Gram Positive Bacteria

Staphylococcus Coagulase negative Group A Streptococcus Viridans-group Enterococcus

S. aureus Staphylococcus S. pyogens streptococcus

Gram stain Gram + Gram + Gram + Diplococcus, Gram + Diplococcus, pairs Gram +
Shape/ Coccus, clusters Coccus, clusters chains Coccus, chains/pairs
Arrangement
Culture Yellow color, usually beta- Will grow in high [NaCl]
hemolytic Will hydrolyze esculin in presence
of high [bile]
Catalase & other Catalase + Catalase - Catalase Catalase - Catalase
tests PYR test
Normal body sites Mucosa and Skin Nose, intestine, skin Mucosa of upper Mouth, GI, vagina Large intestine
Nares (25%), hand, skin, respiratory system
vagina

Source/route of Contact (direct or fomites) Nasal secretions, droplets Contact Persontoperson via contact
acquisition Food ingestion Contact

Evasion of Protein A binds Fc domain of S. pyogenes: Lowvirulence organisms Highly

immune response IgG, blocking Ab opsonization M proteins  access for antibiotic resistant
of bacterium complement and inh. Alt
Cytolytic toxins (hemolysins) pathway
Coagulase Capsules with selfantigens

How does bacteria Alterations in coagulase Associated with breaks in Streptolysin O and S Cause disease in compromised
damage host Enzymes digestion of host skin and mucosa Enzymes degrading host hosts
tissue tissues (streptokinase,
Cytolysins DNAse, hyaluronidase)
Pyogenic inflammation Strep. pyrogenic exotoxins
Enterotoxins* (Spe), aka superantigens
Exfoliative toxins (TSS and scarlet fever)
(keratinocytes)*
TSST-1*
Manifestations *specific
S. aureus: manifestations
staphylococcal S. saprophyticus: UTI in Group A strep: pharyngitis, Endocarditis UTI
scalded skin syndrome, women necrotizing fasciitis, otitis Meningitis Endocarditis
bullous impetigo, S. epidermidis: infections media, sinusitis, abscess, Pneumonia
folliculitis/carbuncle/furuncle, on foreign objects scarlet fever, rheumatoid
cellulitis, endocarditis, toxic Cause infections on arthritis, glomerulonephritis;
shock syndrome (TSST1) foreign objects (artificial erysipelas
heart valves, IV catheters,
prosthetics)