Updated: 3/13/2019

Gram-Positive Bacteria

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https://upload.medbullets.com/topic/104192/images/gram positive - moises dominguez.jpg
https://upload.medbullets.com/topic/104192/images/gram_stain_anthrax.jpg
Introduction
  • Definition
    • gram-positive bacteria stain purple on a gram-stain test
      • the bacterial cell wall of these organisms have thick peptidoglycan layers, which take up the purple/violet stain
  • Treatment
    • gram-positive bacteria are susceptible to antibiotics that target the cell wall, as they often lack an outer membrane
      • penicillins
      • vancomycin
      • carbapenem
      • daptomycin
    • other antibiotics used include
      • linezolid
      • clindamycin
 
Gram-Positive Bacteria
COCCI
Staphylococcus
Bacteria Disease Treatment
Staphylococcus aureus 

  • Abscesses and mastitis
  • Endocarditis
  • Gastroenteritis
  • Osteomyelitis
  • Pneumonia
  • Scalded skin syndrome
  • Skin infections
  • Toxic shock syndrome
  • Penicillinase-resistant penicillins
  • Vancomycin
  • Linezolid
Staphylococcus epidermidis 
  • Normal skin and genital tract flora
  • Associated with use of catheters and prosthetic devices and biofilm development
  • Vancomycin
Staphylococcus saprophyticus 
  • Normal genital tract flora
  • Urinary tract infection
  • Trimethoprim-sulfamethoxazole
Streptococcus
Streptococcus pneumoniae 
  • "MOPS"
  •  Meningitis
  •  Otitis media
  •  Pneumonia
  •  Sinusitis
  • Penicillins
  • 3rd generation cephalosporins
Streptococcus pyogenes (Group A) 
  • Pyogenic infections
    • pharyngitis
    • cellulitis
    • impetigo
    • erysipelas
  • Toxigenic infections
    • scarlet fever
    • necrotizing fasciitis
  • Immunologic infections
    • glomerulonephritis
    • rheumatic fever
  • Penicillins
Streptococcus agalactiae (Group B) 
  • Normal vaginal flora
  • Neonatal septicemia
  • Neonatal meningitis
  • Ampicillin
Streptococcus viridans 
  • Normal throat flora
  • Dental caries
  • Endocarditis
  • Penicillin G
Streptococcus bovis (Group D) 
  • Normal gut flora
  • Bacteremia
  • Endocarditis (subacute)
  • Associated with colon cancer
  • Penicillin or ceftriaxone
Enterococci
Enterococci faecalis (Group D) 
  • Normal gut flora
  • Endocarditis (subacute)
  • Urinary tract infection
  • Biliary tract infections
  • Some strains are vancomycin-resistant (VRE)
  • Linezolid and streptogramins
  • Penicillins, vancomycin, or daptomycin
  • Often resistant to penicillin G
BACILLI
Spore-Forming
Bacillus anthracis 
  • Cutaneous anthrax
  • Pulmonary anthrax
  • Ciprofloxacin
  • Doxycycline
Bacillus cereus 
  • Food poisoning (rice)
  • Self-limiting
  • Clindamycin
  • Aminoglycosides
Clostridium tetani 
  • Tetanus
  • Antitoxin with or without vaccine booster
  • Benzodiazepines for muscle spasms
  • Surgical debridement
Clostridium botulinum 
  • Botulism
  • Human botulinum immunoglobulin
Clostridium perfringens 
  • Gas gangrene
  • Food poisoning
  • Clindamycin
  • Penicillin
Clostridium difficile 
  • Antibiotic-associated diarrhea
  • Colitis
  • Pseudomembranous colitis
  • Metronidazole
  • Vancomycin (oral)
  • Fidaxomicin
  • Fecal microbiota transplant
Non-Spore Forming
Corynebacterium diphtheriae 
  • Diphtheria
  • Erythromycin
  • Penicillin G
  • Diphtheria antitoxin
Listeria monocytogenes 
  • Meningitis
    • neonatal
    • immunocompromised
  • Amnionitis
  • Spontaneous abortion
  • Granulomatosis infantiseptica
  • Gastroenteritis
  • Ampicillin
  • Trimethoprim-sulfamethoxazole
BRANCHING FILAMENTS
Nocardia spp.
  • Pulmonary infection (immunocompromised)
  • Cutaneous nocardiosis (associated with trauma)
  • Trimethoprim-sulfamethoxazole
  • Carbapenems
Actinomyces spp.
  • Oral and facial abscesses
    • associated with poor dental hygiene or maxillofacial trauma
  • Yellow "sulfur granules"
  • Pelvic inflammatory disease
    • associated with intrauterine devices
  • Penicillin
  • Tetracycline

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Questions (1)

(M1.MC.14.78) A 43-year-old patient with a history of esophageal cancer presents with sudden onset slurred speech. On CT scan, she is found to have an acute intraparenchymal hemorrhage, likely from a metastasis, with interventricular extension. Due to concern for hydrocephalus, an external ventricular drain is placed in order to control the intracerebral pressure. Two weeks later, she undergoes a lumbar puncture due to altered mental status, and the gram stain of the fluid is depicted in Figure A. Which part of the bacteria is responsible for the blue color on the stain?

QID: 106887
FIGURES:
1

Cell wall

88%

(90/102)

2

Mitochondria

2%

(2/102)

3

Golgi

0%

(0/102)

4

Nucleus

7%

(7/102)

5

Endoplasmic reticulum

0%

(0/102)

M 1 D

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