Staphylococcus

Staphylococci
Characteristics
Gram positive non spore-forming non-motile, spherical cells, usually
arranged in grape-like clusters
Single cocci, pairs, tetrads and chains are seen in liquid cultures
Young cocci stain strongly gram-positive, on aging many cells become
gram-negative
Types
The three main species of clinical importance
. Staphylococcus aureus
. Staphylococcus epidermidis
. Staphylococcus saprophyticus
Cultural Characteristics
Can readily grow in ordinary media under aerobic and microaerophilic
conditions
Grow most rapidly at 37oC but form pigment best at room temperature of 20-
25oC
Colonies on solid media are round, smooth, raised and glistening
Some of them are normal flora of the skin and mucus membrane of human,
others cause suppuration abscess formation and fatal septicemia
Produce catalase, which differentiate them from the streptococci
Relatively resistant to drying, heat, and 9% NaCI, but readily inhibited by 3
% hexachlorophene
Antigenic Structure
1. Peptidoglycan( Mucopeptide): Polysaccharide polymer which provide the rigid
exoskeleton of the cell wall. It is important in the pathogenesis of infection like eliciting
production of cytokines and opsonic antibodies; chemoattractant for polymorphs; and
activate complement
2. Teichoic acid: Polymer of glycerol or ribitol phosphate
3. Protein A: Important in immunologic diagnostic test (coagglutination test)
4. Capsule: Anti-phagositic property
5. Enzymes
. Catalase- Produced by staphylococci
◦ Converts H2O2 into H2O and O2
Catalase test differentiates staphylococci(catalase-positive) from streptococci (catalase-
negative)
Antigenic Structure - Continue
. Coagulase and clumping factor
. Coagulase clots oxidated or citrated plasma. Coagulase may deposit fibrin on the surface of organism and
alter ingestion by phagocytic cells.
. Clumping factor: A surface compound that is responsible for adherence of the organism to fibrinogen and
fibrin
Produced by Staphylococcus aureus determines invasive potential of the organism.
Coagulase test differentiates S.aureus (coagulase positive) from S. epidermidis (coagulase-negative)
. Hyaluronidase-Spreading factor
. Proteinases and lipases
. Staphylokinase- Fibrinolysin
. β-lactamase-Provides resistance of staphylococcus to β-lactam antibiotic like penicillin.
. Dnase: Deoxyribonucleotidase
. Nuclease
Toxins
. Exotoxins (α, β, γ, δ)
. Enterotoxin-Produced by S.aureus when grown in carbohydrate and protein foods.
Multiple (A-E, G-I, K-M) soluble heat-stable, gut enzyme resistant toxins which act on neural
receptors in the gut to stimulate vomiting center in the central nervous system. It is superantigen
causing staphylococcal food poisoning
Toxic shock syndrome toxin- Superantigen desquamative toxin Produced by S.aureus and
Causes fever, shock, multiple-organ failure and skin rash.
Exfoliative toxin-Epidermolytic superantigen produced by S.aureus and uses generalized
desquamation of the skin (staphylococcal scalded skin syndrome).
Epidermolytic toxin A: Chromosomal gene product and heat stable
Epidermolytic toxin B: Plamid mediated and heat labile
Leukocidin: S aureus toxin which kills WBCs by forming pores and increasing cation permeability
Clinical Features:
Folliculitis: Infection of one hair follicle.
Carbuncle: Infection of multiple hair follicle and surrounding skin.
Cellulitis: Infection of skin and subcutaneous tissue.
Abscess formation: focal suppuration
Mastitis: Infection of breast, especially in lactating mother
Impetigo: Crusted superficial skin lesion
Pneumonia: Infection of lung parenchyma.
Empyema: Accumulation of pus in pleural space
Osteomyelitis: Infection of bone
Endocarditis and meningitis: Infection of heart tissue and leptomeninges
respectively.
Food poisoning: Caused by enterotoxin produced by S.aureus. Characterized by
violent nausea, vomiting, and diarrhea
Clinical Features – Continue
Toxic shock syndrome: Caused by toxic shock syndrome toxin-1 produced by S.aureus
. Characterized by abrupt onset of high fever, vomiting, diarrhea, myalgia, scarlatiform rash, and
hypotension with cardiac and renal failure in the most severe disease
. Occurs with in 5 days after the onset of periods in young women who use tampoons
Staphylococcal scalded skin syndrome: Caused by exfoliative toxin produced by S.aureus.
OTHER STAPHYLOCOCCI
S. saprophyticus: Relatively common cause of urinary tract infections in young women
S. epidermidis: Occasional cause of infection often associated with implanted appliances and
devices
Laboratory Diagnosis
Specimen: Surface swabs, pus, blood, sputum, cerebrospinal fluid
Smear: Gram positive cocci in clusters, singly or in pairs.
Culture: Grow well aerobically and in a CO2 enriched ordinary media at
an optimal temperature of 35oC-37oC
Colony Appearance
S. aureus: characteristically golden colonies, frequently non-pigmented
after over-night incubation.
Hemolytic on blood agar plate
7.5% NaCl containing media is used for mixed flora contaminated
specimen
Mannnitol salt agar is used to screen for nasal carriers of S. aureus
S. epidermidis: white colonies, non-hemolytic
S. saprophyticus: may be white or yellow, non-hemolytic
Biochemical Reactions
1. Catalase test
Active bubbling…………….Catalase producing bacteria (Staphlococci)
No active bubbling…………Non-catalase producing bacteria (streptococci)
2. Coagulase test
a. Slide test: To detect bound coagulase
Clumping with in 10 seconds………… S. aureus
No clumping with in 10 seconds………CONS (Coagulase negative staphylococci)
c. Tube test: To detect free coagulase
Fibrin clot…………….S.aureus
No fibrin clot…………CONS
Biochemical Reactions – Continue
2. Coagulase test:
b. Tube test: To detect free coagulase
Fibrin clot…………….S. aureus
No fibrin clot…………CONS
Sensitivity testing:
Novobiocin sensitive……. S. aureus and S. epidermidis
Novobiocin resistant……...S. saprophyticus
Differentiation of Species
Organism Colony Catalase Coagulase Novobiocin Hemolysin on
Appearance Production Production Sensitivity Blood agar
S. aureus Golden Positive Positive Sensitive Positive
S. epidermidis White -gray Positive Negative Sensitive Negative
S. saprophyticus White -gray Positive Negative Resistant Negative
Treatment
Penicillin sensitive Staphylococci………penicillin, ampicillin
Penicillin resistant Staphylococci………cloxacillin, Nafcillin
Methicillin resistant Staphylocicci……… Vancomycin

Staphylococcus

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Staphylococci

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