II. Characteristics

III. Labs: Classification

  1. Hemolytic effect on Red Blood Cells (RBCs)
    1. Beta-hemolytic Streptococcus
      1. Beta-hemolytic streptococci completely lyse RBCs
      2. On a culture plate, colonies are surrounded by a clear zone of Hemolysis
    2. Alpha-hemolytic Streptococcus
      1. Beta-hemolytic streptococci partially lyse RBCs
      2. On a culture plate, colonies are stained green (Hemoglobin metabolite)
    3. Non-hemolytic Streptococcus
      1. No effect on Red Blood Cell lysis
  2. Lancefield Groups
    1. Renecca Lancefield subdivided streptococcal Bacteria into groups based on cell wall Antigens
      1. First isolated in the 1930s, from the milk of cows with bovine Mastitis
      2. Bacterial cell surface C Carbohydrate Lancefield Antigens
      3. Streptococci are classified as Group A, Group B, Group C, Group D... Group S
    2. Although historically used to differentiate Streptococci, more advanced methods are now used in practice
      1. Most Streptococcal species (>30 total) are not assigned Lancefield Antigens
      2. Only 3 of the significant streptococcal human pathogens have Lancefield Groups (A, B, D)

IV. Types: Beta-hemolytic Streptococcus

  1. General
    1. Beta-Hemolytic strep are also the source of several derived medications (e.g. Streptokinase, Hyaluronidase)
  2. Group A Streptococcus (Streptococcus Pyogenes)
    1. Causes Strep Throat, Scarlet Fever as well as respiratory infections and Cellulitis
    2. Complications include Rheumatic Fever, Toxic Shock, Glomerulonephritis, Reactive Arthritis and Henoch Schonlein Purpura
  3. Group B Streptococcus (Streptococcus agalactiae)
    1. Causes Group B Streptococcus Neonatal Sepsis (vertical transmission during delivery via vaginal colonization)
    2. Immunocompromised patients may also become infected with Group B Streptococcus (e.g. Pneumonia, Sepsis)
  4. Group C Streptococcus
    1. Normal human flora of the nasopharynx, skin, and genital tract, and rarely a cause for human infection
    2. Streptokinase
      1. Activates plasmin, triggering Fibrinolysis (nearly identical to staphylokinase)
      2. Streptokinase was extracted from Group C Strep to be used in MI and Stroke (prior to tPA, TNK)
  5. Group G Streptococcus

V. Types: Alpha-hemolytic Streptococcus

  1. Streptococcus Pneumoniae (Pneumococcus)
    1. Gram Positive Cocci in Pairs (Diplococcus), with no Lancefield Group assigned
    2. Polysaccharide Capsule protects it from Phagocytosis
      1. With infection, antibodies develop to capsule, but only protect against one of 84 serotypes
      2. Vaccines are polyvalent (21 of the most virulent serotypes as of 2024)
    3. Infections include Pneumococcal Pneumonia, Pneumococcal Meningitis, Otitis Media
  2. Viridans Streptococcus (Bacterial Endocarditis)
    1. Viridans is named for the greenish glow on culture media (Alpha-hemolytic Streptococcus)
    2. Subdivided into at least 5 sub groups
    3. Normal human colonization or the GI Tract and oropharynx
    4. Human Infections include SBE, Dental Infections and abscesses

VI. Types: Non-hemolytic Streptococcus (Gamma-Hemolytic)

  1. Certain members of Groups B, C, D, H, and O
  2. Group D Streptococcus
    1. General
      1. Gram-positive facultative anaerobic cocci
      2. Organisms colonize the human GI Tract as normal flora
      3. Hardy organisms that can survive in the harsh GI Tract, including 40% bile
      4. Extracellular Dextran allows binding to Heart Valves (Streptococcus Viridans, Group D Strep, Enterococcus)
    2. Non-Enterococcus
      1. Streptococcus equinus
      2. Streptococcus bovis
        1. Frequently found in patients with Colon Cancer
    3. Enterococcus
      1. Enterococcus was classified under Streptococcus
      2. Enterococcus was reclassified under its own genus as of 1984 following DNA analysis
        1. Enterococcus faecalis
        2. Enterococcus faecium

VII. References

  1. Patterson (1996) Streptococcus in Baron, Medical Microbiology, 4th ed., Galveston, Texas, chapter 13
    1. https://www.ncbi.nlm.nih.gov/books/NBK7611/

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Ontology: Streptococcus (C0038402)

