STREPTOCOCCI

Dr. Abid Hussain Chang

Associate.Proff.
• St.pyogenes
• St.agalactiae
• E.faecalis
• St.bovis
• Viridans

• Are catalase -ve

 Classification
• Alpha
• Beta
• Gama
 Antigens
• C carbohydrate
• M protein
• Lancefield groups;
-A-U -- antigenic differences in C
carbohydrate
• Group A (St.pyogenes).
• Group B (St.agalactiae).
• Group D (E. faecalis, E.faecium) &
St.bovis
Non Beta Hemolytic Streptococci
• Alpha
St. pneumoniae
Viridans
• Peptostreptococci
 Transmission
• Most are normal flora
• Disease occurs when access to tissues or
blood
St.pyogenes – Skin, oropharynx
St.agalactiae – Vagina, colon
Virdans -- Oropharynx
Enterococci/pepto - Colon
 Pathogenesis
• Group A (St.pyogenes);
Disease by 3 mechanisms

1-Pyogenic inflammatin
2-Exotoxin
3-Immunologic
 Enzymes & Toxins
• Hyaluronidase
• Streptokinase-Converts plasminogen to
plasmin & dissolves fibrin
• DNase
Enzymes & Toxins
• Erythrogenic toxin
• Streptolysin O
• Streptolysin S
• Pyrogenic exotoxin A
• Exotoxin B

- Group B (St.agalactiae);
 Clinical features
• St.pyogenes (Group A):
-3 types of diseases,
1-Pyogenic dis-Eysipelas,cellulitis
2-Toxigenic dis
3-Immunologic
Clinical features

• Group B (St.agalactiae):
Neonatal sepsis & meningitis
Neonatal pneumonia

*also in adults*,
pneumonia, endocarditis, arthritis,
osteomyelitis & cellulitis
Clinical features

• Viridans St.
*Infective endocarditis* (esp after dental
surgery).
Brain abscesses & abdominal abscess
• Enterococci:
UTI – hospital acquired
Endocarditis, pelvic & I/abd infections
• St.bovis: Endocarditis (++with Ca colon)
 Laboratory diagnosis
• Specimens:
• Microscopy:
Gram Staining; G +ve cocci in chains
• Culture: St.pyogenes St. agalactiae
beta hemolytic
• Bacitracin; S R
• Hippurate; -ve Hydrolyzed
• CAMP ; -ve + ve
Laboratory diagnosis:

• Group D: Enterococci S.bovis

6.5% Nacl +ve -ve
Penicillin G R S

Viridans
Pneumococci
Bile soluble No yes
Optochin R S