WEEK 5: STREPTOCOCCI Flashcards

1
Q
  • Complete lysis of RBC’s around colony
  • **Clear area **around colony
A

BETA

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1
Q
  • Partial lysis of RBC’s around colony
  • Greenish discoloration of area around colony
A

ALPHA

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2
Q
  • No lysis of RBC’s around colony
  • No change in agar
A

GAMMA

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3
Q

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

A

ALPHA PRIME

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4
Q

i. Gram (+) cocci arranged in pairs or chains
ii. Facultative anaerobe but some are aerotolerant anaerobes
iii. Some are capnophilic
iv. Non-motile; (-) catalase, oxidase and gas production

A

Streptococci

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5
Q

Negative in Catalase test

A

Streptococci

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6
Q

test the ability of the organism to
breakdown of H2O2 into oxygen and water

A

Catalase Test

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7
Q

organisms that are positive in catalase test

A

Staphylococcus & Micrococcus

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8
Q

in catalase test, copious bubble form if the organism is?

A

Positive

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9
Q

No or few bubbles

A

Negative in Catalase test

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10
Q

What is being extracted in Lancefield Classification?

A

C Carbohydrate

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11
Q

Group A strep

A

S. pyogenes

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12
Q

Group B strep

A

S. agalactiae

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13
Q

Group C strep

A

S. dysgalactiae, S. equisimilis

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14
Q

Group D Non enterococcus

A

S. bovis group / S. gallolyticus

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15
Q

Group D Enterococcus

A

E. faecalis, E. faecium

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16
Q

Pneumococcus

A

S. pneumoniae

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17
Q

Which of the species under Streptococci group does not have a Lancefield Classification?

A

S. pneumoniae

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18
Q

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

A

S. anginosus, mutans, mitis

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19
Q

What is the hemolytic pattern of Group A strep? (S. pyogenes)

A

β (beta)

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20
Q

What is the hemolytic pattern of Group B strep? (S. agalactiae)

A

β (beta)

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21
Q

What is the hemolytic pattern of Group C strep? (S. dysaglactiae, S. equisimilis)

A

β (beta)

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22
Q

What is the hemolytic pattern of Group D Non enterococcus? (S. bovis group)

A

α,γ (alpha, gamma)

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23
Q

What is the hemolytic pattern of Group D Enterococcus? (E. faecalis, E. faecium)

A

α,β,γ (alpha, beta, gamma)

