PNEUMOCOCCUS

Gram + ve , lanceolate diplococci, aerobes &

facultative anaerobes.
Reclassified as Streptococcus pneumoniae
Pneumonia & Otitis media (children),
sinusitis, bronchitis, bacteraemia, meningitis
MORPHOLOGY
Elongated cocci in pairs, one end pointed
other broad.
Capsulated, stained by Indian ink clear halo.
CULTURAL CHARACTERISTIC
Enriched media
Optimum temperature 37C (25-42C)
PH 7.8 (6.5-8.3)
BLOOD AGAR
Small dome shaped, green discoloration haemolysis (18
hrs incubation)
Anaerobic condition haemolysis ( Pneumolysin O)
BIOCHEMICAL REACTION
Sugar ferment acid
Bile solube diagnostically important
Catalase & oxidase negative
RESISTANCE
Destroyed by heat & antiseptics
Sensitive to sulphonamides & several antibiotics,
less to tetracycline rarely to penicillin
ANTIGENIC PROPERTIES
Polysaccaride of capsule SSS specific soluble
substances
Polysaccharide ag type I, II, III & heterogenous
group IV
Group IV 85 different serotypes 1 85.
Typing
Quellung reaction/capsule swelling reaction Neufeld
Suspension of Pneumococci + drop of type specific
antiserum

Loopful of methylene blue solution

Antiserum homologous swollen capsule , sharply
delineated & refractile.
Quellung test Sputum (acute pneumonia)
Other antigens
Nucleoprotein
Somatic C carbohydrate ag
M protein
Forssmann ag lipoteichoic acid
Variation
S subculture R
Transformation Griffith experiment
TOXIN & VIRULENCE FACTORS
O2 labile haemolysin
Leucocidin
Capsular polysaccharide acidic & hydrophilic
properties.
Non capsulated - avirulent
PATHOGENICITY
1. Lobar Pneumonia
. airborne infection of respiartory tract with
Pneumococcus (avirulent)
Pneumococci
penetrates

Bronchial mucosa
through peribronchial tissues &
lymphocytes

Spread to lung
. Bacteraemia, Toxaemia diffusion of capsular
polysaccharide blood & tissues.
2. Bronchopneumonia
Secondary infection followed by viral infection
of respiratory tract
Pneumococcus
damage
respiratory epithelium excessive
bronchial secretion

invasion of bronchial tree

Other agents Staph aureus, Str pyogenes,
Pseudomonas aeruginosa, Fusobacterium,
Bacteriodes, Proteus.sp
3. Acute excerbation in chronic bronchitis
Copious respiratory secretion Pneumococcal
invasion
Other bacterium Haemophilus influenzae
4. Meningitis
Secondary to pnemococcal infection
pneumonia, otitis media, sinusitis/conjuctivitis
Common in children
5. Suppurative lesions
Pericarditis, otitis media, sinusitis,
conjuctivitis, suppurative arthritis & peritonitis
EPIDEMIOLOGY
Source respiratory tract of carriers, inhalation
of contaminated dust, droplets/ droplet nuclei
Disease resistance lowered by respiratory viral
infection, pulmonary congestion, stress,
malnutrition/alcoholism
Lobar pneumonia sporadic disease ( epidemic
army camp)
Bronchopneumonia epidemic of influenza or
other viral infection of respiratory tract.
Common - winter
LAB DIAGNOSIS
Specimen sputum, serum coated laryngeal swab
(infants), blood, CSF, urine
Sputum homogenised blood agar
(37 C 5-10% CO2, overnight)
Blood glucose broth
CSF gram stained, culture, demonstrate SSS by precipitation
with antisera
Capsular polysaccharide counter immunoelectrophoresis
Antibodies agglutination, quantitaive precipitation, indirect
haemagglutination, indirect fluorescent ab, RIA
PROPHYLAXIS
Immunity type specific
Prophylactic immunisation impracticable 85 different serotype