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    LGT - Pyogenic Cocci - Strept - DR.S Zeiny

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    This document provides information from a lecture on the genus Streptococci. The lecture was given on October 11, 2022 at the University of Baghdad College of Medicine by Dr. Sarmad Zeiny. The objectives of the lecture were to outline important Streptococci species, describe their morphology and physiology, determine virulence factors and diseases, analyze pathogenicity, and outline laboratory diagnosis. Key points included that Streptococci are Gram-positive cocci that can cause diseases like pharyngitis, pneumonia, and meningitis. Species like S. pyogenes and S. agalactiae were discussed in terms of virulence factors, diseases caused, and diagnostic methods.

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    LGT - Pyogenic Cocci - Strept - DR.S Zeiny

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    thaeonloore
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    This document provides information from a lecture on the genus Streptococci. The lecture was given on October 11, 2022 at the University of Baghdad College of Medicine by Dr. Sarmad Zeiny. The objectives of the lecture were to outline important Streptococci species, describe their morphology and physiology, determine virulence factors and diseases, analyze pathogenicity, and outline laboratory diagnosis. Key points included that Streptococci are Gram-positive cocci that can cause diseases like pharyngitis, pneumonia, and meningitis. Species like S. pyogenes and S. agalactiae were discussed in terms of virulence factors, diseases caused, and diagnostic methods.

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    LGT_Pyogenic Cocci_Strept_dr.S Zeiny

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    This document provides information from a lecture on the genus Streptococci. The lecture was given on October 11, 2022 at the University of Baghdad College of Medicine by Dr. Sarmad Zeiny. The objectives of the lecture were to outline important Streptococci species, describe their morphology and physiology, determine virulence factors and diseases, analyze pathogenicity, and outline laboratory diagnosis. Key points included that Streptococci are Gram-positive cocci that can cause diseases like pharyngitis, pneumonia, and meningitis. Species like S. pyogenes and S. agalactiae were discussed in terms of virulence factors, diseases caused, and diagnostic methods.

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    8 views29 pages

    LGT - Pyogenic Cocci - Strept - DR.S Zeiny

    Uploaded by

    thaeonloore
    This document provides information from a lecture on the genus Streptococci. The lecture was given on October 11, 2022 at the University of Baghdad College of Medicine by Dr. Sarmad Zeiny. The objectives of the lecture were to outline important Streptococci species, describe their morphology and physiology, determine virulence factors and diseases, analyze pathogenicity, and outline laboratory diagnosis. Key points included that Streptococci are Gram-positive cocci that can cause diseases like pharyngitis, pneumonia, and meningitis. Species like S. pyogenes and S. agalactiae were discussed in terms of virulence factors, diseases caused, and diagnostic methods.

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    University of Baghdad

    College of Medicine
    2022-2023

    Title: Pyogenic Cocci: Genus Streptococci

    Grade: 3rd
    Module: Infectious Diseases Module
    Speaker: Sarmad Zeiny
    Date: 11 – Oct - 2022
    Pyogenic Cocci
    Gram positive cocci
    Genus Streptococci

    Department of Microbiology, College of Medicine, University of Baghdad


    Dr. Sarmad M.H Zeiny (M.B.Ch.B, M.Sc., F.I.C.M./Path)
    OBJECTIVES:
    Upon completion of this lecture, the student will:

     Outline the medically important Streptococci species.


     Describing the morphology & physiology for Streptococci.
     Determine the virulence factors for Streptococci.
     Analyze the diseases & pathogenicity for Streptococci.
     Demonstrate the epidemiology/transmission for Streptococci.
     Outline the laboratory diagnosis for Streptococci.
    Clinically important Gram +ve cocci

    S.Pyogenes S.aureus
    S.agalactia
    Streptococci Staphylococci S.epidermidis
    Viridans S.
    S.saprophyticus

    S.Pneumoniae
    Staphylococcus
    lugdunensis
    S.enterococci
    Streptococci
    (Gram+ve cocci
    catalase –ve)
    General characteristic for genus streptococci :

     G+ve cocci, arrange in chains or pairs.


     Some strains are capsulated
     Majority are facultative anaerobic, few are obligatory
    anaerobic.
     Catalase –ve
     Non motile.
     Non spore forming
     Fastidious microorganism
    Gram slide for genus streptococci
    Genus Streptococcus

    Hemolysis Lancefield (serology)

    Serogroups (cell wall polysaccharide


    β hemolysis α hemolysis γ hemolysis Ag)

    S. Pyogenes S.Pneumoniae
    S.Bovis Group A Group B Group D
    Enterococcus
    Viridans
    S. agalactiae
    Streptococci
    S. Pyogenes S. agalactiae S.bovis

    80 Serotypes,
    (M-protein)
    S.pyogenes
    (Group A β- hemolytic,GABH):

    M-protein

    >80 serotypes

    Reservoir Transmission
    Human throat and skin Spread by respiratory droplets or
    direct contact
    Virulence factors:
    Virulence factors & Pathogenesis for S.pyogenes

    1) M protein and capsule.


