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Staphylococcus Eva L. Dizon, M.D.,FPPS,FPIDSP
Staphylococcus Staphyle- Bunch of grapes 0.5 to 1 um Non motile Aerobic or Facultative Anaerobic Catalase positive Grow in media containing 10% NaCl at temp 18 to 40 C Present on the skin and mucuos membrane
Species ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Physiology and Structure
Structure
 
Structure CAPSULE - loose fitting polysaccharide layer  (slime layer) - protects bacteria by inhibiting  chemotaxis and phagocytosis - facilitates adherence of bacteria to  catheters and synthetic materials PEPTIDOGLYCAN - half of the cell wall - consist of layers of glycan chains with  alternating subunits of N –acetylmuramic  acid and N- acetylglucosamine - has endotoxin like activity
Structure TEICHOIC ACID-  phosphate containing polymers  bound to peptidoglycan layer or to  cytplasmic membrane - mediates the attachment of  staphylococcus to mucosal surfaces S. aureus  Ribitol teichoic acid with N-acetylglucosamine  ( Polysaccharide A)  S. epidermidis  glycerol  teichoic acid with glucosyl residues (polysaccharide B)-
PROTEIN A-  covalentlylinked to peptidoglycan   - has affinity to Fc receptor of Ig  - blocks opsonization and phagocytosis
Structure CYTOPLASMIC MEMBRANE-  osmotic barrier for the  cell and provides an anchorage for the  biosynthetic and respiratory enzyme COAGULASE and other SURFACE PROTEIN -Clumping factor or Bound coagulase  binds fibrinogen convert to insoluble  fibrin causing staphylococcus to  clump - collagen , elastin and fibronectin binding  protein
Toxins ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cytotoxins Lyse neutrophils    release of lysosomal enzymes    damage sorrounding tissues Alpha toxin  – disrupts the smooth muscle in blood      vessels    - toxic to erythrocytes, hepatocytes,      platelets, cultivated cells   - integrates to host cell membrane         pores    efflux of K and influx of Na,Ca        osmotic swelling    cell lysis - septic shock
Cytotoxin Beta Toxin  -  Sphingomyelinase C   - specific for sphingomyelin and      lysophosphatidylcholine   - toxic to RBC, WBC,Macrophage and fibroblast   - catalyze hydrolysis of  membrane phospholipids in    susceptible cells   - tissue destruction and abscess formation Delta toxin-  disrupts cell membrane   - toxic to variety of cells
Cytotoxin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Exfoliative toxin ,[object Object],[object Object],[object Object],[object Object],[object Object]
Enterotoxin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
TSST-1 ,[object Object],[object Object],[object Object],[object Object],[object Object]
Staphylococcal enzymes convert fibrinogen   react with globulin    plasma factor    insoluble fibrin to form  staphylothrombin   Clumping Cause formation of fibrin layer  around abscess protecting staphylococcus from phagocytosis Coagulase Bound  Free
Staphylococcal enzymes ,[object Object],[object Object]
Staphylococcal enzymes ,[object Object],[object Object],[object Object],[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sites of infection
Ritters disease or SSSS ,[object Object],[object Object],[object Object]
SSSS most commonly in children and neonates. Starts abruptly with perioral (around the mouth) erythema with sunburn-like rash rapidly turning bright red spreading to bullae (large vesicle appearing as a circumscribed area) in 2-3 days and desquamating (peeling) within 5 days.
Staphylococcal food poisoning ,[object Object],[object Object],[object Object],[object Object]
Toxic shock syndrome ,[object Object],[object Object]
TSS
Cutaneous infection ,[object Object],[object Object],[object Object],[object Object],[object Object]
Folliculitis - superficial folliculitis is essentially a staphylococcal  impetigo in which a small area of erythema develops around a hair follicle and subsequently becomes a dome-shaped pustule. Carbuncle - a deep-seated pyogenic infection of the skin and subcutaneous tissues.
Impetigo - a contagious superficial pyoderma, caused by S. aureus and Streptococcus pyogenes, that begins with a superficial flaccid vesicle which  ruptures and forms a thick yellowish crust, most commonly occurring in the face.
Others  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pneumonia
S.Epidermidis and CNS ,[object Object],[object Object],[object Object],[object Object]
Laboratory diagnosis Microscopy Culture Grow rapidly within 24 hours Large, golden, smooth colonies Blood Agar- hemolysis Selective media- add NaCl 7.5% Mannitol – fermented by S. aureus Serology Insensitive  Antibody against teichoic acid Bacteremia. Endocarditis  After 2 weeks
Culture – S. aureus
S. epidermidis  S. saphrophyticus
Coagulase test Showing positive (upper tube) and negative (lower tube) coagulase tests.
Mannitol Salt Agar test
Identification ,[object Object],[object Object]
Treatment and Prevention ,[object Object],[object Object]
 
