Notes in Staphlococcus
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7/28/2019 Notes in Staphlococcus
1/5
Morphology and Physiology:Nonmotile Gram-positivefacultativeanaerobiccocci(seeWebLinked
image; seeWebLinked image; seeWebLinked image)
Microscopically cells occur singly and in pairs, short chains, and grape-likeclusters
Both respiratory and fermentative metabolism; Nitrate often reduced tonitrite
Capsuleorslime layer(diffuse capsule) may be present morecommonly in vivo; Particularly important in Staphylococcus epidermidiscolonization
Cell wall contains teichoic acid
Ribitol teichoic acid (Polysaccharide A) in Staphylococcus aureus
Glycerol teichoic acid (Polysaccharide B) in S. epidermidis
Enzymes:
StronglycatalasepositiveDifferentiates staphyloccoci fromstreptococci
CoagulaseS. aureus iscoagulasepositive
1. Both free and bound coagulase2. Bound coagulase = clumping factor
All other staphyloccocci are coagulase negative
Usually oxidase negative
Protein A
Uniformly coats surface ofS.aureus
Not present on coagulase-negative staphylococci
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S. aureus ferments mannitol; Most other staphyloccocci are mannitolnegative
Halotolerant (grow in medium containing < 10% NaCl); Salt is useful as aselective constituent in isolation media
Wide temperature range for growth (18oC - 40
oC)
Staphylococcal strains vary in pigmentation and susceptibility to antibiotics
Clinical Syndromes:S. aureus:
Cutaneous Infections:
Folliculitis
Furuncles(boils)
Carbuncles
ImpetigoBullousimpetigoPustular impetigo
Wound infections
Toxin-Mediated Infections:
Scalded skin syndrome: neonates and children under the age of four
Toxic-shock syndrome
Food poisoning
Other infections:
PneumoniaEmpyema
Bacteremia (hospital-acquired)
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Endocarditis
Osteomyelitis: disease of growing bone
Septic arthritis
Septicembolization
Metastatic infections
S. epidermidis and other coagulase-negative staphylococci:
Endocarditis: infections of either native or artificial heart valves
Catheter and shunt infections
Prosthetic joint infections
Otheropportunistic infections
Staphylococcus saprophyticus:
Urinary tract infections in sexually active young women
Dysuria
Pyuria
Epidemiology:Staphylococci are common flora: skin, nasal cavity, oropharynx,
gastrointestinal tract, genitourinary tract
Transient colonization by S. aureus
Transmission by direct contact or byfomite
Carrierstate: short or long-term, often colonizing the anterior nares
Endemicandepidemicdisease
Nosocomialinfections
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Pathogenesis:Extracellularvirulencefactors:
Enzymes:
Coagulases:
1. bound (clumping factor)2. free (coagulase-reacting factor)
Hyaluronidase: "spreading factor" ofS. aureus
Nucleases: S. aureus; Cleaves DNA (DNase) and RNA (RNase)
Fibrinolysin: staphylokinase
Lipases: esterases
Penicillinase
Exotoxins:
Cytotoxins (hemolysins): cytopathic and cytolytic for a broad range ofaffected cells,
includingerythrocytes,leukocytes,macrophages,hepatocytes,lymphocytes,lymphoblasts,fibroblasts,neutrophilsandplateletsAlpha toxin
Beta toxin: sphingomyelinase C (phospholipase)Delta toxin: detergent-like activityGamma toxin: hemolytic activityLeukocidin
Enterotoxins (A to E)
Exfoliative toxin (epidermolytic toxin or exfoliatin) (A and B)
Toxic shock syndrome toxin-1 (TSST-1) (formerly pyrogenic exotoxin C)
Somaticvirulence factors:
Slime layer (capsule)
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Protein A: binds Fc receptors of IgG
Teichoic acid: bindsfibronectin
Laboratory Identification:Microscopy: gram reaction and morphology
Culture and biochemical confirmation
Serology
Treatment and Prevention:Drain infected area
Deep/metastatic infections: semi-synthetic penicillins; cephalosporins,erythromycin or clindamycin
Endocarditis: semi-synthetic penicillin plus an aminoglycoside
Carrier status prevents complete control
Proper hygiene, segregation of carriers from highly susceptible individuals
Good aseptic techniques when handling surgical instruments
Control of nosocomial infections
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