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Micrococcaceae and Streptococcaceae: Structure, Pathogenicity, and Clinical Relevance

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Micrococcaceae

General Characteristics

The family Micrococcaceae includes the genera Micrococcus and Staphylococcus. These bacteria are notable for their Gram-positive cell walls, catalase positivity, coccoid shape, and pigment production.

  • Gram-positive: Retain crystal violet stain due to thick peptidoglycan layer.

  • Catalase positive: Produce the enzyme catalase, which breaks down hydrogen peroxide into water and oxygen.

  • Coccoid shape: Spherical cells, often arranged in characteristic patterns.

  • Pigment producers: Many species produce colored colonies.

Genus Micrococcus

  • Gram-positive, catalase positive, coagulase negative

  • Susceptible to Bacitracin

  • Growth in tetrads: Cells often appear in groups of four.

  • Non-pathogenic: Generally considered harmless.

  • Example: Micrococcus luteus

    • Normal skin flora, especially on extremities

    • Also found in soil

Genus Staphylococcus

  • Gram-positive, catalase positive

  • Growth in grape-like clusters

  • Can be normal flora or opportunistic pathogens

Staphylococcus saprophyticus

  • Normal flora of skin and mucosa of genitourinary tract

  • Causes community-acquired urinary tract infections (UTIs) in young, sexually active females

  • Infections outside urinary tract are rare

Staphylococcus epidermidis

  • Normal flora of skin and mucous membranes (respiratory system)

  • Non-pathogenic but can be found in wounds

  • DNase negative, coagulase negative

  • Unable to ferment mannitol

  • Grows in 7.5% NaCl

  • Gamma hemolytic (no hemolysis)

Staphylococcus aureus

  • Normal flora of skin and upper respiratory tract (especially nose and throat)

  • Pathogenic under certain conditions (e.g., immunosuppression, wounds)

  • Most common cause of skin infections

  • Associated with boils, pimples, impetigo, pneumonia, carditis, meningitis, arthritis

  • Leading cause of nosocomial (hospital-acquired) infections

  • MRSA and VRSA: Resistant to most antibiotics; infections can be fatal

Diseases and Syndromes Caused by S. aureus

  • Scalded Skin Syndrome

  • Toxic Shock Syndrome (TSS)

    • High fever, rash, vomiting, diarrhea, sometimes death

    • First recognized in menstruating women using tampons

    • Also occurs post-surgery

    • Caused by toxic shock toxin (a superantigen) that triggers massive T cell activation and inflammatory response

  • Food Poisoning

    • Caused by enterotoxin A (a superantigen)

    • Symptoms: Severe but short-lived diarrhea and vomiting

Virulence Factors of S. aureus

  • Coagulase positive: Enzyme induces fibrin clot formation, protecting bacteria from phagocytosis

  • Leukocidin production: Destroys white blood cells, contributing to pus formation

  • Proteolytic enzymes:

    • Hyaluronidase

    • Fibrinolysin

    • Lipase

    • Ribonuclease

    • Deoxyribonuclease (DNase positive)

  • Growth in 7.5% NaCl

  • Ferments mannitol

  • Beta hemolytic (complete hemolysis on blood agar)

Streptococcaceae

General Characteristics

The family Streptococcaceae includes Streptococcus, Lactococcus, and Enterococcus species. These bacteria are Gram-positive cocci, catalase negative, and are classified into Lancefield groups based on cell wall antigens.

  • Catalase negative

  • Lancefield grouping: Groups A through O (based on carbohydrate antigens)

    • Group A: Beta hemolytic strains in humans

    • Group B: Associated with animals (e.g., mastitis in cows)

    • Group D: Enterococci

    • Group N: Lactococci

Streptococcus pyogenes (Group A Streptococcus)

  • Frequently isolated from upper respiratory tract

  • Causative agent of streptococcal pharyngitis (strep throat): Severe sore throat, enlarged tonsils, exudates, tender lymph nodes, mild fever

  • Can cause otitis media, mastitis, impetigo

  • Rheumatic fever: Immune-mediated damage to heart, joints, kidneys due to cross-reactive antibodies

