How streptococci enter the human body. Is streptococcal infection contagious?

Scientific classification of staphylococcus:
Domain:
Type: Firmicutes
Class: bacilli
Order: Lactobacillales (Lactobacilli)
Family: Streptococcaceae (Streptococcus)
Genus: Streptococcus (Streptococcus)
International scientific name: Streptococcus

Streptococcus ( lat. Streptococcus) is a spherical or egg-shaped bacterium belonging to the Streptococcus family (Streptococcaceae).

In nature, this type of bacteria also exists in the ground, on the surface of plants, and fungi.

Streptococcal infection is an opportunistic microflora - it is almost always present in the human body and does not pose any danger, since its quantity and presence in a person is controlled by the immune system. However, as soon as a person begins to weaken (stress, hypothermia, hypovitaminosis, etc.), bacteria immediately begin to actively multiply, release a large amount of their waste products into the body, poisoning it, and provoke the development of various, as written above, mainly – , and systems. And therefore, the main preventive action against the development of streptococcal infection in the body and related diseases is to strengthen and maintain normal functioning immunity. However, all types of streptococci should not be considered pathogenic - some of them are beneficial bacteria, for example - Streptococcus thermophilus, which are used in the production of fermented milk products - yoghurt, sour cream, mozzarella and others.

The main methods of infection with streptococcal infection are airborne droplets and household contact.

Diseases that can cause streptococci

Besides, streptococcal infection can become a secondary infection, joining, for example, enterococcal and other types.

Most often, children and people suffer from diseases of streptococcal etiology old age, as well as office workers.

Characteristics of streptococci

Let's look a little at a brief description of bacteria - streptococcus.

Streptococcus is a typical cell, the diameter of which is less than 1 micron, arranged in pairs or chains, forming an elongated rod with thickenings and thinnings, shaped like beads strung on a chain. Because of this shape they got their name. Streptococcal cells form a capsule and can easily turn into the L-form. The bacteria are immobile, with the exception of strains of group D. Active reproduction occurs upon contact with particles of blood, ascitic fluid or carbohydrates. Favorable temperature for normal life infections +37°C, acid-base balance (pH) – 7.2-7.4. Streptococci live mainly in colonies, forming a grayish coating. They process (ferment) carbohydrates, forming acid, break down arginine and serine (amino acids), and in a nutrient medium they synthesize extracellular substances such as streptokinase, streptodornase, streptolysins, bacteriocins and leukocidin. Some representatives of streptococcal infections - groups B and D form red and yellow pigments.

Streptococcal infection includes about 100 types of bacteria, the most popular of which are hemolytic streptococci.

How to inactivate streptococcus?

Streptococcus bacteria die when:

— their treatment with solutions of antiseptics and disinfectants;
— pasteurization;
- exposure antibacterial agents– tetracyclines, aminoglycosides, penicillins (not used for invasive streptococcal infection).

How is streptococcus transmitted? Let's look at the most popular ways of contracting streptococcal infections.

The conditions under which a person begins to develop streptococcal diseases usually consist of two parts - contact with this infection and a weakened immune system. However, a person can become seriously ill from ordinary contact with this type of bacteria.

How can streptococcus enter the body?

Airborne path. The risk of contracting a streptococcal infection usually increases during the period of colds, when the concentration of various infections (fungus, etc.) in the air, mainly in enclosed spaces, increases significantly. Staying in offices public transport, performances and other places with large crowds of people, especially during the period, is the main way of infection with these bacteria. Sneezing and are the main signals that warn that it is better to leave this room, or at least ventilate it thoroughly.

Airborne dust path. Dust usually consists of small particles of tissue, paper, desquamated skin, animal hair, plant pollen and various representatives of infection - viruses, fungi, bacteria. Staying in dusty rooms is another factor that increases the risk of streptococcal infection.

Contact and household path. Infection occurs when sharing dishes, personal hygiene items, towels, bed linen, and kitchen utensils with a sick person. The risk of the disease increases when the mucous membrane of the nasal or oral cavity, as well as the surface of the skin, is injured. Very often, at work, people become infected through the use of one cup for several people, or drinking water from the same bottle.

Sexual path. Infection occurs when intimacy with a person who suffers from streptococci, or is simply their carrier. This type of bacteria tends to live and actively reproduce in the organs of the genitourinary system of men (in the urethra) and women (in the vagina).

Fecal-oral (nutritional) route. Infection with streptococci occurs when non-compliance is observed, for example, when eating food with unwashed hands.

Medical path. Infection of a person occurs mainly during examination, surgical or dental intervention with non-disinfected medical instruments.

How can streptococcus seriously harm a person's health, or what weakens the immune system?

Presence of chronic diseases. If a person has chronic diseases, this usually indicates a weakened immune system. In order not to complicate the course of diseases, and streptococcal infection does not join existing diseases, pay due attention and focus on their treatment.

The most common diseases and pathological conditions in which streptococcus often attacks the patient are: and other body systems, injury to the mucous membranes of the mouth and nasal cavity, throat, and genitourinary system.

In addition, the risk of infection with streptococcus increases:

Bad habits: drinking alcohol, smoking, drugs;
Absence healthy sleep, chronic fatigue;
Eating food mainly;
Sedentary lifestyle;
Insufficiency in the body and ();
Abuse of certain medications, for example, antibiotics, vasoconstrictors;
Visiting beauty salons of a dubious nature, especially manicure, pedicure, piercing, tattooing procedures;
Working in contaminated areas, for example in the chemical or construction industries, especially without respiratory protection.

Symptoms of streptococcus

The clinical picture (symptoms) of streptococcus is very diverse, and depends on the location (organ) that affects this genus bacteria, strain of infection, health status and immune system, person's age.

Common symptoms of streptococcus may include:

, change in voice timbre;
The formation of plaque, often purulent, on the patient’s tonsils;
, malaise, muscle pain and;
, from 37.5 to 39 °C;
Redness of the skin, as well as itching and the appearance of blisters or plaques on it;
Abdominal pain, lack of appetite, ;
Feeling of pain and itching in the organs of the genitourinary system, discharge from them;
– (runny nose), and;
Difficulty breathing, sneezing, shortness of breath;
Impaired sense of smell;
Respiratory tract diseases: and pneumonia ();
, disturbance of consciousness;
Disruption of the normal functioning of certain organs and tissues, which have become a source of bacterial sedimentation.

Complications of streptococcus:

Glomerulonephritis;
Inflammation of the heart muscle - endocarditis;
Vasculitis;
Purulent;
Loss of voice;
Lung abscess;
Rheumatoid arthritis;
Severe forms ;
Chronic lymphadenitis;
Erysipelas;
Sepsis.

In total, about 100 species of streptococci are known, each of which is characterized by its pathogenicity.

For convenience, this genus of bacteria, depending on the type of hemolysis of red blood cells, was divided into 3 main groups (Brown classification):

Alpha streptococci (α), or viridans streptococci - cause incomplete hemolysis;
Beta streptococci (β)- cause complete hemolysis, and are the most pathogenic bacteria;
Gamma streptococci (γ)– are non-hemolytic bacteria, i.e. they do not cause hemolysis.

Lancefield's classification, depending on the structure of carbohydrate C in the bacterial cell wall, also distinguishes 12 serotypes of β-streptococci: A, B, C... to U.

