Group A Streptococcus

Oleh
Kiran Shadentyra Akbari
 GAS

• Classified by serologic specificity of the cell wall group-specific substance :

Carbohydrate. Grouping into Lancefield groups A-H and K-U.
• The serologic specificity of the group specific carbohydrate is determined by
an amino sugar. For group A streptococci, this is rhamnose-N-
acetylglucosamine.
 STREPTOCOCCUS PYOGENES

• Most streptococci contain the group A antigen are S. pyogenes

• Main human pathogen associated with local or systemic invasion and
poststreptococcal immunologic disorders.
• Produces large zones of β-hemolysis around colonies greater than 0.5 mm in
diameter
• Susceptible to bacitracin and PYR-positive
 MORPHOLOGY AND IDENTIFICATION

A. Typical organisms
• Cocci are spherical or ovoid and are arranged in chains
• Gram positive; exc. culture ages (overnight incubation)
• Strains produce capsules composed of hyaluronic acid
• Cell wall contains protein (M, T, R antigens), carbohydrates (group
specific), and peptidoglycans. Hair like pili project through the capsule
consist partly of M protein and are covered with lipoteichoic acid
 CONT’D

B. Culture
• Grow in solid media as discoid colonies, usually d=1-2 mm
• β-hemolytic
C. Growth Characteristics
• Energy obtained by utilized glucose to lactic acid
• Need enriched to grow in solid or broth such as blood or tissue fluids
• Growth and hemolysis are aided by incubation in 10% CO2
• Grow best at 37°C
• Facultative anaerobes
 CONT’D

D. Variation
• May show different colony form, S.pyogenes strains giving rise to matte or
glossy colonies
 ANTIGENIC STRUCTURE

M proteins
• Major virulence of S. pyogenes
• Filamentous structure anchored to the cell membrane that penetrates and
projects from streptococcal cell wall/
• Able to resist phagocytosis
• More than 150 types of M protein
• Two major structural classes, I and II
 TOXIN AND ENZYMES

A. Streptokinase (Fibrolysin)
transforms plasminogen to plasmin -> digest fibrin -> bacteria escape
from blood clot
B. Deoxyribonucleases
degrade DNA and facilitate spread of streptococci by liquefying pus.
C. Hyaluronidase
splits hyaluronic acid
 CONT’D

D. Pyrogenic Exotoxins (Erythrogenic toxin)

Three antigenically distict Spe A,B,C. Spe A carry lysogenic phage
associated with streptococci toxic shock syndrome and scarlet fever.
Spe C, encoded by a phage, may contribute to the syndrome. Spe B, a
potent protease, interfere with phagocytosis.
Act as superantigen, binding with MHC II, stimulate T cells release
cytokines and mediate shock and tissue injury.
E. Hemolysis
Elaborates 2 hemolysins (streptolysins): Streptolysin O, protein that is
hemolytically active but rapidly inactivates in the presence of O 2. ASO as
quantitive test. Streptolysin S, agent responsible for hemolytic zones around
streptococcal colonies on blood agar. Elaborated in presence of serum. It is
not antigenic