Streptococci and enterococcus Flashcards
What are the principles used to categorize streptococci?
- Colony morphology and hemolytic reactions on blood agar
- Serologic specificity of the cell wall group-specific substance (Lancefield antigens)
- Biochemical reactions and resistance to physical and chemical factors
What are the different outcomes of tests for hemolysis with streptococci?
- Complete (β) hemolysis, leaving clear medium
- Incomplete (α) hemolysis, leaving a green pigment
- No (γ) hemolysis
How is the Lancefield grouping determined for different streptococci?
Antibody development to different antigens present on the surface of the bacterial strain
Which streptococcus is group A streptococcus (GAS)?
Streptococcus pyogenes
Which streptococcus is group B streptococcus (GBS)?
Streptococcus agalactiae
What are the β-hemolytic streptococci?
- S. pyogenes
- S. agalactiae
How can the β-hemolytic streptococci be differentiated?
- Sensitive to bacitracin: S. pyogenes
- Not sensitive to bacitracin: S. agalactiae
How can the α-hemolytic streptococci be differentiated?
- Sensitive to optochin: S. pneumoniae
- Not sensitive to optochin: S. viridans group
What are the α-hemolytic streptococci?
- S. pneumoniae
- S. viridans group
What are the morphologic features of S. pyogenes?
- Spherical cocci
- 1–2 µm in diameter
- Arranged in short chains in clinical specimens
- After 24 hours of incubation, small white colonies with large zones of β-hemolysis are observed
How does S. pyogenes avoid opsonization and phagocytosis?
- Its hyaluronic acid capsule is poorly immunogenic and interferes with phagocytosis
- M proteins also interfere with phagocytosis by blocking the binding of C3b. They are the most important anticomplement virulence factors
- S. pyogenes has a C5a peptidase on its surface, degrading the chemotactic agent
How does S. pyogenes adhere to host cells?
Several antigens, notably M proteins and F proteins
What is the significance of streptococcal pyrogenic exotoxins (Spe)?
Superantigens
What is streptolysin S?
- An oxygen-stable, nonimmunogenic, cell-bound hemolysin
- Lyses erythrocytes, leukocytes, and platelets
- Is the enzyme responsible for β-hemolysis
What is streptolysin O?
- An oxygen-labile hemolysin
- Lyses erythrocytes, leukocytes, platelets, and cultured cells
- Antistreptolysin O (ASO) antibodies are used to document recent GAS infection (unless the infection was cutaneous)
What is streptokinase?
- Two forms: streptokinase A and B
- Lyse blood clots and fibrin deposits and facilitate the rapid spread of GAS in infected tissues
What is the role of DNases A–D in S. pyogenes pathogenesis?
- Depolymerizes free DNA present in pus
- This reduces the viscosity of the abscess material and facilitates the spread of the bacteria