Streptococcus - anaerobes
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|Streptococcus pyogenes Group A
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|Streptococcus agalactiae Group B
|Streptococcus - anaerobes
|Microbiology and Assessment of Streptococcus
📖 About
- Includes anaerobic cocci such as Peptococcus and Peptostreptococcus.
- Normal commensals but opportunistic pathogens in mixed infections.
🔬 Characteristics
- Gram-positive cocci, usually in chains or pairs.
- Non-motile, non-spore forming.
- Strictly anaerobic (slow-growing, require enriched culture media).
🏠 Source
- Part of normal flora of the gastrointestinal tract and female genital tract.
- Also present in the oral cavity.
⚠️ Pathogenicity
- 💢 Abscesses: abdominal, pelvic, brain, lung.
- 🦷 Dental infections (periodontitis, oral abscesses).
- 👩🍼 Pelvic inflammatory disease.
- Often polymicrobial, especially with anaerobes (e.g. Bacteroides) and coliforms.
🧪 Investigations
- Bloods: FBC, U&E, CRP for systemic infection and inflammation.
- Culture: Anaerobic cultures from pus/aspirates (may require special transport media).
- Imaging: CT or ultrasound to locate deep-seated abscesses.
💊 Sensitivity
- Usually sensitive to Penicillin and Metronidazole.
- Variable resistance may occur, so always check culture results.
🩺 Management
- 🔧 Drainage: Abscesses require surgical or radiological drainage - antibiotics alone are rarely sufficient.
- 💊 Antibiotic Therapy:
- First-line: Penicillin + Metronidazole (broad anaerobic cover).
- Penicillin allergy: Clindamycin or a Carbapenem (e.g. meropenem).
- Duration: Typically 2–4 weeks, longer if deep abscess or slow clinical response.
- 💧 Supportive Care: Hydration, electrolyte monitoring, pain relief, antipyretics.
- 🖥️ Monitoring: Repeat imaging for deep infections to ensure resolution.
- 📅 Follow-up: Outpatient review for prolonged antibiotic courses or post-surgical recovery.
