Streptococcus and Enterococcus Flashcards
1
Q
Streptococcus spp. and Enterococcus spp. belong to the family ___________.
A
Streptococcaceae
2
Q
A characteristic which differentiates Streptococcus spp. and Enterococcus spp. from Staphylococcus spp. and Micrococcus spp.
A
Catalase Reaction, wherein Streptococcus spp. and Enterococcus spp. are CATALASE NEGATIVE
3
Q
Describe the appearance of both Streptococcus spp. and Enterococcus spp.
A
- Gram (+) cocci, in pairs, and in chains (common for streptococci)
- Enterococcus spp. appears more elongated
4
Q
What are the aerotolerance levels of Streptococcus spp. and Enterococcus spp.?
A
- Facultative Anaerobes (majority)
- Aerotolerant Anaerobes
- Capnophilic
5
Q
Capnophilic species of streptococci and enterococci requires ______________.
A
More than 5-10% amount of CO2
6
Q
TRUE OR FALSE.
Streptococcus spp. and Enterococcus spp. can ferment glucose with gas.
A
False (w/o gas)
7
Q
Describe the colonies of Streptococcus spp. and Enterococcus spp.
A
Small (pinpoint) and transparent
8
Q
________ of the group-specific carbohydrate is determined by an amino sugar.
A
Serologic Specificity
9
Q
Serologic Specificity of the group-specific carbohydrate is determined by an ___________.
A
amino sugar
10
Q
SEROLOGIC SPECIFICITY OF THE CELL WALL GROUP-SPECIFIC SUBSTANCE
Group A streptococci
A
Rhamnose-N-acetylglucosamine
11
Q
SEROLOGIC SPECIFICITY OF THE CELL WALL GROUP-SPECIFIC SUBSTANCE
Group B streptococci
A
Rhamnose-glucosamine polysaccharide
12
Q
SEROLOGIC SPECIFICITY OF THE CELL WALL GROUP-SPECIFIC SUBSTANCE
Group C streptococci
A
Rhamnose-N-acetylgalactosamine
13
Q
SEROLOGIC SPECIFICITY OF THE CELL WALL GROUP-SPECIFIC SUBSTANCE
Group D streptococci
A
Glycerol teichoic acid containing D-alanine and glucose
14
Q
SEROLOGIC SPECIFICITY OF THE CELL WALL GROUP-SPECIFIC SUBSTANCE
Group F streptococci
A
Glucopyranosyl-N-acetylgalactosamine
15
Q
These are exotoxins which serves as a virulence factor that damages the intact RBC.
A
Hemolysin
16
Q
Identify the Hemolytic Pattern
Description: Complete lysis of the RBCs around the colony.
Apperance: Clear area around the colony.
A
β-hemolytic pattern
17
Q
Identify the Hemolytic Pattern
Description: No lysis of the RBCs around the colony.
Apperance: No change in agar
A
γ-hemolytic pattern or non-hemolytic pattern
18
Q
Identify the Hemolytic Pattern
Description: Partial lysis of the RBCs around the colony.
Apperance: Greenish discoloration of area around the colony.
A
α-hemolytic pattern
19
Q
Identify the Hemolytic Pattern
Description: Small area of intact RBCs around the colony surrounded by a wider zone of complete hemolysis.
A
α’-hemolytic pattern
20
Q
Which hemolytic pattern is not associated with streptococci?
A
α’-hemolytic pattern
21
Q
What was the classification scheme developed by Rebecca Lancefield?
A
Lancefield Classification
22
Q
________ developed a classification scheme which divided streptococci into serologic groups, designated by letters.
A
Rebecca Lancefield
23
Q
When was the Lancefield Classification developed?
A
1930
24
Q
The Lancefield Classification is based on the __________.
A
C-carbohydrates
25
Where are C-carbohydrates found?
In the cell wall
26
# *Streptococcus pyogenes*
Lancefield Group Antigen
A
27
# *Streptococcus pyogenes*
Hemolysis Type
β
28
# *Streptococcus pyogenes*
Common Terms
Group A streptococci
29
# *Streptococcus pyogenes*
Disease(s) Associations
* Rheumatoid Fever
* Scarlet Fever
* Pharyngitis
* Glomerulonephritis
* Pyogenic Infections
30
# *Streptococcus agalactiae*
Lancefield Group Antigen
B
31
# *Streptococcus agalactiae*
Hemolysis Type
β
32
# *Streptococcus agalactiae*
Common Terms
Group B streptococci
33
# *Streptococcus agalactiae*
Disease Associations
* Neonatal sepsis
* Meningitis
* Puerperal fever
* Pyogenic infections
34
# *Streptococcus dysgalactiae* and *Streptococcus equi*
Lancefield Group Antigen
C
35
# *Streptococcus dysgalactiae* and *Streptococcus equi*
Hemolysis Type
β
36
# *Streptococcus dysgalactiae* and *Streptococcus equi*
Common Terms
Group C streptococci
37
# *Streptococcus dysgalactiae* and *Streptococcus equi*
Disease Association(s)
* Pharyngitis
* Impetigo
* Pyogenic Infections
38
# *Streptococcus bovis*
Lancefield Group Antigen
D
39
# *Streptococcus bovis*
Hemolysis Type
α, none
40
# *Streptococcus bovis*
Common Terms
Non-enterococcus member of viridans streptococci
41
# *Streptococcus bovis*
Disease Associations
* Endocarditis
* UTIs
* Pyogenic infections
42
# *Enterococcus faecalis* and *Enterococcus faecium*
Lancefield Group Antigen
D
43
# *Enterococcus faecalis* and *Enterococcus faecium*
Hemolysis Type
α, β, none
44
# *Enterococcus faecalis* and *Enterococcus faecium*
Common Terms
Enterococcus
45
# *Enterococcus faecalis* and *Enterococcus faecium*
Disease Association(s)
* UTIs
* Pyogenic infections
46
# *Streptococcus pneumoniae*
Lancefield Group Antigen
None
47
# *Streptococcus pneumoniae*
Hemolysis Pattern
α
48
# *Streptococcus pneumoniae*
Common Terms
Pneumococcus
49
# *Streptococcus pneumoniae*
Disease Association(s)
* Pneumonia
* Meningitis
* Pyogenic infections
50
Enumerate the different subgroups under Viridans Streptococci
**MNEMONIC:** BAMMSA
* *Streptococcus **b**ovis*
* *Streptococcus **a**nginosus*
* *Streptococcus **m**utans*
* *Streptococcus **m**itis*
* *Streptococcus **sa**livarius*
51
Which Lancefield Group Antigen is **acid-stable**?
