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Staphylococcus
Classification
• Family
• Genus
• Species
Micrococcaceae
Micrococcus and Staphylococcus
S. aureus
S. saprophyticus
S. epidermidis
M. luteusmore
than 20
specie
s
Gram-Positive Cocci
Enterococcus (Group D CHO) γ hemolytic (α or β)
Enterococcus faecalis, E. faecium
FAMILY Micrococcaceae (catalase positive)
Coagulase-positive Staphylococcus aureus
Coag.-neg. Staphylococcus epidermidis, S. saprophyticus
FAMILY Streptococcaceae (catalase negative)
Group A: β-hemolytic Streptococcus pyogenes
Group B: β-hemolytic (occasionally α or γ) S. agalactiae
Group C: β-hemolytic (α or γ) S. anginosus, S. equismilis
Group D: α or γ hemolytic (β) S. bovis
Group F: β-hemolytic S. anginosus
Group G: β -hemolytic S. anginosus
Viridans streptococci: (no group specific CHO)
α or γ hemolytic S. mutans and
S. salivarius, S. sanguis, S. mitis and S. milleri groups
Streptococcus pneumoniae (no group CHO)(α-hemolytic)
Morphology
Morphology
Staph vs. Strep
Gram-positive cocci
in clusters
StreptococcusStaphylococcus
Staphylococcus
See Overheads
~~~~~~~~~~
TSS
Foodborne Intoxication
~~~~~~~~~~
MICROBIAL
PATHOGEN ADHESIN RECEPTOR
Staphylococcus aureus LLiippootteeiicchhooiicc aacciidd Unknown
Staphylococcus spp. SSlliimmee llaayyeerr Unknown
Group A Streptococcus LLTTAA--MM pprrootteeiinn ccoommpplleexx FFiibbrroonneeccttiinn
Streptococcus pneumoniae Protein N-acetylhexosamine-gal
Escherichia coli Type 1 fimbriae
CFA 1 fimbriae
P fimbriae
D-MMaannnnoossee
GM ggaanngglliioossiiddee
P blood grp glycolipid
Other Enterobacteriaceae Type 1 fimbriae D-Mannose
Neisseria gonorrhoeae Fimbriae GD1 ganglioside
Treponema pallidum P1, P2, P3 Fibronectin
Chlamydia spp. Cell surface lectin N-acetylglucosamine
Mycoplasma pneumoniae Protein P1 Sialic acid
Vibrio cholerae Type 4 pili Fucose and mannose
Cell-Associated Virulence Factors
• Capsule or slime layer (glycocalyx)
• Peptidoglycan (PG)
• Teichoic acid is covalently linked to PG
and is species specific:
S. aureus ribitol teichoic acid
(polysaccharide A)
S. epidermidis glycerol teichoic acid
(polysaccharide B)
• Protein A is covalently linked to PG
• Clumping factor (bound coagulase)
Virulence Factors
Extracellular Enzymes
• Coagulases (bound or free)
Antigenic
• Hyaluronidase
“spreading factor” of S. aureus
• Nuclease
Cleaves DNA and RNA in S. aureus
• Protease
Staphylokinase (fibrinolysin)
• Lipases
• Esterases
Virulence Factors: Exotoxins
• Cytolytic (cytotoxins; cytolysins)
 Alpha toxin - hemolysin
• Reacts with RBCs
 Beta toxin
• Sphingomyelinase
 Gamma toxin
• Hemolytic activity
 Delta toxin
• Cytopathic for:
– RBCs
– Macrophages
– Lymphocytes
– Neutrophils
– Platelets
• Enterotoxic activity
 Leukocidin
• Enterotoxin
• Exfoliative toxin (epidermolytic toxin)
• Pyrogenic exotoxins
Virulence Factors: Exotoxins
Pathogenesis
• Pass skin – first line of defense
 Benign infection
• Phagocytosis
• Antibody
• Inflammatory response
Chronic infections
• Delayed hypersensitivity
Clinical Manifestations/Disease
• SKIN
 folliculitis
 boils (furuncles)
 carbuncles
 impetigo (bullous & pustular)
 scalded skin syndrome
