II- Streptococci. Practical 3. Objective: Required materials: Classification of Streptococci: Streptococci can be classified according to:

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Practical 3 II- Streptococci Objective: 1. Use of blood agar to differentiate between,, and hemolytic streptococci. 2. To know Gram reaction, shape and arrangement of streptococci. 3. To differentiate between group A and non group A streptococci using bacitracin sensitivity 4. To identify Strep. agalactiae by CAMP test. 5. To differentiate between Streptococcus pneumoniae and viridans streptococci using optochin sensitivity and bile solubility. Required materials: 1. Overnight cultures of Strep. pyogenes, Strep. agalactiae, Strep. pneumoniae, Strep. viridans and S. aureus. 2. Gram stain "dyes and reagents", filter paper, slides, immersion oil 3. 20 plates of blood agar 4. Bacitracin disks 5. Optochin disks 6. tubes containing 5 ml of 10% bile salts Characters of Streptococci Gram positive cocci 1µm in diameter Chains or pairs Usually capsulated Non motile Non spore forming Facultative anaerobes Fastidious Catalase negative (Staphylococci are catalase positive) Classification of Streptococci: Streptococci can be classified according to: 1

Oxygen requirements Anaerobic (Peptostreptococcus) Aerobic or facultative anaerobic (Streptococcus) Serology (Lanciefield Classification) Divides the streptococci into serotype groups based on the bacteria s antigens (A-H, K-V) (C- carbohydrate antigen of cell wall) Lancefield groups A and B include the significant streptococcal pathogens of humans Beta hemolytic streptococci There is Non-groupable streptococci ; S. pneumoniae (pneumonia) and viridans streptococci e.g. S. mutans that Causing dental carries Hemolysis on Blood Agar (BA) -hemolysis Partial hemolysis Green discoloration around the colonies e.g. non-groupable streptococci (S. pneumoniae & S. viridans) -hemolysis Complete hemolysis Clear zone of hemolysis around the colonies e.g. Group A & B (S. pyogenes & S. agalactiae) -hemolysis No lysis e.g. Group D (Ente rococcus spp) Beta hemolysis Gamma hemolysis Alpha hemolysis 2

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Group A streptococci Include only S. pyogenes Pathogenesis and Virulence Factors Structural components M protein M, which interferes with opsonization and lysis of the bacteria Lipoteichoic acid & F protein adhesion Hyaluronic acid capsule, which acts to camouflage the bacteria Enzymes Streptokinases Deoxynucleases C5a peptidase Pyrogenic toxins that stimulate macrophages and helper T cells to release cytokines Streptolysins Streptolysin O lyse red blood cells, white blood cells, and platelets Streptolysin S Some Disease caused by S. pyogenes Pharyngitis ( strep throat )-inflammation of the pharynx Skin infection, Impetigo Scarlet fever-rash that begins on the chest and spreads across the body Experimental: 1- Gram stain of streptococci 2- Hemolysis on blood agar (,, and hemolysis) 3- Bacitracin susceptibility test 4- CAMP test 5- Optochin susceptibility test 6- Bile solubility test Microscopial examination 4

Gram s +ve cocci arranged in: Chains or pairs (S. Pneumonia) Catalase Test Differentiative test to separate Staphylococci and Micrococci which are catalase +ve from Sterptococci which are catalase ve. Principle: Catalase enzymeh 2 O 2 H 2 o + O 2 Air bubbles Procedure: 3 H 2 O 1 2 5 Streptococcus (-) Staphylococcus (+)

Growth on Blood Agar Sterptococci are divided into three main groups accorging to its action on erythrocytes: β-hemolytic Sterptococci\ α-hemolytic Sterptococci. γ-hemolytic Sterptococci. β-hemolytic Sterptococci Definitive test to differentiate between S.Pyogenes & Non group A β-hemolytic Streptococci Bacitracin Sensitivity Test: Principle: A low conc. of Bacitracin (0.04 units) will selectively inhibit the growth of S.pyogenes giving a zone of inhibition around the disc Procedure: Inoculate blood agar plate with the test organism.. Aseptically apply Bacitracin disc onto the center of the streaked area Incubate the plate at 35oC for 18 hrs Results: Positive test: any zone of inhibition around the disc. Bacitracin Resistant Non group A β-hemolytic Streptococci Bacitracin Sensitive S.Pyogenes 6

CAMP test Principle: Group B streptococci produce extracellular protein (CAMP factor) CAMP act synergistically with staph. -lysin to cause lysis of RBCs Procedure: Single streak of Streptococcus to be tested and a Staph. aureus are made perpendicular to each other 3-5 mm distance was left between two streaks After incubation, a positive result appear as an arrowhead shaped zone of complete hemolysis S. agalactiae is CAMP test positive while non gp B streptococci are negative 7

α-hemolytic Sterptococci Definitive test to differentiate between S.Pneumoniae & Viridans Streptococci Optochin Sensitivity Test: Principle S.Pneumoniae is inhibited by less than 5 µg/ml Optochin reagent giving a zone of inhibition more than 15 mm in diameter. Procedure Inoculate blood agar plate with the test organism. Aseptically apply Optochin disc onto the center of the streaked area. Incubate the plate at 35oC for 18 hrs. Accurately measure the diameter of the inhibition zone around the disc. Optochin sensitive S.pneumoniae Optochin resistant Viridans Streptococci 8

Bile Solubility test Principle: S. pneumoniae produce a self-lysing enzyme to inhibit the growth The presence of bile salt accelerate this process Procedure: Add ten parts (10 ml) of the broth culture of the organism to be tested to one part (1 ml) of 2% Na deoxycholate (bile) into the test tube Negative control is made by adding saline instead of bile to the culture Incubate at 37oC for 15 min Record the result after 15 min Results: Positive test appears as clearing in the presence of bile while negative test appears as turbid S. pneumoniae soluble in bile whereas S. viridans insoluble 9

γ-hemolytic Sterptococci Definitive test for Enterococcus faecalis Growth on MacConkey s agar Principle MacConkey s agar is a selective medium for Gram s ve bacteria. It contains bile salt and crystal violet to inhibit the growth of Gram s +ve bacteria. Enterococcus faecalis is the only Streptococcus species which can grow on MacConkey s agar giving pink colonies. Procedure: Inoculate MacConkey s agar plate with the test organism by streaking. Incubate the plate at 35oC for 24 hrs. Flame & Cool Flame & Cool Results: Flame & Cool Growth of pink colonie Enterococcus faecalis No Growth Other Strain of Sterptoco 11

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