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8/11/2019 C15 - Streptococci - P1 (1).pptx
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8/11/2019 C15 - Streptococci - P1 (1).pptx
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Characteristics of GramPositive Cocci
The Family Micrococcaceae,Staphylococcaceae Gram positive, Catalase Positive
Genera'si. Micrococcus
ii. Staphylococcus
The Family Streptococcaceae
Gram positive, Catalase Negative Genera
i. Streptococcus
ii. Enterococcus
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Chapter 15 -Streptococci
Streptococcus
spp.
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Streptococci
I. General CharacteristicsII. Clinically Signicant Species
III. Laboratory iagnosis
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Streptococci
I. General Characteristics
A. Intro!ction
". Cell #all Str!ct!reC. $emolysis
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Streptococci
I. General Characteristics
A. Intro!ction
i. Gram %& cocci arrange in pairs or chainsii. Aerotolerant anaero(es
iii. Catalase negative
iv. Some are capnophilic
v. Non)motile
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Streptococci
I. General Characteristics
A. Intro!ction
Catalase Test ) test the a(ility o* theorganism to (rea+on o* $--into
o/ygen an ater. 01 $-- - & $-2
Catalase
Positive!Copio!s
(!((le *ormation"Staphylococcus#Micrococcus$
%egative!
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Streptococci
I. General Characteristics
A. Intro!ction
i. Cell #all Str!ct!re %3ance4el gro!pingii. Pattern o* hemolysis %"ron5s Classi4cation
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Streptococci
I. General Characteristics
A. Intro!ction
i. Cell #all Str!ct!re %3ance4el gro!pingSpecies Lanceel
&Common 'erms
S. pyogenes A Gro!p A strep
S. agalactiae " Gro!p " strepS. dysgalactiae, S.equi
C Gro!p C strep
S. bovis group 6 Gro!p 6 Nonenterococc!s
E. faecalis, E. faecium 6 Gro!p 6 Enterococc!s
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Streptococci
I. General Characteristics
A. Intro!ction
i. Cell #all Str!ct!re %3ance4el gro!ping)e/traction o* C car(ohyrate
3ate/ aggl!tination
Positive Negative
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Streptococci
I. General Characteristics
A. Intro!ction
i. Cell #all Str!ct!re %3ance4el gro!ping 3ate/ aggl!tination
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Streptococci
I. General Characteristics
A. Intro!ction
ii. Pattern o* hemolysis %"ron5s Classi4cationSpecies Lanceel
&Common 'erms
S. pyogenes A Gro!p A strep
S. agalactiae " Gro!p " strepS. dysagalactiae, S.equi
C Gro!p C strep
S. bovis group 6 Gro!p 6 Nonenterococc!s
E. faecalis, E. facium 6 Gro!p 6 Enterococc!s
Species Lanceel&
(emolysis Common 'erms
S. pyogenes A 9 Gro!p A strep
S. agalactiae " 9 Gro!p " strep
S. dysaglactiae, S.equi
C 9 Gro!p C strep
S. bovis group 6 :,; Gro!p 6 Nonenterococc!s
E. faecalis, E. 6 :,9,; Gro!p 6 Enterococc!s
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Streptococci
I. General Characteristics
A. Intro!ction
ii. Pattern o* hemolysis %"ron5s Classi4cation(emolysis escription
Alpha ",$Partial lysis o*
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Streptococci
I. General Characteristics
A. Intro!ction
ii. Pattern o* hemolysis %"ron5s Classi4cationSpecies Lance
el&(emolysis Common 'erms
S. pyogenes A 9 Gro!p A strep
S. agalactiae " 9 Gro!p " strep
S. dysgalactiae, S.equi
C 9 Gro!p C strep
S. bovis group 6 :,; Gro!p 6 Nonenterococc!s
E. faecalis, E. 6 :,9,; Gro!p 6 Enterococc!s
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Streptococci
I. General CharacteristicsII. Clinically Signicant Species
III. Laboratory iagnosis
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Streptococci
II. Clinically Signicant Species
). Streptococcus pyogenes
". Streptococcus agalactiaeC. Gro!p C an G Streptococci
6. Streptococcus pneumoniae
E. 8iridans Streptococci
F. Enterococcus
