(Lecture) Streptococcus and Enterococcus Flashcards

1
Q

Streptococcus and Enterococcus spp. belong to the family _____

A

Streptococcaceae

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2
Q

A _____ results differentiate Streptococci and Enterococci from Staphylococci.

A

Negative Catalase Test

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3
Q

Streptococcus and Enterococcus have poor growth on Nutrient Media such as _____

A

Trypticase Soy Agar

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4
Q

Lancefield Classification was developed by _____

A

Rebecca Lancefield

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5
Q

What is the Basis of Classification for Academic/Bergy:

A

Temperature

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6
Q

What is the Basis of Classification for Smith and Brown:

A

Hemolysis

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7
Q

What is the Basis of Classification for Lancefield:

A

Serological (C-Carb of the Cell Wall)

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8
Q

Members on the Academic/Bergy Classification:

A

Pyogenic
Viridance
Entero
Lactic

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9
Q

Members on the Smith and Brown Classification:

A

Alpha
Beta
Gamma

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10
Q

Members on the Lancefield Classification:

A

Groups A-G

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11
Q

Partialization of the RBCs results in a greenish discoloration of the area surrounding the colony and it is termed as the _____

A

Alpha-Hemolysis

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12
Q

Streptococci producing α-hemolysis are also known as _____

A

Viridans Streptococci

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13
Q

When lysis of the red blood cells in the agar surrounding the colony is complete, the resulting area is clear this is termed as the _____

A

Beta-hemolysis

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14
Q

When the red blood cells immediately surrounding the colony are unaffected the bacteria are described as the _____ also known as the _____

A

Non-hemolytic
Gamma Hemolytic

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15
Q

Color around the colonies of the Alpha-hemolysis:

A

Green

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16
Q

Color around the colonies of the Beta-hemolysis:

A

Clear

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17
Q

Color around the colonies of the Gamma Hemolysis:

A

reD

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18
Q

Member/s that can be found under Alpha-hemolysis:

A

S. pneumoniae

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19
Q

Member/s that can be found under Beta-hemolysis:

A

S. equisimilis
S. pyogenes
S. agalactiae
E. faealis

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20
Q

Member/s that can be found under Beta-hemolysis:

A

Some Viridans group

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21
Q

Member/s of the Group A Lancefield Classification:

A

S. pyogenes

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22
Q

Member/s of the Group B Lancefield Classification:

A

S. agalactiae

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23
Q

Member/s of the Group C Lancefield Classification:

A

S. equisimilis
S. equi
S. dysogalactiae
S. zoopidimidus

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24
Q

Member/s of the Group D Lancefield Classification:

A

A. Enterococci
- E. faecalis
- E. faecium
- E. avium
- E. durans

B. Non-Enterococci
- S. bovis
- S. equinus

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25
Q

Pyogenic group does not grow at _____ compared with the viridans group that can grow at that interest temperature.

A

45°C

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26
Q

Pyogenic and viridans group does not grow under _____ but grows best at _____

A

10°C
37°C

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27
Q

_____ group grows at all temperatures

A

Entero

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28
Q

Lactic group grows best at _____ and _____, but does not grow at _____

A

10°C
37°C
45°C

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29
Q

All of the streptococci grows best at optimum temperature of _____

A

37°C

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30
Q

The best defined virulence factor is Streptococcus pyogenes is the _____ encoded by the genes emm

A

M protein

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31
Q

The best defined virulence factor is streptococcus pyogenes is the M protein encoded by the _____

A

Genes emm

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32
Q

A hemolysin that is highly immunogenic; measured using ASO (antistreptolysin O) test and is oxygen labile

