1
Q
What is the family of strep?
A
Streptococcaceae
2
Q
Aerotolerant of Streptococcus spp.
A
FAn, aerotolerant anaerobes, and capnophilic
3
Q
What are the hemolytic patterns for classifications
A
Alpha, Beta, Gamma/nonhemolytic
4
Q
Complete lysis of RBCs and clear area around colony
A
Beta hemolytic pattern
5
Q
Partial lysis of RBCs with greenish discoloration of area around colony
A
Alpha hemolytic pattern
6
Q
No lysis of RBCs and no change in color
what hemolytic patterrn?
A
Gamma/nonhemolytic pattern
7
Q
Amino sugar of group A streptococci
A
rhamnose-N-acetylglucosamine
8
Q
Amino sugar of group B Streptococci
A
rhamnose-glucosamine polysaccharide
9
Q
Amino sugar of group C Streptococci
A
rhamnose-N-acetylgalactosamine
10
Q
Amino sugar of group D Streptococci
A
glycerol teichoic acid containing D-alanine & glucose
11
Q
Amino sugar of group F Streptococci
A
glucopyranosyl-N-acetylgalactosamine
12
Q
What specie is Group A, B, C Streptococci?
A
Streptococcus pyogenes
Streptococcus agalactiae
Streptococcus dysgalactiae & equi
12
Q
Noneneterococcu member of viridans streptococci
A
Streptococcus bovis group
13
Q
Enterococcus species
A
Enterococcus faecalis
Enterococcus faecium
14
Q
Pneumococcus specie
A
Streptococcus pneumoniae
15
Q
Lancefield group A
A
Streptococcus pyogenes
16
Q
Lancefield group B
A
Streptococcus agalactiae
17
Q
Lancefield group C
A
Streptococcus dysgalactiae
Streptococcus equi
18
Q
Lancefield group D
A
Streptococcus bovis group
Enterococcus faecalis
Enterococcus faecium
19
Q
Lancefield group of Streptococcus pneumoniae
A
None
20
Q
Disease associated with Streptococcus pyogenes
A
Rheumatic fever
Scarlet fever
Pharyngitis
Glomerulonephritis
Pyogenic infections
21
Q
Disease associated with Streptococcus agalactiae
A
Neonatal sepsis
Menigitis
Puerperal fever
Pyogenic infection
22
Q
Disease associated with group C streptococci
A
Pharyngitis
Impetigo
Pyogenic infections
Streptococcus dyysgalactiae
Streptococcus equi
23
Q
Disease associated with nonenterococcus member of viridans streptococci
A
Endocarditis
UTIs
Pyogenic infections
Steptococcus bovis group
24
Disease associated with Enterococcus group
UTIs
Pyogenic infections
| *Enterococcus faecalis*
*Enterococcus faecium*
25
Disease associated to specie with Alpha hemolytic pattern
Pneumonia
Meningitis
Pyogenic infections
| *Streptococcus pneumoniae*
26
Disease associated with viridans streptococci
Pyogenic infectioons
Endocarditis
Dental caries
Abscesses in tissues
| Anginosus group
Mutans groups
Mitis goup
Salivarius group
27
VF that is encoded by the gened emm
M protein
## Footnote
Also resist phagocytosis
Located commonly in URT
>150 serotypes
28
VF that adhere to epithelial cell
Protein F (Fibronectin-binding protein) & Lipoteichoic acid
29
VF that impede phagocytosis and most noticable in very young cultures
Hyaluronic acid capsule
30
VF that spread streptococci in tissues by liquifying pus and it is immunogenic
Deoxyribonuclease (DNase)
| Potent protease (infere phagocytosis)
31
Highly immunogenic VF
Streptolysin O
32
Anaerobically hemolysis on BAP
Streptolysin O
33
Oxygen labile streptolysin
Streptolysin O
34
Streptolysin oxygen stable
Streptolysin S
35
Cells lyse by Streptolysin O
Leukocytes, platelets, and other cells as well as RBCs
36
Leukocyte is the only lyse in here
| Streptolysin
Streptolysin S
37
Non-immunogenic streptolysin
Streptolysin S
38
Aerobic streptolysin
Streptolysin S
39
VF that allows bacteria to escape from blood clots
Streptokinase (Fibrinolysis)
| Immunogenic but not specific to GAS
Can be seen in group C and D
40
Spreading factor and solubilized the ground substance of mammalian connective tissue
Hyaluronidase
41
VF that cause a red spreading rash
Streptococcal pyrogenic exotoxins
42
Term for red spreading rash caused by Streptococcal pyrogenic exotoxins
Erythrogenic toxic scarlet fever
43
It causes bacterial pharyngitis "Strep throat" and most common clinical manifestation
*Stretococcus pyogenes*
44
Disease associated with *S. pyogenes* that shows impetigo, cellulitis, erysipelas, wound infection, arthritis, or scarlet fever
Pyodermal infections
45
In which specie is type 1 NF associated?
