This document provides information about Streptococcus bacteria. It discusses their general characteristics, classification, morphology, cultural characteristics, pathogenesis and virulence factors. It focuses on key Streptococcus species including Group A Streptococcus (Streptococcus pyogenes), Group B Streptococcus (Streptococcus agalactiae), the Viridans Group, and Streptococcus pneumoniae. It also covers Enterococcus. Laboratory diagnosis techniques are summarized, including the CAMP test used to identify Group B streptococci.
CONTENT
• General Characteristics
•Classification of Streptococci
• Morphology
• Cultural characters
• Pathogenesis & Virulence Factors
• Group A Streptococcus (Streptococcus pyogenes)
• Group B Streptococcus (Streptococcus agalactiae)
• The Viridans Group (Alpha-Hemolytic Streptococci)
• Streptococcus pneumonia (Alpha-Hemolytic Streptococci)
• Enterococcus
• Lab Diagnosis
• CAMP TEST
3.
General Characteristics ofStreptococci
• Gram-positive spherical/ovoid cocci arranged in long chains; commonly in pairs.
• Non-spore-forming, nonmotile.
• Can form capsules.
• Facultative anaerobes
• Most parasitic forms are fastidious and require enriched media.
• Small, non pigmented colonies.
• Sensitive to drying, heat, and disinfectants
4.
• According to:
•Hemolysis on Blood Agar- α, β, Ƴ
• Lancefield classification- for β hemolytic streptococci, based
on Carbohydrate antigen
Classification of Streptococci
5.
Classification
• Classification systemis based on hemolysis
reactions.
• β - hemolytic Complete hemolysis
•
Clear zone of hemolysis around colonie– A, B, C, D and G (S.
pyogenes)
• α – hemolytic, –Green discoloration around colonies
S. pneumoniae and viridans
• γ – hemolytic, No hemolysis– S.faecalis
• Classification basedon C- carbohydrate antigen of cell wall
• 20 Lancefield groups from A-H & K-V
• One or more species per group
• Group A- Further subdivided based on M, T, R protein (Griffith
typing) in to 80 sertypes
Streptococci
Group A
S. pyogenes
Group B
S. agalactiae
Group C
S. equisimitis
Group D
Enterococcus
Other groups
(E-U)
Lanciefield
classification
Lancefield Classification- β hemolytic
8.
Morphology:
The individual cocciare spherical or ovoid, 0.5-1 µm in diameter and are
arranged in chains and pairs of up to 50 cells or more but stre.salivarius forms
the longest chain.
The length of chain vary widely with cultural conditions.
Streptococci are gram positive
Streptococci are non-motile and non-spore forming.
Most species possess capsule.
10.
Cultural characters :
Aerobe& fac. anerobe-growing best at 37C—growth only in media
with fermentable sugers, enriched blood /serum.
Blood agar—incubet-24hrs—colonies are small-circular, semi
transparent, low convex discs with an area of clear hemolysis around
them.
Colonies are glistening and look like dewdrops.
Growth and hemolysis are promoted by10% Co2.
Capsulated—mucoid colonies
11.
• Structural components
•M protein inhibits phagocytosis of bacteria
• Lipo teichoic acid helps in adhesion of bactera
• Capsule
• Enzymes
• Streptokinases- fibrinolysin
• Deoxyribonucleases
• Hyaluronidase
• Pyrogenic / Erythrogenic exotoxin
• Hemolysins
• Streptolysin O- Oxygen labile, antigenic
• Streptolysin S- serum soluble
Facilitate spread of streptococci in
tissues
Pathogenesis & Virulence Factors
12.
Group A Streptococcus=
Streptococcus pyogenes
• Beta-hemolytic
• Infects the pharynx or skin
• Often causes disease when
normal microbiota are
depleted
• Spreads through respiratory
droplets
13.
Group A Strep-Virulence Factors
1. M protein of fimbriae
• adheres to pharyngeal tissue
• resists phagocytosis
• 80 serotypes
2. Toxins
• Streptolysin O and S - hemolysis
• Erythrogenic toxin - rash
• Pyrogenic toxin - fever
3. Enzymes
• Deoxynuclease
• Hyaluronidase
• Streptokinase – lyse platelets, WBC
• Help spread bacteria through tissue
M protein
14.
Group A StreptococcalDiseases
1. Pharyngitis (“strep throat”)
• inflammation of the pharynx
2. Scarlet fever
• rash that begins on the chest and spreads across the body
3. Pyoderma/Impetigo
• confined, pus-producing lesion that usually occurs on the
face, arms, or legs
• Necrotizing fasciitis
• toxin production destroys tissues and eventually muscle and
fat tissue
15.
Group B Streptococcus=
Streptococcus agalactiae
• Normally colonizes the lower gastrointestinal, genital,
and urinary tracts
Diseases
Most often associated with neonatal
bacteremia, meningitis, and pneumonia
Immunocompromised older patients
are at risk
16.
Alpha-Hemolytic Streptococci:
The ViridansGroup
• Alpha-hemolytic (“viridans = green”)
• No Lancefield group
• Lack group-specific carbohydrates
• Normal microbiota
• mouth, pharynx, GI tract, GU tract
• Opportunistic Disease:
• One of the causes of dental caries and dental plaques;
produces dextran; leads to biofilm formation
• Can cause meningitis and endocarditis
17.
Alpha-Hemolytic Streptococci:
Streptococcus pneumoniae
•Gram-positive diplococcus
• Alpha-hemolytic
• Normally colonizes the mouths
and pharynx
• Can cause disease if travels to the
lungs
• Disease is highest in children and
the elderly
18.
Diseases caused byS. pneumoniae
1. Pneumococcal pneumonia –
• bacteria multiply in the lower lung; cause damage to the
alveolar lining; produce an inflammatory response
• High fever; chest pain; SOB; sputum production
• 85% occur after viral disease
2. Sinusitis and otitis media –
• bacteria invade the sinuses or middle ear, often following a
viral infection
3. Bacteremia and endocarditis –
• bacteria in the bloodstream or in the lining of the heart
4. Pneumococcal meningitis –
• bacteria that have spread to the meninges
19.
Enterococcus
• E. faecalisand E. faecium
• Previously classified as group D streptococci but reclassified as
a separate genus
• Normal microbiota of the human colon
• Opportunistic disease:
• Urinary Tact Infection
• Endocarditis
• Common cause of nosocomial infections
• Treatment: Difficult to treat due to resistance
• Ampicillin and ceftriaxone
• VRE - Vancomycin Resistant Enterococcus
Bacitracin sensitivity
• Principle:
•for presumptive identification of group A
• distinguish between S. pyogenes from other beta
hemolytic streptococci
• Strep. Pyogenes sensitive to Bacitracin giving zone of
inhibition around disk
23.
CAMP test
• CAMPtest- is a test to identify group B beta hemolytic
Streptococci (str. aglactiae) based on their formation of a substance that enlarges
the area of hemolysis formed by the beta hemolysin elaborated from staph. aureus.
To detect the ability of an organism to produce the CAMP factor.
(It is a biochemical test used to differentiate streptococcus from other beta- hemoltic
streptococci).
24.
• Principle:
• GroupB streptococci produce extracellular protein (CAMP factor)
• CAMP act synergistically with staphylococcal -lysin to increase lysis of RBCs