1 Staphylococcus Lecture 1 Last Year
1 Staphylococcus Lecture 1 Last Year
1 Staphylococcus Lecture 1 Last Year
CLASSIFICATION:
B) Based on pathogenicity:
1. Common pathogen: Eg- S. aureus
2. Opportunistic pathogens: Eg- S.
epidermidis
S.
saprophyticus
3. Non pathogen: Eg- S. homonis
STAPHYLOCOCCUS AUREUS
MORPHOLOGY:
CULTURE:
Media used :i) Non selective media: Nutrient agar,
Blood agar,
MacConkeys
agar.
ii) Selective media: Salt-milk agar,
Ludlams medium
Cultural Characteristics:
i) On nutrient agar- The colonies are large,
circular,
convex, smooth, shiny, opaque and easily
emulsifiable. Most strains produce golden
yellow
pigments.
Biochemical reactions:
1) Catalase test- Positive.
PATHOGENICITY:
Source of infection:
A) Exogenous: patients or carriers
B) Endogenous: From colonized site
Mode of transmission:
A) Contact: direct or indirect( through
fomites)
B) Inhalation of air borne droplets
Virulence factors:
These include
A) Cell associated factors
B) Extracellular factors
B)
EXTRACELLULAR
FACTORS
a) Enzymes
b) Toxins
a) Enzymes:
1. Free coagulase
2. Catalase
3. Lipase
4. Hyaluronidase
5. DNAase
6. Thermonuclease
7. Staphylokinase (Fibrinolysin)
8. Phosphatase
b) Toxins:
1. Cytolytic toxins
i) Haemolysins
Alpha haemolysin
Beta haemolysin
Gamma haemolysin
Delta haemolysin
Disease:
Diseases produced by Staphylococcus
aureus
is studied under 2 groups:
A) Infections
B) Intoxications
Folliculitis
Impetigo
Wound infection
Paronychia
Cellulitis
2) Musculoskeletal: Osteomyelitis,
arthritis, bursitis, pyomyositis.
osteomyelitis
Endocarditis
B) INTOXICATIOINS:
The disease is caused by the bacterial
exotoxins,
which are produced either in the infected host
or preformed in vitro.
There are 3 types1. Food poisoning
2. Toxic shock syndrome
3. Staphylococcal scalded skin syndrome
1) Food poisoning:
The common food items responsible are milk and milk products, meat, fish and ice
cream.
Source of infection- food handler who is
a carrier.
Incubation period- 2 to 6 hours.
Clinical symptoms- nausea, vomiting
and diarrhea.
The illness is usually self limited, with
recovery in a day or so.
Types of SSSS:
Severe form
Milder
form
In new born
neonatorum
In older patients - Toxic epidermal necrolysis
impetigo
Bullous
Ritters disease
Pemphigus neonatorum
Bullous impetigo
(cytotoxins; cytolysins)
Beta toxin
Sphingomyelinase
Gamma toxin
Hemolytic activity
Delta toxin
Cytopathic for:
RBCs
Macrophages
Lymphocytes
Neutrophils
Platelets
Enterotoxic activity
Leukocidin
LAB DIAGNOSIS:
Specimens collected: Depends on the type of
infection.
Suppurative lesion- Pus,
Respiratory infection- Sputum,
Bacteremia & septicemia- Blood,
Food poisoning- Feces, vomit & the remains of
suspected food,
For the detection of carriers- Nasal swab.
Methods of examination:
I) Direct microscopy:
Direct microscopy
with Gram stained
smear is useful in
case of pus, where
cocci in clusters are
seen.
II) Culture:
a) Media used:
b) Cultural Characteristics:
c) Gram staining:
Smears are examined
from the culture plate
and reveals Gram
positive cocci(1m in
diameter) arranged in
grape like clusters.
d) Biochemical reactions:
III) Antibiotic sensitivity tests done as a
guide to treatment.
IV) Bacteriophage typing is done for
epidemiological purposes.
V) Serological tests are not useful.
TREATMENT:
Drug resistance is common.
Benzyl penicillin is the most effective
antibiotic, if the strain is sensitive.
Cloxacillin or Methicillin is used
against
beta-lactamase producing strains.
Methicillin Resistant Staphylococcus
aureus (MRSA) strains have become
common.
Vancomycin is used in treatment of
infections with MRSA strains.
Coagulase Negative
Staphylococci( CoNS ):
Two species of coagulase negative
Staphylococci can cause human
infections1. Staphylococcus epidermidis
2. Staphylococcus saprophyticus
S. epidermidis:
It is a common cause of stitch abscesses.
It has predilection for growth on implanted
foreign bodies such as artificial valves,
shunts, intravascular catheters and
prosthetic appliances leading to bacteraemia.
In persons with structural abnormalities of
urinary tract, it can cause cystitis.
Endocarditis may be caused, particularly in
drug addicts.
S.saprophyticus:
It causes urinary tract infections,
mostly in sexually active young
women.
The infection is symptomatic and may
involve the upper urinary tract also.
Men are infected much less often.
It is one of the few frequently isolated
CoNS that is resistant to Novobiocin.