Streptococci
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STREPTOCOCCI. Streptococci facultative anaerobe Gram-positive chains or pairs catalase negative (staphylococci are catalase positive). Streptococcus in chains. Streptococcus pneumoniae (diplococcus). Fluorescent stain. Streptococci Lancefield groups

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STREPTOCOCCI

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Streptococci

STREPTOCOCCI


Streptococci

  • Streptococci

    • facultative anaerobe

    • Gram-positive

    • chains or pairs

    • catalase negative

    • (staphylococci are catalase positive)


Streptococci

Streptococcus in chains


Streptococcus pneumoniae diplococcus fluorescent stain

Streptococcus pneumoniae (diplococcus). Fluorescent stain


Streptococci

  • Streptococci

    • Lancefield groups

      • Satu atau lebih spesies per group

      • antigen permukaan


Groupable streptococci

groupablestreptococci

  • A, B and D

    • most important

  • C, G, F

    • rare


Non groupable

Non-groupable

  • S. pneumoniae

    • pneumonia

  • viridans streptococci

    • e.g. S. mutans

      • dental caries


Hemolysis reaction sheep blood agar

hemolysis reaction - sheep blood agar

  • α (alpha)

    • partial hemolysis

      • green color

  • β (beta)

    • complete clearing

    • A and B

  • γ (gamma)

    • no lysis


Hemolysis

Hemolysis

  • Groups A an B

    • β

  • Group D

    • α or γ

  • S. pneumoniae and viridans

    • γ


Streptococci

  • hemolysis reaction + one characteristic

  • presumptive identification


Group a streptococcus s pyogenes

Group A streptococcus(S. pyogenes)


Streptococci

  • Group A streptococcal menginfeksi semua umur

  • Insiden tertinggi pd usia 5-15 thn


S pyogenes suppurative

S. pyogenes -suppurative

  • non-invasive

    • pharyngitis

    • Infeksikulit, impetigo

  • invasive bacteremia

    • toxic shock-like syndrome

    • "flesh eating" bacteria

    • pyrogenic toxin


Pyrogenic toxin

Pyrogenic toxin

  • superantigen

  • T cell mitogen

  • Mengaktifkan sistem imun


Scarlet fever

Scarlet fever

  • rash

  • erythrogenic toxin


Non suppurative

non-suppurative

  • rheumatic fever

    • inflammatory disease

    • life threatening

    • Sekuel kronik

      • demam

      • jantung

      • sendi

        • rheumatic tidak sama dengan rheumatoid arthritis


Rheumatic fever etiology

Rheumatic fever -etiology

  • M protein

    • cross-reacts heart myosin

    • autoimun

  • Antigen dinding sel

    • sedikit dicerna in vivo

    • bertahan lama


Rheumatic fever

Rheumatic fever

  • penicillin

  • menyembuhkan pharyngitis

  • Menurunkan resiko carditis


Acute glomerulonephritis

Acute glomerulonephritis

  • immune complex disease of kidney


Major pathogenesis factors

Major pathogenesis factors

  • lipoteichoic acid/F protein

    • fimbriae

    • binds to epithelial cells

  • M protein

    • anti-phagocytic


M protein

M protein

  • major target

    • Imunitas alami

  • strain variation

    • antigenicity

  • re-infection

    • Terjadi dengan strain yg berbeda


Capsules

Capsules

  • Anti-phagocytic

    • mucoid strains


Isolation and identification

Isolation and identification

  • β hemolytic colonies

    • bacitracin menghambat pertumbuhan

  • β hemolytic colonies

    • group A antigen


Hemolysis1

β hemolysis

  • hemolysin O

    • Sensitif oksigen

  • hemolysin S

    • Non sensitive oksigen


Post infectious diagnosis serology

Post-infectious diagnosis (serology)

  • Antibodi thd streptolysin O

  • Penting! Bila menetap sekuel kronik terjadi


Streptococci

Serotyping

  • M

  • T

  • R


Group b streptococcus

Group B streptococcus

  • neonatal meningitis

  • septicemia

  • transmission

    • vaginal flora


Group b streptococcus identification

Group B streptococcus - identification

  • β hemolysis

  • hippurate hydrolysis

  • CAMP reaction

    • meningkatkan βhemolisis S. aureus


Group d streptococcus

Group D streptococcus

  • Tumbuhpada bile esculin agar

    • precipitasihitam

      6.5% salin

  • Tumbuh

    • enterococci

  • Tidaktumbuh

    • non-enterococci


Enterococci

Enterococci

  • Hubungannya agak jauh dr streptococci lain

  • genus Enterococcus

  • Flora usus

    • urinary tract infection

      • Kontaminasi dr anus

    • opportunistic infections

      • khususnya endocarditis

  • Paling sering E. (S.) faecalis


Enterococci1

Enterococci

  • resisten thd banyak antibiotik

    • termasuk vancomycin

      • ujung D-ala diganti dengan D-lactat


Minute colony streptococci

Minute colony streptococci

  • Various groups (e.g. group A)

    • berbeda scr genetik

      • koloni yg besar (e.g. S. pyogenes)

    • tdk ada demam rheuma

Koloni besar

Koloni kecil


Viridans streptococci

Viridans streptococci

  • diverse species

  • oral

  • Karies gigi

  • α hemolytic dan negatif thd tes lain

  • non-groupable.

  • termasuk S. mutans

    • endocarditis

    • cabut gigi


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