•Neonates and children under 4 years
Clinical Manifestations/Disease
• Other infections
 Primary staphylococcal pneumonia
 Food poisoning vs. foodborne disease
 Toxic shock syndrome
Metastatic Infections
•Bacteremia
•Osteomyelitis
disease of growing bone
• Pulmonary and cardiovascular
infection
Coagulase-Negative Staphylococci
• Staphylococcus epidermidis
• S. saprophyticus
Staphylococcal Lab ID & Diagnostic Tests
• Microscopic
• Lab isolation
• Coagulase positive
 S. aureus
Mannitol Salts Agar
(MSA)
Staphylococcus aureus
Catalase
2H2O2  O2 + 2H2O
Streptococci vs. Staphylococci
Differential Characteristics
Catalase POS
Staphylococcus
Catalase NEG
S. aureus
Coagulase
Fibrinogen  Fibrin
Differential
Characteristics
Coagulase NEG
Coagulase POS
Staphylococcus
aureus
Treatment
• Drain infected area
• Deep/metastatic infections
 semi-synthetic penicllins
 cephalosporins
 erythromycin
 clindamycin
• Endocarditis
 semi-synthetic penicillin + an aminoglycoside
Prevention
• Carrier status prevents complete control
• Proper hygiene, segregation of carrier
from highly susceptible individuals
• Good aseptic techniques when
handling surgical instruments
• Control of nosocomial infections
REVIEW
Gram-Positive Cocci
Enterococcus (Group D CHO) γ hemolytic (α or β)
Enterococcus faecalis, E. faecium
FAMILY Micrococcaceae (catalase positive)
Coagulase-positive Staphylococcus aureus
Coag.-neg. Staphylococcus epidermidis, S. saprophyticus
FAMILY Streptococcaceae (catalase negative)
Group A: β-hemolytic Streptococcus pyogenes
Group B: β-hemolytic (occasionally α or γ) S. agalactiae
Group C: β-hemolytic (α or γ) S. anginosus, S. equismilis
Group D: α or γ hemolytic (β) S. bovis
Group F: β-hemolytic S. anginosus
Group G: β -hemolytic S. anginosus
Viridans streptococci: (no group specific CHO)
α or γ hemolytic S. mutans and
S. salivarius, S. sanguis, S. mitis and S. milleri groups
Streptococcus pneumoniae (no group CHO)(α-hemolytic)
REVIEW
REVIEW
Which features are only found in S. aureus?
S. epidermidis
S. aureus
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
Lecture pp5&6staphylococcus

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Lecture pp5&6staphylococcus

  • 1.
  • 3. Classification • Family • Genus • Species Micrococcaceae Micrococcus and Staphylococcus S. aureus S. saprophyticus S. epidermidis M. luteusmore than 20 specie s
  • 4. Gram-Positive Cocci Enterococcus (Group D CHO) γ hemolytic (α or β) Enterococcus faecalis, E. faecium FAMILY Micrococcaceae (catalase positive) Coagulase-positive Staphylococcus aureus Coag.-neg. Staphylococcus epidermidis, S. saprophyticus FAMILY Streptococcaceae (catalase negative) Group A: β-hemolytic Streptococcus pyogenes Group B: β-hemolytic (occasionally α or γ) S. agalactiae Group C: β-hemolytic (α or γ) S. anginosus, S. equismilis Group D: α or γ hemolytic (β) S. bovis Group F: β-hemolytic S. anginosus Group G: β -hemolytic S. anginosus Viridans streptococci: (no group specific CHO) α or γ hemolytic S. mutans and S. salivarius, S. sanguis, S. mitis and S. milleri groups Streptococcus pneumoniae (no group CHO)(α-hemolytic)
  • 9.
  • 10.
  • 11.
  • 13.
