Staphylococcus aureus S. epidermis S. saprophyticus S.

hemolyticus & lugdenensis Micrococcus

Gram +/- + + + + +
(An)Aerobic Facultative anaerobe Facultative anaerobe Facultative anaerobe Facultative anaerobe Strict aerobe
Shape Cocci Cocci Cocci Cocci Cocci
Growth
Clusters Clusters Clusters Clusters Divides in more than 1 plane -->
forms clusters (tetrads)
Large, in packets of 8
Cutaneous infections: ABCESSES (Boils= furuncle or abcess)
Impetigo: painless fluid filled blisters (KIDS!!)
Folliculitis: inflammation of hair follicle
Furuncles: circumscribed nodule in skin and has a central core
Line- or device-related infections
Nosocomial
UTIs
--> esp. in young women
--> [sx]: dysuria, pyruria, numerous bugs in urine
Endocarditis
Catheter & shunt infections
Prosthetic joint infections
Arthritis
(usually M. luteus)
usually a contaminant
Commensal, NON-pathogenic
Degrades compounds in sweat &
on skin --> unpleasant odors
--> foot odor
Systemic infections:
Bacteremia, endocarditis, arthritis, osteomyelitis,
TSS, scalded skin syndrome, purpura fulminans
Food poisoning: HEAT-STABLE ENTEROTOXIN (secreted into food)
(Some enterotoxins stable @100C ~30 mins, resistant to acids)
--> Very rapid onset (2- 6 hrs) / quick resolution (w/i 24 hrs of onset)
--> [sx]: Vomiting & large vol. of watery diarrhea (no blood, pus, fever, severe abd.
pain)
Transmission
Direct contact
Fomites
Contaminated food
Normal flora of carriers
Normal skin & mucosal flora Normal skin & mucosal flora Normal skin & mucosal flora
Toxins:
Cytotoxins: !-toxin/ hemolysin
--> lyse many types of cells
--> important in tissue destruction
Exotoxins: Heat stable enterotoxin in food poisioning
TSST-1: Exotoxin/SuperAg
--> stimulates release of cytokines
--> toxin can penetrate mucosal barriers & spread systemically while infection remains
localized
Exfoliatins: Protease
--> degrades intracellular bridges in stratum granulosum epidermis
**PVL (Panton-Valentine Leukocidin)**:
--> Found in many strains of CA-MRSA
--> small % in HA-MRSA
--> Pore-forming toxin --> host cell lysis
Attachment to foreign body
Production of slime
Staphylococcus
Diseases
Pathogenic mechanisms
Gram + cocci arranged in clusters
Catalase +
Facultative anaerobe
Capsule (thin polysaccharide capsule, antiphagocytic)
Slime layer (film composed of monosaccharides, proteins, small peptides; cell attachment & biofilm formation)
Cell wall components:
--> Peptidoglycan: stimulates endogenous pyrogen production/endotoxin-like activity
--> Protein A: binds Fc portion of IgG & prevents immune-mediated clearance
--> Teichoic acids: binds to fibronectin, mediate attachement to mucosal surfaces
Enzymes:
--> Coagulase: fibrinogen --> fibrin (makes clots)
--> Hyaluronidase: hydrolyzes hyalronic acid/conective tissue, promotes spread of bug
--> Fibrinolysin/Staphylokinase: plasminogen --> plasmin (dissolves clots)
--> Lipase & Nuclease
Small Colony Variants:
Populations of thymidine-dependent bugs w/ increased RESISTANCE to abx
Lab Diagnosis:
Specimens
Blood, joint, bone, wound, or skin cultures
(type of specimen dep. upon disease & location of infection)
Blood or catheter tip cultures Urine blood, catheters, artificial devices Blood
Lab Diagnosis:
Colonial Morph
Blood agar white or yellow,
!-hemolytic colonies
Blood agar white NON-hemolytic colonies Blood agar white NON-hemolytic colonies Blood agar white NON-hemolytic colonies large, bright-yellow colonies
Lab Diagnosis:
Biochemical Tests
Catalase & coagulase + Catalase +,
Coagulase NEGATIVE!!!!
Catalase +,
Coagulase NEGATIVE!!!!
RESISTANT to novobiocin (way to differentiate)
Catalase +,
Coagulase NEGATIVE!!!!
PYR + (way to differentiate)
Catalase +,
Coagulase NEGATIVE!!!!
Modified oxidase +
(way to differentiate)
Treatment
Anti-staphylococcal penicillins (nafcillin, methicillin)
1st gen. cephalosporin (cephalothin)
Vancomycin
**Vancomycin**
Linezolid, Daptomycin
SMX-TMP + Rifampin
Minocycline
**Fluoroquinolone** Vancomycin ---
Pathogenic mechanisms