ALPHA HEMOLYTIC
STREPTOCOCCI
Mocule 1t
MODULE 6
MICROBIOLOGY
VIDEO PART 10 – ALPHA HEMOLYTIC
STREPTOCOCCI
GRAM POSITIVE COCCI
STREPTOCOCCI
Viridans Streptococci
Most are __-hemolytic
NF: _____________________-important for the healthy state of the __________________________
Optochin Test: ______________________
Diseases:
1. Subacute Bacterial Endocarditis
• Most ________________ cause
• Reach the ______________________ as a result of trauma
• Develops _______________: ___________ or _____________
Treatment:
• ____________________________ + ____________________
• ____________________________ + ____________________
• Ceftriaxone
2. Dental Carries
• AKA: _______________________
• CA: Streptococcus ___________________
• Produces a ____________ layer : _________________
• Forms a ______________ on tooth enamel à _______________
• Produces ____________ acid- breaks down ____________ of the teeth
Streptococcus pneumoniae
Shape: _____________ shaped
Arrangement: ______________
Polysaccharide Capsule: ____________________
• Basis of _______________
• ____________________ REACTION
- AKA: Capsule _____________________ Test
- used for ________________ and ________________
Hemolysis: _____- hemolytic
NF: _______________________ tract
Optochin Test: ______________- differentiates it from ______________ Streptococci
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ALPHA HEMOLYTIC STREPTOCOCCI
1. Pneumococcal Pneumonia
Most _____________ type of pneumonia
Most common causative agent of ___________
2. Sinusitis
Inflammation of the sinuses: ________ and ____________
3. Otitis Media
AKA: ________________
Severe pain in the ___________: eardrum ruptures
common and painful disease of early _______________
DOC: ____________________________
4. Otitis Externa
AKA: ______________________
Also caused by ___________________, ________________________
Inflammation of the ___________ear
Practice Questions
1. The hemolytic pattern of the Viridans Group Streptococci
A. Alpha hemolysis
B. Beta hemolysis
C. Gamma Hemolysis
D. Both A and B
2. The causative agent of pneumonia and meningitis in adults, and otitis media and sinusitis in
children.
A. Staphylococcus aureus
B. Streptococcus pyogenes
C. Streptococcus pneumoniae
D. Staphylococcus epidermidis
E. Streptococcus agalactiae
3. A patient has subacute bacterial endocarditis, which is caused by a member of the viridans group
of Streptococcus. Which one of the following sites is most likely to be the source of the organism?
A. Skin
B. Colon
C. Oropharynx
D. Urethra
4. Test used to differentiate Viridans Streptococci from Streptococcus pneumoniae:
A. Quellung Test
B. Catalase Test
C. Optochin Test
D. Bacitracin Test
Enterococcus
Characteristics:
• Have the group _____ group-specific substance and were previously classified as group
_______________________
• Normal Flora: ______________________ Tract
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2 important species:
1. Enterococcus _________________
• most ___________________ CA, causes ________ of enterococcal infections
2. Enterococcus __________________
• included in ____________ Pathogens
Antibiotic Resistance
Intrinsic Resistance:
Enterococci are intrinsically resistant to:
• ___________________________
• ___________________________
• ___________________________
Low level resistance: ________________________
Intermediate susceptibility to resistant: ________________________
Less susceptible (than Streptococci)
• ___________________________
• ___________________________
Resistance to Aminoglycosides
Although enterococci have intrinsic _______-level resistance to aminoglycosides
• they have _____________ susceptibility when treated with a ______________–active
antibiotic plus an aminoglycoside
• used in _____________________ infections: _________________________
High-level resistance to aminoglycosides: ___________ susceptible to the synergism.
• Due to enterococcal _____________________________ enzymes.
Vancomycin Resistance
Most common in ______________________, but vancomycin-resistant strains of E faecalis also
occur.
Due to the ___________ gene
Vancomycin resistance was transferred from _____________________ to _________________
• Via ____________________
B-lactam Resistance
Due to production of _____________________ enzyme
Trimethoprim- Sulfamethoxazole Resistance
Enterococci are able to utilize exogenous ________________ available in vivo and thus escape
inhibition by the drugs
Diseases:
- Leading cause of __________________ infections
- transmitted from one patient to another primarily on the _____________ of hospital personnel
- transmitted on ________________________
- In patients, the most common sites of infection are the:
• _________________ tract • __________________tract
• __________________ • ____________________
- Neonates: ____________________and ____________________
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ALPHA HEMOLYTIC STREPTOCOCCI
- Adults: ____________________, ____________________, ____________________ infections
Treatment: ____________________, ____________________ or ____________________ + Aminoglycosides
(____________________ or ____________________)
Practice Questions
1. Enterococci are known to be resistant to the following antibiotics, EXCEPT:
I. Aminoglycosides
II. Vancomycin
III. Penicillinase Resistant Penicillins
IV. Co-trimoxazole
A. I and II
B. I and III
C. I, II, III
D. I, II, III, IV
2. Problems concerning the Enterococci:
A. Antibiotic resistance
B. Causes nosocomial infections
C. Causes meningitis, bacteremia and endocarditis
D. All of the above
3. Commonly implicated as the cause of dental carries and cavities
A. Streptococcus pneumoniae
B. Streptococcus mutans
C. Streptococcus agalactiae
D. Streptococcus pyogenes
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QUICK QUIZ
1. Causative agent of swimmer’s ear:
A. Streptococcus pyogenes
B. Streptococcus mutans
C. Streptococcus agalactiae
D. Streptococcus pneumoniae
2. The Streptococcus most commonly associated with subacute bacterial endocarditis:
A. Staphylococcus aureus
B. Streptococcus pyogenes
C. Staphylococcus saprophyticus
D. Streptococcus viridans
3. Quellung test is used to test for the presence of
A. Streptococcus pyogenes
B. Staphylococcus aureus
C. Streptococcus pneumoniae
D. Mycoplasma pneumoniae
4. The most common cause of community acquired pneumonia
A. Staphylococcus aureus
B. Streptococcus pyogenes
C. Mycoplasma pneumoniae
D. Streptococcus pneumoniae
5. Common normal flora of the mouth
A. Streptococcus pneumoniae
B. Streptococcus mutans
C. Streptococcus agalactiae
D. Streptococcus pyogenes