G. Streptococcus-like Organisms
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Streptococci
II. Clinically Signicant Species
). Streptococcus pyogenes
i. 8ir!lence Factorii. Clinical In*ections
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Streptococci
II. Clinically Signicant Species
A. Streptococcus pyogenes
i. 8ir!lence Factor>. M Protein
-. Protein F
0. 3ipoteichoic aci
?. $yal!ronic aci
@. Streptoornase
. Streptolysin
B. Streptolysin S
. Strepto+inase
D. $yal!ronic aci
>2.Spe A, Spe ", SpeC
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Streptococci
II. Clinically Signicant Species
A. Streptococcus pyogenes
i. 8ir!lence Factor>. M Protein
Antiphagocytic
For aherence to m!cosal cells
-. Protein F %Fi(ronectin)(ining protein Meiates aherence to host epithelial
cells
0. 3ipoteichoic aci Meiates attachment to m!cosal
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Streptococci
II. Clinically Signicant Species
A. Streptococcus pyogenes
i. 8ir!lence Factor?. $yal!ronic aci Caps!le
Prevents opsoni=e phagocytosis
Mas+ (acterial antigens
@. Streptoornase %6Nases Gro!p o* *o!r en=ymes ith n!clease
activity
6egrae host 6NA %6Nase an
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Streptococci
II. Clinically Signicant Species
A. Streptococcus pyogenes
i. 8ir!lence Factor. Streptolysin
S!(s!r*ace hemolysin %/ygen la(ile
To/ic to
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Streptococci
II. Clinically Signicant Species
A. Streptococcus pyogenes
i. 8ir!lence Factor. Strepto+inase %Fi(rinolysin
Ca!ses lysis o* 4(rin clots
D. $yal!ronic aci Sol!(ili=es hyal!ronic aci in connective
tiss!es
>2.Streptococcal pyrogenic e/oto/ins A, ",C %SPE E/oto/in A is associate ith Scarlet
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Streptococci
II. Clinically Signicant Species
A. Streptococcus pyogenes
i. 8ir!lence Factor>. M Protein
-. Protein F
0. 3ipoteichoic aci
?. $yal!ronic aci
@. Streptoornase
. Streptolysin
B. Streptolysin S
. Strepto+inase
D. $yal!ronic aci
>2.Spe A, Spe ", SpeC
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Streptococci
II. Clinically Signicant Species
A. Streptococcus pyogenes
i. 8ir!lence Factorii. Clinical Infections
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Streptococci
II. Clinically Signicant Species
A. Streptococcus pyogenes
ii. Clinical In*ections>. "acterial Pharyngitis an Tonsilitis
-. Pyoermal In*ections
0. Necroti=ing Fasciitis
?. Streptococcal To/ic Shoc+ Synrome
@. Post)Streptococcal Se!elae
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Streptococci
II. Clinically Signicant Species
A. Streptococcus pyogenes
ii. Clinical In*ections>. "acterial Pharyngitis an Tonsilitis
-. Pyoermal In*ectionsa. Impetigo s!per4cial an locali=e
(. Erysipelasac!te spreaing erythemato!slesion
c. Cell!litis involves eeper tiss!e invasion
. Scarlet Fever i!se re rashes %chest to
e/tremities
http://var/www/apps/conversion/tmp/scratch_5/C15%20-%20Streptococci%20H1-H3/C15%20-%20Streptococci%20-%20H1.pptxhttp://var/www/apps/conversion/tmp/scratch_5/C15%20-%20Streptococci%20H1-H3/C15%20-%20Streptococci%20-%20H2.pptxhttp://var/www/apps/conversion/tmp/scratch_5/C15%20-%20Streptococci%20H1-H3/C15%20-%20Streptococci%20-%20H2.pptxhttp://var/www/apps/conversion/tmp/scratch_5/C15%20-%20Streptococci%20H1-H3/C15%20-%20Streptococci%20-%20H1.pptx8/11/2019 C15 - Streptococci - P1 (1).pptx
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Streptococci
II. Clinically Signicant Species
A. Streptococcus pyogenes
ii. Clinical In*ections0. Necroti=ing Fasciitis
S!pp!rative *asciitis, hospitalgangrene, necroti=ing erysipelas
Invasive in*ection characteri=e (yinammation an necrosis o* s+in,s!(c!taneo!s *at an *ascia
?. Streptococcal To/ic Shoc+ Synrome
Conition herein organ system sh!ts
%ecroti0ing+asciitis
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Streptococci
II. Clinically Signicant Species
A. Streptococcus pyogenes
ii. Clinical In*ections@. Post)Streptococcal Se!elae
a.
