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61 terms

The Cocci of Medical Importance

Chapter 18
STUDY
PLAY
Furuncle
Boil; results when an inflammation of hair follicle or sebaceous gland progresses into a pustule (S.aureus)
Folliculitis
Most common; mild; superficial inflammation of hair follicles (S.aureus)
Carbuncle
Deeper lesion created by aggregation of a cluster of furuncles into one large mass; extremely painful (S.aureus)
Erysipelas
Slightly more invasive form; edema and redness of the skin near the portal of entry, fever, chills; cutaneous lesions can
remain superficial or cause long term systemic complications
-S.pyogenes
Pyoderma (Streptococcal impetigo)
Burning, itching papules that break and form highly contagious crust
-S.pyogenes
GPC
Strep, staph, enterococcus
GNC
Neisseria
Staphylococcus
-Inhabitants of skin and mucous membranes
-Irregular clusters, short chains and pairs
S. aureus
-Among most resistant (high salts, temps, extreme pHs)
-Viable after months of air drying, resists many antibiotics and disinfectants
Coagulase
Coagulates plasma and blood; diagnostic (S.aureus)
Hyaluronidase
Digests the hyaluronic acid that binds connective tissue (S.aureus)
-extracellular in S.pyogenes
Staphylokinase
Digests blood clots (S.aureus)
Nuclease
Digests DNA (S.aureus)
Penicillinase
Inactivates penicillin (S.aureus)
Hemolysin
Lyse red blood cells (S.aureus)
Leukocidin
Lysis of neutrophils and macrophage (S.aureus)
Enterotoxin
Act upon gastrointestinal tract (S.aureus)
Exfoliative toxin
Causes skin to peel away; responsible for staphylococcal scalded skin syndrome (S.aureus)
Toxic Shock Syndrome Toxin (TSST)
Probable role in development of toxic shock syndrome (S.aureus)
Bullous Impetigo
Bubble-like epidermal swellings that can break and peel away; most common in newborn (S.aureus)
Osteomyelitis
Pathogen is established in the highly vascular metaphyses of a variety of bones; abscess form (S.aureus)
Bacteremia
Primary origin is bacteria from another infected site or from colonized medical devices; endocarditis possible (S.aureus)
Pneumonia
As nasopharynx is one of the colonization site, pathogens can be aspirated into lungs and cause pneumonia involving multiple lung abscesses (S.aureus)
Food Intoxication
Ingestion of heat stable enterotoxins; food poisoning; cramping, nausea, vomiting, diarrhea
Staph Scalded Skin Syndrome
Toxemia; upon reaching the skin the toxin induces bright red flush; blisters, then desquamation of the epidermis
Toxic Shock Syndrome
Fever, vomiting, rash, potentially fatal complications involving liver, kidney etc.
S. epidermidis
Infections usually occur after surgical procedures such as insertion of catheters; biofilm formation along with other CNS
species
-endocarditis, UTI, coagulase negative
S. saprophyticus
Infrequent resident of the skin, lower intestinal tract & vagina; UTI
MRSA
methicillin-resistant S.aureus
Group A
S. pyogenes
C Carbohydrates
Protect against lysozyme
-surface antigen S. pyogenes
Lipoteichoic acid
-Contributes to adherence
-Bound to fimbriae
-surface antigen S. pyogenes
M-Protein
Resists to phagocytosis, improves adherence
-surface antigen S. pyogenes
Hyaluronic Acid Capsule
Provokes no immune response, antiphagocytic
-surface antigen S. pyogenes
Streptolysin
Hemolysin; injure many cells and tissue
-extracellular toxin, S.pyogenes
Erythrogenic (pyrogenic) Toxin
Induces fever and responsible for typical red rash; key toxin in scarlet fever
-extracellular toxin, S.pyogenes
Streptokinase
Involved in digestion of fibrin clot
-extracellular, S.pyogenes
Streptococcal Pharyngitis
Strep throat
-S.pyogenes
Scarlet Fever
-Strep throat infection involving S.pyogenes carrying a prophage that codes for erythrogenic toxin
- high fever, diffuse rash
-Systemic infection
Streptococcal Toxic Shock Syndrome
Result of a profound bacteremia and deep tissue infection and rapidly progresses to multiple organ failure
-Systemic infection (S.pyogenes)
Rheumatic Fever
Usually follows an overt or subclinical streptococcal pharyngitis in children; carditis, arthritis, fever, usually without lasting damage; in case of severe carditis, extensive valve and muscle damage possible
-sequelae Group A
Acute Glomerulonephritis
Damaged kidney cells can not adequately filter blood- nephritis, increased blood pressure; occasionally heart failure; may clear or become chronic leading to kidney failure
-sequelae Group A
Group B
Streptococcus agalactiae
Streptococcus agalactiae
Residents of human vagina, pharynx and large intestine
• Because of its location in vagina can be transferred to infant during delivery and can cause severe infection
- most prevalent cause of neonatal pneumonia, sepsis and meningitis
- Pregnant women should be screened for colonization and treated.
Enterococcus faecalis
- normal colonists of human large intestine
- Infections arise most often in elderly patients undergoing surgery and affect the urinary tract, wounds etc
- Group D
Group C and G
Common flora of domestic animals; frequently isolated from human upper respiratory tract; occasionally imitate group A streptococci in causing pharyngitis, glomerulonephritis;
bacteremia in severely compromised patients
Subacute Endocarditis
Blood-borne bacteria settle on heart lining or valves that have been previously damaged by rheumatic fever, valve surgery etc; biofilm formation called vegetation; vegetations release masses of bacteria into circulation
-complication of viridans infections
S.pneumoniae
Involved in 60-70% of bacterial pneumoniawhich primarily affect immunocompromise
Otitis Media
Gains access to the chamber of middle ear by way of eustachian tube and cause a middle year infection called otitis media; occurs readily in children under 2 years
-S.pneumoniae
Meningitis
Young children upper respiratory tract infection
-S.pneumoniae
Pneumococcal Treatment
• Traditionally treated with penicillin G or V
• Increased drug resistance
• Two vaccines available
Primary Neisseriaceae Pathogens
gonorrhea, mengintidis
Males (gonorrhea)
Infection of urethra causes urethritis with yellowish discharge; can cause infertility (10 percent asymptomatic)
Females (gonorrhea)
Bloody vaginal discharge, painful urination if urethra is infected; in case of ascending infection -PID (pelvic inflammatory disease) possible; can cause sterility (50 percent asymptomatic)
Opthalmia Neonatorum
Gonococcal eye infections in babies during pregnancy
-prevented by prophylaxis immediately after birth
Gonococcal Diagnosis
Gram stain - presence of Gram-negative diplococci
PPNG
Penicillinase producing N. gonorrhoeae
TRNG
Tetracycline resistant N. Gonorrhoeae
Meningitis Treatment
Treated with intravenous penicillin G, cephalosprin
• Prophylactic treatment of family members, medical personnel, or children in day care who have come in close contact with infected people
• Vaccines available
Branhamella
Found in nasopharynx; significant opportunist in hosts with disturbed immune functions
Moraxella
Short, plump rods as well as cocci; widely distributed on mucous membranes, weakly pathogenic or non pathogenic