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STREPTOCOCCUS PYOGENES
Group A Streptococcus
GRAM POSITIVE STREPTOCOCCI
• Streptococcus Pyogenes (Group A Streptococci)
• Streptococcus Agalactiae (Group B Streptococci)
• Streptococcus Pneumoniae (Pneumococcus)
• Streptococcus Viridans (Streptococci Sanguis, Streptococci Mutans)
• Enterococcus Faecalis
DISEASES
•Suppurative Diseases
(Local & Desseminated)
•Non suppurative
Immunological diseases
•Toxigenic Infections
LOCAL PYOGENIC INFECTIONS
• Pharyngitis
• Sore throat ( Erethema & swelling of soft palate,uvula & posterior pharynx)
• Impetigo
• Crops of vesicles with honey colored crust
• Cellulitis,
• Erethema pain & swelling of lower layer of dorsal foot and other regions.
• Erysipelas,
• Well demarcated border of inflamed area on upper layer of skin.
• Nectrotizing Fasciitis (Streptococcal gangrene )
• Death of parts of the body's soft tissue,
• Appear red/purple skin due lack of blood.
• Clostridum perfringens also cause it.
DESSEMINATED PYOGENIC INFECTIONS
• Sepsis
• Sub acute bacterial endocarditis,
• Vegetation (abnormal growth )on mitral valve.
• Viridans most commonly.
IMMUNE MEDIATED,
POST STEPTOCCOCAL,
NON SUPPURATIVE
• Rheumatic fever
• (Pharyngitis, Mitral valve stenosis,)
• JONES crtieria
• Poly arthritis, Heart disease, Sub cutaneous nodules, Erythema
Marginatum, Sydenham chorea
• Glomerulonephritis
• ( Facial edema, Cola color urine)
TOXIGENIC INFECTIONS
• Scarlet fever
(Strawberry tongue, Pharyngitis, Different rash (swollen,
iritative and pain)
• Toxic shock syndrome
• Systemic symptoms
HABITAT & TRANSMISSION
• Habitat
• Throat & skin
• Transmission
• Respiratory Droplets
• (small aqueous droplet produced by exhalation, consisting
of saliva or mucus)
ENZYMES INVOLVED IN
PATHOGENESIS
• Hyaluronidase
• Breakdown a substance,“Spreading factor” mediates sub cutaneous spread in
celluitits and other Suppurative infection
• Streptokinsase (Fibrinolysin)
• Plasminogen to plasmin, dissolve clot ,thrombi & emboli.
• Dnase (Streptodornase)
• Degrades DNA in exudates or necrotic tissue by immune reaction.
• IGA degrading enzyme
• Protease that cleave the IGA heavy chain.
IMMUNOLOGICAL PATHOGENESIS
• Antibody against component of bacteria for Non suppurative diseases.
• M protein impedes phagocytosis.
• Virulence factor which is rheumatogenic and nephritogenic.
• Rheumatic fever,
• Immunological cross reaction b/w bacterial antigen and heart and joint tissue
• Antibody against Streptococcal M protein react with myosin in cardiac tissue.
• Acute glomerulonephritis, Immune complexes b/w Streptoccocal antigen and
antibody of those antigens trapped by glomeruli membrane.
• Activate complement,neutrophil attracted to site by C5a
• Protease produced by neutrophils damage glomeruli.
TOXINS & HEMOLYSINS
• Erythrogenic toxin
Superantigen cause rash of scarlet fever.
• Pyrogenic exotoxin A,
(Superantigen A & C) cause Toxic shock syndrome.
• Exotoxin B,
Protease rapidly destroy tissue cause Flesh eating streptococci cause nectrotizing
fasciitis.
• Streptolysin O
Hemolysin which is oxygen labile, inactivated by oxidation.
Anti streptolysin O antibody in rheumatic fever.
• Streptolysin S
Hemolysin which is oxygen stable, not inactivated by oxidation.Form B hemolytic
colonies.
CHARACTERISTICS
• Gram positive cocci in chains
• B hemolytic colonies
• Antigenicity of cell wall carbohydrate
• Encapsulated
• Complete breakdown of RBCs.
• Hemolysis due Streptolysin O & S
• Lancefield classification group A
• (total A to U)
GENERAL
• a hemolysis,
• Green zone due biliverdin,
• Incomplete lysis of RBCs in agar.
• b hemolytic,
• Clear zone due hemolysin enzyme O & S,
• Complete lysis of RBCs
• Gamma hemolytic,
• No lysis of RBCs.
• C carbohydrate,
• Antigen on cell wall determine B hemolytic streptococci.
• Differentiate b/w Group A & B
LABORATORY DIAGNOSIS
• Gram stain smear & culture, For Suppurative infections (not useful)
• Blood agar, B hemolytic colonies from throat swab with patient sore throat.
• Catalase negative (H2O2 into H2O and O2) all
• Bacitracin sensitive, (Inhibition growth)
• ELISA, Enzyme linked immunosorbent assay, for group A Steptococcal
antigens in throat swabs not antibody.
• ASO i.e anti streptolysin O antibody titer for detection rheumatic fever
prevous exposure.
• Antibody to streptococcal Dnase B for acute glomerulonephritis and
prevous skin infections i.e impetigo.
TREATMENT
• Pencillin G ( No significant resistance)
• Amoxicillin (Drug of choice)
• Azithromycin and clarithromycin
• (Resistance in some communities)
PREVENTION
• Pencillin for rheumatic fever and recuurent pharyngitis
• Prevent damage to heart valve.
