Lancefield

Hemolysin Rep. Species Characteristics Major Clinical Syndromes

Classification
Local Invasion and/or eotoxin release
 Pus producing
1. Streptoccocal Pharyngitis
 Anti- phagocytic & anti- immunogenic 2. Strep Skin Infections
 Susceptible to Bacitracin a. Cellulitis
 M protein (major virulence factor; weakest point) b. Impetigo
 Pili (partly M protein covered by lipoteichoic acid) c. Necrotizing fascitis
Treatment: Penicillin & clindamycin
Group A PATHOGENIC ENZYMES 3. Scarlet Fever
(rhamnose – N- S. pyogenes  Streptolysin O (O2 labile; antigenic) 4. Streptococcal Toxic Shock Syndrome
acetylglucose- amine)  Streptolysin S (O2 stabile; not antigenic) Delayed Antibody- Mediated Disease
β  Pyrogenic Exotoxin ( causes scarlet fever & streptococcal 1. Acute Rheumatic Fever
toxic shock syndrome)  With prior Strep pharygitis without skin infection
 Streptokinase (activates plasmin)  Myocarditis to rheumatic valvular heart disease
 Hyaluronidase ( splits hyaluronic acid to penetrate and infect)  Prophylactic Penicillin theraphy
 DNAses (degrade DNA -> produce pus) 2. Acute Glomerulonephritis
 Anti-C5a peptidase (inactivates c5)
 1 week after strep pharygitis with skin infection
 Part of normal flora in vagina, urethral mucous membrane,  Neonatal Meningitis
Group B
and lower GIT  Neonatal pneumonia
(rhamnose- S. agalactitiae
 Fever, vomiting, poor feeding, and irritability (NO nuchal  Neonatal sepais
glucoseamine)
rigidity) Treatment: Penicillin + Ampicillin
Viridans Group S. mutans  Bind to teeth and ferment sugar  Dental Carries
 Opportunistic
 Microaerophilic
pathogens of S. intermedius  Abscess in the brain or abdominal organs
low virulence  Normal GIT flora
 UTI
 Normal Bowel Flora  Biliary Tract Infection
Enterococci
Group D  Grow well in 40% bile and 6.5% NaCl  Bacteremia
(glycerol theicoic acid  SBE
with d-alanine &  UTI
S. bovis & S.
glucose)  Grows in 40% bile but not in 6.5% NaCl  Biliary Tract Infection
equinus
 Epidemiologically associated with colon cancer  Bacteremia
(nonenterococci)
α  SBE (Subacute Bacterial Endocarditis
 C polysaccharide (not associated with Lancefield antigen  Pneumonia
 Gram stain: Gram (+) cocci in pairs (diplococci)  Otitis Media in Children
 Virulence Factor: Polysaccharide capsule  Meningitis
Cell Associated Enzymes Vaccines
 Autolysin: hydrolyze CM to activate Lyt A, B, C -> release  Pneumovax (25 common capsular polysaccharide antigens)
S. pneumoniae pneumolysin o For asplenic, immunocompromised, and elderly patients
 Pneumolysin: intracellular virulence factor loacted in the o Low immunogenicity and efficacy
cytosol -> attack CM  Heptavalent Conjugate Vaccine (7 capsular polysacc. Antigens)
o Pneumolysin binds to cholesterol -> stimulates o 4, 6B, 9V, 14, 18C, 19F, 23F conjugated with nontoxic
proinflammatory cytokines -> inhibit leukocytes and diphtheria-toxin
activate complement pathway o 100% efficacy in prevention in children
Reduce cases of otitis media in children