In this slide, I will teach you about gram-positive cocci which streptococcus pneumonia. I will tell you about its diseases, transmission, pathogenesis, characteristics, lab diagnosis, treatment, and prevention in a short and easy way.

2. Streptococcus Pneumoniae
Pneumococcus

3. Diseases
• MOPS
• Pneumonia (Adults)
• Lobar Pneumonia (inflammatory exudate within the intra-alveolar space)
• (Phlegm green-brown or Rust Color Sputum)
• Otitis Media (Children)
• Inflammatory diseases of the middle ear with ear pain
• Sinusitis (Children)
• Inflammation of the mucous membranes that line the sinuses
• Meningitis (In Adults)
• Inflamation of meningies of brain
• Sepsis

4. Habitat & Transmission
•Habitat
•Upper respiratory tract, oropharynx
•(Nose and paranasal sinuses, the pharynx,
larynx above the vocal folds)
•Transmission
•Respiratory droplets

5. Pathogenesis
•Pyogenic, Induce inflammatory response
•Poly saccharide capsule retards phagocytosis.
•Anti poly saccharide anti body opsonizes bacteria
and provide type specific immunity.
•IgA protease degrades secretory IgA on
respiratory mucosa allowing colonization in
orophaynx

6. Predisposing factors
•Viral respiratory infections predispose to
pneumococcal pneumonia by damaging
mucociliary elevator.
•Sickle cell anemeia predispose to pneumonia
•Skull fracture with spinal fluid leakage from
nose predispose to meningitis
•Splenectomy predispose to sepsis

7. Characteristics
• Gram positive diplococci in short chains
• a hemolytic colonies
• No lancefield Group
• C polysaccharide called C substance (Techoic acid in cell wall)
• React with C reactive protein made by liver acute phase protein
elevated as much as 1000 folds in acute inflamation
• Lancet shape
• 85 serotypes based on antigenicity of poly saccharide capsule

9. Three classified encapsulated pyogenic bacteria
•Streptococcus Pneumoniae
•Neisseria meningitides
•Haemophilus influenze

10. Laboratory Diagnosis
• Gram stain smear and culture (Crystal Voilet)
• Blood agar (a hemolytic colonies )
• Catalase negative
• Optochin Sensitive ( Interefere with ATP and Growth is
inhibited)
• Bile soluble Colonies. Growth inhibited by bile
• Quellung reaction, Swelling of capsule with type specific
antiserum
• Test for capsular antigen in spinal fluid
• C polysaccharide in urine

12. Treatment
•Pencillin G
•Low level and high level resistance to
penicillin caused by alterations in pencillin
binding proteins. No B lactamases
•Ceftriaxone
•Macrolides

13. Prevention
• 2 Vaccine
• Capsular polysaccharide of 23 serotype for adults produce IgM
• Capsular polysaccharide of 13 serotypes coupled to carrier protein
(diphtheria toxoid) In children under age of 2 years produce IgG
• 13 valent pneumococcal conjugate vaccine (Prevnar 13)
• In immunocompromised children under age of 5 years and
splenectomized patients
• Serotype replacement (Problem with use of pnemococcal vaccine)
• Oral pencillin for immunocompromised children

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