Alpha hemolytic streptococci:

All types of bacteria included in the genus Streptococcus (Streptococcus): S. acidominimus, S. agalactiae, S. alactolyticus, S. anginosus, S. anthracis, S. australis, S. caballi, S. canis, S. castoreus, S. constellatus, S. criae, S. criceti, S. cristatus, S. danieliae, S. dentapri, S. dentasini, S. dentirousetti, S. dentisani, S. dentisuis, S. devriesei, S. didelphis, S. downei, S. dysgalactiae, S. entericus, S. equi, S. equinus, S. ferus, S. fryi, S. gallinaceus, S. gallolyticus, S. gordonii, S. halichoeri, S. henryi, S. hongkongensis, S. hyointestinalis, S. hyovaginalis, S. ictaluri, S. infantarius, S. infantis, S. iniae, S. intermedius, S. lactarius, S. loxodontisalivarius, S. lutetiensis, S. macacae, S. macedonicus, S. marimammalium, S. massiliensis, S. merionis, S. milleri, S. minor, S. mitis, S. mutans, S. oligofermentans, S. oralis, S. oriloxodontae, S. orisasini, S. orisratti, S. orisuis, S. ovis, S. parasanguinis, S. parauberis, S. pasteuri, S. pasteurianus, S. peroris, S. phocae, S. pluranimalium, S. plurextorum, S. porci, S. porcinus, S. porcorum, S. pseudopneumoniae, S. pseudoporcinus, S. pyogenes, S. ratti, S. rubneri, S. rupicaprae, S. salivarius, S. saliviloxodontae, S. sanguinis, S. sciuri, S. seminale, S. sinensis, S. sobrinus, S. suis, S. thermophilus, S. thoraltensis, S. tigurinus, S. troglodytae, S. troglodytidis, S. uberis, S. urinalis, S. ursoris, S. vestibularis, S. viridans.

Diagnosis of streptococcus

A test for streptococcus is usually taken from the following materials: swabs taken from the oropharynx (for diseases of the upper respiratory tract), vagina or urethra (for diseases of the genitourinary system), sputum from the nose, scrapings of the surface of the skin (for erysipelas), as well as blood and urine .

Thus, the following tests and methods for examining the body for streptococcal infection are distinguished:

and urine;
and urine;
Bacteriological culture of sputum and smears taken from the nasal cavity and oropharynx;
internal organs;
lungs;

In addition, differential diagnosis is necessary to distinguish streptococcal infection from: infectious mononucleosis, rubella, measles, and other types of infection - Trichomonas, Gerdnerella, Candida, Chlamydia, Ureaplasma, Mycoplasma, etc.

How to treat streptococcus? Treatment for streptococcus usually consists of several points:

1. Antibacterial therapy;
2. Strengthening the immune system;
3. Restoration of normal intestinal microflora, which is usually disrupted when using antibacterial drugs;
4. Detoxification of the body;
5. Antihistamines - prescribed to children with allergies to antibiotics;
6. Symptomatic therapy;
7. If there are other diseases at the same time, they are also treated.

The beginning of treatment is a mandatory visit to a doctor, who, using diagnostics, will identify the type of pathogen and an effective remedy against it. The use of broad-spectrum antibiotics can worsen the course of the disease.

Treatment of streptococcal infection can be carried out by different specialists - depending on the form of infection - therapist, pediatrician, dermatologist, gynecologist, surgeon, urologist, pulmonologist, etc.

1. Antibacterial therapy

Important! Before using antibiotics, be sure to consult your doctor.

Antibiotics against streptococci for internal use:"", "Amoxicillin", "Ampicillin", "Augmentin", "Benzylpenicillin", "Vancomycin", "Josamycin", "Doxycycline", "Claritomycin", "Levofloxacin", "Midecamycin", "Roxithromycin", "Spiramycin" , “Phenoxymethylpenicillin”, “Cefixime”, “Ceftazidime”, “”, “Cefotaxime”, “Cefuroxime”, “”.

Well antibacterial therapy prescribed individually by the attending physician. Usually it is 5-10 days.

Antibiotics against streptococci for topical use:“Bioparox”, “Hexoral”, “Dichlorobenzene alcohol”, “Ingalipt”, “Tonsilgon N”, “Chlorhexidine”, “Cetylpyridine”.

Important! Antibacterial drugs of the penicillin series are widely used to treat streptococci. If allergic reactions to penicillins occur, macrolides are used. Tetracycline antibiotics against streptococcal infections are considered ineffective.

2. Strengthening the immune system

To strengthen and stimulate the functioning of the immune system, for infectious diseases it is often prescribed - immunostimulants: “Immunal”, “IRS-19”, “Imudon”, “Imunorix”, “Lizobakt”.

A natural immunostimulant is, a large amount of which is present in products such as rose hips and other citrus fruits, kiwi, cranberries, sea buckthorn, currants, parsley,.

3. Restoration of normal intestinal microflora

When using antibacterial drugs, the microflora necessary for normal functioning digestive system usually depressed. To restore it, in Lately Appointments are increasingly being made probiotics: “Acipol”, “Bifidumabacterin”, “Bifiform”, “Linex”.

4. Detoxification of the body.

As was written in the article, streptococcal infection poisons the body with various poisons and enzymes, which are products of their vital activity. These substances complicate the course of the disease and also cause a considerable number of unpleasant symptoms.

To remove waste products of bacteria from the body, you need to drink a lot of fluid (about 3 liters per day) and rinse the nasal and oropharynx (with furacillin solution, a weak saline solution).

Among the drugs for removing toxins from the body are:"Atoxil", "Albumin", "Enterosgel".

5. Antihistamines

The use of antibacterial drugs by young children is sometimes accompanied by allergic reactions. To prevent these reactions from developing into complications, the use of antihistamines: “Claritin”, “”, “Cetrin”.

6. Symptomatic therapy

To relieve symptoms of infectious diseases, various drugs are prescribed.

At high body temperature: cool compresses on the forehead, neck, wrists, armpits. Among the drugs we can highlight - “”, “”.

For nasal congestion – vasoconstrictors: “Noxprey”, “Farmazolin”.

Important! Before using folk remedies, consult your doctor.

Apricot. Apricots have proven themselves well for the treatment of streptococcal infections - apricot pulp should be consumed 2 times a day, morning and evening, on an empty stomach. At skin lesions, the skin can also be rubbed with apricot pulp.

Black currant. Blackcurrant berries not only contain a high dose of vitamin C, but are also a natural antibiotic. To use these berries as remedy, you need to eat 1 glass of them after each meal.

Chlorophyllipt. As an alcohol and oil solution, it can be used to treat diseases of the ENT organs. Alcohol solution used as a rinse for the nasal cavity and throat; the oil solution is instilled into the nose and lubricated the tonsils. The course of treatment is 4-10 days.

Rose hip. Pour 500 water into the mixture, bring the product to a boil, boil for about 5 minutes and set aside for several hours to infuse. Drink 150 ml of the prepared decoction twice a day. An increase in efficiency was noticed when simultaneous use this remedy with the use of apricot puree.

Onion and garlic. These products are natural antibiotics against various infections. To use onions as a remedy, you don’t need to prepare anything special, you just need to eat them along with other foods, at least a couple of times a day.

A series. Grind thoroughly and pour 400 ml of boiling water over 20 g of dry water, cover the container and leave to infuse. When the product has cooled, strain it well and take 100 ml, 4 times a day.

Prevention of streptococcus includes the following recommendations:

— Avoid places large cluster people, especially indoors and during the season of respiratory diseases;

— If there is a sick person at home, provide him with cutlery, personal hygiene items, a towel and bed linen for his personal use;

— Do not use one container for several people at work, and do not drink water from your throat at the same time with several people;

- Try to eat foods rich in microelements;

- Avoid stress;

— If the living space has an air conditioner, air purifier or

Streptococci - video

Be healthy!

Beta hemolytic streptococcus does not reproduce by spores - these bacteria are immobile. The main condition for their growth is the presence of meat-peptone nutritional conditions. For example, it could be a pot of yesterday's soup.

However, some types of streptococci are also used for good purposes. Hemolytic streptococci are capable of fermenting lactose, as a result of which lactic acid is formed, which is used to produce fermented milk products: kefir, yogurt, fermented baked milk.

But mostly bacteria streptococcus very dangerous. The fact is that it produces toxins that have a very detrimental effect on human health. Toxins produced by streptococcus are capable of triggering autoimmune reactions that develop into serious diseases: rheumatism, glomerulonephritis.

