JORS

Streptococci
Lancefield group ▪ Family of Streptococcacee
▪ Part of indigenous human microbiota
▪ Can cause life-threatening infection
Hemolytic Lancefield group Species
▪ Facultative anaerobes
reaction
o Except: peptostreptococci (obligate anaerobes)
A S. pyogenes ▪ Some are capnophilic
▪ Growth is enhanced by blood, serum, glucose -> agar
β B S. agalactiae ▪ Gram positive spherical cells in chains or pairs
▪ Culture: BAP
C S. dysgalactiae subp. • Colonies: grayish, pinpoint, translucent to opaque, some have
equilsimilis, S. equi mucoid colonies
• Biochem test:
D S. bovis ▪ Catalase: Negative
α or
▪ Oxidase: Negative
γ ▪ Gas production: Negative
▪ Non-motile
β,α D Enterococci ▪ Ferments carbohydrate
or γ ▪️Notorious pathogens: S. pyogenes & S. pneumoniae

None - A, C, F, G Classification
β,α or N Lancefield Viridans ▪ Bergey’s / Academic
antigen - Based on temperature
or γ
o Pyogenic
· 37
α None S. pneumoniae
· β -hemolytic
· · S. pyogenes, group C & G streptococci
▪ Lancefield o Viridans
- Extraction of C carbohydrate -> streptococcal cell wall · 37 & 45
- Rebecca Lancefield · Not part of lancefield group
o Microbiologist · Can be α - or non hemolytic
o Developed the classification · Indigenous microbiota -> upper respiratory tract
o C carbohydrate -> extracted -> cell wall -> placing the organism in dilute · A, C, G, or N Lancefield antigen
acid + heating for 10mins · S. mutans, S. mitis, S. salivarius
o β -hemolytic strep o Lactic group
· 10 & 37
Group A · Non-hemolytic
▪ Not considered as part of indigenous microbiota · Lancefield N antigen
▪ Pathogenic · Often found on dairy
▪ Acquired via contaminated droplets -> released through coughing or · S. lactis -> normal coagulation or souring of milk
sneezing o Enterococcus (streptococci)
▪ Resistant to drying · 10, 45, 37
▪ Recovered from swabs several hours after collection · Indigenous microbiota of intestine
▪ S. pyogenes -> fever producing & flesh eating bacteria · E. faecalis
▪ Principal virulence factor -> M protein -> attached to the peptidoglycan,
antiphagocytic, adherence to mucosal cells ▪ Smith & Brown
▪ Culture: BAP - Based on hemolytic patterns
· Colonies: small, translucent, smooth, well-defined beta hemolysis o α - Partial, greenish
▪ Virulence factors o S. pneumoniae
· Protein F
- Mediates epithelial cell attachment
o β - Total, complete lysis of rbc around the colony, clear zone around

· Lipoteichoic acid the colony

- Adherence to respiratory epithelium o S. pyogenes, S. agalactiae
· Hyaluronic acid capsule o γ - None
- Weakly immunogenic o S. bovis
- Prevents opsonized phagocytosis o Alpha prime
- Masks its antigen · Green discoloration with clear zone
· Hemolysin, toxin, enzymes · Inner zone - α
· Outer zone – β

MICROBIOLOGY – BACTERIOLOGY – GRAM POSITIVE COCCI - STREPTOCOCCUS 1

JORS
· Inflammation
- Heart
- Joints
- Blood
· Complication of pharyngitis Enzymes & toxins
▪ Acute glomerulonephritis/Bright’s disease ▪ Hemolysin
▪ · Streptolysin O(xygen)
▪ Streptococcal toxic shock syndrome - Oxygen labile hemolysin
- Surface hemolysis -> BAP -> incubated anaerobically
- Stab the agar -> anaerobiosis + subsurface lysis
- Highly antigenic
- Induces antibody response
- Antistreptolysin O (ASO) titer test
o Serologic test to detect recent infection -> S. pyogenes
· Streptolysin S(table)
- Oxygen stable hemolysin
- Non-antigenic
- Surface hemolysis -> BAP -> incubated aerobically
▪ DNase
- Lowers the viscosity of exudates
- More mobility of the pathogens
- A, B, C, D
▪ Streptokinase
- Fibrin clot lysis
- Binds to plasminogen
- Activates the production of plasmin
- Activates host blood factor -> dissolves fibrin clot
▪ Hyaluronidase
- Spreading factor
- Solubilizes the groud substance
▪ Pyrogenic toxins
- Serotypes A, B, C, F (super antigens)
- Formerly known as erythrogenic toxins
- Exotixin B (cysteine protease)
o Degrades proteins + mediates rashes -> scarlet fever

Infections & diseases

▪ Pharyngitis or tonsillitis (strep throat)
- Spread -> air droplets + close contact
- Highly virulent strains -> causes outbreaks
➢ Sore throat + scarlet fever @ schools & camps
▪ Scarlet fever (Scarlatina)
- Diffuse erythema
o Neck & upper chest
o Followed by 1-2 days – strep throat
- Communicable
- Spread through inhalation of infectious respiratory droplets
- Caused by release of pyrogenic exotoxin
- Strawberry-colored tongue
- Susceptibility test: Dick’s test (Erythrogenic toxin test)
o Positive: Erythema/redness of skin
- Diagnostic test: Schultz-Charlton test (Anti-erythrogenic toxin test)
o Positive: blanching phenomenon/rash fade
▪ Skin infection
· Cellulitis
- Contagious infection of subcutaneous
- Redness (erythema) + Accumulation of fluid (edema)
· Erysipelas
- Acute infection of dermal layer
- Painful, swollen, reddish spot
· Impetigo
- Skin infection caused by group A strep
- Necrotizing fasciitis
➢ Galloping gangrene or flesh-eating bacteria syndrome
▪ Rheumatic fever
· Fever

MICROBIOLOGY – BACTERIOLOGY – GRAM POSITIVE COCCI - STREPTOCOCCUS 2