STREPTOCOCCUS

AND ENTEROCOCCUS
STREPTOCOCCI
Gram positive, spherical, ovoid or lancet shaped cocci
(in pairs or in chains)
Facultatively anaerobic (catalase negative)
STREPTOCOCCI
Classification
ABIOTROPHIA OR
GRANULICATELLA.
nutritionally variant (pyridoxal or thiol
dependent, satelliting) streptococci
 ENTEROCOCCUS
gram-positive cocci that occur singly, in pairs, and in short
chains
Facultatively anaerobic.
α- or γ-hemolytic on blood agar, but some may exhibit β-
hemolysis
most common species are Enterococcus faecium and
Enterococcus faecalis
Common cause of urinary tract infection in hospitalized
persons
 S. PYOGENES
Antiphagocytic cell wall M protein
lipoteichoic acid- permits bacterial adherence to the
respiratory epithelium
Streptolysin O - antigenic,oxygen-labile enzyme,
produces subsurface hemolysis on blood agar plates
 S. PYOGENES
streptolysin S - nonantigenic, oxygen-stable enzyme,
produces surface hemolysis
Streptokinase - promotes fibrinolytic activity by
converting plasminogen to plasmin
hyaluronidase – enhance the spread of the organism
through connective tissue.
S. PYOGENES
STREPTOCOCCUS
AGALACTIAE
Neonatal sepsis, pneumonia, and meningitis
 S. PNEUMONIAE
pneumonia,
meningitis(especially in infants
and the elderly), spontaneous
bacteremia (in persons who do
not have a spleen), otitis,
sinusitis, and spontaneous
peritonitis.
antiphagocytic polysaccharide
capsule
VIRIDANS
STREPTOCOCCI
Bacterial endocarditis
is the most common
infection caused
S. bovis - bacteremia
has been associated
with malignancies of
the gastrointestinal
tract
LABORATORY
DIAGNOSIS
Streptococci grow well on blood or chocolate agar
vaginal/rectal swabs from pregnant women
specifically for group B streptococci inoculate first
into:
Lim /carrot broth / Todd-Hewitt broth – selective
broth
Granada – selective agar
GROUP A (S. PYOGENES)
Susceptible to bacitracin
β – hemolytic
PYR positive
 BACITRACIN TEST
Principle :
A disk (Taxo A) impregnated
with a small amount of
bacitracin (0.04 units) is placed
on an agar plate.
Result
Positive: Any zone of inhibition
greater than 10 mm; susceptible
Negative: No zone of
inhibition; resistant
GROUP A
GROUP B (S.
AGALACTIAE)
β-hemolytic
Hippurate hydrolysis positive
positive CAMP test
 CAMP TEST

Christie, Atkins, and Munch-Peterson (CAMP) test

Principle
Certain organisms (including group B streptococci)
produce a diffusible extracellular hemolytic protein
(CAMP factor) that acts synergistically with the beta-lysin
of Staphylococcus aureus to cause enhanced lysis of red
blood cells. The group B streptococci are streaked
perpendicular to a streak of S. aureus on sheep blood agar.
 CAMP TEST

Result
Positive:
Enhanced hemolysis is indicated by an
arrowhead-shaped zone of beta hemolysis at the
juncture of the two organisms
Negative:
No enhancement of hemolysis
S. PNEUMONIAE

susceptibility to ethylhydroxycupreine
hydrochloride (optochin / P disk),
positive for bile solubility
α-Hemolytic
colonies are mucoid or flattened with a depressed
center
Quellung test – capsular swelling
 OPTOCHIN TEST
Principle :
Optochin impregnated
disk (TaxoP) is placed on a lawn
of organism on a sheep blood
agar plate
Result
Positive: Zone of inhibition ≥ 14
mm in diameter, with 6-mm disk
Negative: No zone of inhibition
ENTEROCOCCUS

PYRase positive,
Grow in the presence of 6.5% NaCl
hydrolyze esculin in the presence of bile (causing
visible growth and blackening of the agar)
 SALT TOLERANCE TEST
Principle :
heart infusion broth containing 6.5%
NaCl is used as the test medium. This
broth also contains a small amount of
glucose and bromcresol purple as the
indicator for acid production.
Result
Positive: Visible turbidity in the
broth, with or without a color change
from purple to yellow
Negative: No turbidity and no color
change
VIRIDANS

α-Hemolytic streptococci that are optochin

resistant and PYRase negative
γ-hemolytic streptococci that are PYRase
negative and do not grow in 6.5% NaCl
Caramel odor – associated with the milleri
streptococci