 Welcome back to our meds smarter lecture series where we're taking a smarter approach to preparing future physician Before we get started if you'll take just a quick minute and click that like button and also Subscribe and turn the bell on so that you'll be notified when we post new videos Let's continue on in our discussion Staphylococcus safrophidicus. This is a gram positive Catalyse positive Quagulase negative and urease positive cocci that forms in clusters So if you compare this to the previous picture of staff epiderminus, it's gonna look fairly similar because they're all clustering up Just like that previous one, but our big main difference here is going to be that this is actually novo bioson resistant So if we test this against novo bioson Staff epiderminus is sensitive to it where staff safrophidicus is resistant This once again similar to epiderminus is an is normally found on the human body in particular and the female genital tract in the perineum So this can be found on swabs in the genital tract area And it doesn't typically cause any problems unless it is able to seat inside of some sort of a Lesion that allows it into the body or into the skin This is the second most common cause of uncomplicated UTIs in young women first being E. Coli Let's continue on and talk about streptococcus pyogenes. We also know this as group a strep This is a gram positive cocci that are in chains. So previously we've discussed some gram positive Cocci that are in clusters. These are in chains. So they're actually attached end-to-end and Form a line or a rope type structure What is strep pyogenes do well, it's Pyogenic meaning that it can cause pharyngitis cellulitis impotigo and erycephalus And it's toxigenic state it can cause scarlet fever toxic shock-like syndrome and necrotizing fasciitis And and it's an immunologic type state it can cause rheumatic fever and glomerular nephritis Strep pyogenes is sensitive to basatracin It is a beta hemolytic bacteria and we can also check it as it is aero-lamidase positive Typically the pyrrolidonol are Lamedase also known as Pyr Typically that's used to distinguish between our enterococcus and our group D strep But our group A strep does also show these characteristics. So the big key if you see something that is pyr Positive is to check for its beta hemolysis So if it is beta hemolytic it has to be strep pyogenes or group A strep Something that makes this particular microorganism more virulent is its ability to inhibit phagocytosis How does it do that? Well, it has a hyaluronic capsule and an M protein that are on the Surface of the cell that help inhibit phagocytosis our body can actually produce some antibodies against that M protein Which is what's inhibiting phagocytosis it can it can produce antibodies against that M protein But those antibodies actually give us the possibility of rheumatic fever developing If you're wondering if you've had a recent infection with staff pyogenes We can do an ASO titer or an anti-DNA B antibody that will tell us if we have had that recent infection In a way, you can remember some of the clinical symptoms and signs associated with Pyogenes is using the phrase Pyogenes pharyngitis can result in rheumatic fever and glomerular nephritis So the keys here are using the pH for pharyngitis fever nephritis and that will help you remember that it's phyogenes or pyogenes if we do have strains that can Cause impotigo and if you remember impotigo is what gives us those honey crusted lesions Well impotigo strains can induce glomerular nephritis. That's something to remember there now we also have The potential for scarlet fever What is scarlet fever seen as well scarlet fever is blanching sandpaper like body rashes and Specifically this strawberry tongue you can see a picture of that here. It actually looks like the tongue Around the taste bud areas is kind of patchy like the seeds of a strawberry. So that is what strawberry tongue is Really what it does is initially will have a white coating on it which you can kind of see back in the back here and Then the papillae which are those dots those become swollen and reddened And so we've got that then protruding up through the white coat that gives us that strawberry type appearance Let's discuss strep agalactae or streptococcus agalactae group B strep Group B strep is a gram positive cocci. It is resistant to basatracin. It is beta hemolytic We've already talked about that a little bit if you need some refresher on what beta hemolytic means go back and find that video and This does colonize the vagina quite often What are some things that strep to coccus agalactae can cause well it can cause pneumonia it can cause meningitis and it can cause sepsis Specifically what's happening here this virulence factor with strep to coccus agalactae is due to the camp factor now Don't confuse this with cyclic amp with the small C Cyclic amp and camp are two different things Camp here is actually referring to the author who created the test has nothing to do with cyclic amp. So don't confuse those two So strep to coccus agalactae produces camp factor. What does that do? Well, it's going to enlarge the area of hemolysis that's formed by Staph aureus You can test this by using the hip urate test and it's actually going to be positive on the hip urate test and As we've discussed previously when we talked about strep pyogenes that Strap pyogenes is Pyr positive this Group B strep is Pyr negative We always check pregnant ladies around their 35th to 37th week of gestation So that we can see if they do have a strep to coccus or a group B strep infection Using rectal and vaginal swabs if they do have that then what we're going to do is give them some Intrapartum penicillin and ampicillin as a prophylaxis So that they don't pass that infection on to their child as it passes through the birth canal So remember the big thing here group B strep is for babies So we always want to check the mother Before she gives birth for a potential group B infection if she has group B Then we will give Intrapartum ampicillin Penicillin as a prophylaxis to help reduce the risk of the child Contracting an infection as it passes through the birth canal If you found this material helpful for your studying Please like and consider subscribing to the channel also share this video so that more people can benefit from it like you have