Beta hemolytic streptococcus: method of spread

While the streptococcus bacterium can adapt to any environmental conditions, it is also capable of being transmitted from person to person through all imaginable contacts. Ways streptococcus infections a large number of. Hemolytic streptococcus can be transmitted by airborne droplets, tactile, nutritional. A favorable environment for dissemination is closed groups. Streptococcus does not go beyond the “affected zone”, increasing its concentration in enclosed spaces, and is transmitted from person to person with lightning speed.

Examples of such closed groups could be:

kindergartens;
nursery;
schools;
institutions;
army groups.

It is believed that the most dangerous type of streptococcus for humans is group A beta hemolytic streptococcus.

Beta hemolytic streptococcus: main diseases

GABHS (group A beta hemolytic streptococcus) can cause a wide variety of diseases. That is why hemolytic streptococcus is considered the most dangerous virus for a person. Group A beta hemolytic streptococcus can cause:

tonsillitis;
scarlet fever;
erysipelas;
paratonsillar abscess;
phlegmon of the neck;
sepsis;
otitis;
meningitis;
fasciitis and myositis;
streptoderma;
glomerulonephritis.

Treatment of streptococcus

In order to prevent the occurrence of all these terrible diseases, their causative agent, streptococcus, should be destroyed.

Treatment of streptococcus It is carried out both medicinally (with the help of antibiotics and the zapping procedure) and prophylactically.

Treatment of streptococci Only a doctor can prescribe it. To identify streptococcus, you need to take a throat swab test.

It will also not hurt to take immunomodulatory drugs, which also have diuretic properties. Here is a short list of immunomodulatory agents for treatment and prevention of streptococcal infections:

raspberries;
carrot;
hops (infusion from cones);
garden onion;
garlic;
series;
Echinacea purpurea;
Cherry juice;
strawberry;
burdock (vodka tincture);
yarrow;
walnut.

Bacteria of the Streptococcaceae family are gram-positive coccal forms of microorganisms with a facultative anaerobic type of respiration. They are opportunistic bacteria for humans and animals. Entering the human body with food, they colonize the respiratory and digestive tracts, dermis and external genitalia, without leading to the development of an inflammatory process.

When the body's natural defenses are weakened, microbial cells begin to multiply, their virulence increases and they become capable of causing various diseases. Bacteria are able to penetrate the bloodstream, spreading to all organs and tissues (dissemination of infection), causing the development of sepsis, the appearance of distant purulent foci, etc.

At this stage, the patient is dangerous to others due to possible transmission of the pathogen by airborne droplets.

According to statistics, in countries with a temperate climate, streptococcal infections are most common compared to other bacterial diseases. On average, the inflammatory process is observed in 10-15 people per 100 clinical cases.

As noted earlier, group B streptococci are the most dangerous for humans, as they are causative agents of various pathological conditions. The main routes of transmission of streptococcal infection include:

infected wounds and scratches on the skin;
airborne infection (the source of infection is streptococcus carriers in the nasopharynx);
contact and household transmission route through personal items of use of the carrier;
concomitant diseases that contribute to a decrease in immunity and the development of opportunistic microflora against this background. For example, diabetes, HIV, STDs and others.

A distinctive characteristic of streptococcal infection is frequent asymptomatic carriage and ignorance of the development of the pathological process in the early stages.

Symptoms of streptococcal pathologies

At the site of localization of streptococcal infection, a focus of inflammation is formed, accompanied by purulent and serous discharge. Symptoms of streptococcal infection are determined by the location of the outbreak.

With streptococcal pyoderma, pustular rashes are noted, with otitis - ear pain, suppuration from the ear, hearing loss, with pharyngitis - sore throat, purulent plaques on the tonsils, etc.

General symptoms of the development of streptococcal infection in the patient’s body may be

heat;
headache;
general weakness;
muscle joint pain;
dizziness;
nausea;
decreased appetite;
bloating, etc.

There are known cases of the development of allergic reactions to streptococcal infection, during which pathological disorder functioning of the human immune system.

It should also be noted that the danger is posed not only by acute streptococcal infection, but also by its long-term complications (rheumatism, arthritis, myocarditis, heart defects).

Therefore, immediately after diagnosing a streptococcal infection, immediate treatment is required.

Diseases caused by streptococci

The main diseases caused by streptococcal infections in the patient:

– an infectious process characteristic mainly of pediatric patients. Accompanied by high fever, intoxication symptoms, pinpoint rashes, and the appearance of a granular “raspberry” tongue (due to hyperplasia of the papillae). The disease develops as a result of hemolytic streptococcus entering the body; therapy consists of treatment with antibiotics;
acute form() - inflammation of the surface of the tonsils caused by streptococcal or staphylococcal infection, less often - by others pathogenic microorganisms. The pathology is characterized by increased body temperature, a dense white coating on the surface of the tonsils, headaches, sore throat, hyperemia of the posterior pharyngeal wall and enlarged cervical and submandibular lymph nodes. To relieve a sore throat, antibiotics are used for streptococcus in the throat, which have a narrow spectrum of activity. Long-term complications streptococcal infections can manifest as damage to the heart, joints, etc.;
otitis media– a disease accompanied by the development of an inflammatory process in the middle ear cavity. The main symptoms of otitis media are pain in the ear, suppuration from the ear, a feeling of ear fullness, hearing loss, and increased body temperature.
osteomyelitis– purulent-necrotic inflammation of the bone, bone marrow and surrounding soft tissues. In the absence of adequate and timely treatment, sepsis develops, which can be fatal.

Antibiotic therapy for streptococci

Treating streptococcal infections with antibiotics is the preferred choice of therapy. As a rule, it is as a result of a previous streptococcal infection that autoimmune diseases, aimed at destroying the body’s own cells and tissues.

Only a doctor can select the right antibiotics for streptococcal infections, after establishing an accurate diagnosis. At the first stage you need to go through laboratory examination, aimed at isolating and identifying the causative agent of the disease. A smear is taken from the site of inflammation and culture is performed. Grown strains of microorganisms are identified to species, less often to genus. At the second stage, the sensitivity of the resulting bacterial strains to various groups antibiotics.

It has been established that the most effective medications against bacteria of the Streptococcaceae family are antibiotics of the penicillin and cephalosporin group.

The mechanism of action of penicillins is based on disruption of the permeability of the cell wall of prokaryotes, as a result of which a large amount of foreign substances enters the cell and the cell dies. Penicillins are most effective against growing and dividing cells.

The drugs of choice are:

benzylpenicillin ® ;
phenoxymethylpenicillin ® ;

The use of an inhibitor-protected drug, amoxilava ® (amoxicillin ® in combination with clavulanic acid), is highly effective.

Contraindications to the use of penicillins are individual intolerance to the drug (allergy), severe pathologies of the kidneys and liver. In this case, antibiotics of the group are prescribed.

However, it should be borne in mind that some cephalosporins have an allergic cross-reaction with penicillins. Therefore, before using them, it is necessary to take an allergy test.

Cephalosporins inhibit the biosynthesis of murein in microorganisms. As a result, an inferior cell wall is formed. Such a pathology is not compatible with the normal functioning of the cell.

Features of antibiotic therapy for streptococcal diseases

It is important that the course of antibiotic therapy is prescribed by the attending physician. Marked formation high level resistance to antibacterial drugs in bacteria of the Streptococcaceae family. Therefore, independent choice drug therapy and uncontrolled use of antibiotics is unacceptable.

As a rule, at the first stage of treatment, the doctor prescribes an antibiotic wide range actions, since it is necessary to quickly stop the patient’s serious condition and eliminate the symptoms of the disease. After laboratory diagnostics, the course of treatment can be adjusted (if necessary, drugs with a narrow spectrum of action that are active against specific types and strains of bacteria are prescribed).

On the question of the study and classification of streptococci

During the era of the bacteriological stage of the development of microbiology, coccal forms of bacteria located in chains were described by many scientists. Billroth in 1874 proposed calling this group of bacteria streptococci. Binary Latin name, according to the rules of Linnaeus nomenclature, they received in 1881.

