Family Streptococcacea Streptococci General Characteristics:

Classification of Streptococci 1. Smith and Browns classification 2. Lancefield classification

3. 4.

Capsular polysaccharides Academic/ Bergeys classification

A. Smith and Browns classification/hemolysis 1. a-hemolysis 2. b-hemolysis

3. B.

g-hemolysis

Lancefield classification 1. group A streptococci 2. 3. 4. 5. group B group C group D group F

C.

Based of Physiological reactions

Streptococcus pyogenes Cultural characteristics:

Growth char:

Virulence factors of S pyogenes 1. M protein 2. C carbohydrate

3.

T or trypsin resistant protein

4.

F protein or fibronectin binding protein

5.

Lipoteichoic acid

6.

Streptokinase (fibrinolysin)

7.

Streptodornase -(streptococcal deoxyribonuclease)

8. Hyaluronidase (spreading factor) 9. Diphosphopyridine Nucleotidase10. Pyrogenic exotoxins (erythrogenic toxins) Types: a. Exotoxin A b. c. Exotoxin B Exotoxin C

11. Hemolysins Types: i. Streptolysin O

ii.

Streptolysin S

Pathogenesis & Clinical Findings 1. Streptococcal pharyngitis/ sore throat 2. Skin infections

3.

Scarlet fever

4.

Strep. TSS

5.

Poststreptococcal Diseases a. Acute glomerulonephritis

b.

Rheumatic fever

Laboratory test: A. Specimens B. Culture:

C. Microscopic D. Bacitracin test E. Pyr test

F.

Latex agglutination test

G. Dick test H. Schultz-charlton reaction.

Treatment:

Prevention and control

Streptococcus agalactiae

Diagnostic test: Sample: HVS- women, blood and CSF- new born Culture= B-hemolysis, may show double zone of hemolysis- anaerobically 1. CAMP test (Christie, Atkins, Munch, Petterson)

2.

Hippurate test

Viridans Group streptococci

Group D streptococci - Enterococci and Non-enterococci Enterococci

Non-Enterococci

Diagnostic test: Sample: blood, pus, urine 1. Bile Esculin Agar

2.

LAP test

3.

PYR test

4.

Salt tolerance test

5.

Litmus Milk reduction test

Streptococcus pneumonia

Cultural char:

Antigenic structure:

Clinical features:

Types of Pneumococci Adults: types 1-8 Children: 6,14,19,23

PREDISPOSING FACTORS 1. Viral & other respiratory tract infections 2. Alcohol or drug intoxication

3.

Abnormal circulatory dynamics

4.

Other mechanisms- malnutrition, general debility, sickle cell anemia, hyposplenism, nephrosis, or complement deficiency.

Laboratory test: 1. Samples: 2. Direct smears: 3. Culture:

Pneumococci Bile solubility Inulin fermentation Capsular swelling Quinidine Optochin Mouse virulence test 4. Bile solubility test

Streptococci

5.

Optochin test

6.

Quellung Reaction

Treatment: Penicillin G is the drug of choice cephalosporin or erythromycin (pneumonia),chloramphenicol (meningitis), quinolones Vaccines - Capsular antigen vaccine- for older adults and other high risk individuals, effective 5 years - Conjugate vaccine- for children 2-23 months

Nutriotionally variant streptococci- dependent streptococci

Peptostreptococcus