Bacteriology

a-Hemolytic Streptococci
a-Hemolytic Streptococci
Assistant Professor Dr. Sana'a Khudhur
a-Hemolytic Streptococci
 Viridans Group
▪ Large complex group
▪ Normal flora in the gums ,teeth, oral cavity and also
found in nasopharynx.
▪ Not very invasive;but in the dental or surgical
procedures facilitate entrance.
▪ These m.o. lack group specific carbohydrate in their
cell wall.

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 Viridans Group

• They considered as commensal m.o of the mouth

and they can act as opportunistic pathogen and
attack tissue. An opportunistic infection is an infection
caused by pathogens (bacteria, viruses, fungi, or
protozoa) that take advantage of an opportunity not
normally available, such as a host with a weakened
immune system.
• Associated with dental caries and they are the leading
cause of subacute bacterial endocarditis (SBE)
following dental extraction
 Viridans Group
❑Bacteremia, meningitis, abdominal
infection, tooth abscesses
❑Most serious infection –subacute
endocarditis –
❑Persons with preexisting heart disease are at
high risk.

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 Streptococcus pneumonia
• All pathogenic strains form large capsules – major virulence factor.
• Non-pathogenic strains does not contain capsules
• 84 capsular types have been identified
• Causes pneumonia andotitis media
• Also called Diplococcus pneumoniae or pneumococcus.
• Normal inhabitant of the upper respiratory tract (URT) of human
i.e. 40%-70% of normal individuals are carriers of these bacteria.
• No animal reservoir, i.e. transmission is from infected to normal
persons by direct route.
• Some times may cause important human diseases such as
pneumonia, bronchitis, sinusitis, otitis media and less frequently it
invades blood stream producing bacteremia, and the most
important complication of bacteremia includes:
meningitis and septic arthritis.
 Streptococcus pneumoniae
(Pneumococcus)
➢Causes 60-70% of all bacterial pneumonias
➢Small, lancet-shaped cells- Lancet shaped diplococci
➢ arranged in pairs and short chains
➢Culture requires blood or chocolate agar.
➢Growth improved by 5-10% CO2
➢Lack catalase

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 Virulence Markers of Streptococcus
pneumoniae associated with:

• -Polysaccharide large capsule which may prevent or

delay phagocytosis.
• Non capsulated pneumococci are avirulent
(nonpathogenic).

• - Production of IgA protease: this enzyme

inactivate IgA which is the main secretary Ig in
URT(upper respiratory tract).
• This enzyme aids the bacteria to colonize in the
URT.
 Predisposing Factors:
1. Viral infection.
2. Abnormality of respiratory tract.
3. Trauma of pharynx.
4. Allergy.
6. Some change in movement of cilia.
7. Deep anaesthesia.
8. long bed rest.
9.From lung they may invade the blood stream producing
bacteremia.
 Differentiation between a-hemolytic
streptococci

• The following definitive tests used to differentiate

between S. pneumoniae & viridans streptococci

– Optochin Test
– Bile Solubility Test
Photomicrograph of Streptococcus pneumoniae bacteria revealing
capsular swelling using the Neufeld quellung test. Notice the two
streptococci at the top of the photo that appear to have no capsule.
capsule around the bacterial body
 Differentiation between -hemolytic streptococci

Hemolysis Bacitracin CAMP test

sensitivity
S. pyogenes  Susceptible Negative

S. agalactiae  Resistant Positive

Differentiation between a-hemolytic streptococci

Hemolysi Optochin Bile Inulin

s sensitivit solubilit Fermentation
y y
S. a Sensitive Soluble Not ferment
pneumoniae (≥ 14 mm)

Viridans strep a Resistant Insoluble Ferment

(≤13 mm)
Thank you