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Infectious Disease > Streptococci > Flashcards

Streptococci Flashcards

1
Q

alpha hemolytic streptococci?

A

s pneumo, s mutans, and s viridans

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2
Q

beta hemolytic streptococci?

A

strep pyogenes (GAS), strep agalactiae (GBS)

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3
Q

gama (non hemolytic) streptococci?

A

enterococcus

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4
Q
  • gram positive cocci arranged in chains
  • normal flora of skin and mouth
  • facultative anaerobes
  • catalase negative
A

streptococci

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5
Q
  • present in mucosal epithelium of URT or epidermis
  • transmission via direct contact or respiratory droplets (sneezing and coughing)
  • invades mucus membrane of new host
A

GAS S. pyogenes

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6
Q
  • most common bacterial infection of the throat
  • organisms persist 1-4 weeks w/o treatment
  • treat with penicillins
A

acute streptococcal pharyngitis

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7
Q
  • complication of GAS pharyngitis
  • produces SpeA/SpeC exotoxins
  • diffuse erythematous sandpaper rash on chest
  • raw strawberry tongue, desquamation
  • circumoral pallor around moth
  • can lead to rheumatic fever or glomerulonephritis
A

scarlet fever

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8
Q

skin infections of group A strep pyogenes?

A
  • impetigo: young kids 2-5
  • erysipelas: raised bright red plaques with sharply defined borders
  • wound infections, cellulitis
  • toxic shock syndrome and necrotizing fasciitis
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9
Q

Group A strep pyogenes virulence factors?

A
  • M protein
  • hyaluronic acid capsule (non antigenic)
  • streptolysin O: pore forming toxin, lyses target cells
  • Spe: superantigen causes scarlet fever and toxic shock syndrome
  • streptokinases
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10
Q

drug of choice for strep throat?

A

amoxacillin

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11
Q

drug of choice for GAS strep pyogenes cellulitis?

A

penicillin, ceftriaxone

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12
Q

drug of choice for bacteremia/toxic shock syndrome due to GAS strep pyogenes?

A

penicillin + clindamycin (suppresses toxin production)

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13
Q

diagnosis of strep throat?

A

RADT of group A capsule antigen, culture if negative for more sensitivity

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14
Q
  • encapsulated
  • group B antigen
  • Beta hemolytic, weakly
  • colonization of GI and GU tracts
A

GBS s. agalactiae

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15
Q
  • person to person transmission
  • bacteremia, skin and soft tissue infections, pneumonia, endocarditis
  • risk factors: diabetes, cancer, kidney disease, advanced age
A

GBS disease in adults

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16
Q
  • normal vaginal flora

- prenatal screening cultures at 35-37 WGA

A

GBS

17
Q
  • pneumonia, meningitis, sepsis
  • risk factors: maternal colonization, premature rupture of membranes
  • early onset or late onset
A

GBS disease in neonates

18
Q

GBS virulence factors?

A

polysaccharide capsule, adhesins, c5a peptidase inhibits neutrophils, beta hemolysin, CAMP factor

19
Q

drug of choice for group B strep meningitis/bacteremia?

A

penicillin G

20
Q

drug of choice for GBS endocarditis?

A

penicillin G + gentamycin

21
Q

DOC for GBS neonates?

A

ampicillin + gentamycin

22
Q
  • alpha hemolytic
  • commensal and opportunistic pathogen (subacute endocarditis, intra abdominal abscesses, dental caries)
  • bind fibrin platelet aggregates at damaged heart valves
  • resistant to optochin and bile insoluble
A

strep viridans

23
Q
  • gram positive lancet shaped coccus growing in pairs or short chains
  • carbohydrate capsule
  • naturally competent for DNA transformation
  • transmission via respiratory droplets
  • bacteremia higher in African Americans and native Americans
A

strep pneumonia

24
Q
  • most common cause of CAP
  • common cause of sinusitis and otitis media
  • can develop into meningitis in children
  • respiratory viral infection a predisposing factor
A

strep pneumonia

25
Q
  • aspiration of bacteria and replication in alveolar spaces
  • 1-30 day incubation
  • abrupt onset of fever and shaking chills
  • pleurisy, productive cough, blood tinged sputum
  • bactermia
A

pneumonia

26
Q

risk factors for pneumonia?

A

antecedent viral infection (esp influenze), smoking, age less than 2 or greater than 65, hematologic disorders, asplenia, COPD, diabetes

27
Q

atypical walking pneumonia?

A

slow onset, moderate fever, non productive cough

28
Q

strep pneumonia virulence factors?

A

polysaccharide capsule, C polysaccharide present in urine and serum

29
Q

strep pneumonia toxins?

A

pneumolysin toxic to bronchial epithelial cells, autolysin degades peptidoglycan, IgA protease

30
Q

lab diagnosis of strep pneumonia?

A
  • lancet shaped gram (+) diplococci
  • bile soluble, optochin sensitive (Kirby Bauer testing)
  • Quellung reaction visualizes capsule
  • C polysaccharide: capsular anitgen detected in CSF or urine
31
Q

treatment of strep pneumo?

A
  • penicillin
  • vancomycin
  • fluoroquinolone + 3rd gen cephalopsorin (tax, tri, taz)
32
Q

strep pneumo prevention?

A
  • Pneumovax PPSV23: adults >65, chronically ill, immunocompromised
  • PCV7 prevnar, PCV13
33
Q
  • E faecalis and E faecium most common
  • cell wall modification to D-lactate
  • group D streptococcus
A

enterococcus

34
Q
  • opportunistic pathogen
  • subacute endocarditis
  • biliary tract infections, UTIs
A

enterococcus

35
Q

enteroccocus virulence:

  • growth in 6.5% _____ or 40% _____
  • high level antibiotic resistance often encoded on ________
A

NaCl, bile salts

conjugative plasmids

36
Q

enterococcus lab tests?

A
  • non hemolytic, grows in presence of high salt and bile salts
  • positive reaction with group D antisera
37
Q

enterococcus treatment?

A

penicillin, vancomycin, or ampicillin + beta lactamase inhibitor

Infectious Disease (22 decks)

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