Streptococcus - Pathogenesis and Classification

Pathogenesis and Classification

In addition to streptococcal pharyngitis (strep throat), certain Streptococcus species are responsible for many cases of meningitis, bacterial pneumonia, endocarditis, erysipelas and necrotizing fasciitis (the 'flesh-eating' bacterial infections). However, many streptococcal species are nonpathogenic, and form part of the commensal human microbiome of the mouth, skin, intestine, and upper respiratory tract. Furthermore, streptococci are a necessary ingredient in producing Emmentaler ("Swiss") cheese.

Species of Streptococcus are classified based on their hemolytic properties. Alpha hemolytic species cause oxidization of iron in hemoglobin molecules within red blood cells, giving it a greenish color on blood agar. Beta hemolytic species cause complete rupture of red blood cells. On blood agar, this appears as wide areas clear of blood cells surrounding bacterial colonies. Gamma-hemolytic species cause no hemolysis.

Beta-hemolytic streptococci are further characterised via Lancefield serotyping, which describes specific carbohydrates present on the bacterial cell wall. There are 20 described serotypes, named Lancefield groups A to V (excluding I and J).

In the medical setting, the most important groups are the alpha-hemolytic streptococci S. pneumoniae and Streptococcus Viridans-group, and the beta-hemolytic streptococci of Lancefield groups A and B (also known as “Group A strep” and “Group B strep”).