Week 2: Gram Positive Cocci (flowchart)

catalase positive

1. Staphylococcus

2. Micrococcus 

catalase negative

1. Streptococcus

2. Enterococcus

coagulase positive

Staphylococcus aureus

coagulase negative

1. CoNS

2. Micrococcus

3. Streptococcus

4. Enterococcus

how is Staphylococcus aureus confirmed?

1. hemolytic

2. DNase positive

bacitracin resistant (micrococcaceae)

CoN Staphylococcus

bacitracin susceptible (micrococcaceae)

Micrococcus

how is Micrococcus confirmed?

modified oxidase positive

novobiocin susceptible

Staphylococcus epidermidis

novobiocin resistant

Staphylococcus saprophyticus

how is Staphylococcus epidermidis confirmed?

non-hemolytic

what test is done with catalase negative and alpha hemolysis?

optochin

what test is done with catalase negative and beta hemolysis?

1. bacitracin

2. HIPP/CAMP

what test is done with catalase negative and gamma hemolysis?

1. NaCl 

2. bile esculin 

catalase negative, alpha hemolysis, and optochin resistant

viridans Streptococcus

catalase negative, alpha hemolysis, optochin susceptible

Streptococcus pneumoniae

catalase negative, beta hemolysis, bacitracin susceptible

Streptococcus pyogenes GAS

how is Streptococcus pyogenes GAS confirmed?

PYR positive

catalase negative, beta hemolysis, HIPP/CAMP positive

Streptococcus agalactiae GBS

catalase negative, gamma hemolysis, NaCl intolerant

GDS

catalase negative, gamma hemolysis, NaCl tolerant and bile esculin positive 

Enterococcus 

how is Enterococcus confirmed?

PYR positive

what test is done after catalase positive?

coagulase

what test is done after coagulase negative?

bacitracin

what test is done after bacitracin resistant?

novobiocin

what (simple and visual) analysis is done after catalase negative?

hemolysis evaluation 

what test is done after catalase negative, alpha hemolysis

optochin 

what tests are done after catalase negative, beta hemolysis?

1. bacitracin

2. HIPP/CAMP

what tests are done after catalase negative, gamma hemolysis?

1. NaCl

2. bile esculin