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الأحد، مايو 16، 2021

GRAM +VE COCCI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GRAM +VE COCCI


Staphylococcus SPP.

 

 

 

 

 

 

 

·        Cocci.    -Gram +ve

 

·        Catalse +Ve

 

·        arranged in cluster of grapes

 

·        -most staphylococcus Non motile. Non sopre.

 

·        -most staphylococcus facultative anerobic.

 

·        -able to grow in media containing high concentration of salt.

 

·        -at temp from 18C-40C staph bacteria are present on the skin and mucous membrane of human.

 

·        -Opportunistic infections.

 

·        the outer layer of most staphylococcus cell wall covered with (polysaccharide capsule).

 

·        -Eleven capsular serotypes have been identified in S.aureus with serotypes 5 and 7 associated with majority of infection.

 

·        -peptidoglycan can form Half the cell wall of staph.

 

·        protin A can be used as specific identification test for S.aureus( not other Non coagulase staph)

 

·        -There are simple biochemical tests e.g (coagulase, protein A ,

heat- stable nuclease , manitol fermentation) can be used to identify colonies ofS. Aureus and other staph.


 

 

 

 

Staphylococcus aureus

 

 

 

Characteristics

*  cause most Staphylococcal diseases .

*  Gr + Ve Cocci .

*  Non Sporing , Non Motile Cocci

*Usually has capsulate .(polysaccharide)&slim layer.

*  Facultative anaerobic .

 

Habitat

*  Humans ( nose , skin , mucous ) .

*  Always present in hospital environment .

*  Survives drying . Tolerant of Salts

Transmission

*  Direct contact .

*  Airborne route .

 

 

 

 

 

Pathogenesis

*Capsule= inhibits chemotaxis and phagocytosis. And facilitates adherence to foreign bodies.

*Peptidoglycan= inhibits phagocytosis.

*  Hemolysins = lyse RBCs

*  Coagulase = converts fibrinogen to fibrin(clots plasma)

*catalase= remove of hydrogen peroxide.

*  Fibrinolysin = Digest fibrin

*  Leucocidin = kills leukocytes

*  DNase = hydrolyses DNA

*       Protein   A   =    Antiphagocytosis (inhibits  antibody clearance) and anticomplementary.

*  Enterotoxin = Vomiting & diarrhea

*      TSS toxin-1 = produce leakage or destruction of endothelial cells.

*  Exfoliative Toxin = Skin exfoliative

 

 

Diseases

*  Superficial infection(scalded skin syndrome) ( SSS )

*  Surgical Wound Infection

*  Toxic Shock Syndrome . (( TSS ))

*  Toxic Food Poisoning . (( TFP ))

*  Septicemia , Endocarditis , pneumonia .

 

Laboratory Identification

*  White or Golden Colonies on Blood Agar

*  Catalase +Ve , Coagulase +Ve , DNase + Ve


 

 

 

 

Staphylococcus epidermidis

 

 

 

Characteristics

*  Rarely cause infections in health people .

*  Gr + Ve Cocci .

*  Non Sporing , Non Motile Cocci

*Opportunistic pathogen.

*  Facultative anaerobic .

*Slime layer.

 

Habitat

*  Humans (skin) .

*  Always present in hospital environment .

*  Survives drying . Tolerant of Salts

Transmission

* Direct contact

 

 

Pathogenesis

*  Lower pathogenicity than Staph. Aureus .

*    Viscous extracellular slime = Enable the bacteria to adhere to a foreign surface .

 

Diseases

*  Urinary Tract Infection ( UTI )

*    Prosthetic valve Endocarditis.

*Bacteremia.

*surgical wounds.

*central nervous system infection.

 

Laboratory Identification

*  White Colonies on Blood Agar

*  Catalase +Ve , Coagulase -Ve , DNase - Ve

*  Sensitive to Novobiocin disc .


