Gram-Positive Bacteria

Introduction

  • Definition 
    • gram-positive bacteria stain purple on a gram-stain test 
      • the bacterial cell wall of these organisms have thick peptidoglycan layers, which take up the purple/violet stain
  • Treatment
    • gram-positive bacteria are susceptible to antibiotics that target the cell wall, as they often lack an outer membrane
      • penicillins
      • vancomycin
      • carbapenem
      • daptomycin
    • other antibiotics used include
      • linezolid
      • clindamycin
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Gram-Positive Bacteria  
COCCI
Staphylococcus
BacteriaDiseaseTreatment
Staphylococcus aureus Abscesses and mastitisEndocarditisGastroenteritisOsteomyelitisPneumoniaScalded skin syndromeSkin infectionsToxic shock syndromePenicillinase-resistant penicillinsVancomycinLinezolid
Staphylococcus epidermidis Normal skin and genital tract floraAssociated with use of catheters and prosthetic devices and biofilm developmentVancomycin
Staphylococcus saprophyticus Normal genital tract floraUrinary tract infectionTrimethoprim-sulfamethoxazole
Streptococcus
Streptococcus pneumoniae “MOPS” Meningitis Otitis media Pneumonia SinusitisPenicillins3rd generation cephalosporins
Streptococcus pyogenes (Group A) Pyogenic infectionspharyngitiscellulitisimpetigoerysipelasToxigenic infectionsscarlet fevernecrotizing fasciitisImmunologic infectionsglomerulonephritisrheumatic feverPenicillins
Streptococcus agalactiae (Group B) Normal vaginal floraNeonatal septicemiaNeonatal meningitisAmpicillin
Streptococcus viridans Normal throat floraDental cariesEndocarditisPenicillin G
Streptococcus bovis (Group D) Normal gut floraBacteremiaEndocarditis (subacute)Associated with colon cancerPenicillin or ceftriaxone
Enterococci
Enterococci faecalis (Group D) Normal gut floraEndocarditis (subacute)Urinary tract infectionBiliary tract infectionsSome strains are vancomycin-resistant (VRE)Linezolid and streptograminsPenicillins, vancomycin, or daptomycinOften resistant to penicillin G
BACILLI
Spore-Forming
Bacillus anthracis Cutaneous anthraxPulmonary anthraxCiprofloxacinDoxycycline
Bacillus cereus Food poisoning (rice)Self-limitingClindamycinAminoglycosides
Clostridium tetani TetanusAntitoxin with or without vaccine boosterBenzodiazepines for muscle spasmsSurgical debridement
Clostridium botulinum BotulismHuman botulinum immunoglobulin
Clostridium perfringens Gas gangreneFood poisoningClindamycinPenicillin
Clostridium difficile Antibiotic-associated diarrheaColitisPseudomembranous colitisMetronidazoleVancomycin (oral)FidaxomicinFecal microbiota transplant
Non-Spore Forming
Corynebacterium diphtheriae DiphtheriaErythromycinPenicillin GDiphtheria antitoxin
Listeria monocytogenes MeningitisneonatalimmunocompromisedAmnionitisSpontaneous abortionGranulomatosis infantisepticaGastroenteritisAmpicillinTrimethoprim-sulfamethoxazole
BRANCHING FILAMENTS
Nocardia spp. Pulmonary infection (immunocompromised)Cutaneous nocardiosis (associated with trauma)Trimethoprim-sulfamethoxazoleCarbapenems
Actinomyces spp. Oral and facial abscessesassociated with poor dental hygiene or maxillofacial traumaYellow “sulfur granules”Pelvic inflammatory diseaseassociated with intrauterine devicesPenicillinTetracycline