Streptococcus and Related Genera Objectives Flashcards

1
Q

Obj.1 Identify the major macroscopic, microscopic and structural characteristics of the Streptococcaceae.

A

*Gram positive cocci
*Usually arranged in pairs or chains (divide
in one plane)
*Catalase negative
*Aerobic or facultative anaerobes

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2
Q

Obj.2 **Differentiate using colonial, microscopic or biochemical properties between the Staphylococci and Streptococci.

**quiz question

A

Staphylococci:
*Colonies are more opaque, and
white/creamy/yellow
*Catalase positive
*Growth occurs in 6.5% NaCl solution
*PYR test: S. aureus negative, other
species (SI, SL, SS) are positive

Streptococci:
*Colonies are more translucent and gray
*Catalase negative
*Growth occurs in 6.5% NaCl solution
*PYR test: Group A Strep is positive

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3
Q

Obj.3 Describe the difference between the types of hemolysis: alpha, beta and gamma.

A

Alpha: partial lysis of RBCs around colony;
greenish color around colony
Beta: complete lysis of RBCs around
colony; clear area around colony
Gamma: no lysis of RBCs around colony

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4
Q

Obj.4 Correlate alpha and beta hemolysis with possible Streptococcus species (or groups) and Enterococcus.

A

Alpha (or gamma) hemolytic
*Group D Strep
*Streptococcus pneumoniae
*Enterococcus spp.
*Alpha Strep (not Group D)
Beta hemolytic
*Group A: S. pyogenes
*Group B: S. agalactiae
*Group D (rarely beta hemolytic)
*Enterococcus spp. (rarely beta hemolytic)
*Beta Strep (not Group A, B, D)

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5
Q

Obj.5 Differentiate between Streptolysin O and Streptolysin S, including the significance of culture setup and/or incubation.

A

Group A: S. pyogenes, can produce two (2) enzymes, Streptolysin O or Streptolysin S – Streptolysin O is oxygen labile (destroyed by the presence of oxygen) and MUST be incubated in anaerobic conditions to demonstrate the beta hemolysis

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6
Q

Obj. 6 Recognize the principle of Lancefield grouping.

A

“C substance” that was extracted from cell wall and was reacted with a specific antibody – these antigens are denoted by letters and are the basis for strep grouping systems

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7
Q

Obj.7 Describe the principles and procedures of each test used in the identification of Streptococcus (groups or species) or Enterococcus.

CATALASE

A

ALL SPECIES
Catalase: detecting the presence of this
enzyme (prevents against oxidative damage)
-Reagent: hydrogen peroxide
*Strep – negative
*Enterococci – mainly negative, some are
weakly positive

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8
Q

Obj.7 Describe the principles and procedures of each test used in the identification of Streptococcus (groups or species) or Enterococcus.

LAP Test

A

ALL SPECIES
LAP Test:
-Reagent: inoculate a Disk onto a colony and place a drop of colored reagent onto the Disk and observe for a color change (red = positive)
* Strep and Enterococci – positive

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9
Q

Obj.7 Describe the principles and procedures of each test used in the identification of Streptococcus (groups or species) or Enterococcus.

Esculin hydrolysis (Bile Esculin Agar)

A

ALL SPECIES
Esculin hydrolysis (Bile Esculin Agar): selective due to the presence of bile, differential based on the ability to hydrolyze esculin
-Reagent: streaking of the Bile Esculin Agar; incubate and observe for the black precipitate
*Group D Strep and Enterococci – positive

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10
Q

Obj.7 Describe the principles and procedures of each test used in the identification of Streptococcus (groups or species) or Enterococcus.

6.5% NaCl

A

ALL SPECIES
6.5% NaCl
-Reagent: inoculate organism into NaCl solution; incubate and observe for growth (turbidity and color change)
*Enterococci – positive
*Group B strep – variable
*Group D strep – negative

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11
Q

Obj.7 Describe the principles and procedures of each test used in the identification of Streptococcus (groups or species) or Enterococcus.

PYR Test

A

ALL SPECIES
PYR Test: detecting the hydrolysis of PYR
-Reagent: inoculate a Disk onto a colony and place a drop of colored reagent onto the Disk and observe for a color change (red = positive)
*Group A strep and Enterococci – positive

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12
Q

Obj.7 Describe the principles and procedures of each test used in the identification of Streptococcus (groups or species) or Enterococcus.

Optochin Susceptibility Test

A

ALPHA (OR GAMMA) HEMOLYTIC
Optochin Susceptibility Test
-Reagent: create a bacterial lawn, place disk in the middle; incubate and observe for susceptibility/resistance
*S. pneumoniae = Optochin susceptible

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13
Q

Obj.7 Describe the principles and procedures of each test used in the identification of Streptococcus (groups or species) or Enterococcus.

Bile Solubility Test

A

ALPHA (OR GAMMA) HEMOLYTIC
Bile Solubility Test: detecting the presence of lysing by the bile salts
-Reagent: tube method - create a turbid suspension, add bile salt, and observe for clearing/turbidity (clearing = positive)
plate method – a drop of bile salt placed onto colony; observe for flattening/disappearance of colony (+ positive)
*S. pneumoniae – positive

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14
Q

Obj.7 Describe the principles and procedures of each test used in the identification of Streptococcus (groups or species) or Enterococcus.

Quellung Test

A

ALPHA (OR GAMMA) HEMOLYTIC
Quellung Test
-Reagent: add a known antibody that will
react with the capsule forming a precipitate (swelling or clearing around organism = positive)
*S. pneumoniae – positive

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15
Q

Obj.7 Describe the principles and procedures of each test used in the identification of Streptococcus (groups or species) or Enterococcus.