  • Scarlet fever: Caused by erythrogenic toxin (exotoxin) encoded by lysogenic bacteriophage; symptoms include pink-red rash, fever, blood vessel damage

  • Necrotizing fasciitis (rare): Rapid, severe infection of subcutaneous tissue; "flesh-eating bacteria"; high mortality

  • Streptococcal Toxic Shock-like Syndrome: Similar to S. aureus TSS; high mortality; associated with soft-tissue infections

  • Beta hemolytic, esculin hydrolysis negative, bacitracin sensitive, optochin resistant, DNase positive

Streptococcus pneumoniae

  • Frequently isolated from upper respiratory tract

  • Causative agent of pneumonia (often secondary to other respiratory infections)

  • Cells typically in pairs (diplococci), often encapsulated

  • Invasive strains cause strong inflammatory response in alveoli, leading to fluid accumulation and reduced lung function

  • Pneumococcal pneumonia: Untreated mortality ~30%; treated 5-10%

  • Alpha hemolytic, esculin hydrolysis negative, optochin sensitive, bacitracin resistant

Streptococcus agalactiae (Group B Streptococcus)

  • Normal flora of female genital and lower gastrointestinal tract

  • Can be transmitted to neonates, especially after premature rupture of membranes

  • Can cause septic arthritis, postpartum infections (endometritis, pelvic abscesses, septic shock)

  • Neonatal infections: Sepsis, fever, meningitis, respiratory distress, lethargy, hypotension

  • Early onset (first 5 days of life) or late onset (7 days to 3 months after birth)

Streptococcus bovis

  • Esculin hydrolysis positive

  • Alpha hemolytic (weak) or gamma hemolytic

  • Unable to grow in 6.5% NaCl

Streptococcus salivarius

  • Associated with dental caries (tooth decay)

  • Ferments sugars via lactic acid fermentation; lactic acid demineralizes tooth enamel, predisposing to infection

Enterococcus faecalis

  • Isolated from fecal samples (enteric origin)

  • Esculin hydrolysis positive

  • Gamma hemolytic or weakly alpha hemolytic

  • Resistant to bacitracin and optochin

  • Able to grow in 6.5% NaCl

Comparative Table: Key Biochemical and Clinical Features

Organism

Hemolysis

Catalase

Coagulase

Salt Tolerance (7.5% NaCl)

Mannitol Fermentation

DNase

Esculin Hydrolysis

Bacitracin Sensitivity

Optochin Sensitivity

Clinical Significance

Micrococcus luteus

Gamma

+

-

Variable

-

-

-

+

-

Normal skin flora

Staphylococcus aureus

Beta

+

+

+

+

+

-

-

-

Skin infections, TSS, food poisoning

Staphylococcus epidermidis

Gamma

+

-

+

-

-

-

-

-

Normal flora, opportunistic infections

Streptococcus pyogenes

Beta

-

-

-

-

+

-

+

-

Strep throat, scarlet fever, rheumatic fever

Streptococcus pneumoniae

Alpha

-

-

-

-

-

-

-

+

Pneumonia, meningitis

Streptococcus agalactiae

Beta

-

-

-

-

-

-

-

-

Neonatal sepsis, postpartum infections

Streptococcus bovis

Alpha (weak)/Gamma

-

-

-

-

-

+

-

-

Endocarditis, colon cancer association

Enterococcus faecalis

Gamma/Alpha (weak)

-

-

+

-

-

+

-

-

UTIs, endocarditis

Key:

  • + : Positive

  • - : Negative

  • Hemolysis: Beta (complete), Alpha (partial/green), Gamma (none)

Additional info:

  • Superantigens are a class of antigens that result in excessive activation of the immune system, particularly T cells, leading to massive cytokine release and systemic inflammation.

  • Esculin hydrolysis is a biochemical test used to differentiate bacterial species based on their ability to hydrolyze esculin to esculetin and glucose.

  • Salt tolerance (growth in 6.5% or 7.5% NaCl) is used to distinguish between genera and species, especially in clinical microbiology.

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