Staphylococcus, Streptococcus, and Enterococcus

I. General Characteristics: Gram-positive cocci Staphylococcus cells tend to form clusters, but may be single, in pairs, or short chains common skin microbiota of mammals; mucous membranes generally hardy and not nutritionally fastidious facultative anaerobes (w/O2 respire; w/o O2 ferment) catalase-positive (2H2O2 2H2O + O2) species differentiation: coagulase test novobiocin resistance biochemical tests Streptococcus cells tend to form chains common oral microbiota nutritionally fastidious aerotolerant anaerobes/obligate fermenters; some are capnophiles catalase-negative species differentiation: type of hemolysis cell wall carbohydrate group (A, B, C, etc) other tests Enterococcus cells tend to form short chains common normal fecal microbiota hardy and not nutritionally fastidious aerotolerant anaerobes/obligate fermenters catalase-negative grow in 6.5% NaCl bile esculin positive species differentiation: biochemical tests II. Staphylococcus species Staphylococcus aureus Staphylococcus saprophyticus Staphylococcus epidermidis Staphylococcus aureus pathogen/opportunistic pathogen skin/hair follicle infections furuncles (boils), carbuncles wound infections pneumonia bacteremia/sepis toxin producing strains: food poisoning staphylococcal toxic-shock scalded skin syndrome Colony morphology on blood agar Medium to large Creamy golden color Typically hemolytic; may show double zone of hemolysis, particularly when plates are refrigerated) Distinguishing Staph. aureus from other Staph. species Hemolysis Coagulase/clumping factor (positive)

Coagulase-negative Staph Staphylococcus saprophyticus Urinary tract infections Colony morphology on blood agar Medium (similar to other coagulase-negative Staphylococcus species) Distinguishing Staph. saprophyticus from other Staph. species Coagulase (negative) Novobiocin susceptibility (resistant) Staphylococcus epidermidis Common member of the normal skin microbiota/ occasional opportunist Hospitalized patients (particularly those with indwelling catheters) Colony morphology on blood agar Small to medium (similar to other coagulase-negative staphylococcal species) Distinguishing Staph. epi from Staph. aureus and Staph. saprophyticus Coagulase (negative) Novobiocin susceptibility sensitive) III. Streptococcus species beta-hemolytic Streptococcus pyogenes (Group A strep) Streptococcus agalactiae (Group B strep) alpha-hemolytic Streptococcus pneumoniae viridans streptococci non-hemolytic (gamma-hemolytic) other streptococci Streptococcus pyogenes (Group A strep = GAS) pathogen pharyngitis (strep throat) wound infections pnemonia bacteremia/sepsis toxin producing strains scarlet fever streptococcal toxic-shock Notable characteristics of GAS Colonies on blood agar Small, beta-hemoytic** Grown anaerobically, 100% of strains are beta-hemolytic Grown aerobically, 85% of strains are beta hemolytic (15% are non-hemolytic) two hemolysins (streptolysins) - O and S O = encoded by 100% of strains; O2 labile S = encoded by 85% of strains; O2 stable To reliably observe hemolysis of GAS, incubate cultures anaerobically Throat cultures R/O GrpA Distiguishing GAS from other beta-hemolytic stretococci bacitracin susceptibility (generally sensitive) pyrase (positive) latex agglutination using Ab to Group A carbohydrate antigen fluorescent Ab test

Streptococcus agalactiae (Group B strep) Pathogen (primarily in neonates; transmitted via the maternal genital tract) neonatal meningitis neonatal sepsis post-partum infections, bacteremia Notable characteristics of Group B strep Colony morphology on BA plates Small, beta hemolytic less obvious hemolysis when incubated aerobically colonies can be orange Distinguishing Group B strep from other beta-hemolytic strep bacitracin susceptibility (resistant) sodium hippurate (positive) latex agglutination using Ab to Group B carbohydrate antigen Streptococcus pneumoniae (pneumococcus) Opportunist (commonly carried in the throat) pneumonia meningitis Colony morphology on blood agar Small, alpha-hemolytic; often mucoid on primary isolation Distinguishing pneumococcus from other alpha-hemolytic streptococci optochin susceptibility (sensitive) bile solubility (soluble) viridans streptococci - a group of alpha-hemolytic species normal microbiota of the throat; occasional opportunists must be distinguished from pneumococcus in a sputum specimen Colony morphology on blood agar Tiny, alpha-hemolytic Distinguishing viridans strep from pneumococcus optochin susceptibility (resistant) bile solubility (insoluble) IV. Enterococcus normal fecal microbiota/opportunist Urinary tract infections (UTI) Bacteremia Colony morphology on blood agar Small, gray, sometimes slightly hemolytic Distinguishing enterococci from other catalase-negative GPC bile-esculin (positive) growth in 6.5% NaCl (positive) pyrase (positive)