Definition (NCI_CDISC) Any bacteria that is not assigned to the species level but can be assigned to the Streptococcus genus level.
Definition (NCI) A genus of Gram-positive bacteria in the phylum Firmicutes and the lactic acid bacteria group.
Definition (MSH) A genus of gram-positive, coccoid bacteria whose organisms occur in pairs or chains. No endospores are produced. Many species exist as commensals or parasites on man or animals with some being highly pathogenic. A few species are saprophytes and occur in the natural environment.
Definition (CSP) genus of gram positive, coccoid bacteria whose organisms occur in pairs or chains; no endospores are produced; many species exist as commensals or parasites on man or animals with some being highly pathogenic; a few species are saprophytes and occur in the natural environment.
Concepts Bacterium (T007)
MSH D013291
SnomedCT 58800005
LNC LP32498-5, LP17202-0
French Streptocoques, Streptococcus, Streptocoque
Swedish Streptococcus
English STREP, Genus Streptococcus (organism), Streptococcus (organism), Streptococcus, Streptococcus Rosenbach 1884, Streptococci sp., Streptococcus sp, streptococcus bacteria, streptococcus, streptococcus organism, STREPTOCOCCI SP., STREPTOCOCCUS, Streptococcus, NOS, Genus Streptococcus
Spanish estreptococo, género Streptococcus (organismo), género Streptococcus, Streptococcus (organismo), Streptococcus
Czech Streptococcus
Finnish Streptokokki
Russian STREPTOKOKKI, STREPTOCOCCUS, СТРЕПТОКОККИ
Croatian STREPTOCOCCUS
Polish Paciorkowce, Streptococcus
Norwegian Streptococcus
German Streptococcus
Italian Streptococcus
Dutch Streptococcus
Portuguese Streptococcus

Ontology: Alpha-hemolytic streptococcus (C0318153)

Definition (NCI_CDISC) A bacteria that is assigned to the genus Streptococcus that is able to reduce the iron content in hemoglobin in red blood cells, thus producing green-colored colonies on blood agar plates.
Definition (NCI) A bacterium that is assigned to the genus Streptococcus that is able to reduce the iron content in hemoglobin in red blood cells, thus producing green colored colonies on blood agar plates.
Concepts Bacterium (T007)
SnomedCT 60631002
English Alpha hemolytic streptococcus, Alpha haemolytic streptococcus, alpha-hemolytic Streptococcus, alpha Streptococcus, Alpha-Hemolytic Streptococcus, alpha hemolytic streptococcus, alpha haemolytic streptococcus, streptococcus alpha, alpha hemolytic strep, alpha streptococcus, alpha-hemolytic streptococcus, ALPHA-HEMOLYTIC STREPTOCOCCUS, STREPTOCOCCUS ALPHA-HEMOLYTIC, Alpha-hemolytic streptococcus, Alpha-haemolytic streptococcus, Alpha-hemolytic streptococcus (organism)
Spanish estreptococo alfahemolítico (organismo), estreptococo alfahemolítico, estreptococo hemolítico alfa, estreptococo alfa - hemolítico, Streptococcus alfa - hemolítico (organismo), Streptococcus alfa - hemolítico

Ontology: Beta-hemolytic streptococcus (C0318154)

Definition (NCI_CDISC) A bacteria that is assigned to the genus Streptococcus that is able to facilitate the complete rupturing of red blood cells, thus producing wide, clear, zones around colonies on blood agar plates.
Definition (NCI) A bacterium that is assigned to the genus Streptococcus that is able to facilitate the complete rupturing of red blood cells, thus producing wide, clear, zones around colonies on blood agar plates.
Concepts Bacterium (T007)
SnomedCT 53490009
LNC LP15187-5, MTHU002580
English Beta hemolytic streptococcus, Beta haemolytic streptococcus, beta-hemolytic Streptococcus, beta Streptococcus, Beta-Hemolytic Streptococcus, beta haemolytic streptococcus, beta-hemolytic streptococcus, streptococcus beta, beta-haemolytic streptococcus, hemolytic beta strep, beta hemolytic strep, beta streptococcus, streptococcus beta hemolytic, beta hemolytic streptococcus, Streptococcus.beta-hemolytic, STREPTOCOCCUS BETA-HEMOLYTIC, BETA-HEMOLYTIC STREPTOCOCCUS, Beta-hemolytic streptococcus, Beta-haemolytic streptococcus, Beta-hemolytic streptococcus (organism)
Spanish estreptococo beta - hemolítico, Streptococcus beta - hemolítico (organismo), Streptococcus beta - hemolítico

Ontology: Lancefield group (C0449537)

Concepts Intellectual Product (T170)
SnomedCT 260804001
English Lancefield group, Lancefield group (attribute)
Spanish grupo Lancefield (atributo), grupo Lancefield

Ontology: Hemolytically variant streptococcus (C0579242)

Concepts Bacterium (T007)
SnomedCT 302604000
English Haemolyt variant streptococcus, Haemolytically variant streptococcus, Hemolytically variant streptococcus (organism), Hemolytically variant streptococcus
Spanish Streptococcus de una variedad hemolítica (organismo), Streptococcus de una variedad hemolítica