    2) Streptolysin O*: destroys RBC & WBC, antigenic. anti-streptolysin O (ASO)
    antibodies develop.
    3) Streptolysin S: destroys RBC, not antigenic.
    4) Pyrogenic exotoxin (erythrogenic toxin): few strains,
    scarlet fever, few strains superantigens. streptococcal toxic shock syndrome
    5) Streptokinase* plasmin  breaks fibrin  spreading factor

    6) Hyaluronidase  spreading factor

    7) Streptodornases (DNAases)  spreading factor


    8) (Anti-C5a) peptidase anti-inflammatory
    9) Diphosphopyridine Nucleotidase  kill leukocyte
    * Used clinically for diagnosis and for treatment.
    DISEASES of S.pyogenes
    LOCAL INFECTIONS (invasion)

    • Sore throat (acute pharyngitis, pharyngotonsillitis).


    • Skin infections: (Wound infection, cellulitis, fasciitis and
    myonecrosis (flesh-eating), Impetigo, Erysipelas.

    SYSTEMIC INFECTION (invasion &/or toxin)


    • Sepsis.
    • Meningitis.
    • Puerperal Sepsis.
    • Streptococcus toxic shock syndrome
    • Scarlet fever

    POST STREPTOCOCCAL sequel (delayed antibody mediated diseases)

    • Rheumatic fever
    • Acute Glomerulonephritis
    Erysipelas
    POST STREPTOCOCCAL complication
    (delayed antibody mediated diseases)

     Rheumatic fever:
    - After pharyngitis only.
    - Type 2 hypersensitivity reaction.
    - Involves heart and joints.

     Acute Glomerulonephritis:
    - After pharyngitis or skin infections.
    - Type 3 hypersensitivity reaction.
    - Involves kidney.
    Rheumatic fever (Rheumatic heart disease):
     It usually strikes children 5-15 years of age. When it
    occurs, it has been shown to follow untreated beta-
    hemolytic group A streptococcal pharyngitis (but NOT
    after a skin infection).

     Rheumatic fever is antibody-mediated.There are antigens in


    the heart that are similar to the antigens of the beta-
    hemolytic group A streptococci.Therefore, the antibodies
    that forms to eradicate this particular streptococcus also
    cross-react with antigens in the heart.
    Acute post-streptococcal glomerulonephritis (PSGN)
     It occurs after infection of either the pharynx OR skin by nephritogenic
    (having the ability to cause glomerulonephritis) strains of beta-hemolytic group
    A streptococci.

     Certain antigens from these nephritogenic streptococci induce an antibody


    response. The resulting antigen-antibody complexes travel to and are
    deposited in the glomerular basement membrane, where they activate the
    complement cascade. This leads to local glomerular destruction in the kidney.

     Clinically, a child will show up in your office, and his mother will complain that
    his face is puffy. This is caused by the retention of fluid from his damaged
    kidney. His urine is darker than normal (tea or Coca-Cola colored) due to
    hematuria (blood in the urine).
    ASO test:
     Measure Anti-Streptolysin O Ab.
     ASO test uses in poststreptococcal infection. This test used to
    determine significance of current (recent) streptococcal
    infection by measuring the ASOT:
     ASOT (Ab Titer):
    Normal < 200 > significance result (recent infection)
    Laboratory study

    Laboratory diagnostic steps


    Direct
    Specimens
    Gram’s Slide

    Biochemical Culture

    Antibiotics
    Serology
    sensitivity
    S.agalactia
    (Group B β- hemolytic):
    Normal flora of female genital tract (15-20% of woman), male
    urethra & GIT.

    Leading Cause for neonatal sepsis, pneumonia & meningitis. (acquire


    these bacteria during delivery).
    Diagnostic Lab. features

    Bacitracin resistant, PYR -VE

    Hydrolyzes hippurate. (purple color)

    cAMP test-positive produces definitive arrow when close to


    Staphylococcus aureus.
    Summary
    • Streptococci classified according to the type of hemolysis & antigenic components.
    • S.pyogenes is the most pathogenic species because of their virulent factors.
    • S.pyogenes can cause post-infection severe complications.
    • ASO test used in suspected case of rheumatic fever.
    • Streptococci easily diagnosed in the lab. By using Gram’s staining, culture and
    biochemical tests.
    • S.agalactia is the leading Cause for neonatal sepsis, pneumonia & meningitis.
    • streptococci infections can be prevented by regular hygiene precautions and by
    antibiotics, no vaccine.
    Reference:

    Jawetz Melnick & Adelbergs Medical Microbiology -


    27E (2016)

    THANKS

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