1. GRAM POSITIVE COCCI Gram positive and negative bacteria:
The cell wall very different:
. Peptidoglycanvery strong,
thick and rigid.
. Teichoic acid surface antigen.

2. Species cause of human disease:
Staphylococcus aureus
Streptococcus pneumoniae
Streptococcus pyogenic
ect

3. Structure and function
Capsule antiphagocytosis
Peptidoglycan stimulate production of endogenous pyrogens
Protein spesific:A,M,F antiphagocytosis,anticomplementary
Teichoic acid attachment to mucosal

4. Pathogenesis and Immunity
The virulence is determined by: a variety of structural molecule and elaborated toxins and enzymes.  virulence factors

5. Toxins
- Exotoxin : 1. Cytotoxin
2. Enterotoxin food poisoning
.resistant to gastric &jejunal enzymes.
.heat stable
.stimulate intestinal peristalsis

6. Enzymes
. Coagulase  fibrin layer
. Catalase  H2O2
. Hyaluronidase  spreading factors
. Lipase
. Fibrinolysin
. Penicillinase
. Ig A protease
. Hemolysin : Streptolysin O  antigenic

7. Important features of pathogenesis
Staphylococcus aureus
1. Pyogenic (abscess)
- local  skin infection
surgical wound infection
- disseminated  sepsis
2. Toxigenic  food poisoning

8. Staphylococcus epidermidis
Pyogenic  iv catheter sites & prostetic devices
Staphylococcus saprophyticus
Pyogenic  UTI(Urinary Tract Infection )

9. Streptococcus pyogenes
1.Pyogenic
. Local : skin,pharing
. Disseminated : sepsis
2. Toxigenic
3. Immune-mediated(post Streptococcal infection,non suppurative)

10. Poststreptococcal disease
Immunologic response to streptococcal M protein that cross-react with human tissues.
Acute Glomerulonephritis
antigen-antibody complexes on glomerular.
Acute Rheumatic Fever
autoimmune disease

11. Streptococcus pneumoniae
Pyogenic : . Pneumonia
. Otitis media
. Meningitis