 

 

 

 

Staphylococcus saprophyticus

 

 

Characteristics

*  Gr + Ve Cocci .

*  Non Sporing , Non Motile Cocci

*  Facultative anaerobic .

 

Habitat

*  Skin

*    Genitourinary mucosa .

Transmission

*  Direct contact

*  Endogenous spread to urinary tract .

 

 

Pathogenesis

*  Virulance factors unknown

*    But , this bacteria has ability to colonize periurethral skin & mucosa .

 

Diseases

 

* Urinary Tract Infection ( UTI ): opportunistic infection.

 

Laboratory Identification

*  White Colonies on Blood Agar

*  Catalase +Ve , Coagulase -Ve , DNase - Ve

*  Resistance to Novobiocin disc .


Streptococcus SPP

 

- Gram +ve cocci

-catalase –ve.

-arranged in pairs or chains.

-most streptococcus facultative anaerobic.

-some grow only in atmosphere enhanced with carbon dioxide(capnophilic growth).

-carbohydrates are fermented, resulting in the production of lactic acid.

- most B-hemolytic streptococcus have group –specific antigen.

-most (but not all) alpha-hemolytic streptococcus and nonhemolytic streptococcus (gamma) do not have the group –specific antigen.

-PYR ( L-pyrrolindonyl-B-arylamidase)

if positive(Streptococcus pyogenes) or negative (Streptococcus anginosus)

 

-ASO tests useful confirming test for rheumatic fever or acute glomerulonephritis caused BY Streptococcus pyogenes.

 

 

 

 

Classification of Common Streptococcal Pathogens

 

Biochemical

Classification            Serologic Classification           Hemolysis Patterns

 

S. pyogenes                                A                                             β

 

S. agalactiae                               B                      β; occasionally nonhemolytic

 

S. dysgalactiae                           C, G                                          β

 


S. anginosus group                   A, C, F, G, nongroupable


β; occasionally α or nonhemolytic


 

S. bovis                                   D                    α; nonhemolytic; occasionally β Viridans group                                  Nongroupable                     α or nonhemolytic


S. pneumoniae

 

Enterococci


Nongroupable D


Α

 

α – β or Gamma


 

 

 

Biochemical Identification of Common Streptococci

 

 

 

Organism

Susceptibility Bacitracin Optochin

Hippurate hydrolysis

CAMP

reaction

Bile solubility

 

S. pyogenes*

 

S             R

 

-

 

-

 

-

S. agalactiae

R            R

+

+

-

S. anginosus

R            R

-

-

-

S.

dysgalactiae

R            R

-

-

-

 

S. pneumoniae

 

R             S

 

-

 

-

 

+

Viridans group

R            R

-

-

-

 

 

S= Sensitive R= Resistant


Streptococcus pyogenes

( Group A , B hemolytic streptococcus )

 

 

 

Characteristics

*  Gr + Ve cocci in chain .

*  Non Sporing , Non Motile Cocci .

*  Some strains produce a hyaluronic acid capsule .

*  Facultative anaerobic .

*Growth is optimal on enriched-blood agar media.

*inhibited if the medium contain high conc.of glucose.

*the basic structural cell wall is peptidoglycan.

 

Habitat

* Commensal in the throat or skin

Transmission

Direct contact Airborne route

 

 

 

 

 

Pathogenesis

·         M Protein = Antiphagocytosis [ Major Virulence Factor ]

*T protein= unknown function.

*capsule=Antiphagocytosis.

·         Hemolysins = lyse RBCs.

·         Erythrogenic toxins = cause fever & rash in scarlet fever

·         Streptokinase = lyses Blood clot .

·         DNAse = hydrolyses DNA .

·         NADase = Kills Leucocytes .

 

 

Diseases

·         Pharyngitis , Tonsilitist , Otitist media .

·         Erysipelae & lampotigo .

·         Scarlet Fever .

·         Rheumatic Fever .(ASO confirming test)

·         Endocarditis .