B
52
It is encoded by the gene "emm."
M protein
53
M protein is encoded by the gene ______.
emm
54
How is M protein virulent?
- Resists phagocytosis
- Attach to mucosal cells
55
*S. pyogenes* is typically found in the __________.
Upper Respiratory Tract
56
There are ____ serotypes of M protein.
>150 (Mahon: >80)
57
________ most common serotype of M protein.
M1 Protein (in pharyngitis)
58
Protein F is also known as ___________.
Fibronectin-binding Protein
59
How is Protein F and Lipoteichoic Acid virulent?
They allow the bacteria to adhere to epithelial cells
60
They secure the attachment of streptococci to the oral mucosal cells.
Lipoteichoic acid, together with M protein and protein F
61
Lipoteichoic acid, together with M protein and protein F, _______________.
secure attachment of streptococci to the oral mucosal cells
62
**TRUE OR FALSE.**
Hyaluronic Acid Capsule is weakly immunogenic.
True
63
How is hyaluronic acid capsule virulent?
- Impedes opsonized phagocytosis
- Allows the bacteria to mask its antigen and remain unrecognized by the host
64
____ is most noticeable in young cultures.
Hyaluronic Acid Capsule
65
Hyaluronic acid capsule is most noticeable in _________.
young cultures (18-24 hours old)
66
# Streptolysin O (SLO)
Hemolysis on BAP
Anaerobically
67
Which streptolysin is anaerobic?
Streptolysin O (SLO)
68
# Streptolysin S
Hemolysis on BAP
Aerobically
69
Which streptolysin is aerobic?
Streptolysin S
70
# Streptolysin O (SLO)
Hemolysin
O hemolysin
71
Which hemolysin is **oxygen-labile**?
O hemolysin
72
# Streptolysin S
Hemolysin
S hemolysin
73
Which hemolysin is **oxygen stable**?
S hemolysin
74
# Streptolysin O (SLO)
Cells lysed
Leukocytes, platelets, and RBCs
75
# Streptolysin S
Cells lysed
Leukocytes
76
# Streptolysin O (SLO)
Immunogenicity
Highly immunogenic
77
Which streptolysin is highly immunogenic?
Streptolysin O (SLO)
78
# Streptolysin S
Immunogenicity
Non-immunogenic
79
Which streptolysin is non-immunogenic?
Streptolysin S
80
Streptolysin O also serves as an __________
Antigen
81
Since SLO is highly immunogenic, it stimulates the host's immune system to produce antibodies called _________.
Anti-streptolysin O antibodies
82
Anti-streptolysin O antibodies can be detected by ________.
Anti-streptolysin O Test
83
How is Deoxyribonuclease (DNAse) virulent?
- Potent protease that interferes with phagocytosis
- Contributes to the spread of streptococci by liquefying pus
84
**TRUE OR FALSE.**
DNAse is not immunogenic
False
85
How does DNAse contribute in the spread of streptococci?
By liquefying pus
86
How is Streptokinase/Fibrinolysin virulent?
They are capable of lysing fibrin clots through the action of plasminogen -> plasmin.
87
________ activates plasminogen for it to be converted into plasmin.
Streptokinase
88
The lysing of fibrin clots allow the *Streptococcus pyogenes* to _____________.
escape and cause infection
89
**TRUE OR FALSE.**
Streptokinase/Fibrinolysin is immunogenic.
True
| But not specific to GAS, they can also be in Group C and Group G
90
Hyaluronidase is also known as __________.
spreading factor
91
__________ solubilizes the ground substance in the connective tissue.
Hyaluronidase
92
Streptococcal pyrogenic exotoxins are previously known as ________.
Erythrogenic Toxins
93
_______ causes a red spreading rash called Scarlet Fever.
Streptococcal Pyrogenic Exotoxins
94
The red spreading rash caused by Erythrogenic Toxins is known as _______.
Scarlet Fever
95
What are the four exotoxin types found in *S. pyogenes*?
SpeA, SpeB, SpeC, and SpeF
96
The most common clinical manifestation of GAS infection.
Pharyngitis and Tonsillitis
97
Bacterial Pharyngitis is also known as _________.
Strep Throat
98
Pyodermal infections lead to ______________.
Impetigo, cellulitis, erysipelas, wound infection, arthritis or scarlet fever
99
If the portal of entry is through the skin, it can possibly cause _______.
