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Streptococci: General Characteristics of Streptococci
Streptococci: General Characteristics of Streptococci
different
groups
characterized
and
some
-hemolytic
S. pneumoniae
showing
greenish zones
typical of hemolysis.
Biochemical properties
Catalase-negative, facultative anaerobes
Note: Species in bold type are the most significant sources of human infection and disease.
N = none V = varies
*Urinary tract infection.
**Upper respiratory tract.
***No group C-carbohydrate identified.
Species of Streptococci
Streptococcal species
Sites of Colonization
Sites of Infection
S. pneumoniae
Oropharynx , nose
S. pyogenes
Oropharynx , rectum
S. agalacti ae
Gp. B streptococci
GU tract, Oropharynx
Neonatal
infections, CNS,
Viridans streptococci
GU tract, Oropharynx
Identification of Streptococci
Streptococcus pyogenes
Exotoxins:
Pyrogenic exotoxins A-C - function as superantigens
producing a sepsis syndrome
SPE A Structurally similar to the staphylococcal superAgs
SPE B Cys protease that destroys tissue
Invasive
Scarlet fever-rash that begins on the chest and spreads
across the body
Pyoderma-confined, pus-producing lesion that usually
occurs on the face, arms, or legs
Necrotizing fasciitis-toxin production destroys tissues and
eventually muscle and fat tissue
Glomerulonephritis:
Immunologically mediated damage perhaps resulting from
streptococcal antigens that cross react with kidney tissue
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Acute Glomerulonephritis
Caused by deposition in the glomerulus of antigen
antibody complexes with complement activation and
consequent destruction of glomerular membrane,
allowing blood and proteins to leak into urine
Type II hypersensitivity reaction
M proteins of some nephritogenic strains share
antigenic determinants with glomeruli
Streptokinase also been implicated both through
molecular mimicry and through its plasminogen
activation capacity
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Diagnosis
As noted clinical criteria for streptococcal
pharyngitis of limited value
Culture remains the gold standard
Rapid streptococcal antigen detection kits
based on carbohydrate recognition are highly
specific
Treatment/Prevention of S. pyogenes
Infection
The species remains exquisitely sensitive to penicillin
The use of antibiotics that are protein synthesis
inhibitors (e.g. clindamycin) that inhibit protein
synthesis may improve outcome
Soft tissue infections often require surgical
debridement
Intravenous immunoglobulin may also have a
beneficial role
Prophylactic antibiotics
Vaccines - under investigation
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