A

Streptolysin O

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33
Q

A hemolysin that is nonimmunogenic and have a stable oxygen

A

Streptolysin S

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34
Q

A toxin that causes Scarlet Fever

A

Streptococcal Pyrogenic Exotoxin

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35
Q

Streptococcal Pyrogenic Exotoxin is also called _____

A

Erythrogenic Toxin

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36
Q

A toxin that causes Acute Glomerulonephritis

A

Nephrogenic Toxin

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37
Q

Streptococcal Pyrogenic Exotoxin causes _____

A

Scarlet Fever

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38
Q

Nephrogenic Toxin causes _____

A

Acute Glomerulonephritis

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39
Q

The four immunologically distinct exotoxin types found in Streptococcus pyogenes are the:

A

SpeA
SpeB
SpeC
SpeF

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40
Q

Identify the Virulence Factor:

  • Spreading factors localized in the skin
  • An important Streptococcus factor which has a critical role in the pathogenesis of invasive Streptococcal diseases
A

Streptokinase

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41
Q

An enzyme that solubilizes the ground substance of mammalian connective tissue which is hyaluronic acid.

A

Hyalurodinase

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42
Q

Virulence Factor that acts as an adhesion molecule

A

Lipoteichoic Acid and Protein F

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43
Q

Additional molecules that mediate attachment to host epithelial cells

A

Lipoteichoic Acid and Protein F

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44
Q

Identify the Virulence Factor bases on the characteristics given:

  • Produced by S. agalactiae
  • Heat stable protein
  • Enhances the beta-hemolysis of S. aureus
A

CAMP Factor

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45
Q

Gram Stain Morphology of Streptococcus spp.

A

Gram-positive cocci in pairs or chains

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46
Q

Cultural Characteristics of Streptococcus spp.

A

Pinpoint Colonies

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47
Q

Identify the Specie based on its Cultural Characteristics:

Small, transparent and smooth; beta-hemolytic; when grows in sheep’s blood agar

A

S. pyogenes

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48
Q

Identify the Specie based on its Cultural Characteristics:

Grayish white mucoid colonies; beta-hemolytic (small zone)

A

S. agalactiae

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49
Q

Test result of Streptococcus spp on Catalase Test:

A

Negative Catalase Test; no bubble formation

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50
Q

A test that differentiates Group A Streptococci from other Streptococci

A

Bacitracin Susceptibility Test (Taxo A)

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51
Q

What specie/s is positive for Bacitracin Susceptibility Test (Taxo A)?

A

Group A Strep

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52
Q

What specie/s is negative for Bacitracin Susceptibility Test (Taxo A)?

A

Other Beta-hemolytic Streptococci spp.

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53
Q

A test that is helpful in screening for Group A Streptococcus in throat cultures

A

Bacitracin Susceptibility Test (Taxo A)

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54
Q

This test is used to differentiate Streptococcus agalactiae from other Streptococcal species

A

CAMP Test

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55
Q

“CAMP” in CAMP Test means _____

A

Christie, Atkins, Munch, and Petersen

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56
Q

CAMP is an acronym for Christie, Atkins, and Munch-Petersen which was identified in _____

A

1944

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57
Q

Positive test result in CAMP Test shows:

A

Arrowhead hemolysis [Group B Strep] or bowtie appearance [S. agalactiae]

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58
Q

Positive color result in PYR Hydrolysis Test:

A

Cherry Red/Pink

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59
Q

Test for Group A and Group D Streptococci

A

PYR Hydrolysis Test

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60
Q

Substrate in PYR Hydrolysis Test:

A

L-pyrrolidonyl-beta-napthylamide

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61
Q

Reagent used in PYR Hydrolysis Test:

A

p-dimethyl-aminocinnamaldehyde

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62
Q

Enzyme in PYR Hydrolysis Test:

A

pyrroglutamylamino peptidase or pyrrolidomylaryl amidase

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63
Q

The only species of Streptococcus that is PYR positive.

A

Streptococcus pyogenes

64
Q

Medium for Hippurate Test:

A

Broth with hippurate

65
Q

Reagent indicator for Hippurate Test:

A

Ninhydrin

66
Q

Positive color on Hippurate Test:

A

Purple (S. agalactiae)

67
Q

A test that differentiate Group D from Beta-hemolytic.