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Streptococci
II. Clinically Signicant Species
A. Streptococcus pyogenes
ii. Clinical In*ections>. "acterial Pharyngitis an Tonsilitis
-. Pyoermal In*ections
0. Necroti=ing Fascitis
?. Streptococcal To/ic Shoc+ Synrome
@. Post)Streptococcal Se!elae
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Streptococci
II. Clinically Signicant Species
A. Streptococcus pyogenes
. Streptococcus agalactiaeC. Gro2p C an& G Streptococci
. Streptococcus pneumoniae
3. 4iridans Streptococci+. 3nterococcus
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Streptococci
II. Clinically Signicant Species
". Streptococcus agalactiae
i. 8ir!lence Factor Caps!lar material inter*eres ith phagocytic
activity an complement cascae
activation.
ii. Associate isease Transmission occ!rs vertically or !ring
elivery %associate itho(stetric complications
Ca!ses pne!monia an meningitis
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Streptococci
II. Clinically Signicant Species
C. Gro!ps C an G Streptococci
>. S. dysgalactiae subsp. equisimilis 3arge)colony *orming 9)hemolytic
isolates
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Streptococci
II. Clinically Signicant Species
6. Streptococcus pneumoniae
i. 8ir!lence Factor Caps!lar polysaccharie Antigenic polysaccharie res!lting to 2
serogro!p
Antiphagocytic
ii. Associate 6isease
>. Pne!monia %lo(ar an comm!nityac!ire
-. Sin!sitis titis Meia "acteremia
St t
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Streptococcuspneumoniae
A. Morphology an othercharacteristics
Gram)positive iplococci %lancet or(!llet shape
Capnophilic
St t
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Streptococcuspneumoniae
A. Morphology an other characteristics Ne!*el reaction %H!ell!ng, caps!lar
selling positive "oy !is is mi/e ith S. pneumoniae)
speci4c caps!lar antisera. I* positive thecaps!le sellJ.
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Streptococci
II. Clinically Signicant Species
E. 8irians Streptococci %A,C,F, G,N
i. 8ir!lence Factor Polysaccharie caps!le, e/tracell!lar
e/tran an cell s!r*ace)associate proteins %ahesins
Enhance attachment to host cells!r*aces
ii. Associate 6isease
>. S!(ac!te (acterial enocaritis *romatients ith ama e heart valves.
