Pathogenic Gram Positive Bacteria

Part I

: Microbiology with Diseases by Taxonomy

BIOM 1005/1905
Dr. Shivanthi Samarasinghe

Aims and leaning outcomes

Aims: to learn more about medically
important Gram-positive bacteria.
Learning outcomes: After
attending the lecture you should be
able to name examples of Grampositive organisms, their structure,
pathogenicity, disease they
cause, Diagnosis, Treatment and
Prevention.

Gram-Positive Bacteria
Characteristics
Stain purple when Gram
stained.
Contains thick peptidoglycan
cell wall structure.
Based on the common
phylogeny and cell wall
structure, G+ ve, can divided
into
non-spore-forming bacteria.
cells that lack cell wall.
spore-forming bacteria.

Gram-positive
cell wall structure
Ref: Brock, Biology
of Microorganisms

Gram Stained
Gram-Positive Bacteria

Bacillus subtilis
subtilis spore staining

Kocuria rhizophilia

B.

Reference: Gram stains were produced by BIOM

1005 and 1905
student group 07, in their Microscopy practical

Staphylococcus

Ref: Microbiology with Diseases by Taxonomy

Staphylococcus
Members of every human's
Staphylococcus.
microbiota.
Grapelike structure
Can be opportunistic pathogens.
Ref: Microbiology with
Structure and PhysiologyDiseases by Taxonomy
Facultative anaerobes
Nonmotile
Synthesize catalase
Salt-tolerant; Tolerate salt on human skin
Tolerant radiation, and heat

Staphylococcus
Two species commonly associated with
diseases in humans,
Staphylococcus aureus
More virulent strain
Variety of conditions depending on
site of infection.
Staphylococcus epidermidis
Normal microbiota of human skin
Opportunistic pathogen.

Pathogenicity/How
microbes cause
infection?
Infections result when microbes breach
body's physical barriers.
Entry of only a few hundred bacteria can
result in disease.
Pathogenicity results from three features
Structures that enable it to evade
phagocytosis.
Production of enzymes (heamolysins,
coagulase).
Production of toxins.

Pathogenicity of
Staphylococcus

Structural defenses

against phagocytosis
Produce Coagulase; Converts
fibrinogen into fibrin molecules,
Fibrin clots hide the bacteria
from phagocytic cells.
Synthesize polysaccharide slime
layers (capsules);Inhibit
phagocytosis, facilitate
attachment of Staphylococcus to
surfaces

Structure of a boil
Coagulase leads
to fibrin formation,
and fibrin walls
off infection.

Staphylococcal Diseases
Noninvasive disease
Food poisoning
Due to ingestion of enterotoxin-contaminated
food.

Cutaneous diseases
Various skin conditions.
Ref: Microbiology
with
Diseases by
Taxonomy

Scalded skin syndrome

Impetigo

Reddening of the skin

Outer layer of skin peels off in sheets.

Reddened patches of skin become

puss-filled and eventually crust ove

Staphylococcal Diseases
Toxic-shock syndrome
Some Staphylococcus strains produce TSS
toxin
TSS toxin absorbed into the blood
Produces fever, vomiting, rash, low
blood pressure
Toxic-shock
syndrome
Fetal infection involves not
only red rash but internal
organs as well.
Ref: Microbiology with
Diseases by
Taxonomy

Staphylococcus Disease
Diagnosis, Treatment, and Prevention
Diagnosis
Detect Gram-positive bacteria in grapelike
arrangements.
Ferments sugar mannitol, turns red to yellow
deferential media plate.

Treatment
Methicillin, Vancomycin used to treat MRSA infections.

Prevention
Hand antisepsis important to prevent nosocomial
infections.

Streptococcus

S. pyogens

S. pneumoniae

Facultative anaerobes.
Cocci arranged in pairs or chains.
Often categorized based on Lancefield
classification
Divided into serotypes based on
bacteria's antigens
Lancefield groups A and B include
the significant human pathogens

Laboratory diagnosis
Streptococcal Grouping test How does this work?
Streptococci are often divided into immunological groups;
A,B,C,D,F and G based on the presence of cell wall
antigens.
Latex agglutination test:
Antibody coated beads clump together in the presence of
the appropriate streptococcal antigen (No.4).

Streptococcus
S. pyogens

S. pneumoniae

Haemolytic reaction on
blood agar used to
subdivide the genus.
haemolysis; large zone of
complete lysis: S. pyogens

-haemolysis; partial lysis,

colonies with greenish or
haemolysis- S. pyogen
brownish zone.

