Staphylococcus aureus

Greek “staphyle”- “bunch of grapes”

 Latin “aurum”- “gold”
Gram-positive cocci arranged in clusters
Facultative anaerobe
Normal flora of the skin.
 Cultural characteristics
Β-hemolytic in BAP
Butter-like (butyrous), off-white, cream, gray,
yellow or orange colonies
Oil paints-like pinhead colonies
Jet-black in tellurite lysine agar
 Virulence Factors
1. Toxins

A. Enterotoxins (heat-stable exotoxin)-causes

food poisoning
• Enterotoxin B, C, and I - associated with TSS (
Toxic Shock Syndrome)
• Enterotoxin B – is linked to staphyloccocal
pseudomembranous colitis
B. TSST-1 – (Toxic Shock Syndrome Toxin-1)
formerly called Enterotoxin F
- causes TSS, which is seen in
menstruating women who use tampons

C. Exfoliative toxin- also called epidermolytic

toxin or exfoliatin. It causes bullous impetigo
and SSSS (Stahylococcal Scalded Skin
Syndrome also known as Ritter’s disease)
D. Cytolytic Toxins
• Alpha-hemolysin – lyses RBC, platelets,
and macrophage
• Beta-hemolysin – acts on
sphingomyelinase C on RBC membrane
- also known as “hot-cold” lysin
• Gamma-hemolysin – associated with PVL
(Panton-Valentine Leucocidin)
• Delta-hemolysin – a less toxic toxin

• Panton-Valentine Leucocidin toxin –

suppresses phagocytosis. Associated w/
cutaneous infections, necrotizing
pneumonia and community- associated
Methicillin Resistant Staphylococcus aureus
infections.
2. Enzymes
 Hyaluronidase (spreading factor) – also
called Duran- Reynal factor
 Staphylokinase (spreading factor) –
dissolves clot
 Lipase
 Protease
 Coagulase
 Gelatinase
3. Protective Protiens
A. Protein A – component of cell wall binds
IgG (Fc receptor) preventing opsonization
and phagocytosis
B. Coagulase
C. Hemolysin
D. Leukocidin
E. Penicillinase
 Disease caused by Staphylococcus
aureus
1. Folliculitis – inflammation of hair follicle
2. Furuncle (boil) – inflammation of single hair
follicle that progress into a large red and
tender abscess or pustule
3. Carbuncle – bigger lesions brought about by
aggregation of furuncles
4. Bullous impetigo – bubble-like epidermal
swellings
5. TSS (Toxic Shock Syndrome)
6. SSSS (Staphylococcal Scalded Skin Syndrome)
7. TEN ( Toxic Epidermal Necrolysis)
8. Food poisoning
9. Bacteremia
10.Osteomyelitis
11.Arthritis
12.Endocarditis
13.UTI (Urinary Tract Infection)
Laboratory diagnosis of Staphylococcal
infections
1. Gram-stain (gram-positive cocci in clusters)
2. Culture (should have 7.5-10 % NaCl and
mannitol to make it more selective)
 BAP
 NA
 MSA/MSPA (Mannitol Salt Agar or Mannitol Salt
Phenol Agar
 PEA
 CNA ( Columbia Colisitin-Nalidixic acid Agar)
 Chapman-Stone
 Vojel-Johnson
3. Biochemical reaction
 Catalase (+)
 DNAse/thermonuclease (+)
 Coagulase (+)- 4hrs
• Slide method – a test for cell wall bound
coagulase or clumping factor (presumptive)
• Test tube method – a test for free
coagulase/staphylocoagulase (definitive test)
Staphylococcus epidermidis
part of the normal flora of the skin
Causes stitch abscess (prosthetic heart valve
endocarditis) and UTI in elderly men
Associated with hospital-acquired infections
Virulence factor – exopolysaccharide
(Polysaccharide capsule) slime layer that
allows adhering to surface of plastics. Thus
can be possibly seen in indwelling medical
devices.
Mannitol fermentation (-), phosphatase (+)
Novobiocin sensitive
Staphylococcus saprophyticus
 Common cause of UTI in sexually active
women and prostitis in men
An obligate anaerobe
Mannitol fermentation (+), phosphatase (-)
Novobiocin resistant
Some Staphylococci have resistance to
some antibiotics:
• Some S. aureus have become resistant to
Penicillin
• S. aureus is resistant to Polymyxin
• S. epidermidis is resistant to Nafcillin, Oxacillin,
and Methicillin
• S. saprophyticus and S. citrues are resistant to
Novobiocin and Nalidixic acid