question

Pathogenic Gram-Positive Cocci and Bacilli

answer

Stain purple when gram-stained

question

Staphylococcus is a _____ member of every human’s microbiota.

answer

Normal

question

Staphylococcus is located:

answer

In nasopharynx
On skin
Colonizes the infant w/in hours

question

Staphylococcus found in hospitals in

answer

Nurseries and surgical wards.

question

Staphylococci live and reproduce on

answer

almost every square inch of human skin

question

Staphpylococcus can be ______ pathogens causing anywhere from minor to life threatening diseases

answer

opportunistic

question

Staphylococcus genus name comes from Greek term staphle meaning ______

answer

“bunches of grapes”

question

Coccus (pl.cocci) =

answer

spherical–shaped bacterial cell

question

staph =

answer

staff or group (Cluster like grapes)

question

Staphylococcus colonies appear

answer

cream colored, white to light gold, and “buttery-looking”

question

Staphylococcus is Gram _____

answer

positive cocci, nonmotile, facultative anaerobes

question

Staphylococcus grows best when _____ present, but can continue to grow under ____ conditions.

answer

O2, anaerobic

question

Staphylococcus is _____-tolerant

answer

salt

question

Staphylococcus tolerates the ____ present on human skin

answer

salt

question

Staphylococcus is tolerant of desiccation (capsule). What does this mean?

answer

allows survival on environmental surfaces such as fomites
Object inadvertently used to transfer pathogen to new host: needle or coin

question

Staphylococci are catalase positive or negative?

answer

positive

question

Catalase Converts H202, (hydrogen peroxide) Into_____ and ____?

answer

H20 and 02

question

Staphylococci can disarm neutrophil’s and macrophage’s H2O2 with ______?

answer

catalase

question

_______ is secreted by neutrophils and macrophages to kill bacteria

answer

Hydrogen peroxide

question

To test for catalase:

answer

Inoculating loop is rubbed across a colony of Staphylococcus and mixed with H202 on a slide.
If bubbles appear, the enzyme catalase must be present.
So Staphylococcus is catalyst positive

question

Staphylococcal infections range from the

answer

trivial to the rapidly fatal

question

Are Staphylococcal infections easy to treat?

answer

No, They can be difficult to treat

question

Why are Staphylococcal infections difficult to treat?

answer

Because staphylococci can acquire antibiotic resistance

question

“Staph” infections result when staphylococci

answer

breach the body’s physical barriers.

question

Entry of only a few hundred bacteria (ID) can result in

answer

disease

question

Staphylococci are ______ in nature with about a _____ species part of our human flora

answer

ubiquitous, dozen

question

How many species are commonly associated with staphylococcal diseases in humans?

answer

2

question

What are the 2 species commonly associated with staphylococcal diseases in humans?

answer

1.Staphylococcus aureus is one of the most common causes of infections
2.Less virulent,opportunist Staphylococcus epidermis may cause prosthetic implant infections

question

Staphylococcus aureus is one of the most common causes of

answer

infections

question

Less virulent, opportunist Staphylococcus epidermis may cause

answer

prosthetic implant infections

question

Staphylococcus epidermidis is the______ of human skin

answer

Normal microbiota

question

Staphylococcus epidermidis is the normal microbiota of human skin that can cause ?

answer

opportunistic infections to immunocompromised patients or when introduced into parts of body

question

Staphylococcus aureus is located on

answer

skin, nares, mucous membranes (pharynx and vagina)

question

What pigment is Staphylococcus aureus on sheep blood agar?

answer

Gold pigment

question

Pathogenicity of Staphylococus (3 things)

answer

1.Cell wall structures that prevent phagocytosis
2. Enzymes
3. Production of toxins

question

Cell wall structures that prevent phagocytosis (3 things)

answer

a. Protein A
b. Bound coagulase
c. Capsule/slime layer

question

2. Enzymes (5 things)

answer

a. Coagulase
b. Staphylokinase
c. Hyaluronidase
d. Lipase
e. B-lactamses

question

3. Toxins (4 things)

answer

a. Cytolytic toxins
b. Exfoliative toxins
c. Toxic-shock-syndrome (TSS) toxin
d. Enterotoxins

question

Staphylococcus aureus has Protein A which causes_____to bind upside-down _____ antigen. This _____ opponization and ________.