Streptococcus pyogenes
Pathogenicity
Hyaluronidase enzyme: Facilitates the spread of

Streptococcus through tissues

Pyrogenic toxins: Can stimulate fever, rash, and

shock
Streptolysins: Lyse red blood cells

Epidemiology
Typically infects the pharynx or skin
Often causes disease when normal microbiota are
depleted
Spreads via respiratory droplets

Streptococcus pyogenes diseases:

Pharyngitis ("strep

throat")
Inflammation of the pharynx

Scarlet fever
Can occur following streptococcal
pharyngitis infections
Chest rash develops that spreads
across the body

Necrotizing fasciitis
Streptococcus enter the body and
spread along the fascia/mussel tissue
Secrete enzymes and toxins that
destroy tissue

Diagnosis and treatment

Diagnosis
Skin infections diagnosed by the
presence of Gram-positive bacteria in
short chains or pairs
Rapid strep test used to diagnose
respiratory infections

Treatment and Prevention

Penicillin, Methicillin, Vancomycin is
effective for most Staphylococcus but
ineffective against MRSA
Hand antisepsis important to prevent

The Mycoplasmas; Bacteria that

lack cell wall
Smallest free-living microbes
Mycoplasma cells are pleomorphic
(coccus and filaments)
Require various growth factors from a

host or supplied in laboratory media

Mycoplasma mycoides

Can colonize the mucous membranes

of the respiratory and urinary tracts

Associated with pneumonia and

urinary tract infections

Only a few species cause significant

human disease

Colonies of Mycoplasm
On agar 19
fried-egg

Mycobacterium
Non-endospore-forming pathogen
Cell wall contains a waxy lipid called
mycolic acid; Identified by Acid-Fast
stain (red colour)
unique characteristics

Slow growth
Protection from lysis after phagocytosis
Capacity for intracellular growth
Resistance to Gram staining, detergents,

Tuberculosis
Respiratory disease caused by
Mycobacterium tuberculosis.
Acid-fast stained M. tuberculosis
Three types of tuberculosis
Primary tuberculosis
Results from the initial infection with M.
tuberculosis
Secondary or reactivated tuberculosis
Reestablishment of active infection after
period of dormancy
Disseminated tuberculosis
Results when infection spreads throughout
the body
Symptoms arise due to complications at
the various sites involved

Development of tuberculosis in
the lungs.
Inhaled
respiratory
droplets

1
Respiratory
droplets

Bronchiole
Macrophage

Respiratory
bronchiole
Alveoli

Alveolus

Beginning
of tubercle

Mycobacterium

Blood vessel

Collagen fibers

Mycobacterium

Bronchiole
Caseous
necrosis

Tubercle

Ruptured
tubercle

Tubercle

Alveolus
4

5
Primary tuberculosis infection

Ref: Microbiology with Diseases by Taxonomy

Blood vessel
Secondary or reactivated tuberculosis

Diagnosis, treatment, and

Diagnosis

prevention

Tuberculin skin test identifies possible

exposure
Chest X rays identify individuals with
active disease
Treatment
Common antimicrobials ineffective
Combination therapy used for
months to treat the disease
Prevention
Immunization with BCG vaccine
where TB is common.

Tubercles

Summary/ You learned

about
mples of Gram-positive
organisms;

pical Gram positive and Gram positive lacks cell wall

coplasmas
eir
ructure and physiology,
thogenicity,
sease they cause,
agnosis,
eatment and Prevention.
fferent staining methods for different gram po

Final Exam Preparation

say Question:
ame two examples (50 marks for each)
f medically important
ram-positive organisms and explain
heir
tructure and physiology, (10 marks)
athogenicity, (10 marks)
isease they cause, (10 marks)
iagnosis, (10 marks)
reatment and Prevention associated with thes
rganisms (10 marks)
Total 100 marks). Time: 30 min.

Reference

Brock; Biology of
Microorganisms

Self Directed Learning

More about
thogenic Gram-positive bacteria:

Streptococcus
pneumoniae
Capsule

Ref: Microbiology with

Diseases by Taxonomy

Streptococcus pneumoniae
Cocci that most commonly form pairs
Form unpigmented, alpha-hemolytic colonies on
blood agar
Lacks Lancefield antigens
Pathogenicity
Polysaccharide capsule, Protein adhesin: mediates

binding of cells to epithelial cells of pharynx

Epidemiology
Present in the mouths and pharynges of most
humans
Causes disease when travel to the lungs
Infections occur most often in children and the
elderly

Streptococcus
pneumoniae

Pneumococcal diseases

Pneumococcal pneumonia; Most

common disease caused by S.
pneumoniae
Bacteremia and endocarditis; S.
pneumoniae can enter the blood
through tissue damage
Pneumococcal meningitis;
Mortality rate higher than other

Diagnosis, treatment, and prevention

Streptococcus pneumoniae

Diagnosis
Gram stain of sputum or blood
Treatment
Penicillin
Resistant strains have emerged
Prevention
Vaccine made from purified
capsular material

Ref: Microbiology with Diseases by Taxonomy

Leprosy
Also referred to as "Hansen's
disease"
Caused by Mycobacterium leprae
Bacteria do not grow in cell-free culture
Two different forms of the disease
Tuberculoid leprosy
Nonprogressive form of the
disease
Due to a strong cell-mediated
immune response
Lepromatus leprosy
More virulent form of the disease
Due to a weak cell-mediated
immune response
Cases are becoming relatively rare
Transmitted via person-to-person contact
or break in the skin

Diagnosis, treatment, and

prevention
Diagnosis
Based on signs and symptoms of
disease
Treatment
Combination of antimicrobial drugs
Lifelong treatment is sometimes
needed
Prevention
Limiting exposure to the pathogen
BCG vaccine provides some protection