C15 - Streptococci - P1 (1).pptx

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


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


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


A. Intro!ction

i. Cell #all Str!ct!re %3ance4el gro!pingii. Pattern o* hemolysis %"ron5s Classi4cation


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Streptococci


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


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


A. Intro!ction

i. Cell #all Str!ct!re %3ance4el gro!ping 3ate/ aggl!tination


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Streptococci


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


A. Intro!ction

ii. Pattern o* hemolysis %"ron5s Classi4cation(emolysis escription

Alpha ",$Partial lysis o*


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Streptococci


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




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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


). Streptococcus pyogenes

i. 8ir!lence Factorii. Clinical In*ections


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Streptococci


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




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



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



i. 8ir!lence Factor. Streptolysin

S!(s!r*ace hemolysin %/ygen la(ile

To/ic to


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Streptococci



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




-. 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



i. 8ir!lence Factorii. Clinical Infections


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Streptococci



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




-. 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
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Streptococci



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


Conition herein organ system sh!ts

%ecroti0ing+asciitis


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Streptococci



ii. Clinical In*ections@. Post)Streptococcal Se!elae

a.


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Streptococci




-. Pyoermal In*ections

0. Necroti=ing Fascitis


@. Post)Streptococcal Se!elae


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Streptococci



. Streptococcus agalactiaeC. Gro2p C an& G Streptococci

. Streptococcus pneumoniae

3. 4iridans Streptococci+. 3nterococcus


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Streptococci


". 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


C. Gro!ps C an G Streptococci

>. S. dysgalactiae subsp. equisimilis 3arge)colony *orming 9)hemolytic

isolates


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Streptococci


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


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


>. S!(ac!te (acterial enocaritis *romatients ith ama e heart valves.


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Streptococci


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


>. Nosocomial in*ection

-. KTI %catheteri=ation, (acteremia


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Streptococci


Species isease )ssociations

S. pyogenes Pharyngitis, Pyoermal in*ections, NF,STSS, PSS %


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Streptococci




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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


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


". 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,;
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Streptococci


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


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


6. "iochemical Ienti4cation

>. "acitracin an ST-. CAMP

0. $ipp!rate hyrolysis

?. 3AP

@. P. "acitracin an ST-. CAMP


?. 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


?. 3AP

@. P

C15 - Streptococci - P1 (1).pptx

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