Bacitracin Test

A

BETA HEMOLYTIC
Bacitracin Test
-Reagent: create a bacterial lawn, place disk in the middle; incubate and observe for susceptibility/resistance
*Beta Strep (Group A) = susceptible

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16
Q

Obj.7 Describe the principles and procedures of each test used in the identification of Streptococcus (groups or species) or Enterococcus.

CAMP Test

A

BETA HEMOLYTIC
CAMP Test: CAMP factor, of Strep, enhances beta lysin when in contact w/ S. aureus
-Reagent: streak S. aureus in the center of plate; stagger controls and unknowns on each side (arrowhead of hemolysis = positive)
*Beta Strep (Group B) – positive

+ control: Beta Strep (Group B)
- control: non-group B beta hemolytic strep

17
Q

Obj.7 Describe the principles and procedures of each test used in the identification of Streptococcus (groups or species) or Enterococcus.

Sodium Hippurate Hydrolysis (NaHippurate)

A

BETA HEMOLYTIC
Sodium Hippurate Hydrolysis: detection of hippuric acid hydrolyzed
-Reagent: details not required for examination (purple = positive)
*Beta Strep (Group B) – positive

18
Q

Obj.8**List the tests which are used for identification of Streptococci (include whether the tests are used for all Streptococci, alpha Streptococci, or beta Streptococci).

**quiz question

A

ALL Streptococci
*Catalase
*LAP Test
*Esculin hydrolysis (Bile Esculin Agar)
*6.5% NaCl
*PYR
Alpha Steptococci
*Optochin Susceptibility
*Bile Solubility Test
*Quellung Test
Beta Steptococci
*Bacitracin Test
*CAMP Test
*Sodium Hippurate Hydrolysis

19
Q

Obj.11 Recognize which of the identification tests are rapid vs. overnight tests.

A

Rapid
*Catalase
*LAP Test
*PYR
*Bile Solubility Test
*Quellung Test
Overnight
*Esculin hydrolysis (Bile Esculin Agar)
*6.5% NaCl
*Optochin Susceptibility
*Bacitracin Test
*CAMP Test
*Sodium Hippurate Hydrolysis

20
Q

Obj.12 **Propose alternative biochemical tests which could be used for organism identification if a biochemical test is unavailable for use.

**quiz question

A
  1. Antigen testing (direct/indirect)
  2. Fluorescent AB (esp. Group A)
  3. Kit systems
21
Q

Obj.14 Define “pyogenic” and list the streptococcal groups that more commonly cause pyogenic infections.

A

“Pus forming”
1. S. pyogenes (Group A)
2. S. agalactiae (Group B)
3. S. dysgalactiae (Groups C,G)

22
Q

Obj.15 Discuss the symptoms, pathogenicity and complications of post streptococcal diseases that occur with Group A Strep infections.

A

Damage resulting from Ag/Ab complexes – NOT an infection
1. Acute Glomerulonephritis
*Ag/Ab complexes causes inflammation of glomeruli
2. Acute Rheumatic Fever
*Fever, inflammation of heart, joints, blood vessels and subcutaneous tissues
*Results in damage to heart valves

23
Q

Obj.16 Recognize the major virulence factor of Group A Streptococci.

A

M protein (only Group A)

24
Q

Obj.17 Explain the actions of various bacterial metabolites which are responsible for the virulence of Group A Streptococci (erythrogenic toxin causes scarlet fever rash, etc.).

A
  1. Erythrogenic toxin causes scarlet fever rash
  2. Streptokinase/fibrolysin and hyaluronidase causes spreading of the infection
  3. Other exotoxins that cause fever, shock, tissue damage, etc.
25
Q

Obj.18 Recognize the symptoms of Scarlet fever.

A

Can result from strep throat – associated with the erythrogenic toxin – rash that begins on chest/truck and spreads, strawberry tongue

26
Q

Obj.19 Discuss the various methods for performing “Strep screens” and the rationale for these methods.

A
  1. Throat cultures
    *ONLY looking for Group A Strep
  2. SBA incubated anaerobically
    *To detect strains that are producing ONLY Steptolysin O
  3. SXT (trimethoprim-sulfa) plate
    *Inhibits normal flora, Group A will grow
27
Q

Obj. 20 Compare and contrast Strep cultures with rapid Strep screens (ease of use, final report time, sensitivity, specificity, etc.)

A

*Throat swab
*Direct Ag detection of Group A Strep
*TAT is minutes relative to 24-48 hrs. for culture results
*High specificity, lower sensitivity – conclusive for positive results, MUST reflex to culture if negative

28
Q

Obj. 21 Recognize that Group A Strep infections are universally susceptible to…

A

Penicillin

29
Q

Obj. 22 Discuss the rationale for screening pregnant women for Group B Streptococcus and the recommendations for screening, including when to screen and recommended broth for culture.

A

Because some women may have Group B Strep colonized that can be transmitted to the newborn upon birth leading to meningitis/septicemia – ALL pregnant women must be screen at 35-37 weeks

LIM broth or “carrot” broth

30
Q

Obj. 23 Identify patient populations at risk for infections with Group B Streptococcus.

A

Newborns, post-partum women, females

31
Q

Obj. 25 List the species of Streptococcus which is/are capnophilic.

A

S. pneumoniae

32
Q

Obj. 26 Recognize the two groups of Streptococci that make up “viridans” Streptococci.

A

Alpha or Gamma hemolytic

33
Q

Obj. 27 List the areas of the body where “viridans” Streptococci are found as normal flora.

A

Oral, GI, and skin flora

34
Q

Obj. 28 Recognize the Streptococcal group (and species name) that is frequently isolated from the blood of patients with colon cancer.

A

Streptococcus bovis group (Group D)