q

Colony Characteristics

Larger that Group A streptococci; translucent to
opaque; flat glossy; narrow zone of β hemolysis

A

Group B strep

133
Q

Colony Characteristics

Minute to small, gray, domed, smooth; α, β,γ hemolytic

A

Viridans

134
Q

Colony Characteristics

Small, cream or white, smooth; α, β,γ hemolytic

A

Group D strep

135
Q

Colony Characteristics

Small, round, glistening, dome-shaped, mucoid colonies.
Colonies tend umbilicated as they age; α hemolytic

A

Pneumococci

136
Q

Physiologic Characteristics

Produce pus, mostly β-hemolytic

A

Pyogenic

137
Q

Physiologic Characteristics

Nonhemolyticorganism with lancefield
group N, often found in dairy products

A

Lactococci

138
Q

Physiologic Characteristics

Normal biota of the human intestine

A

Enterococci

139
Q

Physiologic Characteristics

Found as normal biota in the upper
respiratory tract of humans

A

Viridans

140
Q

Culture Media for Streptococcus

Enriched isolation of Streptococci

A

Blood Agar

141
Q

Culture Media for Streptococcus

Selective medium for Beta-hemolytic
Streptococci

A

Blood Agar
with trimethoprim and sulfamethoxazole

142
Q

Taxo A susceptible and SXT Resistant

A

Group A

143
Q

Taxo A resistant and SXT resistant

A

Group B:

144
Q

Taxo A resistant and SXT susceptible

A

Group C, F, G

145
Q

Test for the synergistic hemolysis between group B Streptococcus and β-hemolytic S. aureus.

A

CAMP Reaction

146
Q

is a diffusible, proteinlike compound produced by Group B

A

CAMP factor

147
Q

CAMP Reaction
Positive: Enhanced hemolysis in
arrowhead pattern

Strep group ?

A

group B

148
Q

Test for the ability to hydrolyze hippuric acid (Sodium
hippurate ) to benzoic acid and glycine

A

Hippurate Hydrolysis

149
Q

Glycine can be detected with Ninhydrin reagent

A

Hippurate Hydrolysis

150
Q

Hippurate Hydrolysis
Positive:
Deep blue (purple) color

group ?

A

group B

151
Q

Hippurate Hydrolysis
Negative:
Colorless or very slight purple

group ?

A

group A

152
Q

Detects for the ability of the bacteria to hydrolyze
Leucine-β-naphthylamide by enzyme leucine
aminopeptidase to β-naphthylamide.

A

LAP Test

153
Q

Positive: Development of a red color within
1 minute after adding cinnamaldehyde
(DMACA) reagent

A

LAP Test

154
Q

LAP Test

S. Pneumoniae and S. pyogenes,
Enterococcus, Pediococcus

A

+

155
Q

LAP Test

Aerococcus and Leuconostoc

A

-

156
Q

Detects for the ability of the bacteria to grow in the
presence of 40% bile and hydrolyze esculin.

A

Bile Esculin Hydrolysis

157
Q

Positive: Blackening of the agar

A

Bile Esculin Hydrolysis

158
Q

Bile Esculin Hydrolysis

Group D Streptococcus

A

+

159
Q

Bile Esculin Hydrolysis

Viridans Streptococcus

A

-

160
Q

Test the ability of the organism to grow in 6.5% NaCl

A

salt Tolerance Test (6.5% NaCl)

161
Q

Positive: Visible turbidity
in broth and color change

A

salt Tolerance Test (6.5% NaCl)

162
Q

salt Tolerance Test (6.5% NaCl)

(Group D Enterococcus)

A

+

163
Q

salt Tolerance Test (6.5% NaCl)

(Group D Non Enterococcus)

A

-

164
Q

-Used to differentiate Streptococcus pneumoniae from other α-hemolytic streptococci
-Ethylhydrocupreine hydrochloride

A

Optochin (Taxo P) Susceptibility

165
Q

Optochin (Taxo P) Susceptibility

Positive: Zone of inhibition is
>14mm (using 6 mm P disk) or
>16mm (using a 10 mm P disk)

A

S. pneumoniae

166
Q

Test for the solubility to bile salt (2% sodium
deoxycholate or sodium taurocholate)

A

Bile Solubility Test

167
Q

Positive: Colony disintegrates

A

Bile Solubility Test

168
Q

alpha hemolytic
optochin resistant
bile esculin hydrolysis + =GROUP D

PYR or 6.5% broth
+

A

enterococcus

169
Q

alpha hemolytic
optochin resistant
bile esculin hydrolysis +
=GROUP D

PYR or 6.5% broth

A

non enterococcus

170
Q

alpha hemolytic
optochin SUSCEPTIBLE
bile esc, pyr, 6.5%-

A

s. pneumoniae

171
Q

alpha hemolytic
optochin RESISTANT
bile esc, pyr, 6.5%-

A

s. viridans

172
Q

all streptococci are bacitracin RESISTANT except

A

group A

173
Q

all streptococci are SXT RESISTANT except

A

group C,F,G viridans

174
Q

betahemolytic

Group ?
Bacitracin: S
SXT: R
CAMP: -
Bile-Esculin: -
6.5% NaCl: -
PYR: +

A

A

175
Q

betahemolytic

Group ?
Bacitracin: R
SXT: R
CAMP: +
Bile-Esculin: -
6.5% NaCl: -
PYR: -

A

B

176
Q

betahemolytic

Group ?
Bacitracin: R
SXT: S
CAMP: -
Bile-Esculin: -
6.5% NaCl: -
PYR: -

A

C, F, G viridans

177
Q

betahemolytic

Group ?
Bacitracin: R
SXT: R
CAMP: -
Bile-Esculin: +
6.5% NaCl: -
PYR: -

A

D streptococcus

178
Q

betahemolytic

Group ?
Bacitracin: S
SXT: R
CAMP: -
Bile-Esculin: +
6.5% NaCl: +
PYR: +

A

D enterococcus

179
Q

gamma hemolytic

group ?
bile esculin: -
6.5% salt broth: -
PYR: -

A

viridans

180
Q

gamma hemolytic

group ?
bile esculin: +
6.5% salt broth: +
PYR: +

A

D enterococcus

181
Q

gamma hemolytic

group ?
bile esculin: +
6.5% salt broth: -
PYR: -

A

D non enterococcus