Aerobic Gram-positive cocci: Staphylococcus

Che-Hsin Lee, Ph.D.

Department of Biological Sciences
National Sun Yat-sen University

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Gram stain of Staphylococcus

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Common Stahylococcus species and their diseases

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Staphylococcus aureus virulence factors I

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Staphylococcus aureus virulence factors II

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Staphylococcus aureus virulence factors
III

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Epidemiology

Staphylococci are ubiquitous.

Approximately 15% of normal healthy adults

are persistent nasopharyngeal carriers of S.
aureus, with a higher incidence reported of
hospitalized patients.

Staphylococci are susceptible to high

temperatures and disinfectants and
antiseptic solutions.

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Staphylococci disease: clinical summary I

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Staphylococci disease: clinical summary II

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Staphylococci disease: clinical summary III

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Staphylococcal diseases

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Staphylococcal scalded skin syndrome

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Toxic shock syndrome

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Diagnosis, treatment, prevent and control

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Aerobic Gram-positive cocci: Streptococcus and
Enterococcus

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Important Streptococci I

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Important Streptococci II

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 Three different overlapping schemes
Serologic properties: Lancefield groupings

Hemolytic patterns: complete (β hemolysis), incomplete (α

hemolysis) and no(γ hemolysis) hemolysis

Biochemical properties

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β-hemolysis (Streptococcus pyogenes (group A))

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 β-hemolysis (Streptococcus pyogenes (group A))

M protein is the major type-specific protein associated with virulent

strains. M protein cause rheumatic fever.

M protein interfere with phagocytosis.

Lipoteichoic acid, F and M protein facilitate binding of host cells.

The streptococcal pyrogenic exotoxins act as superantigens

Streptolysin S and Streptolysin O can lyse erythrocytes, leukocytes and

platelets.

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β-hemolysis (Streptococcus pyogenes (group A))
Pharyngitis and pyoderma are the most common infections.

Pharyngitis caused by S. pyogenes is primarily a disease of children

between the ages of 5 and 15 years.

Clinical Disease:
Pharyngitis Scarlet fever
Pyoderma
Erysipelas
Cellulitis
Necrotizing fasciitis
Streptococcal toxic shock syndrome
Bacteremia

Nonsuppurative Streptococcal disease

Rheumatic fever
Acute glomerulonephritis
Erysipelas
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 β-hemolysis (Streptococcus pyogenes (group A))

Laboratory diagnosis

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 β-hemolysis (Streptococcus pyogenes (group A))

Treatment, prevention and control

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β-hemolysis (Streptococcus agalactiae (group B))

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 β-hemolysis (Streptococcus agalactiae (group B))

Laboratory diagnosis

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 β-hemolysis (Streptococcus agalactiae (group B))
Treatment, prevention and control

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 α-hemolysis (Streptococcus pneumoniae)

α-hemolysis colonies Gram stain of S. pneumoniae

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α-hemolysis (Streptococcus pneumoniae)

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 α-hemolysis (Streptococcus pneumoniae)

S. pneumoniae can ferment carbohydrates, producing lactic acid, and

lacks catalase.

Virulent strains of S. pneumoniae are covered with a complex

polysaccharide capsule.

C polysaccharide precipitates C-reactive protein.

F antigen can cross-react with host surface antigens.

Phosphorylcholine plays an important role in cell wall hydrolysis.

Amidase practices in the pneumococcal autolysin during cell division.

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α-hemolysis (Streptococcus pneumoniae)

S. pneumoniae is a human pathogen that colonizes the

oropharynx and can spread to the lung, paranasal sinuses, or
middle ear. It can also transported in the blood to brain.

Secretory Ig A protease prevents IgA antibody interaction.

Pneumolysin binds cholesterol in the host membrane.

Capsule help S. pneumoniae survive phagocytosis.

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α-hemolysis (Streptococcus pneumoniae)

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 α-hemolysis (Streptococcus pneumoniae)
Laboratory diagnosis

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 α-hemolysis (Streptococcus pneumoniae)

Treatment, prevent and control

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 Important Enterococci

The enterococci are gram-positive cocci, arranged in pairs and short chains.

Cell wall with group-specific antigen (group D).

Virulence mediated by ability to adhere to host surface. (biofilms and

antibiotic resistance))
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Gram stain of Enterococcus faecalis

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Enterococci

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 Enterococci
Laboratory diagnosis

Treatment, prevent and control

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Thank you for your attention!!

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