What is the most serious pathogen within the genus Staphylococcus?
A)Staphylococcus epidermidis
B)Staphylococcus saprophyticus
C)Staphylococcus hominis
D)Staphylococcus aureus
E)Staphylococcus capitis
D)Staphylococcus aureus

Why is Staphylococcus aureus considered a troublesome hospital pathogen?
Because it resists the effects of many disinfectants and antibiotics.

What is the most diagnostic species characteristic of Staphylococcus aureus?
The production of coagulase

Which is not an effect of the Staphylococcus aureus -toxin?
A) It acts upon the human gastrointestinal tract.
B) It lyses red blood cells of various mammals.
C) It causes leukocyte damage.
D) It damages skeletal and heart muscle.
E) It damages kidney tissues
A) It acts upon the human gastrointestinal tract.

Staphylococcus aureus is most frequently isolated from what body site?

What is the most common infection caused by Staphylococcus aureus?

Staphylococcal enterotoxicosis is associated with eating all but which of the following foods?

A) Custards
B) Chicken salad
C) Ham and processed meats
D) Hamburger
E) Cream pastries

D) Hamburger

What factor appears to support colonization and proliferation of both Staphylococcus aureus and the coagulase-negative staphylococci within patients?
A foreign body

What is the key test that separates Staphylococcus aureus from other staphylococci?
Coagulase test

What is the principal reservoir for the pathogenic staphylococci?

How are the streptococci differentiated from the staphylococci when viewed microscopically following the Gram stain procedure?
Staphylococci are Gram positive and grow in grape-like clusters, while streptococci are also Gram positive, but grow in chains.

What is the most serious streptococcal pathogen of humans?
Streptococcus pyogenes

Why do toxic shock syndrome and necrotizing fasciitis cause such severe pathology to host tissues?
The streptococcal toxins act as superantigens.

Primary infections caused by Streptococcus pyogenes are due to the organisms invading what two body sites?
Skin and throat

What species of the streptococci can be transferred to an infant during delivery?
Streptococcus agalactiae

What test allows for the differentiation of Group A streptococci from other -hemolytic streptococci?
Bacitracin sensitivity

Which streptococcal species is involved in the production of cavities?
Streptococcus mutans

What is the major virulence factor of Streptococcus pneumoniae?

What organism is responsible for the majority of cases of otitis media in children?
Streptococcus pneumoniae

Virulence factors of Neisseria gonorrhoeae include all except which of the following?

Most cases of gonorrhea occur within what age range?
18-24 years

How do Neisseria gonorrhoeae appear when stained with the Gram stain and viewed microscopically?
Gram negative diplococci

Meningitis associated with Neisseria meningitidis usually occurs as what type of disease?

What is the reservoir of Neisseria meningitidis?
Human carriers

How is Neisseria meningitidis spread?
Through respiratory secretions or droplets

Beta hemolytic and bacitracin resistant cocci in chains or pairs
Streptococcus agalactiae
Septicemia, pneumonia, and meningitis in neonates

Ampicillin with cefotaxine or gentamicin

Gram positive cocci in chains sensitive to bacitracin
Streptococcus Pyogenes

Final diagnosis is baced on positive growth in 6.5% NaCl and PYR positive
Streptococcus faecalis

Gram positive cocci in chain, resistant to optochin and bile soluble
Streptococcus viridans

Beta-hemolytic, golden yellow pigment in NA, and yellow (mannitol fermanter) in Mannitol Salt Agar is diagnostic
Staphylococcus aureus

an environmental Gram possitive in clusters causing UTI
Staphylococcus saprophyticus

Gram possitice cocci in clusters abundant in the skin
Streptococcus Pneumoruae

Gram positive cocci in chain characterized with no growth on 6.5% NaCI.
Streptococcus bovis

Which one is catalase negative?
A. Staphylococcus
B) Streptococcus
B) Streptococcus

A 40-year old alcoholic man presents to the emergency room with a 3 day history of cough productive of blood-tinged sputum has many white blood cells and Gram-possitive cocci in chain. The most likely causative organism is:
Streptococcus pneumoniae