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Streptococci
II. Clinically Signicant Species
F. Enterococc!s
i. 8ir!lence Factor E/tracell!lar s!r*ace protein, serine
protease an gelatinase *or ahesion
Cytolysins an resistance to
antimicro(ial agents
ii. Associate 6isease
>. Nosocomial in*ection
-. KTI %catheteri=ation, (acteremia
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Streptococci
II. Clinically Signicant Species
Species isease )ssociations
S. pyogenes Pharyngitis, Pyoermal in*ections, NF,STSS, PSS %
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Streptococci
I. General CharacteristicsII. Clinically Signicant Species
III. Laboratory iagnosis
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Streptococci
I. Laboratory iagnosis
A. $emolytic Patterns
". Colony CharacteristicsC. Physiologic Characteristics
6. 3ance4el Classi4cation
E. "iochemical Ienti4cation
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Streptococci
I. Laboratory iagnosis
A. $emolytic Patterns
Species (emolysis
Common 'erms
S. pyogenes 9 Gro!p A strep
S. agalactiae 9 Gro!p " strep
S. dysgalactiae, S. equi 9 Gro!p C strepS. bovis group :,; Gro!p 6 Non
enterococc!s
E. faecalis, E. faecium :,9,; Gro!p 6 Enterococc!s
S. pneumoniae : Pne!mococc!s
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Streptococci
I. Laboratory iagnosis
". Colony Characteristics
Species escription
Gro!p AGrayish hite %pinpoint, transparent totransl!cent, matte orglossyL large =one o* 9 hemolysis
Gro!p "
3arger that Gro!p A streptococciL transl!cent
toopa!eL *lat glossyL narro =one o* 9
hemolysis
8iriansMin!te to small, gray, ome, smoothL :, 9,;hemolytic
Gro! 6 Small, cream or hite, smoothL :, 9,;
http://var/www/apps/conversion/tmp/scratch_5/C15%20-%20Streptococci%20H1-H3/C15%20-%20Streptococci%20-%20H3.pptxhttp://var/www/apps/conversion/tmp/scratch_5/C15%20-%20Streptococci%20H1-H3/C15%20-%20Streptococci%20-%20H3.pptx8/11/2019 C15 - Streptococci - P1 (1).pptx
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Streptococci
I. Laboratory iagnosis
C. Physiologic Characteristics
Gro2p escriptionPyogenic Pro!ce p!s, mostly 9)hemolytic
3actococ
ci
Nonhemolytic organism ithlance4el
gro!p N, o*ten *o!n in airypro!cts
Enterococci
Normal (iota o* the h!manintestine
Fo!n as normal (iota in the
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Streptococci
I. Laboratory iagnosis
C. 3ance4el Classi4cation
Species Lanceel&
S. pyogenes A
S. agalactiae "
S. dysgalactiae, S.equi
C
S. bovis group 6
E. faecalis, E.
faecium
6
C lt &i f
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C2lt2re e&ia forStreptococcus
>. "loo Agar Enriche isolation o* Streptococci
-. "loo Agar ith trimethopriman s!l*ametho/a=ole
Selective mei!m *or "eta)hemolytic
Streptococci
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Streptococci
I. Laboratory iagnosis
6. "iochemical Ienti4cation
>. "acitracin an ST-. CAMP
0. $ipp!rate hyrolysis
?. 3AP
@. P. "acitracin an ST-. CAMP
0. $ipp!rate hyrolysis
?. 3AP
@. P; or ?.5Abroth
+ -
Entero
coccu
Non-
enterococ
S2sceptible
;esistant
S.pneumoniae
S. Viridansor Gro2p
)lpha hemolytic
P>; or ?.5Abroth
+ -
Entero
coccus
Non-
enterococcus
I&entication of ,
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I&entication of ,(emolytic Streptococci
Gro2p9ptoch
in
ile3sc2li
n
?.5Aroth
P>;
6Enterococc!s < %) D D D
6Non)Enterococc!s
< %) D - -
S. pneumoniae S %& - - -S. viridans < %) - - -
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Bacitracin/PYR
diskSusceptible/
+
Group A
Beta hemolytic
Resistant / -
Group B
CAMP + / ippurate ydrolysis
!denti"ication o"
#-hemolytic streptococci
+ -
ile esc2linhy&rolysis
+ -
%ot gro2p )**
P>; or ?.5Abroth
+ -
Enterococc %on-
I&entication of
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Gro2pacitra
cinS7'
C)P
ile-3sc2l
in
?.5A%aCl
P>;
A S %& . "acitracin an ST-. CAMP
0. $ipp!rate hyrolysis
?. 3AP
@. P