STREPTOCOCCUS

Dr. SUHAEMI, SpPD, Finasim

What is group A streptococcus (GAS)?
- Group A streptococcus is a bacterium
often found in the throat and on the skin
- People may carry group A streptococci in
the throat or on the skin and have no
symptoms of illness.
- Most GAS infections are relatively mild
illnesses such as "strep throat," or
impetigo.
- On rare occasions, these bacteria can
cause other severe and even
life-threatening diseases .
 How are group A streptococci spread?
-These bacteria are spread through:
* direct contact with mucus from the nose or
throat of infected persons or
* through contact with infected wounds or sores on
the skin.

-Ill persons, having strep throat or skin infections, are

most likely to spread the infection.
- Asymptomatic carriers are much less
contagious.

-Treating an infected person with an antibiotic for 24

hours or longer generally eliminates their ability
to spread the bacteria.
-It is not likely that household items like plates, cups,
or toys spread these bacteria.
 Streptococcus pyogenes
Pyogenes means pus producing

• One of the most important pathogens

• Gram positive cocci in chains

• Lancefield Serological Group A

• Beta Hemolytic on blood agar

Gram Stain of S. pyogenes
Group A streptococcus (S. pyogenes)
Streptococcus pyogenes –
coccoid prokaryote
(dividing)
Group A strep. SEM x56,000
© Dr Dennis Kunkel, University
of Hawaii. Used with permission
 S.pyogenes
S. pneumonia
Beta hemolysis
Alpha hemolysis
Mixed flora of throat swab
 Streptococcus pyogenes
• CLINICAL MANIFESTATION
• Acute Streptococcal Infection
• Pharyngitis & Scarlet Fever
• Skin Infections: Impetigo, cellulitis, erysipelas, wound infection,
gangrene
• Infective endocarditis, subacute endocarditis
• Streptococcal shcock syndrome
• Sequelae of Acute Strep. infection
• Acute rheumatic fever (ARF)
• Acute post-streptococcal glomerulonephritis (AGN)
 Poststreptococcal diseases
• Rheumatic Fever-autoimmune disease
involving heart valves,joints, nervous system.
Follows a strep throat
• Acute glomerulonehritis or Bright’s Disease-
inflamatory disease of renal glomeruli and
structures involved in blood filter of kidney.
Due to deposition of Ag/Ab complexes
Rheumatic Fever & RH. Heart
Disease:
-It is a febrile illness occurring as a delayed
sequel of infections with GAS
-This is evidenced by occurrence of
antibodies to streptococcal antigens.
-The disease can be prevented by
antimicrobial therapy or prophylaxis of
GAS.
-The mechanism by which the hemolytic
streptococci initiate rheumatic fever is still
obscure.
- The organisms exert their effect through
some indirect process ( not by presence of
GAS in the host tissues).
 Rheumatic Fever
• Most common cause of permanent heart
valve damage in children
• Exact cause not yet known but there appears
to be some antibody cross reactivity between
the cell wall of S. pyogenes and heart muscle
 Glomerular Nephritis
• Diagnosis based on history of Strep throat and
clinical findings.
• Symptoms include fever, malaise,edema,
hypertension and blood or protein in urine
• Occurs in 0.5% of those having strep throat.