STREPTOCOCCUS

PYOGENES
(B-Hemolytics group A)
Streptococcus
• They are gram +
immotile and catalase
negative cocci.
• They can be isolated in a
medium enriched with
blood.
They are classified by:
• Group A
• Group B (S. agalactiae)
Streptococcus pyogenes
• Found in pairs or chains
• Facultative anaerobes
• In humans it invades the
skin or mucous
membranes.
• Hemolytic properties in
blood agar.
• Serological groups

General characteristics
 .. Hemolysis
to
They are classified by: gar
A. Hemolytic properties in blood.
Alpha-hemolytics
Beta-hemolytics
Gamma-hemolytics

B. Serological groups, by Lancefield: It is

based on the antigenic composition of the
carbohydrates of the cell wall.
They are classified according to a
polysaccharide such as
Carbohydrate C, it is an
n ' oS~I
t 'LeAFene
N9wMFF
STRUCTURE:
• Carbohydrate C.
• Protein F: Mediates anchoring in the
pharyngeal epithelium
• Protein M: At least 80 antigenic types
are known; essential element of
virulence .
• Fimbriae or pili.
 CAPSULE (AC. HYALURONIC)

CELLULAR MEMBRANE

PEPTIDOGLYCAN

— CARBOHYDRATE C

FIMBRIA / PROTEIN M

LIPOTEIC ACID
 Epithelial cell
Surface
fibronectin
Protein F

M protein

Lipoteichoic acid
Protein F
Pilus
Pili------------- Lipoteichoic acid
Hyaluronic acid
M protein-------------------
Cell wall
lycan

Lancefield —
carbohydrate

cell membrane
 Group A M protein
streptococci

M protein-sbrinogen
aggregate

M protein released from

bacterial surface

~ Degranulation
* Respiratory burst
nóiph nud J Endothelal damage
eükoeVté .
Endothelium

scula
M protein-fibr nogen aggregate
PRODUCTS
EXTRACELLULAR AND
I AXMNI/SISs:
They damage cell membranes and
cause hemolysis.

• Pyrogenic exotoxins A, B and C

(erythrogenic toxin).
They cause the exanthema (rash) of
scarlet fever.
PATHOGENY:
• Adhesion to host cells. Pharyngeal
colonization (pili, M protein,
lipoteichoic acid).

• Effect of enzymes and toxins

(prevents localization of the
infection)
Diagnosis:
• Sample collection
• Crop:
• Gram stain.
• Q. biochemical:
• Catalase.
• Hemolysis.
• Bacitracin sensitivity.
 DISEASES
AUSA: "adwd

— • Pharyngitis: reddened pharynx with

frequent presence of exudates
II mg gmngeige
IMII Scarlet fever: Complication of streptococcal
•

pharyngitis; begins in the chest and spreads

to the extremities;
ae Pyoderma: it is a localized infection and
5.3 purulent skin kj0 primarily affecting exposed
areas ' *(face, arms and legs).
2 e Erysipelas: localized skin infection with pain,
inflammation (the affected skin is elevated
from the rest)
• Necrotizing fasciitis: deep infection of the
skin that causes the destruction of muscle
layers and adipose tissue
• Streptococcal toxic shock syndrome):
respiratory failure and many or
Sensitivity of Streptococcus
pyogenes to antibiotics.
• A progressive increase in resistance to
clarithromycin or azithromycin has been
demonstrated.
• Perhaps because they are used so
frequently.
• The presence of other species with
microorganisms carrying resistance
genes.
• In Spain, 441 strains from 20 laboratories
were evaluated and it was shown that they
 were sensitive to penicillin.
Invasive disease due to
Streptococcus pyogenes
• Clinical cases of invasive infection by S.
pyogenes , without infectious focus.

• The estimated minimum of 500,000 annual

deaths places the S. pyogenes as one of
the major pathogens of man, surpassed
only by the Human Immunodeficiency
Virus, Mycobacterium tuberculosis,
Plasmodium falciparum and
Streptococcus pneumoniae.
INVESTIGATION OF THE CARRYING OF
STREPTOCOCCUS PYOGENES IN HEALTHY
ADULT POPULATION
m • Human beings constitute the natural reservoir of S.
pyogenes, which is transmitted from person to
person through the respiratory route.
Hi * Carriage in a healthy adult population, from a
university community (University of Morón) in a
range of 21 to 80 years. No fever, no sore
throat, no recent antibiotic treatment

RESULTS
Out of a total of 260 adults, a
5.39% of carrier population.
Bibliography
• T. Stuart Walker, 1999, Microbiology,
McGrawHill, 1st edition, Mexico City, 532
pages.
• Wolfgang K Joklik, et. Al, 1983, Zinsser
Microbiología, Médica Panamericana,
17th edition, Argentina, page 1412.
• Jawetz, Melnick and Aldelberg, 1999,
Medical Microbiology, The Modern
Manual, Mexico. d. F.
• Patrick R. Murray, et. Al, Medical
Microbiology, Elsevier, 4th edition, Madrid
Spain.