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 Transmission:

“Process of transmitting something”


Sites of S. aureus colonization:
• Nose
• Skin
• Vagina
• Fomites
Predisposing factors for S. aureus:
• Contaminated environment
• Compromised immune system
• Diabetes
• Users of intravenous drugs
• Chronic granulomatous disease
 Pathogenesis:
S. aureus causes disease both by producing toxins and by inducing pyogenic
inflammation. The typical lesion of S. aureus pyogenic infection is an abscess.
Abscess undergo central necrosis and usually drain pus to the outside, but organisms
may disseminate via bloodstream as well.
Several important enzymes and toxins are produced by S. aureus.
Enzymes:
• Coagulases- forms fibrin clots and prevent migration of neutrophils
• Staphylokinases- is a fibrinolysin that can lyse thrombi
• Proteases- breakdown proteins
• Nucleases- catalyze the cleavage phosphodiester bond
• Lipases- breakdown fats
Exotoxins:
Toxins Causes Mode Of Action

1. Enterotoxin Food poisoning Within the GIT stimulate the release of large amount
(Superantigen) of IL-1 and IL-2 from macrophages and helper T cells
respectively.

2. Toxic shock Toxic shock It stimulates the release of large amount of IL-1, IL-2
syndrome toxin and TNF results in production of cytokines.
(Superantigen)

3. Exfoliative toxin Scalded skin syndrome It cleaves desmoglein leading to separation of


(protease) Bullous impetigo epidermis at the granular cell layer results in cell
separation.

4. Alpha toxin Skin Necrosis It cause formation of holes in the cell membrane and
Hemolysis loss of low-molecular-weight substances from
damaged cell

5. P-V leukocidin Kills cells It destroy leukocytes by creating lytic pores in them.
(pore-forming toxin) Necrotizing Pneumonia
 Clinical findings:
The diseases caused by S. aureus are divided into two groups:
• Pyogenic
• Toxin mediated

Pyogenic Diseases :
Following are the pyogenic diseases caused by S. aureus:
1. Skin and soft tissue infections such as conjunctivitis ,postpartum breast infection,
cellulitis, carbuncle. These infections are community acquired.
2. Sepsis can originate from any localized lesion, especially wound infections or as a
result of intravenous drug abuse.
3. Endocarditis may occur on normal or prosthetic heart valves.
4. Osteomyelitis and arthritis may arise either by hematogenous spread from a distant
info Ted focus or be introduced at wound site.
5. Postsurgical wound infections are caused by S. aureus.
6. Pneumonia can occur in postoperative patients .
7. Conjunctivitis with burning eye pain and purulent discharge is caused by S. aureus .
It is transmitted by contaminated fingers.
8. Metastatic abscesses are caused by S. aureus.
9. Postsurgical wound infections are caused by S. aureus.

Toxin mediated diseases:


10. Food poisoning is caused by ingestion of enterotoxin.
11. Toxic shock syndrome is characterized by fever, hypotension and sun burn like
rash.
12. Scalded skin syndrome is characterized by fever, rash and electrolyte imbalance.
13. Bullous impetigo is caused by S. aureus.
Kawasaki disease:
o It is a disease of unknown etiology but its featured resemble with toxic shock
syndrome.
o It is vasculitis involving small and medium sized arteries especially coronary
arteries.
o It is common cause of acquired heart disease.

Symptoms of disease:
• Fever
• Conjunctivitis
• Lesions of lips
• Erythema
• Edema of hand and feet
o It is common in younger children.
o KD is aneurysm of coronary arteries.

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