answer

antibody stems,S. aureus
Inhibits, phagocytosis

question

Staphylococcus aureus has ________ that converts fibrinogen into ______ that form clots around pathogen.

answer

enzyme coagulase, fibrin

question

Fibrin clots ______ Staphylococcus aureus from phagocytic cells

answer

hide

question

Staphylococcus aureus forms slime layer/capsule that prevents:

answer

Phagocytosis and Dessiccation

question

Slime layer facilitates attachment of
Staphylococcus to artificial surfaces such as (5 things)

answer

catheters, shunts, artificial heart valves and joints

question

Coagulase triggers fibrin clotting, which hides the _______

answer

Staphylococcus aureus

question

Staphylokinase

answer

Dissolves fibrin threads in clots, allowing S.aureus to free itself from clots and spread to new location

question

Hyaluronidase

answer

Breaks down hyaluronic acid, enabling S. aureus spread deeper between cells

question

Lipases =

answer

digest lipids allowing Staphylococcus aureus to grow on surface of skin and sebaceous glands

question

B-lactamase =

answer

penicillinase now in 90% of S. aureus strains and thus resistant to penicillin and cephalosporins

question

Cytolytic toxins Disrupts the ______ ______ ______of a variety of cells such as

answer

mammalian cytoplasmic membrane
Heart, skeletal muscle, renal cells, platelets

question

Hemolysins damage

answer

RBCs

question

Leukocidin lyses

answer

Leukocytes, Macrophages, and neutrophils

question

Leukocidin provides S. aureus ______ from _____.

answer

protection from phagocytosis

question

Exfoliative toxins = ET causes

answer

Exofoliation

question

Exfoliative toxin dissolves

answer

desmosomes
The patient’s epidermal layer of skin to slough off

question

Toxic-shock-syndrome toxin symptoms

answer

High fever, rash, peeling of skin, vasodilation, drop in BP

question

Staphylococcus aureus produces enterotoxin proteins which in turn stimulate which 4 things?

answer

Intestinal muscle contractions
Nausea
Intense vomiting
Associated with staphylococcal food poisoning

question

Staphylococcus aureus Enterotoxins are ____ stable

answer

heat

question

Heat does not denature_____ protein

answer

enterotoxin

question

cover dish dinner; take home leftovers; reheat = zap in microwave. This process Does not _______the Enterotoxin

answer

denature

question

Staphylococcal Diseases categorized as which 3 things?

answer

1. Noninvasive Disease
2. Cutaneous Disease
3. Systemic Disease

question

1. Noninvasive Disease

answer

Food poisoning
Ingestion of Staphylococcus aureus contaminated food

question

Ingestion of Staphylococcus aureus contaminated food Bacteria grow on food and secretes

answer

Enterotoxin that is heat stable

question

Common cause of food poisoning?

answer

Staphylococcus aureus

question

Food poisoning is caused by ______ rather than by ______ of the bacteria

answer

enterotoxin, invasion

question

Food must remain at ________for several hours for bacteria to grow, reproduce, and produce toxin

answer

room temperature

question

Enterotoxin causes ____, ____, ____ for how long?

answer

nausea, vomiting, diarrhea for 24 hours

question

Reheating may kill ______ bacteria but does not inactivate _______.

answer

S. aureus, enterotoxin

question

2. Cutaneous Disease
Various skin conditions: name 6

answer

Scalded skin syndrome
Impetigo
Folliculitis
Sty
Furuncles
Carbuncle

question

Staphylococcus aureus causes localized _______(pus filled lesions)lesions

answer

pyogenic

question

Pyogenic =

answer

pus filled lesions

question

Scalded skin syndrome =
Exfoliative toxin causes: name 4 things

answer

Reddening of skin
Large blisters
Epidermis peels off in two days
Subject to secondary bacterial infection

question

Scalded skin syndrome = Exfoliative toxin Usually affects ______ of severed umbilicus & Older children with ______.

