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Collaborative skills by examining a real-world case study

Enhance your analytical, critical thinking, and collaborative skills by examining a real-world case study. Please engage in group discussions to explore various aspects of the case below and then individually articulate your answers to the questions following the cast study.

College sophomore Nadia is a star point guard for her school’s basketball team. She is excited about the divisional finals Friday night—she’s even heard rumors that a professional scout will be in the stands. On Thursday morning, she wakes up with a sore throat. Her forehead doesn’t feel warm, so she forces herself to attend her Thursday classes; but when she wakes up on Friday morning, her throat is noticeably worse. Still, she forces herself to attend Friday morning class but feels tired and much worse by noon. It is downright painful to swallow, and she skips lunch.

Nearly crying, she heads back to the dorm and checks her temperature— 101°F. Desperate, she walks to the student health center, where a nurse practitioner notices white patches on the back of Nadia’s throat and on her tonsils. The divisional basketball game starts in six hours, but it only takes a few minutes for the nurse practitioner to perform a rapid streptococcal antigen test and determine that Nadia has streptococcal, also known as group A Streptococcus (GAS), pharyngitis—strep throat. She will miss the big game.

Strep throat is caused by an encapsulated, Gram-positive bacterium, Streptococcus pyogenes. The only good news is that by taking the prescribed penicillin, Nadia should be ready for her next big game—hopefully, the quarterfinals.

How does the capsule of Streptococcus contribute to the bacterium’s ability to cause disease?
What bacterial structures besides the capsule may be allowing Streptococcus to infect Nadia’s throat?
Penicillin works by interrupting the formation of peptidoglycan. What bacterial structure contains peptidoglycan?
In a Gram-positive organism such as Streptococcus, is peptidoglycan typically thicker or thinner than it would be in a Gram-negative bacterium?

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Sample Answer

 

 

 

Group Discussion Points:

  1. Transmission of Strep Throat: How do you think Nadia might have contracted strep throat? Discuss the different routes of transmission for bacterial infections.
  2. Specificity of Rapid Strep Test: What are the limitations of a rapid strep test? Are there other diagnostic tests for strep throat?
  3. Alternatives to Penicillin: What are potential reasons why a healthcare provider might prescribe an antibiotic other than penicillin for strep throat?

Full Answer Section

 

 

Individual Responses:

  1. Capsule and Disease: The capsule of Streptococcus pyogenes contributes to the bacterium’s ability to cause disease in several ways:
    • Evasion of Phagocytosis:The capsule acts as a slippery coat, making it harder for white blood cells (phagocytes) to engulf and destroy the bacteria.
    • Adherence to Host Cells:The capsule can contain components that help the bacteria adhere to the cells in the throat, facilitating colonization and infection.
  2. Bacterial Structures for Infection: Besides the capsule, other bacterial structures that may be allowing Streptococcus to infect Nadia’s throat include:
    • Adhesins:These are surface proteins or molecules on the bacteria that allow them to specifically attach to host cells in the throat.
    • Toxins:Streptococcus pyogenes produces toxins that can damage or lyse (break open) host cells, contributing to inflammation and the symptoms of strep throat.
  3. Penicillin’s Target: Penicillin disrupts the formation of peptidoglycan, a key structural component of the bacterial cell wall. Peptidoglycan provides strength and rigidity to the bacterial cell wall.
  4. Peptidoglycan in Gram-positive vs. Gram-negative: In Gram-positive bacteria like Streptococcus, peptidoglycan is a thicker layer compared to Gram-negative bacteria. This thicker layer contributes to the positive staining reaction in the Gram stain test.

 

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