Erysipelas
100
Describe the characteristics of an Erysipelas lesion
Raised, red, massive brown edema that rapidly advances to the demarcated margin of infection
101
An acute rapidly spreading infection of the skin which occurs after a mild trauma, burns, wound, and etc.
Cellulitis
102
**TRUE OR FALSE.**
Cellulitis is also characterized by erythema.
True
103
How is the lesion in cellulitis different from the lesion in erysipelas?
1. Lesion is not raised (flat)
2. The line between the involved and uninvolved tissue is indistinct.
104
There are how many types of Necrotizing Fascitis (NF)?
3
105
Type 1 NF is caused by _______.
*Vibrio* spp.
106
Type 2 NF is caused by __________.
*Streptococcus* spp.
| Commonly GAS
107
Type 3 NF is caused by __________.
*Clostridium* spp.
108
Necrotizing Fascitis (NF) is also known as _______.
Flesh-eating Disease
109
_______ is an invasive infection characterized by rapidly progressing inflammation and necrosis of the skin.
Necrotizing Fascitis (NF)
110
This infection involves SpeA, M1 and M3.
Streptococcal Toxic Shock Syndrome
111
A complication after *Streptococcus pyogenes* infection, wherein rheumatic fever and acute glomerulonephritis follows.
Poststreptococcal Sequelae
112
The common virulence factor for rheumatoid fever is _______.
Class 1 M Protein
113
The common virulence factor for glomerulonephritis is _________.
Class 1 and 2 M Protein
114
Treatment of Choice for poststreptococcal sequelae
Penicillin
115
It is the most commonly utilized virulence factor of *S. agalactiae*.
Capsule
116
How is the capsule of *S. agalactiae* virulent?
It resists phagocytosis, but is ineffective after opsonization.
117
What is the main component of the capsule in *S. agalactiae*?
Sialic Acid
118
These are the products of *S. agalactiae*, but are not considered to be virulence factors.
Hemolysin, DNAse, Neuramidase, Protease, Hyaluronidase, CAMP Factor
119
What is the infection acquired from *S. agalactiae*?
Invasive Disease of Newborn
120
How is the invasive disease of newborn acquired?
* Through vertical transmission (mother to offspring)
* During delivery since *S. agalactiae* is commonly found in the vaginal canal and rectal area
121
*S. agalactiae* is a normal flora of the _________ and _________
Vaginal canal and Rectal area
122
# Explain the manner of specimen collection
The infection of the patient came from the upper respiratory tract. How will you get a sample of *S. pyogenes*?
By performing a throat swab
123
How is a throat swab performed properly?
By depressing the tongue and avoiding the uvula, rub a swab over the **posterior pharynx** and each **toncillar area**.
124
# Explain the manner of specimen collection
The infection of the patient came from a pyodermal infection. Where will you get a sample of *S. pyogenes*?
On the patient's wound, lesion, or pus
125
# Explain the manner of specimen collection
The infection of the patient has been found to be systemic. Where will you get a sample of *S. pyogenes*?
In the CSF, blood, or bodily fluids
126
In collecting a specimen from exudates, it should be ________.
Touched with swab
127
**TRUE OR FALSE.**
Transport media is required in collecting *S. pyogenes*.
False
| Not necessarily required, pero mas better daw if meron
128
# Explain the manner of specimen collection
The patient is a pregnant woman. Where and how will you get a sample of *S. agalactiae*?
By performing a vaginal canal or rectal swab between 35 and 37 weeks of gestation.
129
Transport media for *S. agalactiae* specimen
- Todd-Hewitt Broth
- Lim Broth
- TransVag Broth
130
Todd-Hewitt Broth content
10 ug/mL colistin
131
Lim Broth content
15 ug/mL nalidixic acid
132
TransVag Broth content
8 ug/mL gentamicin and 15 ug/mL nalidixic acid
133
Describe the appearance of *S. pyogenes* and *S. agalactiae* when Direct Microscopic Examination is performed.
Gram (+) cocci round or oval-shaped, occassionally forming elongated cells
134
Which medium is used to culture *S. pyogenes* and *S. agalactiae*?
**BAP** (with inhibitors such as sulfamethoxazole, colistin, or polymixin B)
135
Which inhibitors are sometimes used in BAP when culturing *S. pyogenes* and *S. agalactiae*?
- Sulfamethoxazole (SMZ)
- Colistin
- Polymixin B
136
Incubation period for *S. pyogenes* and *S. agalactiae*
18 to 24 hours at 35-37 C aerobically or anaerobically
137
Describe the appearance of *S. pyogenes* colonies when performing Macroscopic Examination.
Small, transparent, and smooth with a well-defined area of β-hemolysis
138
Describe the appearance of *S. agalactiae* colonies when performing Macroscopic Examination.
Grayish-white mucoid colonies surrounded by a small zone of β-hemolysis
139
# Which specimen?
Small, transparent, and smooth with a well-defined area of β-hemolysis
*Streptococcus pyogenes*
140
# Which specimen?
Grayish-white mucoid colonies surrounded by a small zone of β-hemolysis
*Streptococcus agalactiae*
141
When the *Streptococcus* spp. are cultured from solid media, under microscopic examination, it appears to be ___________.
Gram (+) cocci with some short chains
142
When the *Streptococcus* spp. are cultured from broth, under microscopic examination, it appears to be ___________.
Gram (+) cocci with longer chains
143
*Streptococcus* spp. and *Enterococcus* spp. result in Catalase Test
Negative (-)
144
Which organism is **positive** in the Bacitracin test?