Didn't exist for a long time unified classification this group of bacteria, since the large number of species and their insufficient knowledge did not allow us to come to a consensus. It is known that the composition of the cell wall can include proteins and polysaccharides of different chemical structures. According to this criterion, streptococci are divided into 27 groups.

Each group is assigned a Latin letter of the alphabet. It is known that group A streptococci are the most common among representatives of the indigenous microflora of the human body. Group B streptococci are among the most pathogenic; their presence causes the development of sepsis and pneumonia in newborns.

Later, another classification was developed, which is based on the ability of streptococci to destruct (hemolyze) red blood cells. According to this classification, developed by Schottmuller and Brown, bacteria of the Streptococcaceae family are divided into 3 main groups:

Alpha hemolytic – partially destroys red blood cells;

Beta-hemolytic – cause complete hemolysis. It is noted that this group characterized by the greatest pathogenicity;

Gamma-hemolytic - are not capable of subjecting red blood cells to hemolysis. Safe for humans.

This classification is the most convenient in terms of practical application and classification of streptococci.

Streptococci are chain-shaped bacteria that live in the microflora of the human body. Very often they coexist with an infection such as Staphylococcus aureus. If the environment is favorable for bacteria, an inflammatory or infectious process may develop. Since these organisms do not form spores, they quickly die when exposed to sunlight and special preparations.

Streptococci of the Viridans type (viridans) make up about 30–60% of the total number of bacteria in the human body. They enter the body along with the food consumed. Most often, bacteria are localized in the gastrointestinal tract, oral cavity, genitals, mucous membrane of the respiratory tract and on the skin.

Transmission path

The development of a pathological process is possible only if there is a favorable environment for this. Infection with staphylococci and streptococci is possible in the following ways:

autoinfection;
infection from outside.

In the first case, infection is possible due to the following circumstances:

self-removal of boils;
dental operations;
infectious diseases in the oral cavity;
chronic;
removal of tonsils.

The infection is transmitted in the following ways:

domestic;
sexual;
airborne;
food;
placental (from an infected mother to her child).

The greatest danger is a person whose infection is located in the respiratory tract. This is possible with sore throat or scarlet fever.

Streptococcus can provoke the development of the following diseases:

erysipelas;
bronchitis, ;
soft tissue abscess.

According to statistics, the disease is diagnosed in 15% of pregnant women. Infection of the fetus with the development of an underlying disease is diagnosed in 0.3%. Most often, streptococcal infection provokes the development of pneumonia and sore throat.

Streptococcal pneumonia

When infection enters the respiratory tract, pneumonia develops. But it should be noted that such pathological processes are possible only if the person’s immune system is too weakened.

The infection leads to inflammation in the alveoli, which quickly invades neighboring tissues. This leads to the formation of exudate in the lungs. Ultimately, this leads to impaired gas exchange and pneumonia.

Symptoms of streptococcal pneumonia:

fever;
cough for no apparent reason;
dyspnea.

Streptococcal pneumonia is most severely suffered by children under 3 years of age and the elderly. Especially if a person has a weakened immune system.

Possible consequences streptococcal pneumonia:

lung abscess;
pneumosclerosis.

But if you start treating pneumonia caused by this infection, complications can be avoided.

The main reasons for the development of streptococcal sore throat include the following factors:

the initial entry of infection into the child’s body;
previous infectious or viral diseases;
long-term treatment with antibiotics, chemotherapy;
weakened immunity.

Children are more susceptible to strep throat due to the fact that their immune systems are much weaker than those of adults.

Symptoms of the development of the disease in children:

irritability, moodiness;
a sore throat;
refusal to eat, significant loss of appetite;
unstable body temperature;
yellow or greenish discharge from the nose;
nausea and vomiting.

Such symptoms in children indicate strong or. Therefore, some parents simply do not apply in a timely manner medical care, which significantly aggravates the situation.

Due to the fact that such an infection quite often grows along with Staphylococcus aureus, the development of other underlying diseases is possible. Also, do not forget that sore throat can cause more complex and dangerous diseases in children.

With streptococcal sore throat, children may experience a dry cough and headache. In general, the clinical picture depends on the child’s developmental characteristics and general health. In rarer clinical cases The manifestation of streptococcal infection in children may be accompanied by rashes in the nose and on the skin near the nose. As a rule, such infections are accompanied by Staphylococcus aureus.

Possible complications:

meningitis;
otitis;
pneumonia or chronic bronchitis;
abscess.

Such complications in children can be avoided if you seek medical help in a timely manner.

Symptoms

There are no uniform symptoms for this infection. The clinical picture depends on what kind of disease the streptococcus caused. The most common symptoms of this infectious disease are:

unstable body temperature;
intoxication of the body;
skin rashes;
enlarged lymph nodes;
sore throat for no apparent reason;
low blood pressure;
tissue necrosis.

In addition to the above symptoms, the patient may often experience discomfort in the kidney area. In this case general list symptoms may be supplemented by the following signs:

problems with urination;
discomfort in the area of the affected organ;
visible during urine analysis increased level hemoglobin and creatinine.

The most reliable sign of the development of streptococcal infection can be considered the following symptoms:

redness of the affected area;
formation of pus;
painful sensations when pressed.

Due to the fact that toxins can enter the blood, a person may be in a state of shock.

When the first symptoms appear, you should immediately consult a doctor. Self-medication can only aggravate the situation and give rise to the development of another underlying illness.

Groups of streptococci

IN official medicine It is customary to distinguish the following groups of this infection:

greening or alpha-hemolytic;
beta-hemolytic (group A streptococci);
non-hemolytic.

Group A streptococci (Streptococcus pyogenes) cause various ailments. The frequency of such diseases depends on the season. So, for children, the greatest danger is streptococci in the throat. IN winter period Streptococci in the throat can cause the development of sore throat, pharyngitis,.

Infection during pregnancy

According to statistics, streptococcal infection is diagnosed in 20% of women during pregnancy. Etiological factors include the following:

failure to maintain intimate hygiene;
wearing synthetic, tight underwear;
use of non-sterile items for personal hygiene;
unprotected sex.

It should be noted that this infection is almost constantly present in the vagina. But during pregnancy, a woman’s body is weakened, which gives rise to the development of this infectious organism. Often, streptococcus can be activated simultaneously with Staphylococcus aureus.

Possible complications during pregnancy:

severe allergic diseases;
purulent otitis;
diseases of the cardiovascular system;
sepsis;
diseases of the genitourinary system.

As for the newborn, the following complications may develop:

sepsis;
meningitis;
pneumonia;
neurological disorders.

If streptococcus is diagnosed during pregnancy along with Staphylococcus aureus, then the baby may develop allergic diseases.

Neurological disorders are caused by streptococcus agalactia. It is noteworthy that this subtype of infection can only be diagnosed during pregnancy. In addition to disorders in the nervous system, Streptococcus agalactia can cause premature birth and even fetal death. As a rule, the infection is diagnosed at 32–33 weeks of pregnancy.

It should be noted that Staphylococcus aureus causes practically the same diseases as streptococcal infection. The main difference is only in the manifestation of the clinical picture and the speed of development of the disease. Since the immune system is weakened during pregnancy, the risk of developing any disease increases significantly.

To avoid this, during pregnancy you should be especially careful about your health and follow the rules of personal hygiene. Thus, the development of diseases caused by streptococcus and Staphylococcus aureus during pregnancy can be prevented.

Streptococcus in a vaginal smear may indicate:

urethritis.

Streptococcus in a smear of the throat or pharynx indicates a sore throat, pharyngitis, laryngitis.

As for streptococcus in the nasal mucosa, the following diseases are possible:

If it is impossible to make an accurate diagnosis using the methods described above, then differential diagnosis is carried out.