A

Bile Esculin Test

68
Q

Enzyme in Bile Esculin Test

A

Esculinase

69
Q

Positive test result in Bile Esculin Test

A

Blackening of medium [Group D]

70
Q

Further test from Bile Esculin Test

A

Salt Tolerance Test (6.5% NaCl)

71
Q

A test that is used in the identification of enterococcal group D streptococcus on the basis of their salt tolerance.

A

Salt Tolerance Test (6.5% NaCl)

72
Q

Negative result in Salt Tolerance Test (6.5% NaCl)

A

Clear/Transparent [Non-enterococci]

73
Q

Positive result in Salt Tolerance Test (6.5% NaCl)

A

Turbid [Enterococci]

74
Q

Substrate in Leucine Aminopeptidase Test

A

Leucine-β-naphthylamide

75
Q

Reagent of Leucine Aminopeptidase Test

A

paradimethylaminocinnamaldehyde reagent

76
Q

Positive color of Leucine Aminopeptidase Test

A

Red color

77
Q

What specie/s is positive in Leucine Aminopeptidase Test?

A

Viridans Streptococci

78
Q

The substrate leucine-beta-naphthylamide is hydrolyzed to _____ after the addition of
paradimethylaminocinnamaldehyde reagent

A

β-naphthylamine

79
Q

The substrate leucine-beta-naphthylamide is hydrolyzed to β-naphthylamine after the addition of _____

A

paradimethylaminocinnamaldehyde reagent

80
Q

Test that is in conjunction with bacitracin is used for the presumptive identification of beta hemolytic streptococci on blood agar.

A

SXT or Sulfamethoxazole Susceptibility Test

81
Q

What specie/s is resistant on SXT or Sulfamethoxazole Susceptibility Test?

A

Group A & B Strep

82
Q

What specie/s is susceptible on SXT or Sulfamethoxazole Susceptibility Test?

A

Other Strep spp.

83
Q

A test that detects carbohydrate component of the cell wall of Streptococci.

A

Serological Tests

84
Q

Principle of Streptex Test

A

Antigen (from colonies) - Antibody (from Reagent) Reaction

85
Q

Positive result in Serological Test

A

Agglutination/clumping [Group A Strep]

86
Q

Negative result in Serological Test

A

No agglutination [S. agalactiae]

87
Q

A rapid latex test system for use in the qualitative detection and identification of the lancefield group of Streptococci

A

Serological Tests

88
Q

A clinical infection that is most often seen in children between 5 and 15 years of age

A

Strep Throat

89
Q

Strep Throat is most often seen in children between _____ and _____ of age

A

5
15

90
Q

Incubation period of Strep Throat

A

1-4 Days

91
Q

Strep Throat subsides within _____ to _____ days

A

1
5

92
Q

A localized skin disease, begins as small vesicles that progress to weeping lesions; inoculation of organisms through minor abrasions or insect bites

A

Impetigo

93
Q

Impetigo It is usually seen in children ages _____ and it affects exposed areas of the skin

A

2-5 years old

94
Q

A pyodermal infection that is followed by deeper invasion of streptococci; life-threatening; with bacteremia or sepsis

A

Cellulitis

95
Q

In patients with peripheral vascular disease or diabetes, cellulitis may lead to _____

A

Gangrene

96
Q

A rare infection of the skin and subcutaneous tissues observed frequently in elderly patients

A

Erysipelas

97
Q

Lesion characteristics of Erysipelas:

A

Acute spreading, intensely erythematous with plainly demarcated but irregular edge

98
Q

A pyodermal infection that is characterized by a diffuse red rash on upper chest and spreads to the trunk and extremities.

