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staphylococcus aureus (gram positive cocci)

 Staphylococcus

Staphylococcus are gram positive cocci arrange in grapes like clusters. Staphylococcus is classified into 32 species and 15 subspecies.

1. Staphylococcus Aureus

Morphology

They are gram positive cocci arranged in clusters, spherical and 0.8-1 micrometre in diameter, non-motile, non- sporing.

Staphylococcus aureus; gram stained smear of pus cells.

Characteristics

They are aerobes and facultative anaerobes.

Optimal temperature for growth is 37 degree Celsius range being 10-42 degree Celsius and optimum PH 7.4-7.6

Culture

Grow rapidly on ordinary culture media.

1. Nutrient agar

24 hours incubation, it mostly produces pigmented, golden yellow, colonies with 2-4mm in diameter that emulsify easily.

2. Blood agar

In organism produces beta-hemolysis in this medium containing rabbit or sheep blood.


3. MacConkey's agar

Organism produce pink colonies due to lactose fermentation.


4. Mannitol salt sugar

Yellow colour calories are seen on this medium due to fermentation of mannitol by most strains of staphylococcus aureus.


5. Liquid medium (broth)

In nutrient broth organism produces uniform muddy like.


Toxins and Enzymes

Staphylococcus aureus form number of toxins and enzymes, that factor of organism for producing disease in host.

1. Haemolysins

2. Leucocidin

3. Enterotoxin

4. Toxic shock syndrome (TSS)

5. Exfoliative toxin

6. Coagulase

7. Phosphatase

8. Fibrinolysis


Sources and Modes of Transmission

1. Direct contact

Breaks cuts and abrasions in skin or mucus membrane.

2. Through wound

3. Carrier

4. Through fomites

Towel, cloths, toys, pen

5. Droplets transmission

6. Contaminated food


Pathogenesis

Staphylococcus disease may be classified as cutaneous and deep Infections; food poisioning, Nosocomial Infections, skin exfoliative disease and toxic shock syndrome.


Infections due to staphylococcus aureus

1. Cutaneous infection

Superficial infection include pustules, boils, abscesses, wound and burn infections cause dermatitis.

Irritation or inflammation of skin.

Infection of eyelash follicle.


2. Deep Infection

Include tonsillitis, pharyngitis, sinusitis, pneumonitis, meningitis, bacteriaemia, septicemia.

Infection with sepsis, septic joint, endocarditis 

3. Food poisioning

Ingested contaminated food which contain enterotoxin of staphylococcus aureus.

4. Nosocomial infection

Cause of hospital acquired infection.

5. Skin exfoliative

Redness and peeling, disease of skin.

Produce by strains of staphylococcus aureus causes underlying tissue of skin occurs exfoliative syndrome.

6. Toxic shock syndrome (TSS)

Causes by TSS mainly use of tampons by menstruation women, skin wounds, surgery.


Lab Diagnosis

Specimen collection; 

Suppurative lesions, Pus, Sputum, Blood, Urine, CSF, food or vomit, Faeces.

Transport

Sterile container under aseptic condition.

Direct microscopy

With gram stained smears of pus or wound where, gram positive cocci in cluster seen.

Blue coloured.

Culture

Optimum temperature 37 degree celcius. Optimum PH; 7.4

Colony morphology and gram staining

On blood agar, colonies are 2-4mm in diameter, circular, produce golden yellow pigment, beta haemolysis is seen around colonies.

On gram staining, they are gram positive cocci (1 micrometre in diameter) arranged in grapes like clusters. 

Non- motile cocci in cluster are seen in hanging drop preparation.

 

Biochemical reactions

To distinguish pathogenic strains of staphylococcus aureus.

Only staphylococcus aureus species can ferment mannitol, useful for identification of staphylococcus aureus.


Serological test

Treatment and Prevention

Infection can be prevented by following hygienic practices;

1. Wash hands with soap

2. Keep food preparing area and utensils clean and sanitized, hygienic food, hygienic living practices.

3. Disinfection of fomites

4. Control Nosocomial Infection

Benzyl penicillin is the most effective antibiotics.

Oxacillin, cloxacillin, flucloxacillin and methicillin are penicillin; staphylococcus aureus resistance.


Infection due to staphylococcus aureus

Staphylococcus

Many strains

1. Localized factors

Local infection abscesses

Surgical wound infection

Otitis

Sinusitis

Bacteriaemia

Disseminated Infection

Endocarditis

Septic thrombophlebitis 

Deep localized

Osteomyelitis

Septic arthritis

Other deep abscesses 


2. Toxins 

Exfoliative; scalded skin

TSS

Food fever 

Enterotoxins

Poisoning

Toxin shock syndrome; group of sign of illness.

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