Staphylococcus spp.

Important species:
S epidermidis is the most important coagulase-negative staphylococcus (CNS) species and is the
major cause of infections associated with prosthetic devices and catheters. Multiple antibiotic
resistance is increasingly common in S aureus and S epidermidis. Methicillin resistance is
indicative of multiple resistance. Methicillin-resistant S aureus (MRSA) causes outbreaks in
hospitals and can be epidemic S aureus (nares) and S epidermidis (nares, skin) are common
commensals and also have the greatest pathogenic potential. S saprophyticus (skin,
occasionally) is also a common cause of urinary tract infection. S haemolyticus, S simulans, S
cohnii, S warneri and S lugdunensis can also cause infections in man.

Sources:
Staphylococcus aureus or “staph” is a type of bacteria found on human skin, in the nose,
armpit, groin, and other areas.
S aureus colonizes the nasal passage and axillae. S epidermidis is a common human skin
commensal. Other species of staphylococci are infrequent human commensals. Some are
commensals of other animals.

Foods at risk:
Foods that are associated with staph food poisoning include:
 Meats.
 Poultry and egg products.
 Salads such as egg, tuna, chicken, potato, and macaroni.
 Bakery products such as cream-filled pastries, cream pies, and chocolate eclairs.
 Sandwich fillings.
 Milk and dairy products.

Characteristics:
Staphylococcus is a genus of Gram-positive bacteria in the family Staphylococcaceae from the
order Bacillales. Under the microscope, they appear spherical (cocci), and form in grape-like
clusters. Staphylococcus species are facultative anaerobic organisms (capable of growth both
aerobically and anaerobically).

Growth conditions:
Temperature range: 4-46 °C (39-115°F) for growth and toxin production. Optimum
Temperature: 37°C (98.6°F) pH range: 4.8-8.0.
Transmission:
Many healthy people normally have staph on their skin, in their noses, or other body areas.
Most of the time, the germ does not cause an infection or symptoms. This is called being
colonized with staph. These persons are known as carriers. They can spread staph to others.
Some people colonized by staph develop an actual staph infection that makes them sick.
Most staph germs are spread by skin-to-skin contact. They can also be spread when you touch
something that has the staph germ on it, such as clothing or a towel. Staph germs can then
enter a break in the skin, such as cuts, scratches, or pimples. Usually the infection is minor and
stays in the skin. But the infection can spread deeper and affect the blood, bones, or joints.
Organs such as the lungs, heart, or brain can also be affected. Serious cases can be life-
threatening.
These bacteria are spread by having direct contact with an infected person, by using a contaminated
object, or by inhaling infected droplets dispersed by sneezing or coughing. Skin infections are common,
but the bacteria can spread through the bloodstream and infect distant organs.

Illness and symptoms:

A staph infection is caused by a Staphylococcus (or "staph") bacteria. Actually, about 25% of
people normally carry staph in the nose, mouth, genitals, or anal area, and don’t have
symptoms of an infection. The foot is also very prone to picking up bacteria from the floor. The
infection often begins with a little cut, which gets infected with bacteria. This can look like
honey-yellow crusting on the skin.
These staph infections range from a simple boil to antibiotic-resistant infections to flesh-eating
infections. The difference between all these is the strength of the infection, how deep it goes,
how fast it spreads, and how treatable it is with antibiotics. The antibiotic-resistant infections
are more common in North America, because of our overuse of antibiotics.
One type of staph infection that involves skin is called cellulitis and affects the skin's deeper
layers. It is treatable with antibiotics.
This type of infection is very common in the general population -- and more common and more
severe in people with weak immune systems. People who have diabetes or weakened immunity
are particularly prone to developing cellulitis

Symptoms of a staph skin infection can include:

 A painful red lump or bump. This is often a boil or carbuncle (cluster of boils) ...
 Hot, red and swollen skin. This could an infection called cellulitis. ...
 Sores, crusts or blisters. This could be impetigo, which often affects the face. ...
 Sore, red eyelids or eyes.
Staph cellulitis usually begins as a small area of tenderness, swelling, and redness. Sometimes it
begins with an open sore. Other times, there is no obvious break in the skin at all.
The signs of cellulitis are those of any inflammation -- redness, warmth, swelling, and pain. Any
skin sore or ulcer that has these signs may be developing cellulitis. If the staph infection
spreads, the person may develop a fever, sometimes with chills and sweats, as well as swelling
in the area.
Other staph infections of the skin include impetigo, a painful rash that is contagious, boils, and
in babies and young children, staphylococcal scalded skin syndrome, which causes rash, blisters,
and fever.

Dose:
Antibiotics are used to treat staph infections. But there's been a gradual change in how well
these antibiotics work. While most staph infections used to be treatable with penicillin,
stronger antibiotics are now used.

Issues relating to control:

Patients and staff carrying epidemic strains, particularly MRSA, should be isolated. Patients may
be given disinfectant baths or treated with a topical antibiotic to eradicate carriage of MRSA.
Infection control programs are used in most hospitals.

Follow these steps to avoid a staph infection and prevent it from spreading:
 Keep your hands clean by washing them thoroughly with soap and water. Or use an
alcohol-based hand sanitizer.
 Keep cuts and scrapes clean and covered with bandages until they heal.
 Avoid contact with other people's wounds or bandages.
 Do not share personal items such as towels, clothing, or cosmetics.

Testing:
Diagnosis is based on performing tests with colonies. Tests for clumping factor, coagulase,
hemolysins and thermostable deoxyribonuclease are routinely used to identify S aureus.
Commercial latex agglutination tests are available. Identification of S epidermidis is confirmed
by commercial biotyping kits.

Main disease causing Factor:

 α-toxin
 β-toxin
 δ-toxin
 γ-toxin and leukocidin
 Superantigens: enterotoxins and toxic shock syndrome toxin(TSST)
 Epidermolytic (exfoliative) toxin (ET)
S aureus can express several different types of protein toxins which are probably responsible for
symptoms during infections. Some damage the membranes of erythrocytes, causing hemolysis; but it is
unlikely that hemolysis is relevant in vivo. The leukocidin causes membrane damage to leukocytes and is
not hemolytic. Systemic release of α-toxin causes septic shock, while enterotoxins and TSST-1 cause
toxic shock.