Faculty of Dental Medical: Gram Positive Cocci Lecture 9
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Questions and Answers

What is the number of medically important species of Staphylococcus?

  • 3 (correct)
  • 2
  • 4
  • 5
  • What is the arrangement of Staphylococcus in a microscope?

  • In chains
  • Randomly scattered
  • In a straight line
  • In pairs or clusters (correct)
  • What is the primary function of the catalase enzyme in Staphylococcus aureus?

  • To break down hydrogen peroxide into water and oxygen (correct)
  • To form biofilms on host tissues
  • To destroy white blood cells
  • To produce a protective fibrin clot
  • What is the main function of surface adhesions in Staphylococcus aureus?

    <p>To allow the bacteria to adhere to host tissues and form biofilm</p> Signup and view all the answers

    What is the characteristic of Staphylococcus aureus colonies on nutrient agar?

    <p>Large yellow-golden colonies</p> Signup and view all the answers

    What is the function of protein A in Staphylococcus aureus?

    <p>To allow the bacteria to evade the immune response</p> Signup and view all the answers

    What is the type of hemolysis caused by Staphylococcus aureus on blood agar?

    <p>β-hemolysis</p> Signup and view all the answers

    What percentage of people have Staphylococcus aureus in their nasal mucosa?

    <p>40%-50%</p> Signup and view all the answers

    What is a common feature of skin and soft tissue infections caused by S. aureus?

    <p>Pus, red, swollen, and painful areas on the skin</p> Signup and view all the answers

    What is the target of Toxic Shock Syndrome Toxin (TSST) in the body?

    <p>Gastrointestinal tract and blood vessels</p> Signup and view all the answers

    What is the characteristic of enterotoxin produced by S. aureus?

    <p>Heat stable and short incubation period</p> Signup and view all the answers

    What is the purpose of Catalase test in the identification of S. aureus?

    <p>To identify the bacterium as Gram positive or negative</p> Signup and view all the answers

    What is the characteristic of colonies of S. aureus on blood agar?

    <p>B hemolysin colonies</p> Signup and view all the answers

    What is the indicator used in Manitol salt agar?

    <p>Phenol red</p> Signup and view all the answers

    What is the purpose of Gram staining in the identification of S. aureus?

    <p>To identify the bacterium as Gram positive or negative</p> Signup and view all the answers

    What is the specimen used for the diagnosis of S. aureus?

    <p>Swap from lesions, pus, sputum, CSF, blood culture</p> Signup and view all the answers

    What is the selective media used for cultivating aureus colonies?

    <p>Manitol Salt Agar</p> Signup and view all the answers

    What is the purpose of cultivating the specimen from tampon or vaginal swab or serum on MSA for 24h at 37c?

    <p>Diagnosis of Toxic Shock Syndrome</p> Signup and view all the answers

    Why are semi-synthetic penicillins such as Methicillin, Oxacillin, and Nafcillin used to treat aureus infections?

    <p>Because aureus is resistant to natural penicillin</p> Signup and view all the answers

    What is the characteristic of S.epidermidis and S.saprophyticus on nutrient agar at 37c for 24h?

    <p>White colony</p> Signup and view all the answers

    What is the mechanism by which S.epidermidis acts as an opportunistic pathogen?

    <p>Both A and B</p> Signup and view all the answers

    What is the disease caused by S.saprophyticus?

    <p>Honeymoon cystitis</p> Signup and view all the answers

    What is the treatment for S.epidermidis?

    <p>Vancomycin, Gentamicin</p> Signup and view all the answers

    What is the active medicine for MRSA?

    <p>Linezolid, Daptomucin</p> Signup and view all the answers

    Study Notes

    Gram-Positive Cocci: Staphylococcus

    • There are over 40 species of Staphylococcus, but only three are medically important: S. aureus, S. epidermidis, and S. saprophyticus.
    • Staphylococcus are Gram-positive cocci that arrange in pairs or clusters (grape-like).
    • They are facultative anaerobes and can grow on simple media.
    • They are catalase positive, which means they can break down hydrogen peroxide (H2O2) into water and oxygen.

