9-2 Staph/Strep/Enterococci Flashcards

1
Q

[T or F]

Micrococci are NOT associated with disease

A

TRUE

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2
Q

Defects in _______ and _________ can predispose an individual to [Staph Aureus] Infection.

Name the 6 Dz that can cause Leukocyte Chemotaxis

A

Defects in [Leukocyte Chemotaxis] and [Ab Opsonization] can predispose an individual to Staph Aureus.

Name the 4 Dz that can cause Leukocyte Chemotaxis

“A [DJ from DR] can ruin ur [Leukocyte Chemotaxis]”

  1. Down Syndrome
  2. Job’s Syndrome
  3. DM
  4. Rheumatoid Arthritis
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3
Q

Name the 6 usual sites of infection for [Staph Aureus]

A

Staph Aureus typically infects areas in which it is Normal Flora

1) Skin
2) Anterior Nares
3) Throat
4) GI
5) Vagina
6) Urethra

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4
Q

Carbuncle

B: Two places they’re mostly found

A

an Abscess larger than a boil with 1 or more opening draining pus onto the skin

B:

  • Back
  • Nape of the Neck
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5
Q

3 Toxin-Mediated Infections associated with [Staph Aureus]

A
  1. Scalded Skin Syndrome (neonates and children under 4)
  2. Toxic-Shock syndrome
  3. Food Poisoning
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6
Q

Panton-Valentine Leukocidin (PVL)

A

[Staph Aureus] enzyme that alters leukocyte permeability to allow cations to pass—> Leukocyte Destruction

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7
Q

STAPH AUREUS VIRULENCE FACTOR :

a-hemolysin (3)

A
  1. Lyses RBC of several animals
  2. Dermonecrotic on SubQ injection
  3. Leukocyte toxicity
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8
Q

STAPH AUREUS VIRULENCE FACTOR :

B-hemolysin (2)

A

ºSphingomyelinase –> varying hemolysis of RBC due to differences in membrane sphingomyelin content

ºProduces HOT-COLD lysis in which hemolysis is ENHANCED at COLD temperatures after 35ºC incubation

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9
Q

STAPH AUREUS VIRULENCE FACTOR :

DELTA-hemolysin (3)

A
  • Produced by 97% [Staph Aureus]
  • acts as surfactant to disrupt cell membrane and form channels that increase over time—> leakage
  • Some [coag-NEG Staph] can use this to cause NEC in neonates
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10
Q

STAPH AUREUS VIRULENCE FACTOR :

Hyaluronidase

A

Hydrolyzes intercellular matrix of acid mucopolysaccharides in tissue –> allows [S.Aureus] to spread to adjacent tissue

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11
Q

STAPH AUREUS VIRULENCE FACTOR :
Phospholipase C

A: 2 types of pt its found in

B: Function

A

STAPH AUREUS VIRULENCE FACTOR
A: Found in pt with ARDS & DIC

B: Causes tissues to become more susceptible to damage by [bioactive complement components]

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12
Q

A: List the 3 Superantigen Toxins of [S.Aureus]

B: Name the 2 Biologic Characteristics they all display

A

A: [PYROGENIC TOXIN SUPERANTIGENS]

1) Toxic Shock Syndrome Toxin -1 (TSST1)
2) Strep Pyrogenic Exotoxins (SPE)
3) [Strep superantigens]

B: •All of these induce Polyclonal T-cell proliferation
•Enhance lethal effects of small amounts of endotoxin

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13
Q

A: Which bacteria is the 2nd most common cause of uncomplicated cystitis in [women in college/child-bearing age]?

B: What’s the FIRST most common cause?

C: The bacteria in (A) is RESISTANT TO ______ but susceptible to ______

A

A: 2nd most common cause= Staph Saprophyticus

B: E.Coli is 1st

C: [Staph Saprophyticus] is [RESISTANT TO NOVOBIOCIN] but [susceptible to Furozolidone]

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14
Q

A: What is special about [Staph Lugdunensis]?

B: Where does this bacteria typically colonize?

A

A: Only species that is both [PYR AND Ornithine Positive]!

B: Human Inguinal Area

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15
Q

A: What is [SCCmec]

B: What does the mecA gene do?

