Genus Staphylococcus (normal flora → common inhabitant of skin & mucous m.

)
Morphology Gram-positive, spherical cells arranged in grapelike irregular clusters
(singly, pair, tetrads, short chains, clusters)
Culture nutrient agar, blood agar & mannitol salt agar at 37 °C but form pigment best at RT (20 - 25 °C)
under aerobic / microaerophilic. conditions
Biochemical Catalase test → staphylococci from the streptococci. Catalase positive
reactions Coagulase test →Staph. aureus from Staph. epidermidis & Staph. saprophyticus
Clinical Staphylococcus aureus:
importance • anterior nares 50-75% healthy people.
• skin & mucous membranes.
• hospital environment.

Staphylococcus epidermidis:
• resident skin flora, gut, upper respiratory tract

Staphylococcus saprophyticus
• Urinary tract in young women
Pathogenicity 1. Defenses Against Phagocytosis
& virulence (i) Protein A coats the cell surface
factors • Binds to class G antibodies
• Inhibits complement cascade
(ii) Slime layer
• Inhibits chemotaxis of leukocytes
• Helps Staphylococcus attach to artificial surfaces

2. Produces Enzymes
(i) Coagulase:
• Converts fibrinogen → fibrin to form blood clots.
• Fibrin clots hide bacteria from phagocytic cells.
(ii) Hyaluronidase:
• Breaks down hyaluronic acid → bacteria to spread between cells.
(iii) Staphylokinase:
• Dissolves fibrin threads in blood clots → S. aureus to free itself from clots.
(iv) Lipases:
• Digest lipids → staphylococcus to grow on the skin’s surface and in oil glands.
(v) β-lactamase:
• Breaks down penicillin.
• Allows bacteria to survive treatment with β-lactam antimicrobial drugs.
• Methicillin –Derivative of penicillin → resistant to beta-lactamase
(MRSA- Methicillin resistant Staphylococcus aureus)
 3. Produces Exotoxins
(i) Cytolytic toxins
• Disrupt host’s cell membrane.
• Leukocidins lyse leukocytes.
(ii) Exfoliative toxins
• Causes skin cells to separate and slough off.
(iii) Toxic-shock-syndrome toxin
(iv) Enterotoxins
• Stimulate intestinal muscle contractions, nausea, intense vomiting associated
with staphylococcal food poisoning
• Toxin → heat-stable; resistant to boiling
Infections Staphylococcus aureus:
1. Cutaneous infections i) Focal suppuration (abscess)
ii) wound infections
iii) Acne, pyoderma or bullous impetigo
2. Deep infections i) Pneumonia
ii) Empyema
iii) Meningitis
iv) Endocarditis
v) Osteomyelitis
vi) Sepsis with suppuration in organs.
3. Scalded skin syndrome (exfoliative toxins)
4. Bullous exfoliation (exfoliative toxins)
5. Toxic shock syndrome
6. Food poisoning due to staphylococcal enterotoxin.
Staphylococcus epidermidis:
→ members of normal flora of human skin & respiratory & GIT
→ rarely produces suppuration but may infect orthopedic or cardiovascular prostheses or cause
disease in immunosuppressed persons.
Staphylococcus saprophyticus: urinary tract infections (UTI) in young women
Treatment ✓ Methicillin (semisynthetic form of penicillin & × inactivated by β -lactamase)
✓ MRSA- methicillin-resistant Staph. Aureus
✓ Vancomycin – drug of choice for moderate to severe infections
 Genus Streptococcus
Morphology Gram-positive cocci, arranged in pairs or chains
Culture HEMOLYSIS
1. Complete hemolysis → β-hemolysis
2. Incomplete (partial) hemolysis → α-hemolysis
3. No hemolysis → γ-hemolysis
CAPSULAR POLYSACCHARIDES (Strept. pneumoniae & Strept. agalactice)
LANCEFIELD GROUPING
(into serotype groups based on the bacteria’s cell wall antigens Group A and B are pathogens)
Biochemical sugar fermentation reactions, tests for presence of enzymes & susceptibility /resistance to
reactions certain chemical agents
 1 - Group A Streptococcus pyogenes
✓ Beta-hemolytic on blood agar
✓ Lancefield group A
✓ Infects the pharynx or skin
✓ Often causes disease when normal microbiota is depleted
✓ Spreads through respiratory droplets
Virulence
factors

Infections 1. Pharyngitis (“strep throat”)

