01 Gm Positive Cocci

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  • beta, clear halo

  • alpha, green halo, from oxidation of hemoglobin

Staph Aureus

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  • Purple cloth: gram positive

  • Egyptian cat: Catalase Positive

  • Moses parting sea: Coagulase positive

  • Light bulb red: Beta hemolytic

  • Tall man: Ferments mannitol salt, turns yellow

_

A staph: Protein A binds Fc portion of IgG.,

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Egyptian nose: Colonizes nares.,

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  • Running camel and mortar/pestel: acute rapid onset tricuspid endocarditis in IV drug users

  • Running camel with women nauseating: Fast onset food poisoning, meats/mayonnaise

  • Fish bones: Osteomyelitis

  • Red camel humps: Abscess formation

  • 2 dices: Icosahedral shaped virus, post viral URI pneumonia

  • Coughing and patchy clothes: Pneumonia: patchy infiltrate on CXR

  • Bald man burned: Scalded skin syndrome: exfoliative toxin

  • Lightning cape with shock: TSST (acts as super antigen) causes toxic shock syndrome

  • Kneeling, joints: Septic arthritis

_..

  • Pharoah: MRSA (mercy)

  • Altered PBP workers: Altered penicillin binding protein (allows methicillin resistance)

  • Caravan: Vancomycin for treatment if MRSA

_..

  • Pencil: Nafcillin for Staph infections (not MRSA)

Staph Epidermis and Sapro

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  • Purple curtains: Gm +

  • Bowl of jelly untouched: Coagulase negative

  • Cat: Catalase positive

  • NH3 bottle: Urease positive

  • Navel exposed: S. epidermidis is novobiocin sensitive

  • Navel not exposed: S. saprophyticus is novobiocin resistant

_..

  • Plumber working: staph epidermis associated with prosthetic joint infection and catheters

  • Heart shaped valve: Associated with prosthetic valve infection

  • Green gunk: Staph epidermis produces thick biofilms that adhere to prosthetic surfaces

  • Dirty pan: Staph epidermis commonly contaminates blood cultures

  • Dirt on plumber's hands: staph epidermis part of normal skin flora

_..

  • Van: Vancomycin may be used to treat staph epidermis

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  • Sexy girl with UTI cup: S. saprophyticus is a common cause of UTI in sexually active females

Strep Pyogenes

_aka GAS.,

_..

  • Hot Apple under container: Hyaluronic Acid capsule

  • B bulb: Beta hemolytic

  • Baci hound eating bread: Bacitracin sensitive

S pyogenes are catalase-negative, β-hemolytic, gram-positive cocci in chains. S pyogenes is unique among β-hemolytic streptococci as it is susceptible to bacitracin. Because the bacitracin test is not very specific for S pyogenes, it has been replaced in many laboratories by the pyrrolidonyl arylamidase (PYR) test; S pyogenes is PYR-positive.

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  • Honey crusted lemon pie: Impetigo

  • Red gloves: cellulitis and erysipelas

  • Red bandana: Pharyngitis

_..

  • scarlet fever: erythrogenic toxin

  • Strep-TSST (acts as super antigen) causes Streptococcal Toxic Shock Syndrome

  • Burnt ginger with legs falling off: Necrotizing Fasciitis (Exotoxin B)

_..

(erythrogenic toxin)

  • Sticking tongue out and lick strawberry: Strawberry tongue

  • Red bandana: Pharyngitis

  • Ginger: diffused rash sparing face

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  • rheumatic fever: master chef with M

  • PSGN: post strep glomerulonephritis: chef on phone

Rheumatic Fever

_..

  • M hat and prevent stealing: M protein: prevents phagocytosis

  • Mitral hat: Endocarditis: affects mitral valve; M protein molecular mimicry with muscle myosins. Mitral stenosis

  • anti-M protein antibodies cause Rheumatic Fever

  • Red bandana: Pharyngitis precipitates RF, especially in children

Jones criteria

_..