A

A: The [SCCmec] is a [Staph Aureus] mobile chromosome that encodes for mecA

B: mecA is a gene that alters [Penicillin Binding Protein] —> [PBP2a] which allows [Staph Aureus] to become [Methicillin/B-lactam Abx RESISTANT]

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16
Q

3 Substances that can GENERATE ERRORS during a [PCR MRSA nasal test] for pts?

A
  1. Whole Blood
  2. Mucus
  3. Nasal Spray
17
Q

Which bacteria is associated with [Skin and Soft Tissue Infection]

A

MRSA

18
Q

Streptococci prefers [______ atmosphere] and require ______ media to grow

A

Streptococci prefers [Anaerobic/CO2 atmosphere] and require COMPLEX media to grow

19
Q

A: Why does [Strep Pyogenes] reoccur?

B: How is it transmitted?

A

A: [Strep pyogenes] reoccurs due to the lack of an Antibody to the M-protein

B: [Strep Pyogenes] is transmitted by Respiratory Droplets

20
Q

A: What bacteria is Scarlet Fever associated with?

B: What toxin causes this?

C: Explain the symptom manifestation

D: When does it appear exactly?

E: What key characteristic sign should it display?

F: When does it resolve?

A

A: Scarlet Fever is associated with [Strep Pyogenes - Group A]

B: Caused by Erythrogenic exotoxin

C:
1st starts as Rash w/tiny red bumps on chest, abdomen and behind ears BUT SPARES THE FACE

D: Appears 12-48 hours after the fever

E: Fine, red and rough-textured BLANCHES on pressure

F: Rash resolves 3-4 days after onset and then DesQuamation begins

21
Q

What’s the difference between [Staph Aureus Toxic Shock] and [Strep Pyogenes Group A Toxic Shock]

A

Unlike pt with [Staph Aureus Toxic Shock], [STREP Pyogenes Group A Toxic Shock] will result in a Positive Culture

22
Q

A: Puerperal Sepsis

B: Who is this typically seen in?

A

A: [Strep Pyogenes] colonizing the genital tract or from Ob/Gyn Doc invade upper genital tract —>
[Strep Pyogenes Group A Toxic Shock] / [necrotizing fasciitis] /lymphangitis

B: Seen in women post delivery or post abortion

23
Q

A: List the 2 Main sx of [Post-Streptococcal Sequelae]

B: Which strep is this associated with?

A
  1. Rheumatic Fever
  2. Glomerular Nephritis

B: [Strep Pyogenes Group A]

24
Q

A: Rheumatic Fever Description

B: When does this reoccur?

C: List 4 symptoms

D: This is 1 of the 2 symptoms for what syndrome?

A

A: Nonsuppurative inflammation occurring 1-5 weeks after [Strep pharyngitis]

B: Attacks reoccur into adulthood

C:

  1. Fever
  2. [SubQ Nodules]
  3. Chorea
  4. [Characteristic Cardiac lesions - Aschoff bodies and mitral valve damage]

D: Syndrome: [Post-Streptococcal Sequelae]

25
Q

A: Acute Glomerulonephritis 2º to [Post-Streptococcal Sequelae] occurs when? Etiology?

B: Name 4 sx

C: Which bacteria causes this?

D: Why does this reoccur consistently?

A

A: Occurs AFTER a skin/respiratory infection. [Antigen + Ab + C] all deposit in the glomeruli

B:

a) edema
b) HTN
c) hematuria
d) proteinuria

C: [Strep Pyogenes Group A]

D: [Strep Pyogenes] has different [M Proteins] which allows for it to evade the immune system upon reoccurrence and some [M proteins] will illicit a more nephropathogenic etiology

26
Q

A: Compare Virulence Factors [Streptolysin S vs. Streptolysin O] in ______ bacteria

B: What are 3 other [Virulence factor enzymes] for this bacteria?

C: What 2 enzymes allow this bacteria to spread into other tissues?

A

[Strep Pyogenes]
A: [Streptolysin S]= O2 stable / non-antigenic
vs.

B: [C5a peptidase] / Hyaluronidase / Streptokinase

C: Streptolysin and Streptokinase allow [Strep Pyogenes] to spread into other tissues

27
Q

A: [M Protein] binds to ______ cells and allows bacterial ______. It’s Antiphagocytic because it DEGRADES ______.

