streptococcus tao chuanmin. widespread in nature some strains as virulent pathogens other strains...
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Streptococcus
Tao Chuanmin
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Widespread in nature
Some strains as virulent pathogens
Other strains live harmoniously
Transient colonizers of skin
Resident colonizer of mucous membranes
Normal flora of alimentary, respiratory and genital tracts
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Classification40 species and subspecies
Traditional rules Hemolytic reactions
α hemolytic
β hemolytic
γ hemolytic
Lancefield serological testsA 、 B 、 C 、 D 、 E…
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Clinical significantGroup A streptococci(S. pyogene
s)
Impressive human pathogen
Acute pharyngitis,respiratory inf
ection
Skin (impetigo and erysipelas) an
d soft tissue infection
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Endoarditis, meningitis, sca
rlet fever and more serious t
oxic shock-like symptoms
Acute glomerulonephritis, r
heumatic fever
Numerous virulence factors
M protein, Pyrogenic exotoxins, Hyaluronic acid capsule, Hemolysins etc.
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Group B streptococci(S. agalactiae) Neonatal infection
sepsis and meningitis
Group C and G streptococci
Similar to S. pyogenes
Viridans Streptococci
Normal flora
Subacte bacterial endocaditis(S
BE)
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Streptococcus pneumoniae
Community-acquired pneumonia,
bacteremia
Otitis media, sinusitis, meningitis,
and endocarditis
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Microbial Characters
GPCArranged : single,pairs,chains
S. pneumoniae :
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Facultatively anaerobe
Chemical reaction: active metabolism
Catalase : negative
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Microbial diagnosticsprocedure
specimen
Smear and stain culture direct examination
colony
Smear and stain biochemical serology antibiotic
identification identification susceptibility返回
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Microbial diagnostics
Specimen collectionThroat swab, sputum, pus and blood, et al
Specimen direct diagnosticsSmear and Gram stain
Direct antigen detection
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Culture and identification
β hemolytic PYR test : Group ABacitracin-susceptible :
Group AVP(Voges-Proskauer) t
estCAMP test : Group B
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Non β hemolyticOptochin test
Bile solubility test
Bile esculin test
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Serologic tests : Streptolysin O
Antibiotic susceptibilities : A 、 B 、 C grou
p
Evaluation, interpretation and reporting of re
sultsBeta-hemolytic streptococci and pneumococci ar
e virulent pathogens, all reporting PRSP(penicillin resistant Streptococcus pneumonia)
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Enterococcus
Common descriptionWidespread in nature
Gastrointestinal and genitourinary tract flora
Hospital-acquired infection pathogen
ClassificationE. feacalis and E. faecium
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Clinical significant
Urinary tract infections(UTIs) : underlying structural abnormalities and u
ndergone urologic manipulations
Abdominal and pelvic
infections
sepsis
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Microbial CharactersGPC(single, pairs, short chains)
Facultative anaerobes
PYR test positive
Higher resistance to chemical and physical agents
Bile-esculin positive
Resistance to several antibiotics
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Microbial diagnosticsprocedure
Specimen collection
Direct detection
Culture and identific
ation
Catalase negative
Grow in 6.5% NaCl
broth
Bile-esculin positive
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Antibiotic susceptibilitiesA group Penicillin or ampicillin
B group Vancomycin
C group Tetracycline, erythromycin, chlormphenic
ol, Rifampin
D group Ciprofloxacin, Norfloxin
high-level resistance(HLR) to aminoglycosides En
terococcus
500ug/ml gentamicin 2000ug/ml streptomycin
vancomycin resistant Enterococcus (VRE)
6ug/ml vancomycin
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Neisseria and Branhamella
Neisseriaceae
Neisseria, Branhamella, Moraxella, Kingella and Acinet
obacter
Mainly pathogens
N. gonorrhoeae
N. meningitidis
B. catarrhalis
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Clinical significant
N. gonorrhoeae Common sexual transmitted diseases(STD)
Transmitted by direct, close, usually sexual
Transmission to neonates usually occurs durin
g birth
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virulence factor :pili
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N. meningitidis Meningitis, meningococcemia
Usually transmitted by direct contact with conta
minated respiratory secretions or air-borne dro
plets
School-age children, adolescents, and young adu
lts
B. catarrhalis Acute localized infections: otitis media, sinusitis,
and bronchopneumonia
Life-threatening systemic diseases: endocarditis
and meningitis
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Microbial Characters
Gram-negative diplococci
Adjacent sides flattened to give a characteristic kidn
ey or coffee bean appearance
Nonmotile , no endospores , some species are enc
apsulated
Cell may autolyze in culture
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Complex growth requirements
aerobe
The growth is enhanced by humidity and CO2
Oxidase positive
catalase positive
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Microbial diagnostics
Procedure
Collection
Direct detection Direct microscopy
Antigen and nucleate detection
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Culture and identification
Selective media : MTM , ML , N
YC ( N. gonorrhoeae )Nonselective media : Chocolate agar or blood agar5%CO2
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Colonial appearance
N. G : small,smooth
N. M : small,smooth,flat,mucoid
B. C : small, friable
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Presumptive identification GNC , OX+
Confirmatory identification G.M : acid production from glucose and malt
ose G.N : acid production from glucose B.C : DNase + , nitrate reduction +
DNA 酶试验 硝酸盐还原试验阳性
(-) (+)
氧化酶
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Antibiotic Susceptibilities
Penicillin, cephalosporin 、 tetracycline 、ciprofloxacin
Resistant strains G.N : 3rd cephalosporins 、 new fluoroqui
nolone B.C : extended-spectrum penicillin + pen
icillinase inhibitory
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Evaluation, interpretation and reporting results
N.G
confirm : depend on culture and
identification
Early and rapidly diagnosis
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Summary
Staphylococcus
Streptococcus
Enterococcus
Neisseria and
BranhamellaClassification 、 Clinical Significance 、 Microbial Characters 、 Micro
bial diagnostics
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