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24
What is the hemolytic pattern of Pneumococcus? (S. pneumoniae)
α (alpha)
25
What is the hemolytic pattern of Viridans strep? (Anginosus, mutans, mitis)
β, α, γ (beta, alpha, gamma)
26
- Grows at 37C - Mostly has β-hemolytic reactions - S. pyogenes, group C and G streptococci
Pyogenic group
27
- Grows at 37C and 45C - indigenous microbiota in the URT - S. mutans, S. mitis and S. salivarius
Viridans group
28
- Grows at 10C and 37C - found on dairy products - S. lactis
Lactic group
29
- Grows at 10C, 37C and 45C - part of the indigenous microbiota of the human intestine - E. faecalis
Enterococcus group
30
 Attached to the peptidoglycan  Antiphagocytic  For adherence to mucosal cells  Primary
M Protein
31
Mediates adherence to host epithelial cells
Protein F (Fibronectin-binding protein)
32
Mediates attachment to mucosal cells
Lipoteichoic acid
33
 Prevents opsonized phagocytosis  Mask bacterial antigens
Hyaluronic acid Capsule
33
 Group of four enzymes with nuclease activity  Degrade host DNA (DNase) and RNA
Streptodornase (DNases)
34
 Subsurface hemolysin (Oxygen labile)  Toxic to RBC’s, WBC’s and platelets  Induces antibody response - anti-streptolysin O
Streptolysin O
34
 Surface hemolysin (Oxygen stable)  Lysis WBC’s and is non immunogenic
Streptolysin S
34
Causes lysis of fibrin clots
Streptokinase (Fibrinolysin)
34
Solubilizes hyaluronic acid in connective tissues
Hyaluronidase
35
Exotoxins are associated with Scarlet Fever and Streptococcal Toxic shock-like syndrome
Streptococcal pyrogenic exotoxins A, B, C (SPE)
35
Spreading-factor enzyme
Hyaluronidase
36
 Suppurative fasciitis, hospital gangrene, necrotizing erysipelas  Invasive infection characterized by inflammation and necrosis of skin, subcutaneous fat and fascia
Necrotizing Fasciitis
37
superficial and localized
Impetigo
37
involves deeper tissue invasion
Cellulitis
38
acute spreading erythematous lesion
Erysipelas
39
Two types of Post-Streptococcal Sequelae
Rheumatic Heart Fever and Acute glomerulonephrits (AGN)
39
diffuse red rashes (chest to extremities)
Scarlet Fever
40
Condition wherein organ system shuts down leading to death
Streptococcal Toxic Shock Syndrome
40
what organism causes these clinical Infections? 1. Bacterial Pharyngitis and Tonsilitis 2. Pyodermal Infections 3. Necrotizing Fascitis 4. Streptococcal Toxic Shock Syndrome 5. Post-Streptococcal Sequelae
Streptococcus pyogenes
41
i. Virulence Factor  Capsular material interferes with phagocytic activity and complement cascade activation  normal flora usually found in vagina or GIT
Streptococcus agalactiae
41
Deposition of ab-ag complexes in glomeruli
Acute glomerulonephrits (AGN)
41
 Cross reactive antibodies against streptococcal antigens and human heart tissue  Fever and inflammation of heart and blood vessels
Rheumatic Heart Fever
41
 Transmission occurs vertically or during delivery (associated with obstetric complications)  In newborn it causes pneumonia, sepsis and meningitis  In adult, causes endometritis and wound infections
Streptococcus agalactiae
42
 Small-colony forming β-hemolytic isolates  Resembles S. pyogenes infections
S. anginosus group
42
 Large-colony forming β-hemolytic isolates  Resembles S. pyogenes infections
S. dysgalactiae subsp. equisimilis
42
i. Virulence Factor  Capsular polysaccharide  Antigenic polysaccharide resulting to 80-100 serogroup  Antiphagocytic
Streptococcus pneumoniae
43
ii. Associated Disease 1. Pneumonia (lobar and community acquired) – leads to edema of lungs and drowning in own fluids 2. Sinusitis, Otitis Media, Bacteremia, Meningitis
Streptococcus pneumoniae
43
* Gram-positive diplococci (lancet or bullet shape) * Capnophilic
Streptococcus pneumoniae
43
Products produced by S. agalactiae
- Hemolysin - DNases - Hyaluronidase - Protease - CAMP factor (Christie-Atkins-Munch-Peterson)
43
leads to edema of lungs and drowning in own fluids
Pneumonia
44
 Polysaccharide capsule, extracellular dextran and cell surface-associated proteins (adhesins)  Enhance attachment to host cell surfaces
Viridans Streptococci
44
1. Subacute bacterial endocarditis from patients with damaged heart valves. 2. Bacteremia, septicemia and cavities
Viridans Streptococci
44
In Neufeld- Quellung reaction, it's positive if the capsule ______.
Swell
45
What are the five groups under Viridans Streptococci
- S. mitis - S. mutans - S. salivarius - S. bovis - S. anginosus
45
i. Virulence Factor  Extracellular surface protein, serine protease and gelatinase for adhesion  Cytolysins and resistance to antimicrobial agents
Enterococcus
46
ii. Associated Disease 1. Nosocomial infection 2. UTI (catheterization), bacteremia (hemodialysis, surgery), endocarditis (prosthetic heart valves)
Enterococcus
47
Disease Associations: Pyogenic infections, endocarditis, dental caries
S. anginosus, S. mutans, S. mitis
47
Disease Associations: Pharyngitis, Pyodermal infections, NF, STSS, PSS (Rheumatic fever, AGN)
S. pyogenes
47
Disease Associations: Neonatal sepsis (pneumonia, meningitis) puerperal fever, pyogenic infections
S. agalactiae
47
Disease Associations: Pharyngitis, impetigo, pyogenic infections
S. dysgalactiae, S. equi
47
Disease Associations: UTI, endocarditis, pyogenic infections, bacteremia
E. faecalis, E. faecium