With 5 hours of returning home from lunch at your most favorite fast food restaurant you feel very sick and are vomiting. The most likely causative organrsm ls:
Spaphylococcus aureus

The laboratory calls to alert a patient, who has been in the ICU for a Iong time, has several blood cultures with Gram positive cocci in clusters. You suspect the diagnosis to be line related sepsis due to which organism? (‘Line
retated sepsis’ is sepsis related to the presence of an lV tube or line)
A. Group A streptococcus
B. Straphylococcus sp. not S. aureus
C. Viridans streptococci
D. streptooccus Pneumoniae
B. Straphylococcus sp. not S. aureus

One of the serious disease from staphylococcus aureus is toxic shock syndrome. What is the pathogenicity factor causing this disease?
tsst1 toxin

Which factors contribute to spread of virulence of Group A
streptococcus infection?
A. endotoxin and exotoxin
B. hyaluronidase and streptokinase
B. hyaluronidase and streptokinase

19. The reservoir for Group A Streptococci is (are):
skin and throat

which one is the most common cause of neonatal septicemia and meningitis?
Group B streptococci (AGALACTIAE)

Which characteristic separates Staphylococcus aureus from the other species of Staphylococcus?
A. Hemolysin test
B. coagulase test
C. Catalase test
D. Urease test
B. coagulase test (C. Catalase test positive)

In MRSA cases the most preferred antibiotic to control the disease
would be
A. Penicillin
B. Methicillin
C. Vancomycin
D. streptomycin
C. Vancomycin

Determination of Streptolysin O titer is best done in which suspected diseases?
A. Rheumatic fever
B. Glomerulonephritis
C- Fasciitis
D. Pharyngitis
A. Rheumatic fever

All of the following causes pneumonia but which one has a
commercially-avaitable vaccine?
A. Nocardia
B. Staphylococcus aureus
C. Streptococus pneumonia
D. Mycobacterium
C. Streptococus pneumonia

Which one causes endocarditis associated with human colon?
A. Staphylococcus aureus
B. Streptococcus mutans
C. streptococcus faecalis
D. Actinomyces
C. streptococcus faecalis

which is found in staphytococcus aureus’cell that inhibits
A. Capsule
B. Protein A
C. Coagulase
B. Protein A

Which is not a disease causes by staphylococcus aureus?
A. Boil
B. Toxic shock syndrome
C. pneumonia
D. scarlet fever
D. scarlet fever

Staphytococcus epidermis is implicated in these conditions EXCEPT
A. Biofilms in artificial heart valves
B. Nosocomial infections
C. Blodd culture contamination
D. Tuberculosis
D. Tuberculosis

Which one is implicated in urinary tract infections in sexually active
adolescent women?
A. staphylococcus agalatiae
B. staphylococcus saprophyticus
B. staphylococcus saprophyticus

Which classification of streptococcus is done based on cell wall carbohydrates?
A. capsule
B. Motility
C. Lancefield
D. M protein
C. Lancefield

Group A streptococci can cause these variety of diseases EXCEPT
A. Pharyngitis
B. Acute glomerulonephritis
C. Impetigo
D. Food poisoning
D. Food poisoning

Aside from adult meniggitis and
pneumoniae, Streptococcus pneumoniae also causes
A. toxic shock syndrome
B. impetigo
C. Oititis media and sinusitis
D. Scalded skin
C. Oititis media and sinusitis

Which of the following organisms is incorrectly mached with the disease it most commonly causes?
A. Viridans streptococci-endocarditis
B. Staphytococcus saprophytic – urinary tract infections
C. Strepfococcus pyogenes- pharyngitis
D. Enterococcus faecalis- neonatal meningitis
D. Enterococcus faecalis- neonatal meningitis ( should be strep agalactiae)

What is the most likely mode of transmission for an upper respiratory
tract infection like flu?
A. Sexual contact
B. Food ingestion
C. Droplet transmission
D. Fomites
C. Droplet transmission

Methicilin resistance of MRSA are encoded specifically in
A. Plasmid
B. Phage
C. chromosome
D. Pathogenicity island
A. Plasmid ???
resistant to all except vancomycin