 
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Staphylococcus (1)

  • 1. Staphylococcus Eva L. Dizon, M.D.,FPPS,FPIDSP
  • 2. Staphylococcus Staphyle- Bunch of grapes 0.5 to 1 um Non motile Aerobic or Facultative Anaerobic Catalase positive Grow in media containing 10% NaCl at temp 18 to 40 C Present on the skin and mucuos membrane
  • 3.
  • 6.  
  • 7. Structure CAPSULE - loose fitting polysaccharide layer (slime layer) - protects bacteria by inhibiting chemotaxis and phagocytosis - facilitates adherence of bacteria to catheters and synthetic materials PEPTIDOGLYCAN - half of the cell wall - consist of layers of glycan chains with alternating subunits of N –acetylmuramic acid and N- acetylglucosamine - has endotoxin like activity
  • 8. Structure TEICHOIC ACID- phosphate containing polymers bound to peptidoglycan layer or to cytplasmic membrane - mediates the attachment of staphylococcus to mucosal surfaces S. aureus Ribitol teichoic acid with N-acetylglucosamine ( Polysaccharide A) S. epidermidis glycerol teichoic acid with glucosyl residues (polysaccharide B)-
  • 9. PROTEIN A- covalentlylinked to peptidoglycan - has affinity to Fc receptor of Ig - blocks opsonization and phagocytosis
  • 10. Structure CYTOPLASMIC MEMBRANE- osmotic barrier for the cell and provides an anchorage for the biosynthetic and respiratory enzyme COAGULASE and other SURFACE PROTEIN -Clumping factor or Bound coagulase binds fibrinogen convert to insoluble fibrin causing staphylococcus to clump - collagen , elastin and fibronectin binding protein
  • 11.
  • 12. Cytotoxins Lyse neutrophils  release of lysosomal enzymes  damage sorrounding tissues Alpha toxin – disrupts the smooth muscle in blood vessels - toxic to erythrocytes, hepatocytes, platelets, cultivated cells - integrates to host cell membrane  pores  efflux of K and influx of Na,Ca  osmotic swelling  cell lysis - septic shock
  • 13. Cytotoxin Beta Toxin - Sphingomyelinase C - specific for sphingomyelin and lysophosphatidylcholine - toxic to RBC, WBC,Macrophage and fibroblast - catalyze hydrolysis of membrane phospholipids in susceptible cells - tissue destruction and abscess formation Delta toxin- disrupts cell membrane - toxic to variety of cells
  • 14.
  • 15.
  • 16.
  • 17.  
  • 18.
  • 19. Staphylococcal enzymes convert fibrinogen react with globulin plasma factor insoluble fibrin to form staphylothrombin Clumping Cause formation of fibrin layer around abscess protecting staphylococcus from phagocytosis Coagulase Bound Free
  • 20.
  • 21.
  • 22.
  • 24.
  • 25. SSSS most commonly in children and neonates. Starts abruptly with perioral (around the mouth) erythema with sunburn-like rash rapidly turning bright red spreading to bullae (large vesicle appearing as a circumscribed area) in 2-3 days and desquamating (peeling) within 5 days.
  • 26.
  • 27.
  • 28. TSS
  • 29.
  • 30. Folliculitis - superficial folliculitis is essentially a staphylococcal impetigo in which a small area of erythema develops around a hair follicle and subsequently becomes a dome-shaped pustule. Carbuncle - a deep-seated pyogenic infection of the skin and subcutaneous tissues.
  • 31. Impetigo - a contagious superficial pyoderma, caused by S. aureus and Streptococcus pyogenes, that begins with a superficial flaccid vesicle which ruptures and forms a thick yellowish crust, most commonly occurring in the face.
  • 32.
  • 34.
  • 35. Laboratory diagnosis Microscopy Culture Grow rapidly within 24 hours Large, golden, smooth colonies Blood Agar- hemolysis Selective media- add NaCl 7.5% Mannitol – fermented by S. aureus Serology Insensitive Antibody against teichoic acid Bacteremia. Endocarditis After 2 weeks
  • 36. Culture – S. aureus
  • 37. S. epidermidis S. saphrophyticus
  • 38. Coagulase test Showing positive (upper tube) and negative (lower tube) coagulase tests.
  • 40.
  • 41.
  • 42.  
  • 43.