A

Scarlet Fever

99
Q

An invasive infection characterized by rapidly progressing inflammation and necrosis of the skin, subcutaneous fat, and fascia

A

Necrotizing Fasciitis

100
Q

Necrotizing Fasciitis’ other terms:

A

“Flesh-eating disease or syndrome”
“Suppurative fasciitis”
“Hospital gangrene”
“Necrotizing erysipelas”

101
Q

A condition in which the entire organ system collapses, leading to death. Portal of infection is unknown, although minor injuries or surgeries have been implicated. This condition is caused by a type of streptococcal pyrogenic exotoxin – SpeA

A

Streptococcal Toxic Shock Syndrome

102
Q
  • Follows after S. pyogenes pharyngitis
  • Characterized by fever and inflammation of the heart, joints, blood vessels and subcutaneous tissues
  • Most serious result: chronic, progressive damage to the heart valves
A

Rheumatic Fever

103
Q
  • Follows after cutaneous or pharyngeal infection
  • More common in children than in adults
A

Acute Glomerulonephritis

104
Q

Group A Streptococci are (susceptible or resistant) to penicillin.

A

Susceptible

105
Q

Group A Streptococci are susceptible to _____.

A

Penicillin

106
Q

If a patient is infected with Group A Streptococcal and is susceptible for penicillin, what drugs of choice can be used?

A

Erythromycin

107
Q

What Streptococcus specie is the significant cause of invasive disease in newborn

A

Streptococcus Agalactiae

108
Q

What are the two clinical syndromes that are associated with neonatal GBS disease:

A
  1. Early-onset infection (<7 days old)
  2. Late-onset infection (at least 7 days old to about 3 months old)
109
Q

Early onset infection gives what type of neonatal GBS disease/s?

A

Pneumonia and Sepsis

110
Q

Late-onset infection gives what type of neonatal GBS disease/s?

A

Meningitis and Sepsis

111
Q

Samples collected from pregnant women that will be screen for GBS should be inoculated into a selective broth _____ containing 10 microgram per ml of colistin and 15 microgram ml of nalidixic acid

A

Todd-Hewith Broth

112
Q

How many ml of colistin and nalidixic acid does a Todd-Hewith Broth have?

A

10 microgram per ml of colistin
15 microgram ml of nalidixic acid

113
Q

The drug of choice for treating GBS infection is _____

A

Penicillin

114
Q

Some clinicians recommend a combination of _____ and a _____ for treating GBS infection.

A

Ampicillin
Aminoglycoside

115
Q

Subdivisions of Group C and G Streptococci:

A
  1. Large-colony Forms
  2. Small-colony Forms
116
Q

Streptococcus pneumoniae is also known as _____ or _____

A

Pneumococcus or Diplococcus

117
Q

Streptococcus pneumoniae is a member of _____ group

A

S. mitis group

118
Q

Antigen present in the cell wall of Streptococcus pneumoniae

A

C substance

119
Q

A beta-globulin in human serum

A

C-reactive protein (CRP)

120
Q

Hemolysis pattern of Streptococcus pneumoniae:

A

Alpha-hemolytic

121
Q

Predisposing factors of Streptococcus pneumoniae:

A
  • Alcoholism
  • Anesthesia
  • Malnutrition
  • Viral infections of the upper respiratory tract
122
Q

The vaccine that has been successful in reducing the incidence and severity of pneumococcal disease

A

Heptavalent pneumococcal conjugate vaccine (PCV7)

123
Q

Gram Stain morphology of Streptococcus pneumoniae:

A
  • Gram-positive cocci in pairs (diplococci)
  • The ends of the cells are slightly pointed (oval or lancet shape)
124
Q

Appearance of Young Cultures of Streptococcus pneumoniae:

A

Round, glistening, wet, mucoid, dome-shaped appearance

125
Q

Appearance of Old Cultures of Streptococcus pneumoniae:

A

Coin with a raised rim appearance

126
Q

The more commonly used procedure in order to differentiate Streptococcus pneumoniae from the Viridans streptococci

A

Optochin susceptibility

127
Q

In between Pneumococci and Viridans Streptococci, who is susceptible and who is resistant in optochin test?