Treatment

The main course of treatment for streptococcus consists of taking antibiotics. Because on the body long time strong medications will be used; treatment includes taking medications to restore the microflora:

Linux;
acipol;
bifiform;
cetrin;
zodak

The infection should be treated only under the supervision of a doctor. If the body is in the stage of severe intoxication, you should follow bed rest. Extra physical activity can lead to serious complications.

Please note that under no circumstances should you remove plaque from the throat with streptococcal sore throat. This only leads to worsening of the disease. It is also not recommended to treat such diseases with folk remedies without a doctor’s recommendation.

Use folk remedies Treatment is possible only after consultation with a doctor. As a rule, gargling with a decoction of chamomile and sage is prescribed.

Prevention and prognosis

The main preventive measures are aimed at maintaining personal hygiene and strengthening the immune system. If treatment is started in a timely manner, complications can be avoided.

Streptococci– bacteria are spherical in shape, arranged in the form of chains. They are part of the microflora, but can cause severe infectious diseases in people with weakened immune systems. Streptococci do not form spores and are therefore quite unstable in the environment. They die under the influence of sunlight, disinfectants and antibiotics.

Streptococci are part of the normal human microflora and make up 30-60% of the bacteria contained in the pharynx. They enter the body with food and feed on food debris and desquamated epithelium. Different types of streptococci colonize various areas body: oral cavity, gastrointestinal tract, mucous membrane of the respiratory tract and genital organs, skin.

When decreasing protective properties In the body, streptococci, which are part of the microflora, begin to actively multiply and acquire pathogenic properties. Bacteria or their toxins enter the bloodstream and cause serious illnesses - streptococcal infections. During the period of illness, a person becomes dangerous to others, as he produces a large number of pathogenic streptococci.

In countries with temperate climates, diseases caused by streptococcus are one of the most common groups of pathologies. During the cold season, the incidence reaches 10-15 cases per 100 people.

History of the study. Streptococci have been studied for more than 150 years since their discovery in 1874. Scientists have created several classifications to systematize the huge number of species of these bacteria. The cell wall of streptococci may contain various proteins and specific polysaccharides. Based on this, 27 types of streptococcus are divided. They differ in their “place of residence,” properties, and ability to cause diseases. Each group is designated by a letter of the Latin alphabet. For example, group A streptococcus is the most common, while group B streptococcus can cause pneumonia and sepsis in newborns.

Depending on the ability to destroy (hemolyze) red blood cells, they are divided into 3 groups:

Alpha hemolytic – partial hemolysis of red blood cells
Beta-hemolytic: complete hemolysis. The most pathogenic (pathogenic).
Gamma-hemolytic: non-hemolytic streptococci.

What is streptococcus?

Streptococci have spherical shape, size 0.5-1 microns. Genetic information is contained in the nucleus in the form of a DNA molecule. These bacteria reproduce by dividing in two. The resulting cells do not disperse, but are arranged in pairs or chains.

Properties of streptococci:

They stain well with aniline dyes, so they are classified as gram-positive bacteria.
do not form a dispute
form a capsule
motionless
stability in the external environment:
- in dust, dried sputum and pus can persist for months. At the same time, their pathogenicity is reduced - they cannot cause severe forms of the disease.
- tolerate freezing well
- heating to 56 degrees kills them within half an hour
- disinfectant solutions funds are destroyed within 15 minutes
Facultative anaerobes - can exist with or without air. Thanks to this feature, streptococci colonize the skin and can circulate in the blood.

Streptococci produce a number of toxins - bacterial toxic substances, poisoning the body:

Hemolysins(streptolysins)
- Hemolysin O - destroys red blood cells, has toxic effect on heart cells, suppresses immunity by inhibiting leukocytes.
- Hemolysin S - destroys red blood cells and has a toxic effect on body cells. Unlike hemolysin O, it is a weak antigen and does not stimulate the production of antibodies.
Leukocidin– affects leukocytes (neutrophils and macrophages). Turns off phagocytosis - the process of digestion of bacteria by immune cells. It disrupts the water-electrolyte balance in intestinal cells, causing staphylococcal diarrhea.
Necrotoxin– causes necrosis (death) of cells, which contributes to purulent melting of tissue and the formation of abscesses.
Lethal toxin– causes death when administered intravenously.
Erythrogenic toxin- a specific toxin released during scarlet fever. Causes a red rash. Suppresses the immune system, destroys platelets, irritates the body, suppresses the immune system, and causes an increase in temperature.

Enzymes secreted by streptococci - speed up various biochemical reactions in organism:

Hyaluronidase– breaks down the cell membranes of connective tissue. Membrane permeability increases, which contributes to the spread of inflammation.
Streptokinase(fibrinolysin) - destroys fibrin, which limits the focus of inflammation. This contributes to the spread of the process and the formation of phlegmon.

Streptococcus virulence factors – components of the bacterium that cause manifestations of the disease:

Capsule, containing hylauronic acid – protects bacteria from phagocytes and promotes their proliferation.

Protein M(capsule component) makes phagocytosis impossible. The protein adsorbs fibrin and fibrinogen (the basis of connective tissue) on its surface. It causes the formation of antibodies, including those to connective tissue proteins. Thus, it provokes the development of autoimmune reactions. 2 weeks after infection with streptococcus, the immune system begins to produce antibodies that mistake connective tissue for protein M. This is a mechanism for the development of autoimmune diseases: rheumatoid arthritis, vasculitis, glomerulonephritis.

Most often, diseases are caused by 5 groups of streptococci

Group	Where does it live?	What diseases does it cause?
A	Throat and skin	Most streptococcal infections. Purulent-septic processes. Toxic effects on the heart
IN	Nasopharynx, vagina, gastrointestinal tract	Urogenital infections, postpartum infections, pneumonia and sepsis in newborns, streptococcal pneumonia after ARVI
WITH	Upper respiratory tract	Laryngitis, tracheitis, bronchitis
D	Intestines	Acute toxic infections (intestinal lesions), suppuration of wounds and burns, sepsis
H	Pharynx	Endocarditis

Method of infection with streptococcus

There are two ways of infection with streptococcus.

The most dangerous are people whose foci of infection are in the upper respiratory tract: sore throat, scarlet fever.

Mechanisms of transmission:

Airborne droplet– the main route of infection with streptococcus. Bacteria are released into the external environment with droplets of saliva in the form of an aerosol. This happens when coughing, sneezing, talking. The droplets remain suspended in the air. Healthy man inhales and becomes infected.
Domestic– droplets of infected saliva dry out and are deposited on objects (towels, personal belongings) or settle in house dust. At cold temperature air and high humidity, streptococci remain viable for a long time. Infection can occur through dirty hands.
Sexual. Streptococcal infections of the urogenital tract are transmitted during sexual intercourse.
Food(nutritional) route of infection. Products become infected with streptococcus during preparation and during sale. The most dangerous products are those that do not undergo heat treatment: dairy products, compotes, butter, creamy products, salads, sandwiches. They cause outbreaks streptococcal tonsillitis and pharyngitis.
From mother to child. The child becomes infected from the mother through contaminated amniotic fluid or during the passage of the birth canal. Group B streptococcus is found in 10-35% of women. During childbirth, 0.3% of infants become infected. As a result of infection, the newborn may develop sepsis or pneumonia. In the United States, pregnant women undergo vaginal microflora analysis at 36 weeks of pregnancy. If bacteria are detected, a course of antibiotic therapy is prescribed. In our country, a smear to detect streptococcus in pregnant women is not a mandatory test.

What diseases does streptococcus cause?