answer

neonates, skin infections

question

Staphylococcus aureus causes 80% of

answer

impetigo

question

impetigo is what and occurs on who?

answer

Small, flattened, red patches on face, limbs of children whose immune system is not fully developed

question

impetigo mostly occurs on _____ as pus filled vesicles that crust over and become honey colored, wet, flaky. The pus is filled with ____ and ____

answer

face, S. aureus and WBC

question

Folliculitis =

answer

Infection of hair follicle

question

Folliculitis Becomes red, swollen, and pus filled. When it occurs at base of eye in eyelash follicle it is called a

answer

Sty

question

Furuncle = boil
Penetrates into the ______?

answer

Large, painful, raised nodular extension of folliculitis to surrounding tissue.
Penetrates into the subcutaneous layer

question

Carbuncle =

answer

several furuncles coalesce

question

Carbuncle

answer

Larger, deeper, more painful
May have to be surgically drained
Can be the size of baseball

question

Carbuncle May cause____ and _____ as S. aureus spreads into underlying tissues
may need ______.

answer

fever, chills, antibiotics

question

S. aureus can cause a variety of potentially fatal _____ _____ When introduced to deeper tissues of the body such as ___, ____, ____, and ____.

answer

systemic infections
Blood, heart, lungs, and bones

question

3. Systemic Disease 6 things

answer

TSS
Pneumonia
Bacteremia
Endocarditis
Osteomyelitis
Empyema

question

Staphylococcus aureus produce _____ toxin

answer

TSS

question

Staphylococcus aureus can grow in a _____ or _____ vagina and produce the toxin and cause______.

answer

wound,abraded
Toxic shock syndrome

question

can TSS occur in both males and females?

answer

Yes

question

Toxic Shock Syndrome Toxin causes:

answer

Fever
Vomiting and Diarrhea
Red rash
Loss of sheets of skin
Low BP, shock
Multi-organ failure due to shock

question

TSS fatal in ____% cases. Why?

answer

5%, When BP drops so low O2 cannot be carried to vital organs and causes shock, death

question

Staphylococcus aureus in blood is ______ and Accounts for half of all ______ infections

answer

Bacteremia , noscomial

question

Staphylococcus aureus Bacteremia Causes:

answer

Furuncles
Vaginal infections
Infected surgical wounds

question

Hospitalized patients with chronic disease that contract S. aureus bacteremia have a

answer

high mortality rate

question

Staphylococcus aureus = Endocarditis

answer

Attacks lining of heart and valves

question

Endocarditis is one of the consequences of _______.

answer

staphylococcal bacteremia

question

Staphylococcus aureus = Endocarditis
Symptoms are _____ and ______.

answer

nonspecific, flulike

question

Staphylococcus aureus = Endocarditis
Blood pumped from heart ______ which in turn makes the ____ drop.
50% patients do not

answer

drops, BP, survive

question

Staphylococcus aureus in blood invades _____ causing______.

answer

lungs, pneumonia

question

Mortality rate for staphylococcal pneumonia is _____%.

answer

50%.

question

Staphylococcal pneumonia known to occur as secondary infection to

answer

influenza

question

Staphylococcal pneumonia Particularly occurs in _____ and_______ patients

answer

infants,cystic fibrosis

question

In 10% of patients with Staphylococcal pneumonia… The fluid filling the alveoli is _____, this condition is called ______.

answer

pus, empyema

question

When Staphpylococcus aureusInvades a bone, it causes

answer

Staphylococcal osteomyelitis

question

Staphylococcal osteomyelitis Signs and symptoms are: Inflammation of

answer

Bone marrow, diaphysis and periosteum
Fever, Chills, Swelling and pain
(Brake hip and get stahpylococcus aureus infection in bone)

question

Diagnosis of Staphylococcus Infections

answer

Detection of Gram-positive bacteria
Isolated from pus, blood, or other fluids

question

Treatment: ______ is the drug of choice to treat staphylococcal infections.