  • 14. MICROBIAL PATHOGEN ADHESIN RECEPTOR Staphylococcus aureus LLiippootteeiicchhooiicc aacciidd Unknown Staphylococcus spp. SSlliimmee llaayyeerr Unknown Group A Streptococcus LLTTAA--MM pprrootteeiinn ccoommpplleexx FFiibbrroonneeccttiinn Streptococcus pneumoniae Protein N-acetylhexosamine-gal Escherichia coli Type 1 fimbriae CFA 1 fimbriae P fimbriae D-MMaannnnoossee GM ggaanngglliioossiiddee P blood grp glycolipid Other Enterobacteriaceae Type 1 fimbriae D-Mannose Neisseria gonorrhoeae Fimbriae GD1 ganglioside Treponema pallidum P1, P2, P3 Fibronectin Chlamydia spp. Cell surface lectin N-acetylglucosamine Mycoplasma pneumoniae Protein P1 Sialic acid Vibrio cholerae Type 4 pili Fucose and mannose
  • 15. Cell-Associated Virulence Factors • Capsule or slime layer (glycocalyx) • Peptidoglycan (PG) • Teichoic acid is covalently linked to PG and is species specific: S. aureus ribitol teichoic acid (polysaccharide A) S. epidermidis glycerol teichoic acid (polysaccharide B) • Protein A is covalently linked to PG • Clumping factor (bound coagulase)
  • 16. Virulence Factors Extracellular Enzymes • Coagulases (bound or free) Antigenic • Hyaluronidase “spreading factor” of S. aureus • Nuclease Cleaves DNA and RNA in S. aureus • Protease Staphylokinase (fibrinolysin) • Lipases • Esterases
  • 17. Virulence Factors: Exotoxins • Cytolytic (cytotoxins; cytolysins)  Alpha toxin - hemolysin • Reacts with RBCs  Beta toxin • Sphingomyelinase  Gamma toxin • Hemolytic activity  Delta toxin • Cytopathic for: – RBCs – Macrophages – Lymphocytes – Neutrophils – Platelets • Enterotoxic activity  Leukocidin
  • 18. • Enterotoxin • Exfoliative toxin (epidermolytic toxin) • Pyrogenic exotoxins Virulence Factors: Exotoxins
  • 19. Pathogenesis • Pass skin – first line of defense  Benign infection • Phagocytosis • Antibody • Inflammatory response Chronic infections • Delayed hypersensitivity
  • 20. Clinical Manifestations/Disease • SKIN  folliculitis  boils (furuncles)  carbuncles  impetigo (bullous & pustular)  scalded skin syndrome •Neonates and children under 4 years
  • 21. Clinical Manifestations/Disease • Other infections  Primary staphylococcal pneumonia  Food poisoning vs. foodborne disease  Toxic shock syndrome
  • 22. Metastatic Infections •Bacteremia •Osteomyelitis disease of growing bone • Pulmonary and cardiovascular infection
  • 23.
  • 24. Coagulase-Negative Staphylococci • Staphylococcus epidermidis • S. saprophyticus
  • 25.
  • 26.
  • 27. Staphylococcal Lab ID & Diagnostic Tests • Microscopic • Lab isolation • Coagulase positive  S. aureus
  • 29. Catalase 2H2O2  O2 + 2H2O Streptococci vs. Staphylococci Differential Characteristics
  • 31. S. aureus Coagulase Fibrinogen  Fibrin Differential Characteristics
  • 33. Treatment • Drain infected area • Deep/metastatic infections  semi-synthetic penicllins  cephalosporins  erythromycin  clindamycin • Endocarditis  semi-synthetic penicillin + an aminoglycoside
  • 34. Prevention • Carrier status prevents complete control • Proper hygiene, segregation of carrier from highly susceptible individuals • Good aseptic techniques when handling surgical instruments • Control of nosocomial infections
  • 35.
  • 37. Gram-Positive Cocci Enterococcus (Group D CHO) γ hemolytic (α or β) Enterococcus faecalis, E. faecium FAMILY Micrococcaceae (catalase positive) Coagulase-positive Staphylococcus aureus Coag.-neg. Staphylococcus epidermidis, S. saprophyticus FAMILY Streptococcaceae (catalase negative) Group A: β-hemolytic Streptococcus pyogenes Group B: β-hemolytic (occasionally α or γ) S. agalactiae Group C: β-hemolytic (α or γ) S. anginosus, S. equismilis Group D: α or γ hemolytic (β) S. bovis Group F: β-hemolytic S. anginosus Group G: β -hemolytic S. anginosus Viridans streptococci: (no group specific CHO) α or γ hemolytic S. mutans and S. salivarius, S. sanguis, S. mitis and S. milleri groups Streptococcus pneumoniae (no group CHO)(α-hemolytic) REVIEW
  • 38. REVIEW Which features are only found in S. aureus? S. epidermidis S. aureus

Notas do Editor

  1. Clockwise from Top Left Staphylococcal Scalded Skin Syndrome (SSSS) Bullous impetigo (localized form of SSSS) Pustular impetigo Septic embolization Toxic Shock Syndrome (TSS)