*Streptococcus pyogenes*
145
*S. pyogenes* is (susceptible/resistant) to the bacitracin test.
Susceptible
146
Which organism is **negative** in the Bacitracin test?
Other β-hemolytic streptococci
147
Which organism is **positive** in the Pyrrolidonyl Arylamidase test?
*Streptococcus pyogenes*
148
Which organism is **negative** in the Pyrrolidonyl Arylamidase test?
Other β-hemolytic streptococci
149
Explain the principle of Hippurate Hydrolysis Test
**Principle:** to determine the capability of an organism to hydrolyze hippurate.
* Hippuric Acid → glycine & benzoic acid (hippuricase will hydrolyze)
* Glycine → purple colored products (deaminated by ninhydrin reagent)
**Result:**
* (+) Deep purple color *(S. agalactiae)*
* (-) Colorless or slightly yellow pink color or tinge of purple (other β-hemolytic streptococcus
150
What is the **positive result** in Hippurate Hydrolysis Test?
Deep Purple Color
151
Which organism is **positive** in the hippurate hydrolysis test?
*Streptococcus agalactiae*
152
What is the **negative result** in the hippurate hydrolysis test?
Colorless or slightly yellow-pink or light purple
153
Hippuric acid is hydrolyzed by _________ to form glycine and benzoic acid.
hippuricase
154
Hippuric acid is hydrolyzed by hippuricase to form ______ and ________.
glycine and benzoic acid
155
Glycine is deaminated by _________ to form a deep purple colored product.
Ninhydrin reagent
156
Glycine is _________ by ninhydrin reagent to form a deep purple colored product.
deaminated
157
Explain the principle of CAMP Test
**Principle:** detection of diffusible extracellular protein (CAMP factor) that acts synergistically with β-hemolysin of S. aureus to cause enhanced lysis of RBCs.
* **β-hemolysin** – known factor; detects the presence of the other factor.
* **CAMP factor** – unknown factor
**Result:**
* (+) enhanced hemolysis indicated by an arrowhead-shaped zone of beta-hemolysis at the juncture of the two organisms *(S. agalactiae)*
* (-) no enhancement of hemolysis (other β-hemolytic streptococcus)
158
It is used to detect diffusible extracellular protein (CAMP factor) that acts synergistically with β-hemolysin of S. aureus to cause enhanced lysis of RBCs.
CAMP Test
159
It is the known factor in CAMP test which detects the presence of other factor.
β-hemolysin
160
It is the unkown factor in CAMP test.
CAMP Factor
161
What is the **positive** result in CAMP Test?
Enhanced hemolysis indicated by an arrowhead-shaped zone of beta-hemolysis at the juncture of the two organisms.
162
Which organism exhibits a **positive** result in the CAMP test?
*Streptococcus agalactiae*
163
What is the **negative result** in CAMP Test?
No enhancement of hemolysis
164
*Streptococcus pneumoniae* belongs to the group _________.
Viridans Streptococci
165
Why is *S. pneumoniae* under Viridans Streptococci?
They both exhibit α-hemolytic pattern
166
Which sub-group of Viridans Streptococci does *S. pneumoniae* belong?
*Streptococcus mitis*
167
*Streptococcus pneumoniae* is also known as ______.
Pneumococcus
168
**TRUE OR FALSE.**
*Streptococcus pneumoniae* has C-carbohydrate.
False
169
*Streptococcus pneumoniae* has _______.
C-substance
170
C-substance is found in the ________ of *S. pneumoniae*
cell wall
171
**TRUE OR FALSE.**
*S. pneumoniae* has a Lancefield Antigen Group
False
172
Treatment of choice for *S. pneumoniae*
Penicillin
173
Virulence factor of *S. pneumoniae*
Capsular Polysaccharide
174
It is used to classify *S. pneumoniae* into more than 90 serotypes.
Capsular Polysaccharide
175
*S. pneumoniae* strains that lack capsule are ________.
Non-pathogenic (Avirulent)
176
Infections associated with *S. pneumoniae*
- Pneumonia
- Sinusitis
- Otitis media
- Meningitis
- Bacteremia
177
PCV7 is used in _________.
Children
178
PCV13 is used in ______.
Children >5 years old
179
PS23 is used in _______.
Adults
180
It is a normal microbiota of the upper respiratory tract, female genital tract, and gastrointestinal tract.
Viridans Streptococci
181
Viridans means _________.
green
182
Viridans Streptococci is named after _________.
Its α-hemolytic pattern
183
**TRUE OR FALSE.**
Viridans Streptococci is non-fastidious
False
184
What are the requirements for the fastidious strains of Viridans Streptococci?
CO2
185
*Streptococcus mitis* group
* *S. mitis*
* *S. pneumoniae*
* *S. sanguis*
* *S. oralis*
186
*Streptococcus mutans* group
* *S. mutans*
* *S. sobrinus*
187
*Streptococcus salivarius* group
* *S. salivarius*
* *S. vestibularis*
188
*Streptococcus bovis* group
* *S. bovis*
* *S. equinus*
* *S. gallolyticus*
* *S. infantarius*
* *S. alactolyticus*
189
*Streptococcus anginosus* group
* *S. anginosus*
* *S. constellatus*
* *S. intermedius*
190
# *S. anginosus, S. mutans, S. mitis, S. salivarius*
Lancefield Group Antigen
A, C, F, G, N
191
Viridans Streptococci is the most common cause of this infection.
Subacute Bacterial Endocarditis
192
Viridans Streptococci can cause oral infections such as _________.
