Group B Streptococci

General features & Morphology

Gram positive cocci in chains Ex. Streptococcus agalactiae 25% are colonizers in female vagina Neonates are at risk during delivery May cause infection in mother

Clinical features
Important pathogen to cause neonatal septiceamia and meningitis Genital tract infections in pregnancy

Lab diagnosis
Sample: vaginal swab Gram stain: Culture: BA plate CAMP TEST positive Hippurase positive

CAMP test
Principle:
Group B streptococci produce extracellular protein (CAMP factor) CAMP act synergistically with staph. -lysin to cause lysis of RBCs

Procedure:
Single streak of Streptococcus to be tested and a Staph. aureus are made perpendicular to each other 3-5 mm distance was left between two streaks After incubation, a positive result appear as an arrowhead shaped zone of complete hemolysis S. agalactiae is CAMP test positive while non gp B streptococci are negative

CAMP Factor Test

Group B Streptococcus
(CAMP Factor)

S. aureus
(Spingomyelinase C)

Group A Streptococcus

Enhanced Zone of Hemolysis

Grp B Streptococci
and Campylobacter

Hippurase POS

Hippurase NEG

Enterococcus faecalis Enterococcus faecium

GI tract of humans and animals Group D carbohydrate cell wall antigen Formerly Streptococcus

Features and morphology

Gram positive cocci in pairs Non heamolytic Heat resistant-60 degree for 30 min Grow in presence of 40% bile & 6.5% NaCl PYR test positive

Clinical diseases
Urinary tract infection Wound infections-mainly intraabdominal Bacteremia septicemia

Lab diagnosis
Grows in non selective media Forms non hemolytic colonies on BA On MA-forms magenta colored colonies Resistant to bile Esculin hydrolysis

Enterococcus

Group D Streptococcus

Bile Esculin Agar

Bile Esculin Agar

NEG

POS

Streptococci viridans
Gram positive in long chains S.mutans is known to cause dental caries Forms alpha hemolytic colonies on BA Normal commensal in mouth Usually non-pathogenic

Pathogenesis of dental caries

Streptococcus mutans Breaks down dietary sucrose to acid and dextran Dextran binds to food debris, mucus, and epithelial cells to form dental plaque, while Acid damages dentine Plaque leads to dental caries

 Following tooth extraction these bacteria's can deposited on damaged heart valves to form vegetation's Causes subacute bacterial endocaritis in persons with valvular heart disease, CHD and cardiac surgery

Lab diagnosis and treatment

Optochin resistant Alpha hemolytic colonies on BA Antibiotic prophylaxis before tooth extraction in patients with heart diseases.