B: How is the bacteria eradicated? (4)

A

A: [M Protein] binds to epidermal cells and allows bacterial survival. It’s Antiphagocytic because it DEGRADES [COMPLEMENT C3b].

B:

1) Antibodies to [M protein] activate complement and then kill the bacteria
2) Penicillin/Ampicillin/Amoxicillin = NO RESISTANCE WORLDWIDE
3) Cephalosporins

4) Erythromycin (Use in Penicillin allergic pt)

28
Q

A: [Strep Agalactiae GBS - (Group B Strep)] is normal flora in what 3 areas?

B: What sx does it cause in Adults?

C: Early Onset Neonatal Sx

D: Late Onset Neonatal Sx

E: How does Sialic Acid play a role?

A

A:

  • Throat
  • Vagina
  • [GI tract]

B: Skin and wound infections (Diabetic Adults)

C: Early Onset Neonatal (1st week of life) = [Bacteremia/ Meningitis/ PNA]

D: LATE Onset Neonatal (1 week-3 mo.)= Bacteremia w/Meningitis

E: Sialic Acid on Polysaccharide Capsule inhibits Complement –> allows GBS to multiply

29
Q

Other Beta-Hemolytic Strep:

Group C (3)

A
  1. Veterinary Infections
  2. College Pt Pharyngitis
  3. Sepsis
30
Q

Other Beta-Hemolytic Strep:

Group F

A

Associated with Abscesses

31
Q

Other Beta-Hemolytic Strep:

Group G (2)

A
  1. Pharyngitis

2. Sepsis in neonates and Elderly

32
Q

A: Where is [Strep Viridans] the normal flora of? What MAJOR Dz does is cause?

B: List 2 more rare Diseases for this bacteria

C: What important components does this bacteria LACK? (2)

A

A: Normal Flora of Upper Respiratory Tract and MAJOR cause of [Dental Caries]

B:

  1. Important cause of Endocarditis
  2. [sepsis in a neutropenic CA pt]

C: Lacks Hemolysins and [Beta Strep toxins]

33
Q

A: The BOVIS Group from [Strep ______] consist of non-enterococcal group __ strep that includes:

S. bovis 1 = from (3)

S.bovis 2= from ______

S.bovis 3= from (2)

B: What is the clinical significance of the BOVIS group? (2)

A

A: The BOVIS Group from [Strep Viridans] consist of non-enterococcal group D strep that includes:

S. bovis 1 = from humans/cattle/[koala bears]

S.bovis 2= from Humans

S.bovis 3= from Human and Bovine

B:

  1. BOVIS is strongly associated with presence of [COLON CARCINOMA].
  2. It can cause bacteremia and [native or prosthetic valve-endocardidits]
34
Q

A: [Strep Milleri] includes what 3 bacteria? What’s unique about the culture of this on agar?

B: Where is it normal flora?

C: Sx

A

A: [Strep Milleri] includes CAI [Constellatus/Anginosus/Intermedius] and has a butterscotch odor when cultured on agar plates

b: normally colonizes mouth/GI/vagina

C: Can cause DEEP-SEATED Pyogenic cardiac and CNS infections and often isolated from brain abscesses

35
Q

What are the 2 Nutritionally Deficient Strep Bacteria?

A
  1. Abiotrophia

2. Granulicatella

36
Q

List 4 Common ENTEROCOCCAL Infections

A
  1. [Mixed bacterial wound infections and decubiti]
  2. UTI
  3. Sepsis
  4. Endocarditis

“ENTEROCOCCAL Infections will lead to a [MUSE] “

37
Q

What color colonies does [Enterococcal Casseliflavus] produce?

A

[Enterococcus casseliflavus] produces YELLOW colonies

38
Q

A: What 3 Abx is [Enterococcal] bacteria INTRINSICALLY resistant to?

B: [Enterococcal] is the 2nd most cause of what type of pathogen?

A

Intrinsically resistant to all

(x) cephalosporins
(x) aminoglycosides
(x) trimethoprim-sulfa

” [Enterococcal] is intrinsically resistant to the CAT”

B: Nosocomial Pathogen (Hospital-Acquired Dz)

39
Q

Name the 3 Recommended Tx for [Strep Pneumoniae]

A
  1. Penicillin if susceptible
  2. [Cefotaxime or ceftriaxone] if susceptible
  3. Alternative agents: Macrolides