Disease	Mechanism of occurrence	Severity of the disease
Acute tonsillitis (tonsillitis)	Acute inflammation of the tonsils of the pharyngeal ring caused by streptococci. When decreasing local immunity Streptococci multiply rapidly, which leads to catarrhal, lacunar, follicular or necrotic inflammation. Bacterial toxins are absorbed into the blood and cause fever, weakness, and body aches.	Depending on susceptibility and immunity, the disease can occur in mild form(temperature is normal, slight sore throat). In weakened patients, a severe necrotic form develops (high temperature, severe intoxication, necrosis of the tonsils).	Otitis is an inflammation of the middle ear. Lymphadenitis is inflammation of the lymph nodes. Peritonsillar abscess - acute inflammation in the tissue near the tonsils. Glomerulonephritis is inflammation of the glomeruli of the kidneys. Articular rheumatism is damage to the joints. Rheumatic carditis is inflammation of the lining of the heart.
Pharyngitis	Inflammation of the mucous membrane of the posterior wall of the pharynx, posterior palatine arches, uvula, lymphatic follicles. The disease develops when a pathogenic streptococcus enters or is caused by the activation of opportunistic microflora with a decrease in immunity. The inflammation is descending in nature - bacteria descend into the trachea and bronchi.	Sore throat, sore throat when swallowing, cough, slightly elevated temperature. General state satisfactory.	Peritonsillar abscess - suppuration of tissue near the tonsils. Laryngitis is an inflammation of the mucous membrane of the larynx. Tracheitis is inflammation of the mucous membrane of the trachea.
Scarlet fever	Acute infection caused by beta-hemolytic streptococcus. Streptococcus penetrates the mucous membrane of the pharynx. In most cases, a focus forms in the pharynx where bacteria multiply and release an erythrogenic toxin into the blood. It causes a characteristic rash, severe intoxication, and high fever. If a person has immunity against streptococcal toxin, then infection will not lead to scarlet fever, but to a sore throat.	In adults, there may be erased forms with minor intoxication and a pale rash. In children, the disease occurs with high fever and severe intoxication. Rarely, a severe form occurs: the toxin causes a shock reaction, which is accompanied by damage to the heart.	Inflammation of the lymph nodes. Otitis is an inflammation of the middle ear. Autoimmune complications: Endo- or myocarditis – damage to the membranes of the heart; Nephritis – inflammation of the kidneys; Arthritis is inflammation of the joints.
Periodontitis	Inflammation of the periodontal tissues surrounding the tooth. Streptococci often live in gum pockets. With a decrease in local protective properties (insufficient hygiene, common diseases) bacteria actively multiply, causing inflammation of the gums and periodontal disease.	Mild forms are manifested by swelling and bleeding of the gums. Severe cases of periodontitis are purulent inflammation of the tissues surrounding the tooth.	Tooth loss. Bone atrophy - destruction bone tissue jaws. Periodontal abscess is focal suppuration of gum tissue.
Otitis	Otitis media. When sneezing or blowing your nose, streptococci enter from the nose through eustachian tube into the middle ear. Bacteria multiply in tissues tympanic cavity And auditory tube. Manifestations: sharp shooting pain in the ear and purulent discharge from the ear canal. Otitis externa– streptococci are introduced from the environment. They penetrate small lesions in the skin or hair follicle of the ear canal.	Otitis media is accompanied by severe pain, often fever and decreased hearing.	Chronic otitis media is a chronic inflammation of the middle ear. Rupture of the eardrum. Hearing loss. Labyrinthitis - inflammation inner ear. A brain abscess is a focal accumulation of pus in the brain.
Erysipelas	Streptococcus enters the body through lesions on the skin and mucous membranes. It may be introduced from existing foci of inflammation. Bacteria multiply in the lymphatic capillaries. From the source of infection, bacteria release toxins that poison the nervous system. They cause intoxication: weakness, chills, headache, body aches, apathy. The onset of the disease is always acute. At the site of streptococcus proliferation, an allergic reaction to the toxin and bacterial enzymes occurs. The walls of blood vessels are damaged, microthrombi are formed, the outflow of lymph from the affected area is disrupted - swelling appears. Sections of the cell wall of streptococcus (its antigens) are similar to skin antigens. Therefore, during illness, immune cells attack the skin. Manifestations: the inflamed area has clear boundaries and rises above healthy skin, it is swollen and bright red. After a few days, bubbles filled with liquid appear on its surface.	The severity of the disease depends on the individual's individual predisposition. Severe forms of erysipelas are observed in people who have a genetic predisposition to the disease and in those who have previously encountered the pathogen (group A streptococcus) and the body has developed allergens to it. In severe forms, large blisters with bloody contents form. Children get sick rarely and in a mild form.	Phlegmon is a diffuse purulent inflammation without clear boundaries. Foci of necrosis – cell death. An abscess is a purulent melting of tissue limited by an inflammatory membrane. Ulcers are deep skin defects. Lymphostasis, elephantiasis - lymphatic swelling of tissues caused by impaired lymph outflow.
Streptoderma	Streptococcus penetrates into minor skin lesions. It multiplies, damaging surrounding cells. Thanks to the ability to dissolve fibrin capsules, which limit inflammation. The lesions reach tens of centimeters in diameter. Appearance: round pink spots With jagged edges. After a few days, the spots become covered with purulent blisters. After opening them, purulent flaky scales remain.	Streptococcal impetigo – more superficial light form. The blisters open quickly and do not leave scars after healing. The general condition has not changed. Vulgar ecthyma is a deeper form in which the papillary layer is affected. May be accompanied by a rise in temperature up to 38 degrees, enlarged lymph nodes.	Septicemia is the spread of streptococci into the blood. Streptococcal glomerulonephritis – kidney damage. Scars are dense formations of connective tissue on the skin. Guttate psoriasis is non-inflammatory, scaly patches on the skin.
Bronchitis	Streptococci develop on the mucous membrane of large and small bronchi, causing inflammation and increased secretion of mucus. Manifestations: cough, shortness of breath, fever, general intoxication.	The severity of the disease depends on the state of the immune system. In adults, bronchitis can occur with a slight rise in temperature. Children and weakened patients often develop protracted (up to 3 weeks) severe forms with high fever and persistent cough.	Inflammation of the lungs - bronchopneumonia. Asthmatic bronchitis - spasm smooth muscle bronchi and swelling of the mucous membrane of the respiratory tract. Chronical bronchitis. Chronic obstructive pulmonary disease is a disease that interferes with the movement of air in the lungs.
Pneumonia	Streptococci can penetrate into the lung tissue through the bronchi or be carried through the blood or lymph from other foci. Inflammation begins in the alveoli of the lungs, which quickly spreads through the thin walls to surrounding areas. An inflammatory fluid forms in the lungs, which disrupts gas exchange and the body experiences oxygen deficiency. Manifestations: shortness of breath, fever, weakness, severe cough.	Children under one year of age have a hard time suffering from streptococcal pneumonia. Severe forms occur in people with weakened immune systems and if the disease is caused by streptococcus that is insensitive to antibiotics.	Pneumosclerosis is the proliferation of connective tissue in the lungs. Lung tissue atrophy is the formation of a cavity in the lungs. Pleurisy is inflammation of the pleura. A lung abscess is a cavity filled with pus in the lung. Sepsis is the entry into the blood of streptococci and their toxins.
Lymphadenitis	Streptococci with the lymph flow enter the lymph node from the primary focus (furuncle, purulent wound, caries). Purulent inflammation occurs in the lymph node. Manifestations: enlarged and painful lymph node, the skin over it is changed, fever, general weakness, headache.	The severity of the condition depends on the stage of the disease. On initial stages slight pain develops. Over time, the number of bacteria increases. Pus accumulates in the lymph node capsule, and the general condition worsens.	Necrotizing lymphadenitis is purulent inflammation of the lymph nodes. Adenophlegmon is a purulent inflammation of the tissue around the lymph node. Lymphedema is lymphatic swelling.