  • Jones criteria for RF: Joints (polyarthritis). Frosting on elbow

  • Jones criteria for RF: heart (carditis). Valvular, myocarditis, pericarditis

  • Jones criteria for RF: Nodules (Subcutaneous nodules)

  • Jones criteria for RF: Erythema Marginatum, rash with thick red borders

  • Jones criteria for RF: Sydenham's Chorea, rapid involuntary movement of hands and face

  • erythema marginatum

PSGN

_..

  • Post-strep glomerulonephritis (PSGN)

  • Chef talking on phone: glomerulonephritis from antigen-antibody deposition (type III )

  • Facial puffs: Facial swelling seen in PSGN

  • Cola: Cola colored urine with PSGN

  • Calendar: PSGN occurs 2 weeks after Strep infection

RF Vs PSGN

_..

  • red bandana: both can happen with strep pharyngitis

  • honey crumbs: PSGN most common after superficial skin infection (impetigo). In contrast to Acute RF which requires Strep pharyngitis.

  • Pencil: Early penicillin for treatment (prevents RF but not PSGN). Even though chef has pencil, he still has symptoms

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  • O shaped doughnuts leaking: Streptolysin O, lysis RBC, beta hemolytic

  • Twisted bread: DNAse, dornase

  • Muffins with phosphate: Streptokinase, converts plasminogen to plasmin, fibrinolytic

_..

  • Lady with antibody tongs: Check ASO titer

Group B Strep

_aka strep agalactiae.,

_..

  • Beta light bulb: Beta hemolytic

  • Baci hound licking helmet; baby resistant from being licked: Bacitracin resistant

  • GBS: Hydrolyzes sodium hippurate, positive hippurate test

  • Helmet on hippo: Encapsulated

  • Space camp with golden staff: Positive CAMP Test Enhances hemolysis by Staph aureus

  • Red arrow head: zone of hemolysis on petri dish

_..

  • Meningitis helmet on baby: Meningitis in newborns

  • Red baby cloth: Sepsis in newborns

  • Baby coughing: Pneumonia in newborns

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  • Tunnel: baby gets GBS via vaginal delivery

  • 35 wk: Screen pregnant mothers at 35 weeks

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  • Pencil stabbing into mother ship: Treat mother with intrapartum penicillin

Strep pneumo and viridans

_..

  • green a knight tournament: Alpha hemolytic

Strep pneumo

_..

  • armor: polysaccharide capsule

  • chin not protected: optochin sensitive

  • 2 lances: Gram positive cocci, "lancet shaped"

  • mud on horse legs: Bile sensitive

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  • shield with IgA dimer: IgA protease is major virulence factor

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  • esquire mopping: Causes "MOPS" -meningitis -otitis media -pneumonia -sinusitis

  • #1 sign: #1 cause of mops

  • armor covered with rust: Produces lower lobal pneumonia with "rusty sputum"

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  • sickle: Increased risk in sickle cell population or if asplenic

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  • 3 axes: Ceftriaxone may be used for treatment

  • crows: Macrolides commonly used for uncomplicated cases

_..

Adult M, children G:

  • Polysaccharide vaccine in adults. Produces IgM response, T independent response

  • Conjugate vaccine for children. Produces IgG response

Strep viridans

_..

  • no armor: no capsule

  • protect face with mask: Optochin resistant

  • bile resistant boot: Bile resistant

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  • strep mutans and bovis

_..

  • donkey with yellow teeth: Causes dental carries

  • pope's damaged hat and plate on arm: Adheres to fibrin-platelet aggregates in damaged heart valves (mitral valve)

  • deck of cards: Synthesizes dextrans from glucose, glue sticks to platelets

Enterococcus

_..

  • formerly part of Group D Strep

  • Enterococcus: intestine, coccus; different from enterobacter, gm - rod

  • Resist bili club, bile resistant boots: bile resistant

  • 6.5%: grows on 6.5% NaCl

_..

  • California sign, more people: E. Faecalis - More prevalent, less pathogenic

  • Fees, buffer guy: E. Faecium - Less prevalent, more pathogenic/dangerous

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  • Do U heart trees: May cause of endocarditis, UTI, and biliary tree infection (insoluble in bile)

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  • Resist van: Vancomycin resistant nosocomial infection

  • Police line, department, tiger strip: daptomycin, linezolid, tigecyclin

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