- Gingivitis
- Dental caries
193
*S. anginosus* group is a microbiota of the _______.
Oral Cavity and GIT
194
Which virulence factor is present in *S. anginosus* group?
Polysaccharide Capsule and Cytolysin
195
How is the polysaccharide capsule and cytolysin of *S. anginosus* group virulent?
They adhere and colonize endocarditis
196
Which virulence factor is present in Groups C and G streptococci?
M proteins, SLO, Hyaluronidase, DNAse
197
Which virulence factor is present in Group D streptococci and *S. bovis* group?
D antigen
198
Where will you get a sample of *S. pneumoniae* and/or Viridans Streptococci specimens?
In the Respiratory Tract (RT)
199
It is a diplococci that is characterized by a lancet-shaped morphology.
*S. pneumoniae*
200
What is the appearance of *S. pneumoniae* that came from effusions under direct microscopic examination?
Gram (+) pneumococci with numerous WBCs
201
What is the appearance of *S. pneumoniae* that came from CSF under direct microscopic examination?
Gram (+) cocci in pairs with numerous WBCs
202
What is the appearance of Viridans Streptococci under direct microscopic examination?
Gram (+) cocci in chains
203
Which culture media is used for *S. pneumoniae* and Viridans Streptococcus species?
* Brain Heart Infusion (BHI) w/ 5% sheep's RBCs
* Tryptic Soy Broth (TSB) w/ 5% sheep's RBCs
* Chocolate Agar Plate (CAP)
204
What is the standard incubation period for *S. pneumoniae* and Viridans Streptococcus species?
18-24 hours at 35-37 C with increase CO2 (placed in candle jars)
205
For every 18% decrease in oxygen, it is equivalent to _______.
1% increase in CO2
206
Why is candle jar used for storing BAP?
The flame of the candle will combust the remaining oxygen which decreases its amount, and increases the amount of CO2.
207
# Which organism is being described?
Round, glistening, wet, mucoid, dome-shaped or doughnut appearance of colonies with a large zone of α-hemolysis.
*Streptococcus pneumoniae*
208
# Which organism is being described?
Coin with a raised rim appearance
*Streptococcus pneumoniae*
209
The coin with a raised rim appearance appears when the culture is _____.
beyond 24 hours old
210
Which characteristic of *S. pneumoniae* is responsible for its coin with a raised rim appearance?
Autolytic
211
# Which organism is being described?
Minute to small, gray, domed, smooth or matte appearance of colonies that are α-hemolytic or non-hemolytic.
Viridans Streptococci
212
Appearance of *S. pneumoniae* under microscopic examination
Gram (+) cocci in pairs, or in singly, or in short chains (lancet-shaped)
213
Appearance of Viridans Streptococcus under microscopic examination
Gram (+) cocci in pairs and in chains
214
Explain the principle of Optochin Test
**Principle:** to determine the effect of optochin on an organism.
**Result:**
* (+) zone of inhibition is 14 mm or greater in diameter, with 6-mm disk (S. pneumoniae)
* (-) no zone of inhibition (other α-hemolytic or alpha hemolytic streptococcus)
215
What is the positive result of Optochin Test?
(+) zone of inhibition greater than or equal to 14 mm in diameter, with 6 mm disk
216
Which organism is positive for Optochin Test?
*S. pneumoniae*
217
What is the negative result of Optochin Test?
(-) zone of inhibition
218
Which organism is negative for Optochin Test?
Other α-hemolytic streptococci
219
What is the chemical name of Optochin
Ethylhydrocupreine hydrochloride
220
What is the other term for Optochin Test?
Taxo P
221
What is the other term for Bacitracin Test?
Taxo A
222
Bile salt is chemically known as ___________.
Sodium De(s)oxycholate
223
Explain the principle of Bile Solubility Test
**Principle:** bile or a solution of a bile salt rapidly lyses pneumococcal colonies.
* Bile salts lowers the surface tension between the bacterial cell membrane and the medium.
* Accelerates the organism’s natural autolytic process.
* To detect if S. pneumoniae colonies will be lysed upon the addition of bile.
**Result: Plated**
* (+) lysed colonies (S. pneumoniae)
* (-) intact colonies (other α-hemolytic streptococcus)
**Result: Tubed (broth)**
* (+) clear (S. pneumoniae)
* (-) turbid (other α-hemolytic
streptococcus)
224
# Bile Solubility Test
Positive Result (Plated)
(+) Lysed colonies
225
# Bile Solubility Test
Positive Result (Tubed)
(+) Clear solution
226
# Bile Solubility Test
Positive Organism
*S. pneumoniae*
227
# Bile Solubility Test
Negative Organism
other α-hemolytic streptococcus
228
Explain the principle of Quellung Reaction
**Principle:** pneumococci mixed with specific anti-polysaccharide serum on a slide, the capsule swells markedly, and the organisms agglutinate by cross-linking.
* S. pneumoniae is mixed with specific anti-polysaccharide serum which targets the polysaccharide on the cell wall of bacteria. This results to swelling.
* Useful for rapid identification and for typing of the organisms, either in sputum or in cultures.
**Result:**
* (+) swelling of the capsule (S. pneumoniae)
* (-) no swelling of the capsule (other α-hemolytic streptococcus)
229
# Quellung Reaction
Positive Result
(+) Swelling of capsule
230
# Quellung Reaction
Positive Organism
*S. pneumoniae*
231
# Quellung Reaction
Negative Result
(-) no swelling
232
# Quellung Reaction
Negative Organism
other α-hemolytic streptococcus
233
Quellung Reaction is an _______ test.