Methicillin-Resistant S. aureus Infection
Important cause of nosocomial and community-acquired infections
Resistant to β-lactams due to alteredd penicillin-binding proteins

Lipoteichoic acid and Protein F are adherence factors for
A. Group A Streptococcus
B. Group B Streptococcus
C. Straphylococcus
D. Corynebacterium
A. Group A Streptococcus

The receptors for lipoteichoic acid/Protein F as found in epithelial cells would be
A. adhesins
B. fibronectin
C. protein M
D. protein A
C. protein M

Toxoid usually come from
A. Endotoxin
B. Exotoxin
C. A and B
D. None of the above
B. Exotoxin

Which one would most like hydrolyze hyaluronic acid thereby
contributing to the invasive properties of the bacteria?
A. Coagulase
B. collagenase
C. Hyaluronidase
D. Lecithinase
C. Hyaluronidase

Neonatal meningitis is the most commonly due to
A. Group A streptococci
B. Group B streptococci
C. Group D streptococci
D. rd(on-Lancefield grou pable streptococci
B. Group B streptococci

Which protein glomerulonephritis is associated with
A. Protein A
B. F Protein
C. M12
D. Streptolysin
C. M12

Which enzyme would normally inactivate immunoglubulin A.
A. nucleases
B. proteases
C. lecithinase
D. coagulase
B. proteases

Which part of the Streptococcus pheumonia pneumonia is the source of vaccine against pheumonia?

Beta hemolitic
S aureus

Gram positive rest to optochin
S viridans

Group A Streptococcus
Group B Streptococcus
Group D Streptococcus
Lancefield’s Groups A to U
Group A Streptococcus (Streptococcus pyogenes)

Group B Streptococcus (Streptococcus agalactiae)

Group D Streptococcus (Streptococcus bovis; Enterococcus faecalis)

Treatment for Streptococcus pyogenes
Beta-lactam drugs or erythromycin
Bacitracin resistant

Streptococcus pneumoniae

Teichoic acids:
major virulence factor:
Quellung reaction:

IgA protease: helps in colonization
Teichoic acids: attachment
Polysaccharide capsule:
major virulence factor
retards phagocytosis through inhibition of antibody-independent opsonization via alternative complement pathway
Quellung reaction positive (swelling of capsule with type-specific antiserum)
Penicillin G

which organism causes these 3 disease?
Dental Caries
Infective Endocarditis
In brain or abdominal organs
Viridans Streptococci
Dental Caries:
S. mutans dextran-mediated adherence glues oral onto teeth, forming plaque causing caries
Infective Endocarditis:
Symptoms: malaise, fatigue, anorexia, night sweats, weight loss
Predisposing conditions: damaged (or prosthetic heart valve and dental work without prophylactic antibiotics or extremely poor oral hygiene.
In brain or abdominal organs

Tx for Viridans Streptococci
Penicillin G with aminoglycoside for endocarditis

Pigment-producing on S. aureus
S. aureus-yellow pigment

M protein (group A streptococcus)
Helps prevent phagocytosis.

Identification of gram-positive cocci
1) Staphylococci
2) Streptococci
-On the office’s staph retreat, there was NO StRES.
-OVRPS (overpass)
NOvobiocin-Saprophyticus is
Resistant; Epidermidis is Sensitive.

Optochin- Viridans is Resistant;
Pneumoniae is Sensitive.

Bacitracin-group B strep are Resistant
group A strep are Sensitive.

alpha-hemolytic bacteria:
Form green ring around colonies on blood agar. Include the following organisms:
l . Streptococcus pneumoniae (catalase negative and optochin sensitive)
2. Viridans streptococci (catalase negative and optochin resistant)

B-hemolytic bacteria:
Form clear area of hemolysis on blood agar. Include the following organisms:
l. Staphylococcus au reus (catalase and coagulase positive)
2. Streptococcus pyogenes-group A strep (catalase negative and bacitracin sensitive)
3. Streptococcus agalactiae-group B strep (catalase negative and bacitracin resistant)
4. Listeria monocytogenes (tumbling motility, meningitis in newborns, unpasteurized milk)