answer

Methicillin

question

Treatment:Since (1962) 1987 have:
MRSA =

answer

methicillin-resistant Staphylococcus aureus

question

Treatment: Since 2002 have:
VRSA =

answer

vancomycin resistant S. aureus

question

Prevention = some humans are carriers

answer

Hand antisepsis
Proper cleansing of wounds and surgical openings
Aseptic use of catheters or indwelling needles
Appropriate use of antiseptics

question

The Genus Streptococcus Is a diverse group of

answer

Gram positive cocci

question

Streptococcus can be arranged in ____ or ______

answer

Pairs or chains

question

Streptococcus are arranged in pairs called

answer

diplococci

question

Streptococcus are Arranged in chains like a strip of button
candy called

answer

streptococci

question

Streptococcus is Catalase _____

answer

negative

question

Most Streptococcus are _______ ________.

answer

facultative anaerobes

question

Serological classification of Streptococcus is useful in _______.

answer

identification

question

The Lancefield classification Developed by Rebecca Lancefield in 1938 was
Based on ______ ______.

answer

serological classification

question

The Lancefield classification puts various strains of Streptococcus into _____ different groups.

answer

19.

question

Lancefield groups go from _____ to ____.

answer

A – S

question

Lancefield groups A and B are ______ and ______.

answer

GAS and GBS

question

GAS and GBS Include the significant streptococcal pathogens of _____.

answer

humans

question

There are _____ species of Streptococci
only a few (5) are ______ _______.

answer

Thirty, human pathogens

question

Group A Streptococcus =

answer

Streptococcus pyogenes

question

What do Group A (GAS) Streptococcus pyogenes look like?

answer

Looks like chain of purple pearls on slide

question

Group A Streptococcus: GAS
On blood agar plate, Streptococcus pyogenes forms ______ colonies surrounded by _____ of beta-hemolysis on blood agar plates.

answer

white, zone

question

Streptococcus pyogenes lyse _____ leaving a ____ zone around ____ colony.

answer

RBC, clear, white

question

What is the main representative of group A Streptococcus (GAS)?

answer

Streptococcus pyogenes

question

What is the most serious streptococcal pathogen?

answer

Streptococcus pyogenes

question

Streptococcus pyogenes has a number of
Structures, Enzymes and Toxins that enable it to survive as a ______.

answer

pathogen

question

Pathogenic strains of Streptococcus pyogenes form _____

answer

capsules

question

What are the structural components and enzymes of Streptococcus pyogenes? 5 things?

answer

1.Protein M (protein A in S. aureus)
2.Hyaluronic acid capsule
3.Streptokinase Enzymes
4.Hyaluronidase = spreading factor

question

Protein M ________ complement. Thereby interfering with opsonization, phagocytosis, and lysis of bacteria.

answer

destabilizes,

question

Hyaluronic acid capsule acts to ______ the bacteria

answer

camouflage(WBC cannot recognize)

question

Streptokinase Enzymes ______ blood clots and _______ spread of Streptococcus pyogenes into ______ and _____tissue

answer

dissolves, facilitates, damaged and infected

question

Hyaluronidase called the ______ ______, dissolves hyaluronic acid and facilitates spread of Streptococcus pyogenes into deeper tissue

answer

spreading factor

question

What are Streptococcus pyogenes major Extracellular Toxins? 3 things

answer

Exotoxins
Pyrogenic toxins/ Erythrogenic toxins
Streptolysins toxins

question

Streptococcus pyogenes :Pyrogenic toxins Stimulate______ and ______ cells to release cytokines/pyrogenes

answer

macrophages and helper T cells

question

Streptococcus pyogenes :Pyrogenic toxins Stimulate ______ , causes ____ , and _____ toxic shock

answer

fever,rash and streptococcal

question

Because Pyrogenic toxins cause blood capillaries near surface of skin to dilate producing a red rash known as ____ _____, Some scientist call the toxins _________ toxins

answer

(scarlet fever), Erythrogenic

question

Streptolysins toxins Cause _____ of sheep blood agar. Clear zone around colony

answer

hemolysis

question

Streptolysins toxins Lyses _____, _____ and _______Which interfere with O2 carrying capacity, Immunity, Blood clotting.