Antigenic
234
Explain the principle of LAP Test
**Principle:** detection of the enzyme leucine aminopeptidase.
* **Substrate:** Leucine-β-naphthylamide → β-naphthylamine + cinnamaldehyde reagent
**Result:**
* (+) Red color (Viridans streptococci, S.
pneumoniae)
* (-) No color change or a slight yellow color (other α-hemolytic streptococcus)
235
# LAP Test
Positive Result
(+) Red color
236
# LAP Test
Positive Organism
Viridans Streptococci, *S. pneumoniae*
237
# LAP Test
Negative Result
(-) no color change or slight yellow color
238
# LAP Test
Negative Organism
other α-hemolytic streptococcus
239
# Mannitol: - or +
*S. bovis* group
-
| pero sabi sa book VARIABLE daw
240
# Mannitol: - or +
*S. anginosus* group
-
| sabi sa book VARIABLE din
241
# Mannitol: - or +
*S. mitis* group
-
242
# Mannitol: - or +
*S. mutans* group
+
243
# Mannitol: - or +
*S. salivarius* group
-
244
# Sorbital: - or +
*S. bovis* group
-
245
# Sorbital: - or +
*S. anginous* group
-
246
# Sorbital: - or +
*S. mitis* group
-
| VARIABLE
247
# Sorbital: - or +
*S. mutans* group
+
248
# Sorbital: - or +
*S. salivarius* group
-
249
# Voges-Proskauer: - or +
*S. bovis* group
+
250
# Voges-Proskauer: - or +
*S. anginosus* group
+
251
# Voges-Proskauer: - or +
*S. mitis* group
-
252
# Voges-Proskauer: - or +
*S. mutans* group
+
253
# Voges-Proskauer: - or +
*S. salivarius* group
+
254
# Hydrolysis or Arginine: - or +
*S. bovis* group
-
255
# Hydrolysis or Arginine: - or +
*S. anginosus* group
+
256
# Hydrolysis or Arginine: - or +
*S. mitis* group
-
| VARIABLE
257
# Hydrolysis or Arginine: - or +
*S. mutans* group
-
258
# Hydrolysis or Arginine: - or +
*S. salivarius* group
-
259
# Hydrolysis of Esculin: - or +
*S. bovis* group
+
260
# Hydrolysis of Esculin: - or +
*S. anginosus* group
+
261
# Hydrolysis of Esculin: - or +
*S. mitis* group
+
| VARIABLE
262
# Hydrolysis of Esculin: - or +
*S. mutans* group
+
263
# Hydrolysis of Esculin: - or +
*S. salivarius* group
+
| VARIABLE
264
# Urease: - or +
*S. bovis* group
-
265
# Urease: - or +
*S. anginosus* group
-
266
# Urease: - or +
*S. mitis* group
-
267
# Urease: - or +
*S. mutans* group
-
268
# Urease: - or +
*S. salivarius* group
+
| VARIABLE
269
_________ are previously classified as Group D streptococci.
*Enterococcus* spp.
270
*Enterococcus* spp. are a normal flora of the __________.
Intestinal tract
271
Why were *Enterococcus* spp. separated from Group D streptococci?
Because *Enterococcus* spp. were unique with the following characteristics:
* halophilic (6.5% NaCl)
* can tolerate 45 C
* can tolerate Alkaline pH
272
*Enterococcus* spp. can tolerate ______ of NaCl
6.5%
273
__________ are capable of Pseudocatalase reaction.
*Enterococcus* spp.
274
Most common *Enterococcus* spp.
- *E. faecalis*
- *E. faecium*
275
Majority of *Enterococcus* spp. are ________.
PYR (+)
276
Examples of *Enterococcus* spp.
- *E. durans*
- *E. avium*
- *E. casseliflavus*
- *E. gallinarum*
- *E. raffinosus*
277
Infections associated with *E. faecalis*
- Nosocomial Infections (UTI and bactermia)
- Endocarditis in adult patients
- Intraabdominal and pelvic wound infections
278
Virulence Factors of *Enterococcus faecalis*
- Extracellular surface adhesin proteins
- Extracellular serine protease
- Gelatinase
- Cytolysin
279
How are extracellular surface adhesin proteins, extracellular serine protease, and gelatinase virulent?
They colonize and adhere to heart valves and renal epithelial cells
280
It is similar to bacteriocins produced by gram positive bacteria.
Cytolysins
281
__________ group is divided into 4 DNA clusters.
*S. bovis* group
282
*S. bovis* group is divided into _________.
4 DNA Clusters
283
*Streptococcus equinus* belongs to DNA Cluster ___.
1
284
______ is typically found in animal species.
*S. equinus*
285
Which DNA cluster consists of mannitol fermenters?
DNA Cluster 2
286
DNA cluster 2 consists of __________.
- *S. gallolyticus*
- *S. gallolyticus* subsp. *gallolyticus*
- *S. gallolyticus* subsp. *pasteurianus*
- *S. gallolyticus* subsp. *macedonius*
287
Organisms from DNA cluster 2 are the common cause of _______.
Human endocarditis and colon carcinoma
288
DNA Cluster 3 includes _________.
* *S. infantarius*
* *S. infantarius* subsp. *infantarius*
* *S. infantarius* subsp. *coli*
289
DNA Cluster 4 includes _______.
*S. alactolyticus*
290
Specimens for collecting sample for Group D streptococci
- Blood (if bacteremia)
- Urine (if UTI)
- Wounds
291
Group D streptococci under direct microscopic examination
Gram (+) cocci
292
Group D streptococci is cultured using _______.
