Staphylococcus

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Three main types:

  • Staphylococcus aureus
  • S. epidermis
  • S. saprophyticus

Classification:

Colour

  • S. aureus grey/yellow colonies, other two white.

Coagulase

  • S. aureus has a coagulase enzyme, which forms clots in plasma.

DNAase

  • S. aureus has this enzyme, others don't.

Protein A

  • S. aureus has this cell wall antigen, others don't – so Protein A antibodies will only agglutinate S. aureus.

Novobiocin sensitivity

  • To differentiate between the coagulase-negative types, S. epidermis and S. saprophyticus, only S. epidermis is sensitive to novobiocin.

S. aureus

About

  • Common human commensal, found nasally in 30-50%.
  • Coagulase hinders phagocytosis, as does the cell envelope.
  • Protein A prevents binds to Fc component of antibodies, preventing complement activation.

Pathology

  • Skin - boils, wound infections
  • Respiratory – pneumonia, lung abscesses, worsening of chronic lung disease

Treatment

  • 1st generation: flucloxacillin
  • MRSA generation: vancomycin (glycopeptide)
  • Van resistant generation: you will probably die.

S. epidermidis

About

  • Common human commensal, found on skin in 30-50%.
  • Very good at sticking to artificial surfaces, such as fake heart valves, hips, catheters and central venous lines; through production in some strains of a slime layer (glycocalyx)

Pathology

  • UTIs, especially in catheterised patients.
  • Bacteraemia, most common bacteria found in blood cultures.

Treatment

  • They are similar to aureus, in that they have widespread resistance. Sadly, treatment often needs vancomycin.

S. saprophyticus

About

  • Commonly causes UTIs in sexually active young women, sometimes leading to cystitis with haematuria (honeymoon cystitis)