*Vibrio* spp.
46
In which specie does type 2 NF associated?
*Streptococcus* spp. (GAS)
47
In which specie does type 3 NF associated?
*Clostridium* spp.
48
Disease that is invasive and rapidly progressing inflammation and necrosis of the skin
Necrotizing Fascitis caused by *Streptococcus pyogenes*
49
Steptococcal Toxic Shock Syndrom
SpeAM1 and M3
50
Disease that have rheumativ fever, acute glomerulonephritis
Poststreptococal sequelae
| Class I M protein (RF)
Class I and M protein (AGN)
51
VF that resist phagocytosis but is ineffective after opsonization also have sialic acid component
Capsule
52
VF that is not involve in virulence
Hemolysin, CAMP factor, neuraminidase, DNase, Hyaluronidase & Protease
53
Infecition associated with *Streptococcus agalactiae*
Invasive disease of newborn
## Footnote
Verical transmission
Colonization in vagina and rectal area
54
Specimen collection choice for *Streptococcus pyogenes*
Swab and exudate
55
Transport media uthat is commonly use
Todd-Hewitt broth (10 ug/mL colistin)
Lim broth (15 ug/mL nalidixic acid)
56
Specimen collection method for *Streptococcus agalactiae*
Vaginal and rectal swab between 35-37 weeks of gestation
57
When can we swab vagina and rectum for *Streptococcus agalactiae* ?
35-37 weeks of gestation
58
Direct microscopic examination of Streptococci
Gram (+) cocci round or oval-shaped, occasionally forming elongated cells
59
Macroscopic examination of *Streptococcus pyogenes*
Small, transparent, smooth w/ well defined B hemolytic pattern
60
Macroscopic examination of *Streptococcus agalactiae*
Grayish white mucoid colonies surrounded by small zone of B hemolytic
## Footnote
Strep B Carrot broth; orange or red pigment after incubation for 6hrs.
61
Organism that exhibits (+) result in Bacitracin susceptibility test
| What is the positive result?
*Streptococcus pyogenes*
| Presence of ZOI
62
No presence of ZOI in bacitracin
othe Beta hemolysis Strep
63
Principle of PYR test
Differentiate *S. pyogenes* from other Beta hemolytic streptococcus
64
Results of PYR test
Bright Red (*Sreptococcus pyogenes*)(+)
No color change or orange color (Group B and C) (-)
65
Principle of Hippurate test
Capability of organism to hydrolyze hippurate
66
Results of Hippurate test
Deep purple color (*Streptococcus agalactiae*) (+)
Colorless or slightly yellow pink (Other Beta strep) (-)
67
CAMP test means
Christie, Atkins, & Munch-Petersen test
68
Principle of CAMP test
Detection of diffusable extracellular protein (CAMP factor) that acts synergistically with the beta hemolysin of *S. aureus*
69
Positive results of CAMP test
Arrowhead indication (*Streptococcus agalactiae*)
70
Composition of cell wall of *Streptococcus pneumoniae*
C substance
71
VF that is used to classify *S. pneumoniae* into more than 90 serotypes
Capsular polysaccharide
72
Main cause of pneumonia in ICP patients
*Streptococcus pneumoniae*
73
Vaccines that is used for children. Purified polysaccharides of 7 serotypes conjugated to a diphtheria protein
PCV7
74
Vaccine that have additional serotypes and usually used to children <5 years old
PCV13
| 1, 3, 5, 6A, 7F, and 19A are the added serotypes
75
Vaccine that is used for adults that have 23 purified capsular polysaccharide
PCV23
76
Normal microbiota of viridans streptococcus
URT
Female genital tract
GIT
77
Organisms in *S. mitis* group
*S. mitis, pneumoniae, sanguis, oralis*
78
Organisms in *S. mutans* group
*S. mutans & sobrinus*
79
Organisms in *S. salivarious* group
*S. salivarious & vestibularis*
80
Organisms in *S. bovis* group
*S. equinus, gallolyticus, infantarius, alactolyticus*
81
Organisms in *S. anginosus* group
*S. anginosus, constellatus, intermedius*
82
Most common cause of subacute bacterial endocarditis and oral infections such as gingivits and dental caries
Viridans streptococcus
83
VF that adhere and colonize in endocariditis
| *S. anigonosus* group
Polysaccharide capsule and cytolysin
| Oral and GIT
84
Organism that has M proteins, SLO, hyaluronidase, and DNase
Goups C and G streptococci
85
Express the D antigen
Group D streptococci and *S. bovis* group
