Staphilococ

Gram-Positive Pathogens
Stain purple when gram stained

Can be divided into 2 major groups :
Genera of cocci-shaped organisms-

Staphylococcus, Streptococcus, and
Enterococcus
Genera of bacilli-shaped organisms- Bacillus,

Clostridium, Listeria, Corynebacterium,
Mycobacterium, Propionibacterium, Nocardia,
and Actinomyces
Normal members of human bacterial flora
Can be opportunistic pathogens, causing a
wide range of local or sistemic diseases
Structure and Physiology
Gram-positive cocci, nonmotile, aerobes facultative

anaerobes
Cells occur in grapelike clusters because cells division
occurs along different planes and the cells remain attached
to one another;
Salt-tolerant: allows them to tolerate the salt present on
human skin;
Tolerant of desication: allows survival on environmental
surfaces (objects or fomites);
Structure and Physiology
Two species are commonly associated with
staphylococcal diseases in humans
Staphylococcus aureus: the more virulent
strain that can produce a variety of conditions
depending on the site of infection
Staphylococcus epidermidis (white) normal
flora of human skin that can cause opportunistic
infections in immunocompromised patients or
when introduced into the body
Stapylococcus saprophiticus (yellow) rarely
pathogen
Pathogenicity
Staph infections occur when staphylococci
breake the bodys physical barriers
Entry of only a few hundred bacteria can
result a disease
Pathogenicity results from 3 features
Structures that enable it to evade phagocytosis
Production of enzymes
Production of toxins
Structural Defenses Against
Phagocytosis
1. Protein A coats the cell surface
Interferes with humoral immune responses by binding
to class G antibodies
Inhibits the complement activation cascade
2. Clumping Factor (Bound coagulase)
Converts the soluble blood protein fibrinogen in
insoluble fibrin molecules that form blood clots
Fibrin clots hide the bacteria from phagocytic cells
Structural Defenses Against Phagocytosis
3. Synthetize organized polysaccharide slime

layers (often called capsules)
Inhibit chemotaxis of and phagocytosis by
leukocytes
Facilitates attachment of staphylococcus to
artificial surfaces
Enzymes
1. Coagulase
Triggers blood clotting
2. Hyaluronidase
Breakedown hyaluronic acid, enabling the
bacteria to spread between tissues cells
3. Staphylokinase
Dissolves fibrin threads in blood clots, allowing
Staphylococcus aureus to free itself from clots
Enzymes
4. Lipases
Digest lipids, allowing staphylococcus to grow
on the skins surface and in cutaneous oil
glands
5. -lactamase
Breaks down penicillins
Allows the bacteria to survive treatment with -
lactam antimicrobial drugs
Toxins
Staphylococcus aureus produces many toxins, more
frequently than S.epidermidis
1. Cytolytic toxins
Disrupts the cytoplasmic membrane of a variety
of cells
Leucocidins can destroy leukocytes specifically
2. Exfoliative toxins: cause the patients skin cells to

separate from each other and slough off the body
Toxins
3. Toxic-shock-syndrome toxin (TSST-1)
Causes toxic shock syndrome
4. Enterotoxins
Stimulate the intestinal muscle contractions,
nausea, and intense vomiting associated with
staphylococcal food poisoning
Virulence factors of Staphylococcus aureus
III.
Staphylococcal Diseases
3 categories of diseases:
Noninvasive diseases:
Food poisoning, from the ingestion of enterotoxin-
contaminated food
Cutaneous disease:
Various skin conditions including scalded skin
syndrome, impetigo, folliculitis and furuncles
Staphylococcal Diseases
Systemic Disease
Toxic shock syndrome-TSST-1 toxin is absorbed
into the blood and causes shock
Bacteremia: presence of bacteria in the blood
Endocarditis: occurs when bacteria attack the
lining of the heart
Pneumonia: inflammation of the lungs in which
the alveoli and bronchioles become filled with
fluid
Osteomyelitis: inflammation of the bone marrow
and the surrounding bone
Diagnosis, Treatment, and Prevention
Diagnosis:
Detection of Gram-positive bacteria in grapelike
arrangements isolated from pus, blood, or other
fluids
Diagnosis
Specimen: pus, blood, secrrtions
Smear
Culture: blood agar, enrichement media with salt
Biochemical Reactions: catalase+, coagulase+
Antibiogram: compulsory (MRSA strains frequent)
Typing (phage)
Treatment:
Oxacilin is the drug of choice to treat
staphylococcal infections
Is a semisynthetic form of penicillin and is not
inactivated by -lactamases
Vancomicin for MRSA

Diagnosis, Treatment, and Prevention
Prevention:
Hands antisepsia is the most important measure

in preventing nosocomial infections;
Also important is the proper cleansing of
wounds and surgical procedures, aseptic use of
catheters or indwelling needles, an appropriate
use of antiseptics;
No effective vaccines are available.

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Gram-Positive Pathogens

Stain purple when gram stained

Genera of cocci-shaped organisms-

Genera of bacilli-shaped organisms- Bacillus,

Gram-positive cocci, nonmotile, aerobes facultative

3. Synthetize organized polysaccharide slime

2. Exfoliative toxins: cause the patients skin cells to

Vancomicin for MRSA

Hands antisepsia is the most important measure

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