✓ inflammation of the pharynx
✓ sore throat, cough
✓ high fever
✓ swollen lymph nodes
✓ “beefy” red throat
2. Skin diseases
✓ Erysipelas: results with massive brawny edema & a rapidly advancing margin of
infection.
✓ Cellulitis - acute, rapidly spreading infection of the skin and subcutaneous tissues
✓ Pyoderma/Impetigo: Local infection of superficial layers of skin, esp. children.
- confined, pus-producing lesion that usually occurs on the face, arms, or legs
✓ Necrotizing fasciitis (Streptococcal Gangrene): toxin production destroys tissues and
eventually muscle and fat tissue
3. Scarlet fever
✓ Accompanies strep throat if strain releases erythrogenic toxins.
✓ “strawberry” tongue.
✓ rash that begins on the chest and spreads across the body → erythrogenic toxins.
4. Puerperal Fever
✓ If streptococci enter the uterus after delivery, puerperal fever develops.
5. Bacteremia/Sepsis
✓ Infection of traumatic or surgical wounds with streptococci results in bacteremia,
which rapidly can be fatal.
6. Streptococcal toxic shock syndrome
✓ caused by pyrogenic exotoxins
✓ characterized by shock, bacteremia, respiratory failure & multi-organ failure.
Poststrept. 1) Acute Glomerulonephritis [develops 3 weeks after Strept. pyogenes skin infection (pyoderma, impetigo)]
Diseases - initiated by antigen-antibody complexes on the glomerular basement m.
(Autoimmune
2) Rheumatic Fever
Complications)
- contain cell membrane antigens that cross react with human heart tissue antigen
- most serious sequela → damage to heart muscle & valves
 Genus Bacillus
Morphology Large aerobic, Gram-positive spore-forming bacilli occurring in chains.
• Most are saprophytic contaminants (soil, water, air and on vegetation)
Culture • Aerobic or facultatively anaerobic
• On blood agar: Large, spreading, gray-white colonies, with irregular margins
• beta-hemolytic (differentiating various Bacillus species from B. anthracis)
Bioch. R, Catalase positive (mostly)
Medical imp.

Bacillus Anthracis
Culture On blood agar, the colonies are non-hemolytic (gamma)
Pathogenicity • primarily a disease of herbivorous animal (goats, sheep, cattle, horses, etc.).
• Spores germinate in tissue at site of entry & growth of vegetative org. → formation of a
gelatinous edema & congestion.
• Bacilli spread via lymphatics to blood stream.
Virulence 1. Capsular polypeptide ( aids virulence by inhibiting phagocytosis).
factors 2. Anthrax toxin [complex of 3 fractions]
• edema factor (OF or Factor I)
• protective antigen factor (PA or Factor II)
• lethal factor (LF or Factor III)
Infections 1. injured skin - cutaneous anthrax (hide-porter disease).
2. mucous membranes (rarely) – gastrointestinal anthrax
3. inhalation of spores into lung – pulmonary anthrax [inhalation anthrax] (wool sorter’s disease)
Laboratory 1. Microscopy
diagnosis 2. Culture
3. Animal inoculation Serological demonstration of the anthrax antigen in infected tissues.
4. Antibodies to organism can be demonstrated by gel diffusion, complement fixation,
antigen coated tanned red cell agglutination & ELISA techniques.
Treatment & • Penicillin !!!
Prophylaxis • Erythromycin, chloramphenicol acceptable alternatives
• Doxycycline now commonly recognized as prophylactic
Vaccine (controversial)
→ Laboratory workers, Employees of mills handling goat hair, Active duty military members,
Potentially entire populace of U.S. for herd immunity
 Bacillus Cereus
Properties Gram-positive, motile (flagellated), spore-forming, rod shaped bacterium. facultative anaerobe
• cause foodborne illness
Epidemiology • Transmission → results from consumption of contaminated foods, improper food handling /
storage & improper cooling of cooked foodstuffs.
• Produces toxins that cause disease that is more an intoxication than food-borne infection.
Onset time Type 1: 10-16 hours Type 2: 1-6 hours
Pathogenicity 1. Diarrhoeal syndrome → caused by enterotoxins produced by B. cereus inside host
• Incubation period before onset of disease is 8–16 hours & illness lasts for 12–14 hours,
• Profuse diarrhea with abdominal pain & cramps; fever & vomiting (uncommon)
• Meat, milk, vegetables, fish
2. Emetic syndrome → intoxication caused by ingestion of toxin that is preformed in food
during growth by B. cereus.
• Short incubation period & recovery time [within 24 hours]
• Nausea, vomiting, abdominal cramps & occasionally diarrhea & is self-limiting
• Rice products, potato, pasta, cheese products
Prevention • Thoroughly cook ground meat products
• Cool cooked products to 41°F (5°C) within 4 hrs
• Hold hot foods at / > 140°F (60°C)
Treatment • Rest & drinking plenty of fluids especially fluids which contain electrolytes - to replace salts,
e.g. sodium & minerals lost → vomiting &/or diarrhoea
• Serious cases → hospital treatment (fluids being given IV / oral rehydration & electrolyte replacement)
• Antibiotics × indicated (If required, usually susceptible in vitro to vancomycin, clindamycin, ciprofloxacin,
imipenem, meropenem)

Corynebacterium Diphtheriae
Properties non-motile, non-spore-forming, straight/slightly curved Gram-positive rods with tapered ends
• in short chains ("V" or "Y" configurations) or in clumps resembling "Chinese letters"
• Albert stain: metachromatic granules stained black & bacillary body stained green
Epidemiology • normal flora of skin and nasopharynx
• disease of colder months in temperate zones, involving unimmunized children
• found in adults whose immunization was neglected
• in tropics, seasonal trends are less distinct
• inapparent, cutaneous and wound diphtheria cases are much more common.
Clinical types 1. Nasal diphtheria
2. Nasopharyngeal diphtheria
3. Faucial diphtheria (over the tonsilar region)
4. Laryngeal diphtheria
5. Wound or skin diphtheria occurs chiefly in the tropics.
➢ A membrane may form on an infected wound that fails to heal.
➢ However, absorption of toxin is usually slight & systemic effects negligible.
Listeria monocytogenes