Lecture 8A - STAPHylococcus (Dr. Daniels) Flashcards
Desribe Staphylococcus
Gram Positive cocci non-motile non-spore forming facultative anaerobes
Staphylococcus - gram +/-?
Gram Postitive
Staphylococcus - catalase +/-?
Catalase +
Which genuses are catalse -?
streptococci
enterococci
Can staphylococcus grow in salt?
Yes (7.5% NaCl)
Now that we know it’s staph from the catalase test, let’s do a COAGULASE TEST. It’s positive! So what?
Now we know that it is one of 7 species of staph. Most of these species are important in animals, but one is important in humans.
Which coagulase positive staphylococcus is important for humans?
S. aureus
What can S. aureus cause?
skin infections bacteriemia aspiration pneumonia UTI toxic shock syndrome scalded skin syndrome food poisoning
How do we encounter S. aureus?
live on 30-40% of people
muco-cutaneous jxns
great at surviving
behave commensally usually
how does S. aureus enter?
damage to skin (wounds, burns, insect bites)
damage to mucosal surfaces
What are factors for multiplication/spread of S. aureus?
Bacterial inoculum (how many are present)
immunocompetence
location of infection
Bacteremia + immune compromise = trouble
Who is at elevated risk for severe infections?
Children/Elderly Diabetics Immunosuppressed ppl HIV+ dialysis patients IV drug users
What are some causes of immunosuppression?
Autoimmune diseases (Rheumatoid arthritis) Cancer chemotherapy long-term corticosteroids
What are virulence factors of S. aureus?
- Microbial Surface Components Recognizing Adhesive Matrix Molecules (MSCRAMMs)
- Polysaccharide capsule (blocks phagocytosis)
- Protein A - blocks antibody function
- Pore-forming toxins (pop PMNs)
- Panton-Valentine Leukocidin
Name some MSCRAMMs
FnpbA & FnbpB -fibronectin binding proteins Collagen-binding protein (CNA) Clumping factors bind fibrinogen -important for clot formation -coagulase + test -endocarditis
How does S. aureus cause damage?
Acute suppurative inflammation (accumulation of pus (PMNs))
How do PMNs cause abscesses?
release reactive oxygen species (ROS)
release cytokines
What is a potent pre-forming toxin?
Panton-Valentine Leukocidin
Why is ROS negative for the host?
damages host tissue (sustained inflammation)
Which toxins cause SSSS (Staphylcoccal Scalded Skin Syndrome)?
Exfoliative Toxins A & B
What do exfoliative toxins A and B do?
they are proteases that degrade desmosomal proteins in the skin, causing the layers of the skin to separate.
a 9 year old girl had an oral abscess that lead to achy joints and muscles, septic shock, and renal failure. Why?
Her abscess was infected with S. aureus producing TSST-1, a superantigen.
TOXIC SHOCK SYNDROME
what does TSST-1 do?
It is a superantigen. Unregulated activation of CD4+ cells Cytokine Storm -IL-1 -TNF alpha and beta -IFN-gamma, IL-2
What does IL-1 lead to?
Fever
What do TNF alpha and beta do?
hypotension
capillary leakage
(septic shock importance)
What do IFN-gamma and IL2 do?
rash
What are the 3 staphylococcal disease we talked about in class?
SSSS
TSS
Food poisoning
What does SSSS stand for?
Staphylcoccal Scalded Skin Syndrome
Is food poisoning an infection?
No, it is an INTOXICATION.
What causes food poisoning?
s. aureus secretes ENTEROTOXINS
what is the most common enterotoxin?
Enterotoxin A (but there is B, C, D, and E too)
Are enterotoxins superantigens?
yes. They are heat stable, so even cooking food after it has been left out causes food poisoning.
How to Beta-Lactam antimicrobial drugs target microbes?
they act as inhibitory substrates for PENICILLIN BINDING PROTEINS that link peptidoglycan together
What does translgycoxylase do?
binds NAG-NAM
What does transpeptidase do?
binds amino acids of peptidoglycan to NAG-NAM
How do penicillin binding proteins interact with penicillin and other Beta-lactam antimicrobial drugs?
They bind to the drugs instead of their substrates that normally build peptidoglycan of cell walls
What are penicillin binding proteins?
transglycoxylase and transpeptidase (peptidoglycan bulding enzymes)
what are some Beta lactam antimicrobial agents?
penicillins semi-synthetic penicillins cephalosporins carbapenems monobactams
Most S. aureus are METHICILLIN SUSCEPTIBLE. (MSSA)
MSSA stands for Methicillin susceptible S. aureus.
What does MRSA stand for?
Methicillin resistant S. aureus
Why is MRSA different from MSSA?
it has PSP2a, which will not bind beta-lactam antimicrobials.
Why is MRSA scary?
It is resistant to antimicrobial drugs, and it can frequently carry resistance genes to other drug classes
What is used to treat MRSA?
vancomycin
IV injected
glycopeptide class of drug
What is VRSA?
Vancomysin resistant S. aureus
What is VISA?
vancomycin intermediate S. aureus
What gene to VRSA and VISA have that make them resistant to Vancomysin?
VanA
transferred horizontally by Enterococcus faecium via conjugative tranposon
How many people carry MRSA?
less than 1%
How many healthcare professionals carry MRSA?
5-15%
How many people still carry MRSA 4 years after a diagnosed infection?
21%
Where does MRSA colonize?
Nares
Axilla
Groin