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Staphylococcus. Staphylococceae family. Low G + C Cocci (spheres) Grapelike clusters 3 planes 1 micrometer diameter FA Nonmotile, NSF Halotoerant Catalase (+) Oxidase (-) +/- fermentation. Staphylococcus species. 61 species Important S. aureus S. epidermidis S. saprophyticus

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Staphylococcus

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Staphylococcus l.jpg

Staphylococcus


Staphylococceae family l.jpg

Staphylococceae family

  • Low G + C

  • Cocci (spheres)

  • Grapelike clusters

    • 3 planes

    • 1 micrometer diameter

  • FA

  • Nonmotile, NSF

  • Halotoerant

  • Catalase (+)

  • Oxidase (-)

  • +/- fermentation


Staphylococcus species l.jpg

Staphylococcus species

  • 61 species

  • Important

    • S. aureus

    • S. epidermidis

    • S. saprophyticus

    • S. pseudointermedius

  • Others

    • S. haemolyticus

    • S. capitus

    • S. hominis

    • S. xylosis

    • S. warneri


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Cell Wall


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Location

  • Ubiquitous

  • Normal flora

    • Skin

    • Mouth

    • Nose

    • Throat

  • Predisposing factors

    • Immunosuppression

    • Concurrent disease

    • AB resistance


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Epidemiology

  • Normal microbiotica

  • Direct transmission

  • Portal of Entry

    • Hair follicle

    • Break in skin

    • Respiratory

  • Complications

    • Bacteremia

    • Septecemia

    • Abscess


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Cytological Sample


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Pathogenesis

  • Immune evasion

    • Slime layer biofilm (microcapsule)

      • Evades phagocytosis

    • Protein A on cell wall

      • Binds to IgG @ Fc

      • Blocks opsonization

  • Adhesin proteins

    • Binds to fibrin/fibrinogen

    • Binds to ECM

      • laminin

      • fibronectin

      • collagen


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Enzymes

  • Coagulase

  • Catalase

  • Hyaluronidase

  • Lipase

  • Beta lactamase

  • Staphylokinase (plasminogen activator)

  • Proteases

  • DNase

  • FAME (fatty acid modifying enzyme)


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Staphylococcus Toxins

  • Cytolytic Toxins

    • Alpha = βhemolysis

    • Beta = sphingomyelinase

    • Delta

    • Gamma

    • Leukocidin = hemolysis

    • Leukotoxin = WBC destruction

  • Exfoliative toxin

    • ETA and ETB

    • Protease & esterase activity

  • Toxic Shock toxins

  • Enterotoxins (A-E)


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Superantigens

  • Enterotoxin

    • Food poisoning, V/D

    • TSS if B or C antigenic type

  • TSST-1: desquamation; TSS


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Virulence Factors Summary


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Staph aureus

  • Location

    • Mucous membranes

    • Moist areas

  • Diseases

    • Noninvasive

      • Food poisoning

      • Enterotoxin (V/D)

    • Cutaneous

      • Scalded skin

      • Impetigo

      • Folliculitis

      • Boils, styes, furunculosis

    • Systemic

      • Soft tissue infections


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Systemic Staph. aureus infections

  • TSS

  • Bacteremia

  • Endocarditis

  • Pneumonia

  • Meningitis

  • Osteomyelitis

  • Septic arthritis

  • UTI

  • Phlebitis


Staphylococcal disease summary l.jpg

Staphylococcal disease summary


S aureus l.jpg

S. aureus

  • Dx

    • Isolation

    • DDx MRSA/VRSA

  • Tx

    • AB based on culture

  • Prevention

    • Wound cleansing

    • Hand washing


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MRSA

  • Hosptial associated

  • Community assoc.


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AMA/CDC poster


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VRSA

vanA operon from enterococcus changes cell wall tripeptide sequence


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Opportunistic Staph pathogens

  • S. capitis

  • S. epidermidis

  • S. saprophyticus

  • S. xylosis


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S. epidermidis

  • Location

    • Normal skin flora

    • opportunistic pathogen

      • Skin/wound infections

      • Endocarditis

      • UTI

  • Exposure

    • Direct contact

      • Newborns

      • Elderly

    • Fomites

      • Catheters

      • Shunts

      • IV needles

      • Prosthetics


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S. saprophyticus

  • Pathogenesis

    • Fimbria

    • Adhesion proteins

    • Autolysins

  • Diseases

    • UTI/cystitis

    • Peritonitis

    • Enopthalmitis

    • Endocaritis

    • Septic arthritis


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S. xylosus

  • Commensal

  • Industry

    • Ferment meat

    • Red color of sausage

    • Ferment milk

    • Orange color of cheese

  • Pathogenicity

    • Biofilms

    • Enterotoxins

  • Disease

    • Nosocomial

    • UTI

    • Food poisoning (raw)


S capitis l.jpg

S. capitis

  • Epidemiology

    • Skin microbiotica

    • Head predominantly

  • Pathogenicity

    • Coagulase (-)

    • AB resistance

  • Diseases

    • Valvular endocarditis

    • Neonatal septicemia

    • Osteomyelitis


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S. pseudointermedius

  • Animal microbiotica

  • Epidemiology

    • Zoonotic

    • Enterotoxins

    • +/- coagulase

  • Diseases

    • Pyoderma (animals)

    • Food poisoning


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Rapid Staph test


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Immunology

  • Hyperimmune serum

    • Capsular proteins

    • Surface adhesins

  • Vaccination

    • At risk population

      • ESRD

      • Dialysis patients

      • Premature infants

    • StaphVAX

      • Capsular proteins

      • Exotoxin A (Ps. Aeurginosa)


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Questions?


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