Staphylococcus aureus
Gram-positive cocci in clusters. Protein A (virulence factor) binds Fc-IgG, inhibiting complement fixation and phagocytosis.
l. Inflammatory disease-skin infections, organ abscesses, pneumonia
2. Toxin-mediated disease-toxic shock syndrome (TSST-1), scalded skin syndrome (exfoliative toxin), rapid-onset food poisoning (enterotoxins)
3. MRSA (methicillin-resistant S. aureus) infection-important cause of serious nosocomial and community-acquired infections. Resistant to Beta-lactams due to altered penicillin-binding protein.

Staphylococcus epidermidis
Infects prosthetic devices and intravenous catheters by producing adherent biofilms. Component of
normal skin flora; contaminates blood cultures.

Streptococcus pneumoniae
S. pneumoniae MOPS are Most OPtochin Sensitive.
Pneumococcus is associated with “rusty” sputum, sepsis in sickle cell anemia and
Most common cause of:
Otitis media (in children)
Lancet-shaped, gram-postive diiplocci.
Encapsulated. IgA protease.

Viridans group streptococci:
Sanguis (Latin) = blood. There is lots of blood
in the heart (endocarditis) .
Viridans group strep live in the mouth because
they are not afraid of-the-chin ( op-to-chin
Viridans streptococci are alpha-hemolytic. They are normal flora of the oropharynx and cause dental caries (Streptococcus mutans) and
subacute bacterial endocarditis at damaged valves (S. sanguis) . -Resistant to optochin, differentiating them from S. pneumoniae, which is a-hemolytic but is optochin sensitive.

pyogenes (group A
PHaryngitis can result in rheumatic “PHever”
and glomerulonePHritis.
No “rheum” for SPECCulation : Subcutaneous
plaques, Polyarthritis, Erythema marginatum,
Chorea, Carditis.
l. Pyogenic-pharyngitis, cellulitis, impetigo
2. Toxigenic-scarlet fever, toxic shock-like syndrome
3. Immunologic-rheumatic fever, acute glomerulonephritis
-B acitracin sensitive. Antibodies to M protein enhance host defenses against S. pyogenes but
can give rise to rheumatic fever.
-ASO titer detects recent S. pyogenes infection.

Streptococcus agalactiae (group B streptococci)

B for Babies !

B acitracin resistant, B-hemolytic, colonizes vagina; causes pneumonia, meningitis, and sepsis, mainly in babies.
-Produces CAMP factor, which enlarges the area of hemolysis formed by S. aureus. (Note: CAMP stands for the authors of the test, not
cyclic AMP.)
-Screen pregnant women at 35-37 weeks.
-Patients with positive culture receive
intrapartum penicillin prophylaxis.

Enterococci (group D streptococci)
Enterococci, hardier than nonenterococcal
group D, can thus grow in 6.5% NaCl and bile (lab test) .
Entero = intestine
faecalis = feces
strepto = twisted (chains)
coccus = berry.
Enterococci (Enterococcus faecalis and E. faecium) are normal colonic flora that are penicillin G resistant and cause UTI and subacute endocarditis. Lancefield group D includes the enterococci and the
nonenterococcal group D streptococci.
Lancefield grouping is based on differences in the C carbohydrate on the bacterial cell wall.
Variable hemolysis.
VRE (vancomycin-resistant enterococci) are an important cause of nosocomial infection.

Streptococcus bovis
(group D streptococci)
Colonizes the gut. Can cause bacteremia and subacute endocarditis in colon cancer patients.

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What are the Gram Positive Cocci bacteria? 1. Staphylococcus aureus 2. Staphylococcus epidermis 3. Streptococcus agalactiae 4. Streptococcus bovis 5. Streptococcus faecalis (enterococcus) (D) 6. Streptococcus pneumoniae 7. Streptococcus pyogenes (A) 8. Viridans Groups Streptococcus (Streptococcus mitis, mutans, salivarius, sanguis) …

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