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Definitions, identification methods, and clinical manifestations of streptococcus and enterococcus, two common groups of gram-positive bacteria. Topics covered include hemolytic reactions, serological identification, virulence factors, epidemiology, and treatment. These bacteria are known to cause various infections, such as pneumonia, meningitis, and bacteremia.
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Gram-positive cocci (spherical to ovoid cells) - often arranged in chains and/or pairs - facultative - catalase negative TERM 2
DEFINITION 2 hemolytic reactionsbiochemical testsserological reactions TERM 3
DEFINITION 3 hemolysis - green discoloration (partial hemolysis) of blood cells surrounding colony (beta) hemolysis - clearing (complete lysis) of blood cells surrounding colonies (gamma) nonhemolytic (no change) of blood cells surrounding colonies TERM 4
DEFINITION 4 antibiotic sensitivity / resistance -hemolytic --> optochin - hemolytic --> bacitracin other biochemical tests TERM 5
DEFINITION 5 presence of antigenically unique "C" carbohydrates in the cell wall Group A Streptococcus pyogenesGroup B Streptococcus agalactiaeGroup D Enterococcus faecalis Enterococcus faecium Streptococcus bovis
serological identification within a group or species >80 types of Group A (S. pyogenes) antigenically unique M protein(s) associated with cell wall / fimbria > 85 types of S. pneumonia antigenically unique capsular polysaccharide TERM 7
DEFINITION 7 -hemolytic (usually)Streptococcus pneumoniae viridans group (> 12 species) Streptococcus sanguinis Streptococcus mutans non-hemolytic (usually) Enterococcus faecalis Enterococcus faecium TERM 8
DEFINITION 8 Epidemiology normal flora / colonizes the oropharynx frequency : children 40-70% & adults 5-20%person-to-person transmission by respiratory droplet or direct contactmost healthy individuals are resistant to diseasePredisposing factors for disease
DEFINITION 9 polysaccharide capsule (inhibits phagocytosis in the absence of specific antibody) >80 serological types of capsular polysaccharide produces disease by growth in tissue and subsequent inflammation TERM 10
DEFINITION 10 most common cause (60-80%) of community-acquired pneumonia (CAP)sudden onset, difficulty breathing, fatigue, cough,violent shaking chill, high fever 102-106E Flobar pneumonia - "rusty" or bloody sputum
persistence of bacteria &/or their toxins in the blood pathologic stateSince there has been so much misuse and confusion regarding these terms it is now recommended to use the term sepsis, rather than septicemia TERM 17
DEFINITION 17 High risk groups previous endocarditis prosthetic heart valves unrepaired cyanotic congenital heart disease repaired cyanotic congenital heart disease (to 6 months post surgery) Procedures dental extractions, periodontal treatment, oral surgeries invassive respiratory tract procedures surgery of infected soft tissues gastrointestinal and/or gentourinary tract procedures tatooing & body piercingTreatment regimens vary, ampicillin, amoxicillin, cefazolin, others TERM 18
DEFINITION 18 belong to Lancefield Group D normal microbiota of i ntestinal tractEnterococcus faecalis & Enterococcus faecium cause ~ 90% of clinical enterococcal infections TERM 19
DEFINITION 19 urinary tract infectionswound infections / intestinal abscessesendocarditis** meningitis (uncommon) *** most frequently nosocomial infections,** top 3 causes staphylococci, E.coli, enterococci TERM 20
DEFINITION 20 resistant to many antimicrobialsRecommended Treatment ampicillin (or vancomycin) w/ aminoglycoside (gentamycin) Emerging antibiotic resistance Enterococcus faecium / vancomycin resistance
bacitracin disc test | sensitive ------------------ -----------------
DEFINITION 22 Epidemiology ~ normal flora 5-20% of healthy people usually throat / less common skin Transmission person to person respiratory droplet direct contact