Streptococcus species

General properties
 Gram positive cocci in chain (Lancefield)
 Catalase negative
 Diplococci (Pneumococci)
 Penicillin remain drug of choice

Classification
 According to haemolysis
Classification
1. β-Haemolysis (complete lysis RBCs)
2. α- haemolysis (partial lysis RBCs)
3. γ or non- haemolytic (no lysis)
 Lancefield group (A-V)
 According to carbohydrate antigen
 Used for β-haemolysis
Important species
1. Group A S. pyogenes
 Tonsillitis and otitis
media
2. Group B S. agalactiae
 Neonates meningitis
3. S. pneumonae
 α-haemolysis
 Capsulated
 Pneumonia, meningitis,
otitis
Important species
4. Non- haemolytic (viridians groups)
 Adhere to teeth, heart valve
 Normal flora of mouth and URT
 Endocarditis, dental caries, bacteraemia
5. Enterocci
 Enteroccus faecalis
 Normal flora of colon
 Bile salt tolerant
 UTI, infective endocarditis, catheter infection
Laboratory identification
1. Gram stain and type of haemolysis
2. Sensitivity and resistant to Bacitracin and
Optochin
3. Growth on media contain 6.5% NaCl
4. Bile-esculin test
5. Lancefield grouping
Gram stain and type of haemolysis
Chain arrangement Optochin (S)

Bacitracin (S)

Diplococci
Gamma haemolysis Optochin ®
 Differentiation of β-Haemolytic Streptococci
Group Bacitracin TMP/SMZ CAMP BILE Growth in
susp. susp. reaction ESCULIN 6.5% NaCl
test

A + - - - -

B - - + - +

D - - - + +

Others - + - - -
Alpha-haemolytic streptococci colony

Alpha haemolytic

Bile-esculin test Optichin disc

positive resistant sensitive

Enterococci negative
Group D
S. pneumoniae
Viridans streptococci
positive Growth on 6.5% NaCl Confirm
serologically
Negative (non Enterococci)
 Group D streptococci
Future Enterococci Nonenterococci

Species S. Faecalis S. Bovis

S. Faecium S. equinus
S. durans
Hemolysis β, α, γ α, γ

Growth in yes no
6.5%NaCl
Penicillin yes no
resistant
Nonhemolytic streptococcal colony
Bile-esculin test

positive negative

Group D
Viridans streptococci

Growth in 6.5%nAcL

P N
Nonenterococci
Enterococci
The CAMP (Christie, Atkins, Munch-Peterson) test identifies
Streptrococcus agalactiae (= Group B).