• Handwashing
• No vaccine
BUNDLE OF THANKS
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Streptococcus Pyogenes Bacteria Microbiology Lecture

  • 1.
  • 3. GRAM POSITIVE STREPTOCOCCI • Streptococcus Pyogenes (Group A Streptococci) • Streptococcus Agalactiae (Group B Streptococci) • Streptococcus Pneumoniae (Pneumococcus) • Streptococcus Viridans (Streptococci Sanguis, Streptococci Mutans) • Enterococcus Faecalis
  • 4. DISEASES •Suppurative Diseases (Local & Desseminated) •Non suppurative Immunological diseases •Toxigenic Infections
  • 5. LOCAL PYOGENIC INFECTIONS • Pharyngitis • Sore throat ( Erethema & swelling of soft palate,uvula & posterior pharynx) • Impetigo • Crops of vesicles with honey colored crust • Cellulitis, • Erethema pain & swelling of lower layer of dorsal foot and other regions. • Erysipelas, • Well demarcated border of inflamed area on upper layer of skin. • Nectrotizing Fasciitis (Streptococcal gangrene ) • Death of parts of the body's soft tissue, • Appear red/purple skin due lack of blood. • Clostridum perfringens also cause it.
  • 6.
  • 7. DESSEMINATED PYOGENIC INFECTIONS • Sepsis • Sub acute bacterial endocarditis, • Vegetation (abnormal growth )on mitral valve. • Viridans most commonly.
  • 8. IMMUNE MEDIATED, POST STEPTOCCOCAL, NON SUPPURATIVE • Rheumatic fever • (Pharyngitis, Mitral valve stenosis,) • JONES crtieria • Poly arthritis, Heart disease, Sub cutaneous nodules, Erythema Marginatum, Sydenham chorea • Glomerulonephritis • ( Facial edema, Cola color urine)
  • 9. TOXIGENIC INFECTIONS • Scarlet fever (Strawberry tongue, Pharyngitis, Different rash (swollen, iritative and pain) • Toxic shock syndrome • Systemic symptoms
  • 10. HABITAT & TRANSMISSION • Habitat • Throat & skin • Transmission • Respiratory Droplets • (small aqueous droplet produced by exhalation, consisting of saliva or mucus)
  • 11. ENZYMES INVOLVED IN PATHOGENESIS • Hyaluronidase • Breakdown a substance,“Spreading factor” mediates sub cutaneous spread in celluitits and other Suppurative infection • Streptokinsase (Fibrinolysin) • Plasminogen to plasmin, dissolve clot ,thrombi & emboli. • Dnase (Streptodornase) • Degrades DNA in exudates or necrotic tissue by immune reaction. • IGA degrading enzyme • Protease that cleave the IGA heavy chain.
  • 12. IMMUNOLOGICAL PATHOGENESIS • Antibody against component of bacteria for Non suppurative diseases. • M protein impedes phagocytosis. • Virulence factor which is rheumatogenic and nephritogenic. • Rheumatic fever, • Immunological cross reaction b/w bacterial antigen and heart and joint tissue • Antibody against Streptococcal M protein react with myosin in cardiac tissue. • Acute glomerulonephritis, Immune complexes b/w Streptoccocal antigen and antibody of those antigens trapped by glomeruli membrane. • Activate complement,neutrophil attracted to site by C5a • Protease produced by neutrophils damage glomeruli.
  • 13. TOXINS & HEMOLYSINS • Erythrogenic toxin Superantigen cause rash of scarlet fever. • Pyrogenic exotoxin A, (Superantigen A & C) cause Toxic shock syndrome. • Exotoxin B, Protease rapidly destroy tissue cause Flesh eating streptococci cause nectrotizing fasciitis. • Streptolysin O Hemolysin which is oxygen labile, inactivated by oxidation. Anti streptolysin O antibody in rheumatic fever. • Streptolysin S Hemolysin which is oxygen stable, not inactivated by oxidation.Form B hemolytic colonies.
  • 14. CHARACTERISTICS • Gram positive cocci in chains • B hemolytic colonies • Antigenicity of cell wall carbohydrate • Encapsulated • Complete breakdown of RBCs. • Hemolysis due Streptolysin O & S • Lancefield classification group A • (total A to U)
  • 15. GENERAL • a hemolysis, • Green zone due biliverdin, • Incomplete lysis of RBCs in agar. • b hemolytic, • Clear zone due hemolysin enzyme O & S, • Complete lysis of RBCs • Gamma hemolytic, • No lysis of RBCs. • C carbohydrate, • Antigen on cell wall determine B hemolytic streptococci. • Differentiate b/w Group A & B
  • 16. LABORATORY DIAGNOSIS • Gram stain smear & culture, For Suppurative infections (not useful) • Blood agar, B hemolytic colonies from throat swab with patient sore throat. • Catalase negative (H2O2 into H2O and O2) all • Bacitracin sensitive, (Inhibition growth) • ELISA, Enzyme linked immunosorbent assay, for group A Steptococcal antigens in throat swabs not antibody. • ASO i.e anti streptolysin O antibody titer for detection rheumatic fever prevous exposure. • Antibody to streptococcal Dnase B for acute glomerulonephritis and prevous skin infections i.e impetigo.
  • 17.
  • 18. TREATMENT • Pencillin G ( No significant resistance) • Amoxicillin (Drug of choice) • Azithromycin and clarithromycin • (Resistance in some communities)
  • 19. PREVENTION • Pencillin for rheumatic fever and recuurent pharyngitis • Prevent damage to heart valve. • Handwashing • No vaccine
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