- Brain Heart Infusion (BHI)
- Tryptic Soy Broth (TSB)
both with 5% sheep's blood
293
Inhibitors present in the culture media used for Group D streptococci
- Bile esculin azide
- Colistin-nalidixic acid
- Phenylethyl alcohol
- Cephalexin azteronam-arabinose agar
294
Standard incubation period for Group D streptococci
35 C in the presence of CO2 but does not require a high level of CO2
295
Group D streptococci under macroscopic examination
Small, cream or white, smooth, entire with alpha-, beta-, non-hemolytic (usually)
296
Group D streptococci under microscopic examination
Gram (+) cocci in short chains
297
Biochemical tests associated with Group D streptococci
- Acid production from carbohydrate
- Arginine Hydrolysis
- 0.04% tellurite tolerance
- Pyruvate utilization
- Resistance to 100-ug efrotomycin acid
- (+) motility
298
# Motility: - or +
*E. faecalis*
-
299
# Motility: - or +
*E. faecium*
-
300
# Motility: - or +
*E. durans*
-
301
# Motility: - or +
*E. avium*
-
302
# Motility: - or +
*E. casseliflavus*
+
303
# Motility: - or +
*E. gallinarum*
+
304
# Motility: - or +
*E. raffinosus*
-
305
# Mannitol: - or +
*E. faecalis*
+
306
# Mannitol: - or +
*E. faecium*
+
307
# Mannitol: - or +
*E. durans*
-
308
# Mannitol: - or +
*E. avium*
+
309
# Mannitol: - or +
*E. casseliflavus*
+
310
# Mannitol: - or +
*E. gallinarum*
+
311
# Mannitol: - or +
*E. raffinosus*
+
312
# Sorbose: - or +
*E. faecalis*
-
313
# Sorbose: - or +
*E. faecium*
-
314
# Sorbose: - or +
*E. durans*
-
315
# Sorbose: - or +
*E. avium*
+
316
# Sorbose: - or +
*E. casseliflavus*
-
317
# Sorbose: - or +
*E. gallinarum*
-
318
# Sorbose: - or +
*E. raffinosus*
+
319
# Arabinose: - or +
*E. faecalis*
-
320
# Arabinose: - or +
*E.faecium*
+
321
# Arabinose: - or +
*E. durans*
-
322
# Arabinose: - or +
*E. avium*
+
323
# Arabinose: - or +
*E. casseliflavus*
+
324
# Arabinose: - or +
*E. gallinarum*
+
325
# Arabinose: - or +
*E. raffinosus*
+
326
# Raffinose: - or +
*E. faecalis*
-
327
# Raffinose: - or +
*E. faecium*
-
| VARIABLE
328
# Raffinose: - or +
*E. durans*
-
329
# Raffinose: - or +
*E. avium*
-
330
# Raffinose: - or +
*E. casseliflavus*
+
331
# Raffinose: - or +
*E. gallinarum*
+
332
# Raffinose: - or +
*E. raffinosus*
+
333
# Tellurite: - or +
*E. faecalis*
+
334
# Tellurite: - or +
*E. faecium*
-
335
# Tellurite: - or +
*E. durans*
-
336
# Tellurite: - or +
*E. avium*
-
337
# Tellurite: - or +
*E. casseliflavus*
-
338
# Tellurite: - or +
*E. gallinarum*
-
339
# Tellurite: - or +
*E. raffinosus*
-
340
# Arginine: - or +
*E. faecalis*
+
341
# Arginine: - or +
*E. faecium*
+
342
# Arginine: - or +
*E. durans*
+
343
# Arginine: - or +
*E. avium*
-
344
# Arginine: - or +
*E. casseliflavus*
+
345
# Arginine: - or +
*E. gallinarum*
+
346
# Arginine: - or +
*E. raffinosus*
-
347
# Pyruvate: - or +
*E. faecalis*
+
348
# Pyruvate: - or +
*E. faecium*
-
349
# Pyruvate: - or +
*E. durans*
-
350
# Pyruvate: - or +
*E. avium*
+
351
# Pyruvate: - or +
*E. casseliflavus*
-
| VARIABLE
352
# Pyruvate: - or +
*E. gallinarum*
-
353
# Pyruvate: - or +
*E. raffinosus*
+
354
MGP stands for _______.
Methyl-α-D-glucopyranoside
355
# MGP: - or +
*E. faecalis*
-
356
# MGP: - or +
*E. faecium*
-
357
# MGP: - or +
*E. durans*
-
358
# MGP: - or +
*E. avium*
+
359
# MGP: - or +
*E. casseliflavus*
+
360
# MGP: - or +
*E. gallinarum*
+
361
# MGP: - or +
*E. raffinosus*
+
362
These are previously known as nutritionally variant streptococci.
*Abiotrophia* spp. and *Granulicatella* spp.
363
*Abiotrophia* spp. and *Granulicatella* spp. are previously known as __________.
Nutritionally-variant streptococci
364
**TRUE OR FALSE.**
*Abiotrophia* spp. and *Granulicatella* spp. are non-fastidious.
False
365
What requirement is needed by *Abiotrophia* spp. and *Granulicatella* spp.?
Sulfhydryl compounds
366
The medium used for *Abiotrophia* spp. and *Granulicatella* spp. contains __________.
10 mg/L pyridoxal hydrochloride
367
What happens when there is no pyridoxal hydrochloride in the medium?