answer

RBCs, WBCs and Platelets.

question

Streptolysins toxins also lyse other tissue cells such as

answer

Liver cells
Cardiac muscle cells
Kidney cells

question

Humans are only significant reservoir of ___ to ____ % of population are carriers of virulent strains of Streptococcus pyogenes

answer

5-15%

question

Streptococcus pyogenes
Typically causes disease when:

answer

Competing normal flora is depleted
Immunity is impaired
When large inoculum enables it to get a foot hold (infectious dose) before antibodies form against it

question

Streptococcus pyogenes
Causes following diseases: KNOW these 7

answer

Strep throat
Erysipelas
Streptococcal toxic shock syndrome
Necrotizing fasciitis
Scarlet fever
Rheumatic fever
Post streptococcal glomerulonephritis

question

What is the Streptococcus pyogenes strain for Sore throat, strep throat, or tonsillitis ?

answer

Streptococcal pharyngitis

question

Bacteriological or serological testare needed for a sure diagnosis of ______ _____

answer

Streptococcal pharyngitis

question

What is Streptococcal pharyngitis treated with?

answer

penicillin

question

What is a Sequela?

answer

a condition following and resulting from a disease

question

_____ is a morbid complication that follows a disease

answer

Sequela

question

Some diseases leave sequela In the form of long-term or permanent

answer

Damage to tissues or organs

question

Examples of Sequelas:
Meningitis can result in _____

answer

deafness

question

Examples of Sequelas:
Strep throat can result in _____ _____

answer

scarlet fever

question

Examples of Sequelas:
Strep throat can result in _____ ______ disease

answer

rheumatic heart

question

What is Pyoderma?

answer

streptococcal impetigo

question

streptococcal impetigo is a localized _____ ______.

answer

skin disease

question

streptococcal impetigo Begins as small _____producing lesions that itch, break open and form contagious yellow crust on skin

answer

pus

question

Pyoderma = ____ producing lesion on skin of face, arms, and legs

answer

pus

question

Erisipelas =Slightly more invasive form of ______ infection spreads to _____ and _____ tissues.

answer

skin, dermis and subcutaneous

question

Streptococcus pyogenes: Erisipelas
is called Erysipelas when this infection involved ____ _____.
Triggers pain and inflammation

answer

lymph nodes

question

Hogs can get ______ and infected hogs can infect______

answer

Erysipelas, humans

question

Streptococcus pyogenes can also cause
Streptococcal _____ _____ ______.

answer

toxic shock syndrome

question

Patients are bacteremic with severe multi-system infections and failure if they contract ______?

answer

TSS

question

Necrotizing fasciitis =

answer

Flesh eating strep

question

Necrotizing fasciitis Life threatening with mortality rate of ____% if left untreated

answer

70%

question

Flesh eating Streptococcus pyogenes
follows the path of _____ between subcutaneous tissue and muscle and CT surrounding the muscles

answer

fascia

question

Flesh eating Strep Streptococcus pyogenes first symptoms

answer

Swelling, heat, redness
Skin changes from red to purple to blue to large blisters

question

Flesh eating Streptococcus pyogenes
Skin dies and muscle becomes infected. Need rapid therapy of which drug?

answer

penicillin G

question

What are used to remove the dead tissue sometimes?

answer

maggots

question

Rheumatic Fever is a sequila. which disease does it follow? What does it result in?

answer

strep throat
Results in damage of heart valves and heart muscle.

question

Rheumatic Fever is an _______ response to Streptococcus pyogenes.