86
Normal flora of *S. mitis* group
Oral and GIT, Female Genital tract
87
Effusion direct microscopic examination of *S. pneumoniae*
Gram (+) pneumococci with numerous WBC
88
CSF direct microscopic examination of *S. pneumoniae*
Gram (+) cocci in pairs with numerous WBC
89
Culture for viridans streptococcus
BHI, TSB with 5% sheep RBCs or CAP
90
Principle of Optochin test
The effect of optochin (ethylhydrocupreine) on an organisms
## Footnote
ZOI of 14mm (+) (*S. pneumoniae*)
91
Principle of bile solubility test (Sodium deoxycholate)
Bile or a solution of a bile salt rapidly lyses pneumococcal colonies
## Footnote
Lysed colonies (+) (*S. pneumoniae*) in plated clear in tube
Intact colonies (-) (other alpha strep) in plated turbid in tubes
92
Principle of Quellung reaction
swelling of the capsule, end the organisms agglutinate by cross-linking
## Footnote
Swelling of the capsule (+) (*S. pneumoniae*)
No swelling (-) (Other alpha strep)
93
Biochemical test that is useful for rapid identification and for typing of the oragnisms, either in sputum or in cultures
Quellung Reaction
94
Biochemical test that accelerate the organism's natural autolytic process
Bile solubility test
95
Positive in mannitol and sorbital test
Mutans group
96
Principle of LAP test
Detection of the enzyme leucine aminopeptidase
## Footnote
(+) red color for viridans group
(-) no color change or slight yellow color
97
Voges-Proskauer negative result exhibit in what viridans group?
Mitis group
97
Viridans group that is positive in hyrolysiss or arginine
Anginosus group
98
Previously classifed as group D strep
*Enterococcus* spp.
99
It has D antigen
*Enterococcus* spp.
100
Conditions that nonhemolytic, alpha hemolytic, and beta hemolytic *Enterococcus* spp. grow
6.5% NacL
45 C
Alkaline pH
101
Organism that is able to grow in extreme conditions
*Enterococcus* spp
102
VF of *Enterococcus* spp. that adhere to the heart valved and renal epithelial cells
Extracellular sruface adhesion proteins, extracellular serine protease, and gelatinase
103
VF of *Enterococcus* spp. that is similar to bacteriocins produced by grap (+) bacteria
Cytolysin
104
Infections associated with *Enterococcus* spp.
Nosocomial infections UTI
Endocarditis in elderly patients
Intraabdominal or pelvic wound infections
105
DNA cluster that is animal species
DNA cluster I: *Streptococcus equinus*
106
DNA cluster that ferments mannitol and causes human endocarditis and colon carcinoma
DNA cluster II
## Footnote
*Streptococcus gallolyticus* (subp. *gallolyticus, pasteurianus, macedonius*)
107
Organism in DNA cluster III
*Streptococcus infantarius* sub. *infantarius* and *coli*
108
Organism in DNA cluster IV
*Streptococcus alactolyticus*
109
Biochemical test for *Enterococcus* spp.
Acid production in carbohydrate broth
Arginine hydrolysis
0,04% tellurite tolerance
Pyruvate utilization
Resistance to 100-ug efrotomycin acid
(+) motility
110
*Enterococcus* spp. that is motility (+)
*E. casseliflavus*
*E. gallinarum*
111
*Enterococcus* that is mannitol negative
*E. durans*
112
Enterococci that is sorbose positive
*E. avium*
*E. raffinosus*
113
Enterococci that is arabinose negative
*E. faecalis*
*E. durans*
114
Enterococci that is tellurite positive
*E. faecalis*
115
Enterococci that is arginase negative
*E. avium*
*E. raffinosus*
116
Previously known as nutritionally variant streptococci
*Abiotrophia* and *Granulicatella* spp.
117
Common airborne organisms similar to streptococci in culture and staphylococci in microscopic exam
*Aerococcus* spp.
## Footnote
*A. viridans* bile esculin & PYR (+)
*A. urinae* bile esculin & PYR (-)
Opportunistic pathogen
118
Similar to viridans steptococci in colonial morphology
*Gemella* spp.
119
Previously known as group N strep
*Lactococcus* spp.
120
Susceptible in bacitracin
*S. pyogenes* and *S. pneumoniae*
121
Organism that is Hippurate positive
*S. agalactiae*
122
PYR positive organism
*S. pyogenes*
123
Strep-like bacteria that is susceptible to bacitracin
*Aerococcus* spp.
Bacte
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