Gram-positive cocci are spherical bacteria that retain the crystal violet stain during the Gram staining process, appearing purple under a microscope. These bacteria have a thick peptidoglycan layer in their cell walls, which retains the stain.
Key Groups of Gram-Positive Cocci
- Staphylococcus species
- Staphylococcus aureus: Causes skin infections, abscesses, pneumonia, and food poisoning.
- Staphylococcus epidermidis: Associated with device-related infections.
- Staphylococcus saprophyticus: A common cause of urinary tract infections.
- Streptococcus species:
- Streptococcus pyogenes (Group A Streptococcus): Causes strep throat, scarlet fever, and rheumatic fever.
- Streptococcus agalactiae (Group B Streptococcus): Linked to neonatal infections.
- Streptococcus pneumoniae: Causes pneumonia, meningitis, and otitis media.
- Viridans streptococci: Associated with endocarditis.
- Enterococcus species:
- Enterococcus faecalis and Enterococcus faecium: Common in urinary tract infections and intra-abdominal infections.
Characteristics of Gram-Positive Cocci
- Found in clusters (Staphylococci), chains (Streptococci), or pairs (Diplococci).
- Many are part of the normal flora but can cause infections when immune defenses are compromised.
Flow chart for gram positive Cocci
Here’s a flow chart for identifying Gram-positive cocci bacteria based on common laboratory tests:
Gram Staining
↓
Gram-positive Cocci (Purple under the microscope)
↓
Catalase Test
↓
(+) Positive: Staphylococci (-) Negative: Streptococci/Enterococci
↓ ↓
Coagulase Test Hemolysis on Blood Agar
↓ ↓
(+) Coagulase Positive: S. aureus Beta-hemolysis (Complete lysis, clear zone)
↓ ↓
Species Differentiation by Novobiocin Alpha-hemolysis (Partial lysis, green zone)
↓ ↓
(Sensitive) S. epidermidis Gamma-hemolysis (No lysis)
(Resistant) S. saprophyticus
Here is the test explanation.
- Gram Staining: Identifies Gram-positive cocci (purple).
- Catalase Test:
- Bubbles (positive): Staphylococci.
- No bubbles (negative): Streptococci or Enterococci.
- Coagulase Test:
- Positive: Staphylococcus aureus.
- Negative: Coagulase-negative staphylococci (e.g., S. epidermidis, S. saprophyticus).
- Novobiocin Sensitivity (for Coagulase-negative staphylococci):
- Sensitive: S. epidermidis.
- Resistant: S. saprophyticus.
- Hemolysis on Blood Agar (for Streptococci/Enterococci):
- Beta-hemolysis (clear zone): e.g., S. pyogenes (Group A), S. agalactiae (Group B).
- Alpha-hemolysis (green zone): e.g., S. pneumoniae, Viridans streptococci.
- Gamma-hemolysis (no hemolysis): e.g., Enterococcus species.