A

Suseptible: Pneumococci
Resistant: Viridans Streptococci

128
Q

A test that determines the lysis of streptococcus pneumoniae in the presence of the bile salts.

A

Bile Solubility Test

129
Q

Indicator in Inulin Fermentation:

A

Phenol Red

130
Q

In between Pneumococci and Viridans Streptococci, who is positive and negative in Inulin Fermentation Test?

A

Positive: Streptococcus pneumoniae
Negative: Viridans Group

131
Q

Color of a positive result Inulin Fermentation

A

Yellow

132
Q

Color of a negative result in Inulin Fermentation Test

A

Pink or Red

133
Q

The Capsular Swelling Reaction also known as the _____

A

Nueffeld Quellung Reaction

134
Q

Positive result in the Capsular Swelling Reaction or Neufeld Quellung Reaction:

A
  • Obvious capsule
  • S. pneumoniae
135
Q

Negative result in the Capsular Swelling Reaction or Neufeld Quellung Reaction:

A
  • No capsule
  • All other Alpha hemolytic Streptococci
136
Q

A German microbiologist who identified several flames of the bacterium streptococcus pneumoniae, one of which was virulent and caused death when injected into mice and another which was non-virulent and did not cause illness when injected into mice.

A

Fred Neufeld

137
Q

Positive result in the Mouse Virulence Test:

A

Death of Test Animal

138
Q

The test for the previous infection of Streptococcus pneumoniae and a positive result is induriation or wheale formation in the skin

A

Francis Skin Test

139
Q

Positive result in the Francis Skin Test:

A

Induration or Wheale formation

140
Q

Drug of choice for the treatment of Streptococcus pneumoniae:

A

Penicillin

141
Q

If a patient that is infected with Streptococcus pneumoniae is Penicillin resistant, what drug/s is used for treatment?

A

Erythromycin or Chloramphenicol

142
Q

“Viridans” means _____

A

“Green”

143
Q

Species under the S. mitis group:

A

S. mitis
S. Pneumoniae
S. sanguis
S. oralis

144
Q

Species under the S. mutans group:

A

S. mutans
S. sobrinus

145
Q

Species under the S. salivarus group:

A

S. salivarus
S. vestibularis

146
Q

Species under the S. bovis group:

A

S. equinus
S. gallolyticus
S. infantarius
S. alactolyticus

147
Q

Species under the S. anginosus group:

A

S. anginosus
S. constellatus
S. intermedius

148
Q

S. constellatus subsp. pharyngis produces what disease?

A

Pharyngitis

149
Q

Group D Streptococci is subdivided into two groups. What are the two groups?

A
  • Enterococci
  • Non-enterococci
150
Q

Tests that differentiate the two groups of Group D Streptococci:

A
  1. PYR Test
  2. 6.5% NaCl Test
151
Q

In between the two groups of Group D Streptococci, who is positive and negative in the PYR Test?

A

Positive: Enterococci
Negative: Non Enterococci (Group D Streptococci)

152
Q

In between the two groups of Group D Streptococci, who is positive and negative in the 6.5% NaCl Test?

A

Positive: Enterococci (growth)
Negative: Non-enterococci (no growth)

153
Q

In between the two groups of Group D Streptococci, who is resistant and susceptible in Penicillin Resistance Test?

A

Resistant: Enterococci
Susceptible: Group D Streptococci (Nonenterococci)

154
Q

Common species under Enterococcus group:

A

E. faecalis
E. faecium

155
Q

Enterococcus Group have the ability to grow under extreme conditions. What are the factors that make the Enterococcus Group to grow in extreme conditions?

A
  • Presence of bile
  • 6.5% NaCl or alkaline pH
  • 45 degree Celsius
156
Q

An Enterococci clinical infection from receiving hemodialysis, immunocompromised patients with a serious underlying disease, prior surgical procedure

A

Bacteremia

157
Q

An Enterococci clinical infection from elderly patients with prosthetic valves or valvular heart disease

A

Endocarditis