    Staphylococcus aureus

    • Morphology: Gram-positive cocci arranged in clusters, with some strains being capsulated.
    • Culture: Can grow in nutrient agar and blood agar at 37°C for 24 hours, forming large, yellow-golden colonies.
    • They are β-hemolytic on blood agar.
    • They can ferment mannitol sugar in mannitol salt agar, producing acid.

    Virulence Factors of S. aureus

    • Surface adhesions: allow the bacteria to adhere to host tissues and form biofilms, providing protection from host defenses and antimicrobial agents.
    • Coagulase: an enzyme that converts fibrinogen into fibrin, creating a protective fibrin clot around the bacteria, shielding it from phagocytosis.
    • Leukocidin: destroys white blood cells.
    • Catalase enzyme: breaks down hydrogen peroxide (H2O2) produced by macrophages, allowing the bacteria to survive.
    • Nucleases: DNase and RNase.
    • Protein A: binds to antibodies, preventing the killing of bacteria and allowing S. aureus to evade the immune response.
    • β-lactamase: breaks down β-lactam antibiotics.
    • Exotoxins:
      • Enterotoxin: causes food poisoning.
      • Exfoliative toxin: causes scalded skin syndrome (SSSS).
      • Toxic shock syndrome toxin (TSST): can cause toxic shock syndrome.

    Diseases Caused by S. aureus

    • Skin and soft tissue infections, such as impetigo, pus, and red, swollen, and painful areas on the skin.
    • Staphylococcal scalded skin syndrome (SSSS): a severe skin infection caused by S. aureus that produces exfoliative toxins.
    • Toxic shock syndrome (TSS): caused by TSST, leading to fever, multi-organ dysfunction, and potentially life-threatening conditions.
    • Bacteremia and endocarditis: can cause bloodstream infections.
    • Pneumonia.
    • Food poisoning: characterized by nausea, vomiting, diarrhea, and a short incubation period of 1-6 hours.

    Lab Diagnosis of S. aureus

    • Specimen: swap from lesions, pus, sputum, CSF, blood culture, or urine culture.
    • Direct smear: examination of the specimen under a microscope.
    • Cultivation: on nutrient agar or blood agar at 37°C for 24 hours.
    • Identification: on nutrient agar, the colonies are golden yellow or blood agar, with β-hemolysin colonies.
    • Identification is also done through Gram staining, catalase test, and mannitol salt agar.

    Food Poisoning Diagnosis

    • Cultivation of the vomiting or diarrhea on mannitol salt agar.
    • ELISA test.

    Toxic Shock Syndrome Diagnosis

    • Cultivation of the specimen from tampon or vaginal swab on MSA for 24 hours at 37°C.
    • ELISA test through serum.

    Treatment of S. aureus Infections

    • Most S. aureus are resistant to penicillin, so semi-synthetic penicillin (methicillin, oxacillin, nafcillin) or other antibiotics like linezolide or daptomycin are used.
    • No vaccine available.
    • Prevention involves hand washing and avoiding sharing personal items.

    S. epidermidis and S. saprophyticus

    • Both grow on nutrient agar at 37°C for 24 hours, forming white colonies.
    • Both grow on MSA, forming pink colonies.
    • Both are coagulase-negative and catalase-positive.
    • S. epidermidis:
      • Commonly found on human skin as normal flora.
      • Can act as an opportunistic pathogen, causing wound infections, UTI, and subacute endocarditis.
      • Adheres to devices, such as teeth, by glycocalyx.
      • Produces β-lactamase.
    • S. saprophyticus:
      • Found in soil and water.
      • Attaches to the genitourinary tract and causes honeymoon cystitis.
    • Treatment:
      • S. epidermidis: vancomycin, gentamicin.
      • S. saprophyticus: ciprofloxacin.

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    Description

    This quiz covers the general features of staphylococcus, including their morphology, characteristics, and medical importance. It is part of a lecture on gram positive cocci in a dental medical faculty.

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