Meningitis	Purulent inflammation meninges. It develops when streptococcus enters from the nasopharynx or other foci of inflammation (pneumonia, otitis, phlegmon). Decreased immunity allows bacteria to penetrate the blood-brain barrier. There is little between the meninges immune cells(phagocytes). Nothing stops the growth of streptococcus, and it quickly multiplies on the soft membrane of the brain. Rising intracranial pressure, cerebral edema develops, and toxins poison nerve cells. Manifestations: severe headache, high fever, repeated vomiting, delirium, impaired consciousness, increased muscle tone, specific meningeal symptoms from the nervous system.	Children under 5 years of age are most often affected. The disease can occur in mild, moderate and severe forms. In mild cases (in people with strong immune systems) streptococcal meningitis manifested by intoxication and moderate headaches. In other cases, all symptoms are pronounced. Severe forms develop in patients with suppressed immunity or a removed spleen.	Septic shock – severe changes caused by the presence of streptococcus in the blood. Cerebral edema is an accumulation of fluid in brain cells. Adrenal insufficiency is a decrease in the production of hormones by the adrenal cortex. Septic panophthalmitis is a purulent inflammation of the tissues of the eyeball.
Endocarditis	Streptococci enter the bloodstream during dental procedures, tooth extraction, and bladder catheterization. Bacteria linger on the heart valves and cause inflammation of the inner lining. The development of bacteria leads to thickening of the valve flaps. They lose elasticity and break. In this case, blood circulation in the heart is disrupted. Manifestations: chills, fever, profuse sweating, pallor, minor hemorrhages on the skin.	A serious illness that requires immediate treatment.	Glomerulonephritis is inflammation of the glomeruli of the kidneys. Embolism (blockage) of the pulmonary artery. Stroke is a blockage of an artery supplying the brain. Vice heart valve– disturbance of blood circulation inside the heart.
Caries	Streptococci living in the oral cavity ferment carbohydrates that remain in the spaces of the teeth after eating. As a result, lactic acid is formed, which destroys enamel and demineralizes teeth. This leads to the appearance of caries.	The general condition is not disturbed.	Caries is the destruction of hard tooth tissues. Pulpitis is inflammation of the tooth pulp. Tooth loss.
Soft tissue abscess	An abscess is a cavity filled with purulent contents. The introduction of streptococci can occur through the hair follicle, skin damage, or the canal after injection. At the site of inflammation, bacteria multiply - this is accompanied by saturation of the tissue with inflammatory fluid. Leukocytes migrate to the inflamed area. Under the influence of their enzymes, the tissue melts. Toxins and breakdown products seep through the capsule and enter the blood, causing intoxication. Manifestations: painful, tight area in the muscles or subcutaneous tissue, after a few days the pus melts. The general condition worsens: fever, chills, malaise, headache.	The severity of the condition depends on the location of the abscess and its size.	Sepsis. Spread of pus throughout the subcutaneous tissue. Long-term non-healing fistula (canal connecting inflammatory cavity With environment). Breakthrough of an abscess into a cavity (articular, abdominal, pleural).
Inflammation of the urogenital tract (urethritis, cervicitis and cervicovaginitis)	Inflammation of the mucous membranes of the genital organs caused by the proliferation of streptococcus. This bacterium is found in small quantities in the vaginal microflora of 10-30% of women. However, with a decrease in immunity, dysbiosis occurs. Streptococci begin to multiply quickly and cause inflammation. Manifestations: itching, purulent discharge, painful urination, pain in the lower abdomen, fever.	Relatively easy to carry.	Cervical erosion is the location of the columnar epithelium on the vaginal part of the cervix. Endometritis is an inflammation of the uterine mucosa. Polyps are abnormal growths of the mucous membrane of the genital organs.
Sepsis	Inflammatory process throughout the body. It is characterized by penetration into the blood and tissues large quantities streptococci and their toxins. This happens when the immune system is weakened and cannot localize the infection to one focus. Manifestations: high temperature, rapid breathing and heartbeat, the formation of multiple ulcers in the internal organs.	The condition of the patients is serious	Septic shock - sudden decline blood pressure caused by the activity of streptococcus in the blood.
Diseases caused by streptococcus
Rheumatism (Acute rheumatic fever)	Rheumatism is considered a late complication of tonsillitis or pharyngitis. Streptococcus has a toxic effect on heart cells, destroys connective tissue fibers and causes inflammation. The body produces antibodies to fight group A beta-hemolytic streptococcus. Since it has similar properties to connective tissue and myocardium, the immune system attacks its own tissues. This leads to increased inflammation. Manifestations: shortness of breath, palpitations, murmurs and interruptions in heart function, sweating, increased body temperature. From the joints: severe pain in symmetrical large and medium joints (knee, ankle). Swelling and redness of the skin appears, and movements in the joint are severely limited. Possible wheezing, abdominal pain, damage to the nervous system (fatigue, irritability, memory impairment).	The severity of the condition depends on the degree of damage to the heart. The condition depends on the activity of the rheumatic process. At strong reaction immunity, many symptoms appear, and all of them are pronounced. For some people, the signs of the disease are erased.	Valve defects heart - thickening and subsequent damage to the valve. Atrial fibrillation is an accelerated, irregular heartbeat that is life-threatening. Circulatory failure is a circulatory disorder in which organs cannot perform their functions.
Rheumatoid arthritis	A systemic connective tissue disease that primarily affects small joints. Streptococcus causes disruption of the immune system. In this case, special immune complexes are formed, which are deposited in the affected joints. They break the slide articular surfaces and reduce mobility. Manifestations: pain and swelling, thickening of the synovial membrane of the joint due to cell proliferation. Inflamed cells release enzymes that dissolve cartilage and bone tissue. The joints become deformed. Movements are constrained, especially in the morning.	The severity of the disease depends on the stage of the disease, the susceptibility of the body and hereditary predisposition.	Infectious complications- accumulation of pus in articular capsule. Renal failure is a disorder of the kidneys.
Systemic vasculitis	A systemic disease that affects the walls blood vessels. Streptococcus causes the production of antibodies, which, for unknown reasons, attack the walls of blood vessels. This leads to growth vascular wall. In this case, the lumen of the vessel narrows, the blood circulation of organs is disrupted and their cells die. Manifestations: loss of sensitivity in the affected areas, weight loss, vomiting, muscle pain, skin rash, purulent-bloody nasal discharge, shortness of breath, chest pain, changes in the nervous system.	The severity depends on the degree of the disease and which organ is affected by the circulatory disorder. When blood vessels in the brain narrow, strokes occur, which can have fatal consequences.	Strokes are disorders of cerebral circulation. Pulmonary hemorrhages. Abdominal abscesses. Polyneuropathy is multiple flaccid paralysis caused by damage to peripheral nerves.
Glomerulonephritis	Kidney disease in which inflammation of the glomeruli (glomeruli) is caused by immune cells attacking and deposits immune complexes. Gradually kidney tissue is replaced by connecting. The excretory function of the kidneys is impaired. Manifestations: increased blood pressure, swelling, lower back pain. There is blood and increased protein content in the urine.	The condition depends on the duration of the disease. After 15-25 years from the onset of the disease, renal failure.	Chronic renal failure irreversible damage kidney function.

