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In this video, we'll be combining
two Staphylococcus species.

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These are Staph epidermidis
and Staph saprophyticus.

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We're gonna call the scene,
"Beauty and the Plumber."

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Without further ado, let's get to
drawing out the backdrop of the scene.

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You'll notice, we're using
a lot of violet color.

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This is to signify gram-positive

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because gram-positive organisms
take up a lot of crystal violet stain.

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Our structure for this segment

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will be to discuss unique features
of epidermidis first.

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Then there's the saprophyticus.

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And finally, we'll talk about their
shared features at the end.

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We'll be illustrating all of the unique
characteristics of Staph epidermidis
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around this plumber right here.

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So first, you should know
that Staph epidermidis

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is the enemy of orthopedic surgeons.

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It often infects artificial joins
and other implanted hardware.

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So we've drawn a bunch of hardware
down here

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that the plumber is working on
to remind you of that.

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Now, we'll draw some tubing
down here under the sink

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that look like catheter tubes.

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This is because indwelling catheters

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are also important sources of infection
of Staph epidermidis.

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Staph epidermidis is everywhere.

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It's given a name because
it covers all of our skin

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so when you penetrate the skin
with a line,
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it makes sense that Staph epidermidis

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will be the culprit of these infections.

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Finally, the third major area
of infection for epidermidis

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is really the same as the first.

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It's an infection of an implant
but it's slightly special.

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You have to know that it's the most
common cause of endocarditis

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affecting artificially implanted
heart valves.

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So we'll draw some valves over here

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and one of them will be shaped
like a heart.

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And this is our symbol for endocarditis
of artificial heart valves.

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One reason epidermidis is so good
at infecting prosthesis,

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implanted heart valves, and catheters

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is because it has found a way to stick
to sleek metal and plastic surfaces.

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It produces copious adherent biofilms

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which is a massive polysaccharides

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and not only help it stick to surfaces

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but it also acts as a coating that

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protects it from exposure to antibiotics
and immune cells.

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So to help you remember these biofilms,

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we'll draw a bunch of gunk
under the sink

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coating all of the pipes
and tubes and valves.

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I think that's pretty intuitive.

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Because epidermidis is able to
produce these biofilms,

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it's resistant to many antibiotics.

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So you have to really bring out
the big guns.

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Current guidelines state
that you should treat
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suspected Staph epidermidis endocarditis

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with Vancomycin.

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We'll draw the vancomycin van
outside of the kitchen window.

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Remember, we used a caravan
in Staph aureus

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but that's only because after
doing extensive research

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we found out that vans didn't exist
in Moses' time.

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So we'll continue to use this van symbol
in future drawings.

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Also, you should know if any
implanted joint is infected

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it's more than likely that
you have to replace it.

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Staph epidermidis is a nasty
little bugger.

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If you were to draw blood cultures
on me,

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there's a really decent chance
that Staph epi would grow
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even though I'm not really
infected with it.

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Really I hope I'm not.

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But this is because as I
mentioned earlier,

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it's normal skin flora

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so it's everywhere and can easily
contaminate cultures

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when blood is drawn

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So to remember this, we're gonna put
some dirt on our plumber's hand

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representing that it's covering the skin
and part of his normal flora.

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And then we'll draw this
drip pan over here

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which looks a lot like
a blood culture petri dish.

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We're showing dirty liquid
dripping into the culture

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which altogether is representing

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contamination of blood cultures.
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Alright, we're almost done with
the Staph epidermidis

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but there is another thing that
you should be aware of.

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One of the attributes that distinguishes

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Staph epi from Staph saprophyticus

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is that Staph epi
is Novobiocin-sensitive.

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This can be a tough one
for instance, remember?

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Or at least it was for me.

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But I think we've figured out
a great way to eliminate confusion.

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Novo, kind of sounds like navel.

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Navel as in belly button.

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So we're going to expose
the plumber's navel here

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to help you remember
Novobiocin-sensitive.

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Yes, his stomach is hanging out
but he's a plumber.

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He could lose a little weight, he knows.
He knows.

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He's working on it.

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He's sensitive.

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His navel is sensitive.

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Since that's all for Staph epidermidis,

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let's move on to cover
Staph saprophyticus.

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She'll be represented by this young lady
sitting on the counter.

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Really quickly, notice that her navel
is not exposed.

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She's Novobiocin-resistant.

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Sensitive.

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Resistant.

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Sensitive.

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Resistant.

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Never forget it.

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Truthfully, you probably won't get too
many questions on Staph saprophyticus.

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But there are few things you should
know about it just in case.

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Staph saprophyticus is the common cause
of urinary tract infections

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specifically in sexually active females.

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This is why we made our
saprophyticus girl

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looks as sexy as a cartoon can.

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Twirling her hair and all.

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This should help you remember
saprophyticus' association

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with sexually active females.

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To help you remember that
Staph saprophyticus causes UTIs,

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we're gonna give her our UTI symbol

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which is a yellow drink that is
shaped like a bladder

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and has these two straws coming
out of it that look like ureters.

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Pretty cool.

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Again, this is the symbol you'll see
in future drawings.

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Now we're going to illustrate all
the attributes these two have in common.

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First, both of these microbes
are catalase-positive.

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To remember this, we'll have
our catalase-positive cat

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sitting over here on the counter.

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And all of the Staphylococci
are catalase-positive.

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So this is one way you can tell Staph

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from Strep.

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This next fact is kind of random
and not really important

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for these two microbes.

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But both are actually urease-positive.

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It's more important for proteus
and klebsiella

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which we'll see in future videos
but I'll explain it here.

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Urease converts urea into ammonia.

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So our symbol for urease-positive
is this ammonia spray bottle.

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A household cleaner.

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You'll see it every time we're dealing
with a urease-positive organism.

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Last, and most important
of the shared characteristics

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is that you should know that both of these
microbes are coagulase-negative.

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This is in contrast to Staph aureus
which is coagulase-positive.

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In fact, you often just hear
of Staph epidermidis

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referred to as a coag-negative Staph.

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And they won't even mention the name.

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So to remember this, we'll have
a bowl of jello here on the counter.
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The jello is untouched with a
nice, smooth and liquidy surface

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It doesn't look coagulated at all.

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Remember how in Staph aureus
the red sea was coagulated?

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To make sure you get the comparison
between the coag-negative here

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and coag-positive Staph aureus,

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we've added this little subtlety.

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Notice the jello brand is Moses' GELL-O.

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This will help you make the connection

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that coag-negative separates it
from Staph aureus.

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We also made the hyphen red

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so it looks like a negative symbol.

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And that's it.

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We knocked out two microbes
in one cohesive sketch.

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I hope you enjoyed it.