Satellitism on BAP with *S. aureus*
368
*Abiotrophia* spp. and *Granulicatella* spp. are normal flora of the _________.
Oral and GIT
369
Infections associated with *Abiotrophia* spp. and *Granulicatella* spp.
- Bacteremia
- Endocarditis
- Otitis media
370
*Abiotrophia* spp. and *Granulicatella* spp. are involved in the production of ___________.
- α-galactosidase
- β-galactosidase
- β-glucoronidase
371
Result of *Abiotrophia* spp. and *Granulicatella* spp. in Hippurate Hydrolysis
(+)
372
Result of *Abiotrophia* spp. and *Granulicatella* spp. in Arginine Hydrolysis
(+)
373
*Abiotrophia* spp. and *Granulicatella* spp. is capable of acid production from _________ and ________.
trehalose and starch
374
These are common airborne organisms.
*Aerococcus* spp.
375
*Aerococcus* spp. are considered to be _________ pathogens.
opportunistic
376
Infections associated with *Aerococcus* spp.
- Bacteremia
- Endocarditis
- UTI
377
*Aerococcus* spp. are similar to ____________ in culture.
streptococci
378
*Aerococcus* spp. are similar to ___________ in microscopic exam.
staphylococci
379
**TRUE OR FALSE.**
*Aerococcus* spp. are considered to be weak catalase or pseudocatalase.
True
380
*Aerococcus* spp. can tolerate ______ NaCl.
6.5%
381
Two most common species of aerococci
*A. viridans* and *A. urinae*
382
*A. viridans* is _____ for both bile esculin and PYR.
(+)
383
*A. urinae* is _______ for bile esculin and PYR.
(-)
384
**TRUE OR FALSE.**
*Aerococcus* spp. also require sulfhydryl compounds for growth.
True
385
They are similar to viridans streptococci in colonial morphology.
*Gemella* spp.
386
*Gemella* spp. are similar to __________ in terms of colonial morpology.
Viridans Streptococci
387
Hemolytic pattern of *Gemella* spp.
α-hemolytic or non-hemolytic
388
Microscopic appearance of *Gemella* spp.
Gram (-) cocci in pairs, tetrads, clusters, or short chains
389
Infections associated with *Gemella* spp.
* Endocarditis
* Wounds
* Abscesses
390
Most common species of *Gemella* spp.
*Gemella haemolysans*
391
They are previously classified as Group N streptococci.
*Lactococcus* spp.
392
Microscopic appearance of *Lactococcus* spp.
Gram (-) cocci in singly, pairs, or in chains
393
*Lactococcus* spp. is physiologically similar to __________.
enterococci
394
Hemolytic pattern of *Lactococcus* spp.
α-hemolytic or non-hemolytic
395
Infections associated with *Lactococcus* spp.
UTI and endocarditis
396
________ are physiologically similar to enterococci.
*Lactococcus* spp.
397
How are *Lactococcus* spp. differentiated from *Enterococcus* spp.?
*Lactococcus* spp. are capable of acid production from carbohydrates
398
These are catalase (-), gram positive cocci with irregular morphology.
*Leuconostoc* spp.
399
*Leuconostoc* spp. are intrinsically resistant to __________.
Vancomycin
400
**TRUE OR FALSE.**
*Lactococcus* spp. are found on plant surfaces and vegetables, and in milk products.
False (*Leuconostoc* spp.)
401
Infections associated with *Leuconostoc* spp.
- Meningitis
- Bacteremia
- UTI
- Pulmonary infections
402
They are facultative anaerobes, gram (+) cocci
*Pediococcus* spp.
403
*Pediococcus* spp. grow at _______ C.
45 C
404
*Pediococcus* spp. are intrinsically resistant to ________.
Vancomycin
405
*Pediococcus* spp. are involved with __________.
Gastrointestinal abnormalities
406
# Bile Esculin Hydrolysis Result
*Leuconostoc* spp.
+
407
# Bile Esculin Hydrolysis Result
*Pediococcus* spp.
+
408
# LAP
*Leuconostoc* spp.
-
409
# LAP
*Pediococcus* spp.
+
410
# PYR
*Leuconostoc* spp.
-
411
# PYR
*Pediococcus* spp.
-
412
# 6.5% NaCl
*Leuconostoc* spp.
+
413
# 6.5% NaCl
*Pediococcus* spp.
+
414
# Gas (+) from Glucose Fermentation
*Leuconostoc* spp.
+
415
# Gas (+) from Glucose Fermentation
*Pediococcus* spp.
-
416
*Globicatella sanguis* hemolytic pattern
α-hemolytic
417
*Globicatella sanguinis* is PYR _______.
(+)
418
*Globicatella sanguinis* is LAP _______.
(-)
419
*Globicatella sanguis* is susceptible to ______.
Vancomycin
420
*Globicatella sanguis* is _______ to vancomycin.
Susceptible
421
*Helcococcus kunzii* is involved in _______ infections.
wound
422
_______ is misidentified as *A. viridans*.
*Helcococcus kunzii*
423
*Helcococcus kunzii* is misidentified as _______.
*A. viridans*
424
It causes otitis media in children.
*Alloiococcus otitidis*
425
*Alloiococcus otitidis* hemolytic pattern
non-hemolytic or α-hemolytic
426
*Alloiococcus otitidis* is PYR _________.
(+)
427
*Alloiococcus otitidis* is LAP _________.
(+)
427
______ grow slowly in 6.5% NaCl
*Alloiococcus otitidis*
428
*Enterococcus* spp. can tolerate _______ C
45