47
Selective medium for Beta-hemolytic Streptococci
Blood Agar with trimethoprim and sulfamethoxazole
47
Nonhemolytic organism with lancefield group N, often found in dairy products
Lactococci
48
Disease Associations: Pneumonia, meningitis, pyogenic infections
S. pneumoniae
48
Disease Associations: UTI, endocarditis, pyogenic infections,
S. bovis group
49
Small, round, glistening, dome-shaped, mucoid colonies. Colonies tend umbilicated as they age; α hemolytic
Pneumococci
49
Minute to small, gray, domed, smooth; α, β,γ hemolytic
Viridans
49
Grayish white (pinpoint), transparent to translucent, matte or glossy; large zone of β hemolysis
Group A (S. pyogenes)
49
Small, cream or white, smooth; α, β,γ hemolytic
Group D
49
Larger that Group A streptococci; translucent to opaque; flat glossy; narrow zone of β hemolysis
Group B (S. agalactiae)
50
Test for susceptibility to 0.04U Bacitracin
Bacitracin Susceptibility test (Taxo A)
50
Produce pus, mostly β-hemolytic
Pyogenic
50
Normal biota of the human intestine
Enterococci
50
Found as normal biota in the upper respiratory tract of humans
Viridans
51
Enriched isolation of Streptococci
Blood Agar
51
In Taxo A test, what is the indication that the organism tested positive?
any zone of inhibition
51
Causes pseudo catalase
E. faecalis and E. faecium
51
What group tests positive in Taxo A test?
Group A
52
Meaning of SXT?
Sulfamethoxazole-Trimethoprim
53
Taxo A resistant and SXT resistant
Group B
54
Taxo A susceptible and SXT Resistant
Group A
54
Test for the synergistic hemolysis between group B Streptococcus and β-hemolytic S. aureus.
CAMP Reaction
54
What organisms test positive in SXT?
Group C and G
55
What tests positive in CAMP reaction?
Group B
55
In this test, it's positive if ther is an enhanced hemolysis in arrowhead pattern and no Zone of enhanced hemolysis in arrowhead pattern if it's negative.
CAMP Reaction
55
Taxo A resistant and SXT susceptible
Group C, F, G
56
is a diffusible, protein like compound produced by Group B
CAMP factor
56
* Test for the ability to hydrolyze hippuric acid (Sodium hippurate ) to benzoic acid and glycine * Glycine can be detected with Ninhydrin reagent
Hippurate Hydrolysis
56
if positive in this test, after addition of color developer, it will turn into pink to cherry-red color within 5 minutes and no color change or an orange color if negative.
PYR Test
57
In Hippurate Hydrolysis, what is the indication that it's positive and what is the organism that tested positive?
Deep blue (purple) color, S. agalactiae (group B)
57
Organisms that are positive in PYR test
Group A, Enterococcus
58
Negative: No color change or development of slight yellow color (Aerococcus and Leuconostoc)
LAP Test
58
Detects for the ability of the bacteria to grow in the presence of 40% bile and hydrolyze esculin
Bile Esculin Hydrolysis
58
Test for the ability of the organism to hydrolyze the substrate L-pyrrolidonyl-β-naphthylamide
PYR Test
58
Indication that the organism is positive for Salt Tolerance Test
Visible turbidity in broth and color change
58
Used to differentiate Streptococcus pneumoniae from other α-hemolytic streptococci * Ethylhydrocupreine hydrochloride
Optochin (Taxo P) Susceptibility
58
What is the indication if the organism is positive for Bile Esculin Hydrolysis test?
Blackening of the agar
58
In LAP test, the result is positive if after adding cinnamaldehyde, there is a development of what color within 1 minute?
Red
58
Test for the solubility to bile salt (2% sodium desoxycholate or sodium taurocholate)
Bile Solubility Test
58
Is it negative or positive if in Bile Solubility test, the colony disintegrated?
Positive
58
Identification of α Hemolytic Streptococci Optochin: R Bile Esculin: + 6.5% Broth: - PYR: -
Group D Non-Enterococcus
59
Identification of α Hemolytic Streptococci Optochin: R Bile Esculin: - 6.5% Broth: - PYR: -
S. viridans
59
Detects for the ability of the bacteria to hydrolyze Leucine-β-naphthylamide by enzyme leucine aminopeptidase to β-naphthylamide
LAP Test
59
Identification of α Hemolytic Streptococci Optochin: S Bile Esculin: - 6.5% Broth: - PYR: -
S. pneumoniae
59
Identification of β Hemolytic Streptococci Bacitracin: S SXT: R CAMP: - Bile Esculin: - 6.5% NaCl: - PYR: +
Group A
59
Test the ability of the organism to grow in 6.5% NaCl
Salt Tolerance Test (6.5% NaCl)
60
Identification of β Hemolytic Streptococci Bacitracin: R SXT: S CAMP: - Bile Esculin: - 6.5% NaCl: - PYR: -
Group C,F,G, Viridans
60
Identification of β Hemolytic Streptococci Bacitracin: R SXT: R CAMP: + Bile Esculin: - 6.5% NaCl: - PYR: -
Group B
60
Identification of α Hemolytic Streptococci Optochin: R Bile Esculin: + 6.5% Broth: + PYR: +
Group D Enterococcus
60
Identification of β Hemolytic Streptococci Bacitracin: R SXT: R CAMP: - Bile Esculin: + 6.5% NaCl: - PYR: -
Group D Streptococcus
61
Identification of β Hemolytic Streptococci Bacitracin: R SXT: R CAMP: - Bile Esculin: + 6.5% NaCl: + PYR: +
D Enterococcus
62
Identification of γ Hemolytic Streptococci Bile Esculin: - 6.5% Salt Broth: - PYR: -
Viridans
63
Identification of γ Hemolytic Streptococci Bile Esculin: + 6.5% Salt Broth: + PYR: +
Group D Enterococcus
64
Identification of γ Hemolytic Streptococci Bile Esculin: + 6.5% Salt Broth: - PYR: -
Group D Non-enterococcus