 

Laboratory Identification

·         White small colonies on blood agar .

·         Colonies surrounded by Beta Hemolysis.

·         Catalase –Ve

·         Bacitracin Sensitive

·         PYR +Ve.


 

 

Streptococcus agalactiae

(( Group B , Beta hemolysis Streptococcus ))

 

Characteristics

*  Gr + Ve cocci in chain .

*  Non Sporing , Non Motile Cocci .

*  Facultative anaerobic .

*capsule(polysaccharide)

*the surface protein (C protein)

 

Habitat

* Normal Vaginal ( 25% ) & Oral flora .

Transmission

* Direct Contact

 

Pathogenesis

 

*  Virulance factors not clearly Identified .

*  Capsule is major virulence factor if it is present

.=Antiphagocytosis .

 

 

Diseases

·         Neonatal Meningitis .

·         Septicaemia

·         Septic abortion .

·         Pneumonia.

 

Laboratory Identification

·         Colonies on blood agar larger than S.pyogenes .

·         The colonies are buttery a narrow zone of B- hemolytic.

·         Colonies surrounded by Beta Hemolysis.

·         Catalase –Ve

·         Bacitracin Sensitive .

·         CAMP test +Ve

·         Hippurate hydrolysis +Ve.


 

Streptococcus pneumonia

(( Alpha Hemolytic Sterptococcus ))

 

 

 

Characteristics

·         Commonest pathogen cause pneumonia .

·         Lancet shape.

·         Gr + Ve Diplococci

* Non Sporing , Non Motile Cocci .

·         Ploysaccharide capsule .

·         Facultative anaerobic .

·         Major cell wall structure is peptidoglycan (like all gram-positive cocci).

·         The other major cell wall component is teichoic acid.

 

Habitat

* Commensal in Human Respiratory Tract .

Transmission

* Droplet spread .

 

Pathogenesis

 

* Capsule = Antiphagocytosis .

 

 

Diseases

·         Pneumonia .

·         Septicemia .(Bactermia)

·         Meningitis ( Children less than 3 years & adults 45 years and above ))

·         Otitis Media .

 

Laboratory Identification

·         White small colonies on blood agar .

·         Colonies surrounded by Alpha Hemolysis.

·         Can grow only on enriched media.

·         Can ferment several carbohydrates.(lactic acid)

·         Grow poorly in media with high glucose concentration.

·         Catalase –Ve

·         Optichin Sensitive .

·         Bile solubility Sensitive.


 

 

 

 

Streptococcus viridans

(( Alpha Hemolytic Sterptococcus ))

 

 

 

Characteristics

·         Gr + Ve cocci

·         Non Sporing , Non Motile Cocci .

·         Facultative anaerobic .

·         Do not have group-specific.

 

Habitat

·         Commensal in the human upper respiratory tract .

·         Large Number are found in Oral Cavity .

·         Rarely found in skin because fatty acid in skin are toxic to them

Transmission

·         Droplet Spread .

 

 

Pathogenesis

·         Attachment to tooth enamel & gums via various carbohydrates is important in establishment the colonization .

·         Ability to produce acid cause ---} Dental caries .

 

 

Diseases

·         Dental caries .

·         Bacterial endocarditis (( Bacteria enter the blood stream as result of dental manipulation and attach to damaged cardic valves .

·         Intraabdominal infections.

 

Laboratory Identification

·         White small colonies on blood agar .

·         Produce green pigments on blood agar.

·         Colonies surrounded by Alpha Hemolysis.

·         Catalase –Ve .

·         Optichin Resistant .


 

 

 

 

 

COCCI +VE GRAM

 

اﻟﻤﺮﺟﻊ اﻟﺬي ﺗﻢ اﻻﻋﺘﻤﺎد ﻋﻠﯿﮫ

Medical Microbiology

Patrick Murray ﻟﻠﻤﺆﻟﻒ

 

 

 

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