Streptococci

• Streptococcus
• Enterococcus
• Peptostreptococcus
 Properties
• Gram-positive cocci in chains
• Fastidious, requiring enriched media
• Small, usually haemolytic colonies
• Catalase negative
• Facultative anaerobic
• Non motile
• Commensals on mucous membranes
• Susceptible to desiccation
• Cause pyogenic infection
• 1 micrometer in diameter
Classification of streptococci
 Classification of Streptococci
• A. Hemolytic properties on blood agar
• B. Serologic (Lancefield) groupings
 Hemolytic properties on blood agar

• Beta-hemolysis is complete hemolysis

indicated by clear zones around colonies.
• Alpha- hemolysis is partial or incomplete
hemolysis indicated by greenish or hazy zones
around colonies
• Gamma-hemolysis: No observable changes in
the blood agar around colonies
Beta- hemolytic
Alpha-hemolytic
β and α Hemolytic Reaction
on Blood Agar
Serologic (Lancefield) groupings
 ‫اوصاف نمو‬
‫با عالوه نمودن خون و مایع نسجی رشد شان تقویت می‬ ‫•‬
‫گردد‬
‫پاتوجن های انسانی به فاکتورهای نموئی احتیاج دارند‪:‬‬ ‫•‬
‫نمو و هیموالیز با عالوه کردن ‪ ٪ ۱۰‬کاربن دای اکساید‬ ‫•‬
‫کمک می گردد‬
‫استریپتوکوک ها در‪ ۳۷ /‬درجه سانتی گراد خوب می رویند‬ ‫•‬
‫‪ ENTEROCOCCI‬ف‪///‬رقآ‪/‬نب‪///‬ا ا‪/‬ستر‪/‬یپتوکوکها در‪ /‬ا‪/‬ینا‪/‬ست‬ ‫•‬
‫ک‪///‬ه‪ /‬در غلظتب‪///‬ا‪//‬الین‪//‬مکو ح‪/‬رارتب‪///‬لند ن‪//‬مویب‪///‬هتر دارند‬
 ‫ساختمان انتی جنیک‬
‫• استریپتوکوک های هیموالیتیک به گروپ های سیرولوژیک ‪A-U‬‬
‫تقسیم می شوند‪.‬‬
‫• مواد انتی جنیک موجود در استریپتوکوک ها‪:‬‬
‫‪1. Group Specific cell wall Ag‬‬
‫‪2. M protein‬‬
‫‪3. T Substance‬‬
‫‪4. C Substance‬‬
‫‪5. P Substance‬‬
‫‪6. R protein‬‬
 ‫توکسین ها و انزایم ها‬
• Streptokinase (Fibrinolysin)
• Streptodornase
• Hyaluronidase
• Erythrogenic toxin (Pyrogenic Exotoxin) A-C. Dick
test
• Diphosphopyridine Nucleotidase
• Hemolysin
• Streptolysin O ( Antistreptolysin O ) Antigenic
• Streptolysin S – No antigenic
 Streptococcus pyogenes
• Most streptococci that contain the group A
antigen are S. pyogenes.
• It is a human pathogen
• S.pyogenes is the main human pathogen
associated with local or systemic invasion and
poststreptococcal immunologic disorders
• S.pyogenes typically produces large (1 cm in
diameter) zones of hemolysis around colonies
 Streptococcus pyogenes
• 1. Respiratory infections:
Throat is the primary site of invasion causing sore throat
It may be localized in tonsils- tonsilitis
It may involve pharynx- pharyngitis
Scarlet fever caused by Erythrogenic toxin strain – erythematous rash
From throat streptococci may spread to surrounding tissue causing:
• Otitis media
• Mastoiditis
• Ludwig angina
• Suppurative adenitis
• Meningitis
• bronchopneumonia
 Contd..
• 2. Skin infection:
• Suppurative infection of skin e.g.
 Wound
 Burns
 Lymphangitis
 Cellulitis
 Leads to fatal septicemia
• Erysipelas
• Impetigo
 Contd..
• 3.Genital tract:
• Puerperal sepsis or puerperal fever
• 4. Other infections like abscess of
organs(brain, lungs, liver, kidney) may occur
and it may cause septicemia and pyemia.
• 5. Poststreptococcal Diseases:
• Rheumatic Fever
• Glomerulonephritis
 Glomerulonephritis
• In acute nephritis, there is blood and protein
in the urine, edema, high blood pressure, and
urea nitrogen retention; serum complement
levels are also low. A few patients die; some
develop chronic glomerulonephritis with
ultimate kidney failure; and the majority
recover completely.
 Rheumatic Fever
• This is the most serious sequela of S pyogenes
because it results in damage to heart muscle
and valves.
• Typical symptoms and signs of rheumatic fever
include fever, malaise, a migratory
nonsuppurative polyarthritis, and evidence of
inflammation of all parts of the heart
(endocardium, myocardium, pericardium).
 Streptococcus agalactiae
• These are the group B streptococci. They typically are
beta -hemolytic and produce zones of hemolysis that are
only slightly larger than the colonies (1–2 mm in
diameter).
• Group B streptococci are part of the normal vaginal flora
in 5–25% of women.
• Group B streptococcal infection during the first month of
life may present as fulminant sepsis, meningitis, or
respiratory distress syndrome.
• Intravenous ampicillin given to mothers, who carry
group B streptococci and are in labor, prevents
colonization of their infants and group B streptococcal
disease.
 Groups C and G
• These streptococci occur sometimes in the
nasopharynx and may cause pharyngitis,
sinusitis, bacteremia, or endocarditis.
• They often look like group A S pyogenes on
blood agar medium and are beta -hemolytic.
 Streptococcus bovis
• These are among the nonenterococcal group
D streptococci.
• They are part of the enteric flora, occasionally
cause endocarditis, and sometimes cause
bacteremia in patients with colon carcinoma.
• They are nonhemolytic and grow in the
presence of bile
 Streptococcus anginosus Group
• Other species names in the S.anginosus group
are S.constellatus and S.intermedius. They are
sometimes referred to as the S.milleri group.
• These streptococci are part of the normal
flora.
• They may be Beta or non-hemolytic
 Group N Streptococci
• They are rarely found in human disease states
but produce normal coagulation ("souring") of
milk.
 Groups E, F, G, H, and K–U Streptococci

• These streptococci occur primarily in animals.

• One of the multiple species of group G
streptococci, S.canis, can cause skin infections
of dogs but uncommonly infects humans
• Viridans Streptococci
• S.mitis, S.mutans, S.salivarius, S.sanguis
• Nutritionally Variant Streptococci
• Peptostreptococcus
 Streptococcus pneumoniae
• The pneumococci (S.pneumoniae) are gram-
positive diplococci, arranged in chains,
possessing a capsule of polysaccharide that
permits typing with specific antisera.
• Pneumococci are normal inhabitants of the
upper respiratory tract of 5–40% of humans
and can cause pneumonia, sinusitis, otitis,
bronchitis, bacteremia, meningitis, and other
infectious processes.
Erysipelas
Viridans Streptococci
S. mutans