Streptococcus anginosus
Streptococcus anginosus is a species of Gram-positive bacteria that is part of the Streptococcus anginosus group (SAG), also known as the "milleri group." This group, which also includes Streptococcus constellatus and Streptococcus intermedius, is distinguished by its ability to cause a variety of purulent infections in humans. Streptococcus anginosus itself is often found in the mouth, throat, digestive tract, and urogenital tract of humans, living as a commensal organism without causing disease under normal circumstances. However, when the body's normal barriers are breached, it can become pathogenic, leading to infections that are sometimes severe.
Characteristics
Streptococcus anginosus is a non-motile, facultatively anaerobic organism that forms small, round colonies on blood agar. It is capable of producing a narrow zone of beta-hemolysis when cultured on blood agar plates, although this characteristic can vary among strains. The bacteria are known for their ability to ferment various carbohydrates, producing lactic acid as a byproduct, and for their production of volatile sulfur compounds that can contribute to bad breath.
Pathogenicity
The pathogenic potential of Streptococcus anginosus is significant, particularly because it can cause deep-seated abscesses and systemic infections. It has been implicated in a variety of clinical conditions including brain abscesses, liver abscesses, endocarditis, dental infections, and soft tissue infections. The ability of S. anginosus to cause disease is partly attributed to its production of enzymes such as hyaluronidase, which facilitates the spread of infection through tissues. Additionally, its ability to form biofilms on surfaces, including medical devices, contributes to its pathogenicity and complicates treatment.
Clinical Significance
The clinical significance of Streptococcus anginosus lies in its ability to cause invasive infections that can be difficult to diagnose and treat. Its presence in abscesses is particularly noteworthy, as it can be an indicator of a mixed infection involving anaerobic bacteria. The diagnosis of S. anginosus infections involves culture of the organism from clinical specimens, followed by biochemical and molecular identification. Treatment typically involves the use of antibiotics, with the choice of antibiotic depending on the sensitivity profile of the isolate and the site of infection. Surgical intervention may be required in cases of abscess formation.
Prevention and Control
Prevention of infections caused by Streptococcus anginosus involves general measures to maintain the integrity of the skin and mucosal barriers, as well as good oral hygiene to reduce the bacterial load in the mouth. In healthcare settings, adherence to infection control practices is crucial to prevent the transmission of S. anginosus and other pathogens.
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Contributors: Prab R. Tumpati, MD