answer

Autoimmune

question

Rheumatic Fever is ______ mediated. Antigens in heart are similar to
Antigens on Streptococcus pyogenes, and our_____attach to heart muscle, attack it and causes ____which can damage the heart valves.

answer

antibody, antibodies, myocarditis

question

Acute Glomerulonephritis = AGN
Antibody-antigen complexes of ____ ____. Accumulate in ______.
Obstructs blood flow through _____.

answer

Streptococcus pyogenes, glomeruli, kidneys

question

Acute Glomerulonephritis = AGN
Sequela of ______ ______.

answer

Streptococcus pyogenes

question

Acute Glomerulonephritis = AGN
Leads to ______ and ______ urine output
Face may be puffy, urine is _____ colored

answer

hypertension, low, tea

question

Acute Glomerulonephritis = AGN may cause _____kidney damage in adults.

answer

Irreversible

question

Diagnosis of Streptococcus pyogenes

answer

Observation of Gram-positive bacteria in short chains or pairs

question

Prevention of Streptococcus pyogenes:
Antibodies against M protein provide long-term protection against future infection of S. pyogenes ONLY it it is _____?

answer

the same strain of Streptococcus
(can get strep throat many times from different strains)

question

GBS = Group B Streptococcus:

answer

Streptococcus agalactiae

question

Not until Lancefield classification scheme was Streptococcus agalactiae(GBS)Recognized in _____

answer

humans

question

Streptococcus agalactiae
Newborns with no antibodies are at risk of infection if born to previously uninfected mothers with no antibodies. Why is this?

answer

No antibodies for S. agalactiae were passed to fetus during late gestation

question

Streptococcus agalactiae normally colonizes which 3 things?

answer

GI, Genitals, and urinary tract

question

Newborns can pick up _____ ______ in birth canal during birth

answer

S. agalactiae

question

CDC recommends prophylactic administration of ______ at birth to neonates whose mother’s urinary/genital tract is colonized with S. agalactiae

answer

penicillin

question

Streptococcus _____Causes serious infections in newborns and immunocompromised people

answer

agalactiae

question

think Baby for GBS-
Streptococcus _____ causes Causes of neonatal pneumonia, sepsis, and meningitis

answer

agalactiae

question

Streptococcus agalactiae resides in human ____, ____, _____, and ______.

answer

pharynx, vagina, urinary tract, and large intestine.

question

Viridans Streptococci
(verdant, viridis L. = green)

answer

Many produce green pigment when grown on blood agar

question

Viridans Streptococci is the normal flora in ____, ____, _____, ____ and _____.

answer

Oral cavity, pharynx, GI tract, Urinary and genital tracts

question

Ex. Of Viridans Streptococci
Streptococcus mutans causes _____ _____.

answer

dental caries.

question

During a dental procedures (routine cleaning teeth) there may be showers of Streptococcus mutans into the ______

answer

bloodstream

question

Streptococcus mutans may cause

answer

endocarditis.

question

People with heart conditions or heart murmurs are given _____ antibiotics before visit to dentist.

answer

Prophylactic

question

Streptococcus pneumoniae Gram ____ cocci

answer

positive

question

Streptococcus pneumoniae most commonly forms pairs called ______, formally called _______ _______

answer

diplococci
Diplococcus pneumoniae

question

There are ____ strains of Streptococcus pneumoniae discovered by ______. There are vaccines against ____ strains.

answer

92,Louis Pasteur, 23

question

_____ % of all people carry Streptococcus pneumoniae as normal flora in mouth and pharynx without causing harm BUT if it moves to lungs causes

answer

75%, pneumonia

question

Steptococcus pneumoniae most common cause of which 3 things?

answer

Pneumonococcal pneumonia
Sinusitis
Otitis media

question

Streptococcus pneumoniae important cause of _______ ________ (since we now have a vaccine for Hemophilus influenzae, HiB vaccine), _____ and _____.

answer

Pneumococcal meningitis
Bacteremia/sepsis
Endocarditis

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