Streptococcal infections in infants

A newborn becomes infected with group B streptococcus while passing through the birth canal. Another option is infection with group A streptococcus in utero through the mother’s blood or in the first days of life from a patient or carrier. The disease may appear immediately after birth or several weeks later.

Disease	Mechanism of occurrence	Severity of the disease	Possible consequences and complications
Streptoderma	Streptococcus affects the superficial layers of the skin. Manifestations: a pustule forms - a flat bubble lying flush with the skin. Its contents are first transparent, then purulent. After 2-3 days, the bubble dries out and turns into a crust that lasts up to 5 days. Due to itching, the child is restless and does not sleep well.	The general condition is slightly disturbed.	Deep erosion Scars on the skin.
Vulgar ecthyma	The ulcerative form of streptoderma is a lesion of the deep layers of the skin. Manifestations: blister surrounded by infiltrate. After 2 days, a yellow crust appears in its place, under which a painful ulcer forms. The temperature is rising The lymph nodes increase.	The general condition is disturbed, the child is lethargic and drowsy.	Lymphangitis is inflammation of the lymphatic capillaries and trunks. Lymphadenitis is purulent inflammation of the lymph nodes.
Sepsis	A generalized infection associated with the circulation of bacteria in the blood and damage to multiple organs. Manifestations: persistent fever without a focus of infection. Systolic pressure drops by 1/3. The formation of a large number of ulcers in the internal organs is possible.	It's going hard. Mortality reaches 5-20%.	Streptococcal toxic shock syndrome is a vascular shock reaction and damage to a large number of organs.
Meningitis	Inflammation of the meninges. Getting into the space between the membranes, bacteria colonize them, causing the formation of pus. Manifestations: chills, fever, sudden weight loss, pallor or redness of the skin, lethargy or agitation - manifestations of a severe headache. Skin rash - result toxic damage small vessels.	Mortality 10-15%. 40% of children experience consequences.	Toxic shock. Convulsive muscle contraction. Difficulties in remembering and assimilating information later.
Pneumonia	Streptococcus infects the alveoli of the lungs, causing inflammation and disrupting gas exchange. As a result, organs suffer from oxygen deficiency. Manifestations: severe intoxication, the child is lethargic, refuses food, shortness of breath, cough, pale skin.	The disease is relatively difficult to tolerate. But thanks proper treatment the mortality rate is less than 0.1-0.5%.	Respiratory failure– inability of the lungs to provide gas exchange Toxic shock
Necrotizing fasciitis	Streptococcal infection of the fascia - a membrane of connective tissue covering muscles and organs. Manifestations: woody compaction of the skin, fatty tissue and muscles.	The condition is serious. Mortality rate up to 25%.	Streptococcal toxic shock syndrome A sharp decrease in blood pressure

Symptoms of the infectious process with streptococcus

Symptoms of streptococcal infection are very varied. They depend on the type of streptococcus and the disease it caused.

The most common symptoms of an infectious process with streptococcus:

Diagnosis of streptococcus

Diagnosis of streptococcus is carried out when it is necessary to establish the cause of a sore throat or other bacterial disease. There are rapid antigen tests that can identify bacteria in 30 minutes, but classic bacteriological examination takes 2-5 days.

Purpose of the study:

identify the causative agent of the disease
distinguish streptococcal infection from other diseases
determine the properties of the pathogen and sensitivity to antibiotics

To clarify the type of streptococcus, bacteriological examination

Type of study	Material collection	Pathology
Swab from throat, tonsils, pharynx	The material is taken with a sterile cotton swab from the tonsils and the back wall of the pharynx. Particles of mucus remaining on the tampon are transferred to nutrient media in the laboratory.	Sore throat, pharyngitis and	Abscess, phlegmon and furunculosis
Blood test	With a sterile syringe from the cubital vein	Sepsis, endocarditis
CSF examination	A puncture of the spinal canal is performed in a hospital. After anesthesia, the Beer needle is inserted between III and IV lumbar vertebrae. When the needle enters the spinal canal, cerebrospinal fluid is collected into a sterile tube.	Meningitis
Sputum examination	Bronchial discharge is collected in a sterile container.	Bronchitis, pneumonia
Urine examination	Collect a medium portion of urine in a sterile container.	Nephritis, urethritis

Laboratory diagnosis of streptococcus takes several days.

First day. The collected material is applied to a plate with a solid nutrient medium (5% blood agar) and into a test tube with glucose broth. The test tubes are placed in a thermostat, where optimal temperature for bacterial growth 37 degrees.

Second day. Take out the test tubes and examine the formed colonies. On solid media, streptococcal colonies look like flat grayish plaques. In test tubes with liquid media, streptococcus grows in the form of crumbs at the bottom and near the walls. Suspicious colonies are stained and examined under a microscope. If streptococcus is detected in the test tubes, it is subcultured into test tubes in broth with blood to isolate pure culture. This is necessary to identify the properties of streptococcus.

The third day. From a pure culture, the type of streptococcus is determined using a precipitation reaction with standard sera and an agglutination reaction on glass.

Antibiotic sensitivity determinations. Antibiotic disc method

A suspension containing streptococci is applied to the surface of a solid nutrient medium in a Petri dish. Discs soaked in solutions of various antibiotics will also be placed there. The cup is left in the incubator overnight for bacteria to grow.

After 8-10 hours, the result is assessed. Bacteria do not grow around antibiotic discs.

The highest sensitivity is to the antibiotic around which the diameter of the growth inhibition zone is the largest.
Middle zone growth – streptococcus is moderately resistant (resistant) to this antibiotic.
The growth of bacteria directly near the disc - streptococcus is not sensitive to this antibiotic.

Treatment of streptococcus

Streptococcal infection is treated with antibiotics. This allows you to reduce the risk of complications tenfold, reduce the number of bacteria and prevent the formation of other foci of streptococcal inflammation.

Treatment of streptococcal infection with antibiotics

Antibiotic group	Mechanism therapeutic effect	Representatives	Mode of application
Penicillins	Antibiotic molecules bind to enzymes in the bacterial cell wall and destroy them. They are especially effective against bacteria that grow and divide.	Benzylpenicillin	Administer intramuscularly 6 times a day every 4 hours.
		Phenoxymethylpenicillin (penicillin V)	Take orally 3-4 times a day an hour before or 2 hours after meals. Dose for adults: 1 million units 3 times a day.
		Flemoxin Solutab	Take orally before or after meals, 1 g 2 times a day.
		Amoxiclav Combination with clavulanic acid makes the drug more effective against certain types of streptococci.	Used in the form of a suspension for children, tablets or solutions for intravenous administration. The average dosage is 375 mg 3 times a day.
Cephalosporins	They inhibit the synthesis of the peptidoglycan layer, the basis of the bacterial cell membrane. Acts only on growing and multiplying microorganisms.	Cefuroxime-axetine	Prescribed orally, intramuscularly or intravenously 2 times a day, 250-500 mg.
Cephalosporins		Ceftazidime (Fortum) is prescribed when treatment with other antibiotics is ineffective	Administer intramuscularly or intravenously at 1000-2000 mg 2-3 times a day.

Streptococci are different high sensitivity to penicillins and cephalosporins. One of these drugs is prescribed as soon as the diagnosis is made. After receiving the results of the antibiogram, the treatment is adjusted - switching to an antibiotic to which streptococcus is most sensitive.

Is an antibiogram necessary to treat streptococcal infections?

Antibioticogram– determination of the sensitivity of streptococci to various antibiotics. The study is carried out if pathological microorganisms have been identified in quantities exceeding the norm.

An antibioticogram allows you to prescribe rational antibiotic therapy. Stop the growth of streptococci and avoid the prescription of expensive, potent antibiotics that have a number of side effects.

Doctors usually have data on the sensitivity of streptococcus in a given region or hospital. The accumulated experience allows you to quickly prescribe treatment without determining sensitivity to antibiotics. Therefore, in some cases, an antibiogram is not done, but a course of treatment is carried out with one of the above-mentioned drugs.

What are the consequences of streptococcal infection?

Early complications of streptococcal infection caused by the spread of streptococcus through the blood and lymphatic vessels. They are associated with the formation of purulent inflammation in nearby or distant areas.

Occurs on the 5th day of the disease:

peritonsillar abscess - collection of pus around the tonsils
otitis – inflammation of the middle ear
sinusitis - inflammation of the sinuses
meningitis - inflammation of the membranes of the brain
secondary abscesses of internal organs (liver, kidneys)
pneumonia – purulent foci of inflammation of lung tissue
sepsis is a common inflammatory disease associated with the circulation of streptococcus and their toxins in the blood
septic toxic shock – acute reaction the body for the presence of bacteria and toxins in the body.

Late complications of streptococcal infection. Their appearance is associated with the development allergic reaction and aggression of the immune system towards the body’s own tissues. They appear 2-4 weeks after the infection.

acute rheumatic fever is a connective tissue disease that primarily affects the heart, joints and nervous system
poststreptococcal acute glomerulonephritis – inflammation of the kidneys
rheumatic carditis - damage to the heart, which is accompanied by damage to the valves
Rheumatoid arthritis is a systemic disease that predominantly affects small joints.