Strep, Enterococ

Front 1

gram stain of strep/entero generi (two genera)

Back 1

NOT nice and round;
broth cultures give chains in gram stain.

a little messier than staphs

Front 2

What are the growth characteristics of Streptococcus and Enterococcus?

Back 2

Fastidious, facultative anaerobes (like Staphs, only fastidious)

Grows on BA in increased CO2

Front 3

What are the characteristic antigens on Streptococcus species?

Back 3

C carbohydrates - use lancefield typing

M protein - protects from phagocytosis

Front 4

3 Ways Streps and Enterococcus are differentiated:

Back 4

1. Hemolysis

2. Presumptive tests - biochemical

3. Definitive tests - imunological

Front 5

gamma isolates of strep/enter

Back 5

S. viridans
Enterococcus

Strep group D Non-Enterococcus

Front 6

two tests on gamma isolates

Back 6

-bile esculin (neg shows saprophyticus)

-6.5% NaCl (pos shows enterococ, neg shows strep D non-enter)

Front 7

What test is an alternate to 6.5% NaCl?

Back 7

PYR HYDROLYSIS

Front 8

Where is S. viridans normal flora?

Back 8

mouth/vagina

Front 9

What causes Bacterial Endocarditis?
-Acute
-Subacute

Back 9

Subacute caused by:
-Staphylococcus epidermidis
-Streptococcus viridans

Acute caused by:
Staphylococcus aureus

Front 10

What is used to treat Streptococcus viridans infections?

Back 10

penicillin

Front 11

what is intrinsiclaly resistant to penicillin

Back 11

enterococcus; not due to beta lactamase, it just is

Front 12

4 diseases caused by enterococci

Back 12

bacteremia
endocarditis
wound infections
UTI

Front 13

treat with __ if an enterococcus is

-blactamase neg
-b-lactamase pos

Back 13

neg = ampicillin

pos = vancomycin

Front 14

VRE


(2 genes that encode it)

Back 14

vancomycin resistant enteroc

VanA

VanB

Front 15

how do Van A and Van B mediate resistnc?

Back 15

A - plasmid-mediated; worse cuz it can jump to other bugs

B - chromosomally-mediated; stays within the cell line.

Front 16

know about Strep D non-enteroc:

Back 16

rare in humans, can cause endocarditis, treat w/ penicillin

Front 17

You have an alpha-hemolytic gram positive cocci; what tests do you inoculate?

Back 17

1. bile esculin
2. salt


3. optichin

Front 18

principle of optichin test

Back 18

disc contains ethylhydrocupreine HCl; if the bug is susceptible, zone of more or equal to 14 mm will show. resistant if less. (S. pneumonia and S. viridans are resistant)

Front 19

alpha hemolytic, bile esculin negative, optichin positive/negative: que es?

Back 19

s. pneumoniae is pos
S. viridans is neg

Front 20

what tests is alternate to optichin?

Back 20

bile solubility

Front 21

micro/macro morpho of strep pneumoniae

Back 21

1. lancet shaped GPDC

2. if autolyzed, flat, mucoidy, checkers

MAKES A CAPSULE

Front 22

What makes Strep pneumoniae pathogenic?

Back 22

-capsule
-M-protein which makes it resist phagocytosis

Front 23

lobar pneumonia pathology: what happens?

Back 23

bug enters, inflammatory response is WBC, fluid and RBC; can't breathe across alveoli - lobar consolidation

Front 24

high fever; shaking chills; sharp pleural pain; rusty sputum; what is it?

Back 24

lobar pneumoniae caused by strep pneum.

Front 25

why does s. pneumon cause red sputum?

Back 25

rbc's in it

Front 26

3 diseases caused by strep pneumoniae:

Back 26

lobar pneumonia
meningitis
otitis media

Front 27

to treat s. pneumonia:

Back 27

=penicillin or ciprofloxacin
vancomycin if necess

Front 28

normal flora site of strep pneumoniae

Back 28

oral cavity, small numbers

Front 29

enterococcus normal flora site

Back 29

intestine

Front 30

how do you prevent streptococcal pneumoniae?

Back 30

via vaccine;

pneumovax for over 2 years old,
PREVNAR FOR under 2

Front 31

What test identifies S. viridans?

2 species and commonly caused disease (Kristine)

Back 31

Optichin neg (diff from s. pneumoniae)

S. MUTANS AND S. SANGUIR ASSOC. W/ DENTAL CARIES

Front 32

tests done on beta strep

Back 32

bile esculin
bacitracin or pyr
CAMP or hipp hydrolysis

Front 33

bile esculin of beta strep diffs

Back 33

positive is rare - nothing
negative do tests on

Front 34

test to do on bile esc negative organisms:

Back 34

CAMP - identifies beta strep B

Bacitracin - identifies beta strep A

Front 35

does beta strep A resist or suscept to bacitracin?

Back 35

it's positive, so it resists it

Front 36

principle of CAMP test

Back 36

beta strep B produce compound that in conjunction with S. Aureus' hemolysin will cause complete hemolysis and an arrow shape

Front 37

alternate test for CAMP

Back 37

hippurate

Front 38

Beta strep Antigen aka
how to test for it

Back 38

C- carbohydrate

flourescent antibody or latex agglutination

Front 39

strep group A aka and its normal flora site:

Back 39

aka strep pyogenes; normally in oral cavity in 15% of population

Front 40

s. pyogenes produces what 6 pathogenic products:

Back 40

streptokinase - digest fibrin, spread
streptodornase - break down dna
hylauronidase - break down connect tiss
erythrogenic toxin - red scarlet fever
hemolysins - break down RBC
M protein - resist phagocytosis

Front 41

two hemolysins produced by s. pyogenes, strep group A:

Back 41

Streptolysin S, O
ASO TEST tests for O by antibody action

O is O2 labile

S is O2 stabile

Front 42

diseases caused by strep pyogenes (A)

Back 42

strep throat
scarlet fever
erysipelas and cellulitis
impetigo
wound infections
pyogenic STrep A infections
post-strep diseases

Front 43

what are pyogenic strep A infections?

Back 43

necrotizing fasciitis
toxic shoc-LIKE SYNDROME

Front 44

what are post streptococcal diseases?

Back 44

acute glomerulonephritis
rheumatic fever

Front 45

how do you treat strep pyogenes (group a)

Back 45

with peniccilin

Front 46

strep group B is aka

normal floral site?

Back 46

strep agalactiae

normally in oral cavity in low numbers, maybe vagina but abnormal and must protect fetus before delivery

Front 47

what type of infection does s. agalactiae cause

Back 47

neonatal infections:
-meningitis/sepsis
-respiratory distress syndrome
-osteomyelitis

Front 48

direct specimen test for S. agalactiae

Back 48

group b Antigen test

Front 49

how do you treat group B strep? (s. agalactiae)

Back 49

with penicillin

Front 50

beta hemolytic strep other than A B or D

Back 50

normal flora, COULD cause phjaryngitis (streplike) but normal usually, susceptible to peniccilin

Front 51

what are 5 OTHER cat neg GPC?

Back 51

=leukonostoc - rare, unusual to cause infection, only in compromised; INTRINSIC RESISTANCE TO VANCOMYCIN!

-aerococcus
-gemella
-pediococcus
-lactococcus

Front 52

What are all streptococcus organisms treated with, and what is NOT treated with it?

Back 52

Enterococcus is intrinsically resistant, but everything else is susceptible to penicillin.