{"id":465,"date":"2022-04-04T08:42:15","date_gmt":"2022-04-04T02:57:15","guid":{"rendered":"http:\/\/bacteriologynotes.com\/?p=265"},"modified":"2022-09-20T01:57:53","modified_gmt":"2022-09-19T20:12:53","slug":"laboratory-diagnosis-treatment-and-prevention-of-streptococcus-pneumoniae","status":"publish","type":"post","link":"https:\/\/microbenotes.com\/laboratory-diagnosis-treatment-and-prevention-of-streptococcus-pneumoniae\/","title":{"rendered":"Laboratory diagnosis, Treatment and Prevention of Streptococcus pneumoniae"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_65 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title \" >Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #0a0a0a;color:#0a0a0a\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #0a0a0a;color:#0a0a0a\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/microbenotes.com\/laboratory-diagnosis-treatment-and-prevention-of-streptococcus-pneumoniae\/#laboratory-diagnosis-of-streptococcus-pneumoniae\" title=\"Laboratory diagnosis of Streptococcus pneumoniae\">Laboratory diagnosis of Streptococcus pneumoniae<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/microbenotes.com\/laboratory-diagnosis-treatment-and-prevention-of-streptococcus-pneumoniae\/#treatment-of-streptococcus-pneumoniae\" title=\"Treatment\u00a0of Streptococcus pneumoniae\">Treatment\u00a0of Streptococcus pneumoniae<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/microbenotes.com\/laboratory-diagnosis-treatment-and-prevention-of-streptococcus-pneumoniae\/#prevention-and-control-of-streptococcus-pneumoniae\" title=\"Prevention and control\u00a0of Streptococcus pneumoniae\">Prevention and control\u00a0of Streptococcus pneumoniae<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"laboratory-diagnosis-of-streptococcus-pneumoniae\"><\/span><span style=\"color: #000000;\"><strong>Laboratory diagnosis of <em>Streptococcus pneumoniae<\/em><\/strong><\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"color: #000000;\"><strong>Specimen<\/strong><strong>: <\/strong>Sputum, blood, endotracheal aspirate, bronchoalveolar lavage, cerebrospinal fluid (CSF), pleural fluid, joint fluid, abscess fluid, bones, and other biopsy material.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Microscopy<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Gram staining of sputum shows lancet shaped Gram-positive cocci in pairs.<\/span><\/li>\n<li><span style=\"color: #000000;\">Fresh emulsified sputum mixed with antiserum causes capsule swelling (the quellung reaction) for identification of pneumococci.<\/span><\/li>\n<li><span style=\"color: #000000;\">In acute pneumococcal otitis media, Gram stain of an aspirated fluid smear from middle ear is useful to demonstrate the bacteria.<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong>Culture<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Sputum or blood is plated on blood agar and incubated at 37\u00b0 C in the presence of 5\u201310% carbon dioxide.<\/span><\/li>\n<li><span style=\"color: #000000;\">Gray colonies with alpha-hemolysis are observed after overnight incubation.<\/span><\/li>\n<li><span style=\"color: #000000;\">Diagnosis of pneumococcal meningitis is confirmed by CSF culture.<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong>Identification of bacteria <\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\"><strong>Optochin sensitivity test<\/strong><\/span>\n<ul>\n<li><span style=\"color: #000000;\"><em>S. pneumoniae <\/em>is identified by its sensitivity to optochin (ethylhydrocupreine dihydrochloride).<\/span><\/li>\n<li><span style=\"color: #000000;\">The isolate is streaked onto a blood agar plate and a disk saturated with optochin is placed in the middle of the inoculum.<\/span><\/li>\n<li><span style=\"color: #000000;\">A zone of inhibited bacterial growth is seen around the disk after overnight incubation.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color: #000000;\"><strong>Bile solubility test<\/strong><\/span>\n<ul>\n<li><span style=\"color: #000000;\">It detects an autolytic enzyme, amidase, present in pneumococci, which breaks the bond between alanine and muramic acid of the peptidoglycan of the pneumococcal cell wall.<\/span><\/li>\n<li><span style=\"color: #000000;\">Isolates of <em>S.\u00a0pneumoniae <\/em>are lysed rapidly when the autolysins are activated after exposure to bile.<\/span><\/li>\n<li><span style=\"color: #000000;\">Thus the organism can be identified by placing a drop of bile on an isolated colony.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color: #000000;\"><strong>Inulin fermentation test<\/strong><\/span>\n<ul>\n<li><span style=\"color: #000000;\">It ferments inulin and hence differentiate it from other streptococci.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong>Animal inoculation<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\"><em>S. pneumoniae <\/em>can be isolated from clinical specimens containing few pneumococci by intraperitoneal inoculation in mice.<\/span><\/li>\n<li><span style=\"color: #000000;\">Pneumococci are demonstrated in the peritoneal exudate and heart blood of the mice, which die 1\u20133 days after inoculation.<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong>Antigen detection <\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Pneumococcal C polysaccharide is excreted in urine and can be detected using a commercially prepared immunoassay.<\/span><\/li>\n<li><span style=\"color: #000000;\">The CIEP is a useful test to detect pneumococcal capsular polysaccharide antigen in the CSF for diagnosis of meningitis, and in the blood or urine for diagnosis of bacteremia and pneumonia.<\/span><\/li>\n<li><span style=\"color: #000000;\">Latex agglutination test using the latex particles coated with anti-CRP antibody is employed to detect C reactive protein.<\/span><\/li>\n<li><span style=\"color: #000000;\">The CRP is used as a prognostic marker in acute cases of acute pneumococcal pneumonia, acute rheumatic fever, and other infectious diseases.<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong>Antibody detection <\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">The indirect hemagglutination, indirect fluorescent antibody test, and ELISA are used to demonstrate specific pneumococcal antibodies in invasive pneumococcal diseases.<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong>Nucleic Acid\u2013Based Tests<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Nucleic acid probes and PCR assays are used for identification of <em>S.\u00a0pneumoniae <\/em>isolates in culture.<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-266\" src=\"https:\/\/microbenotes.com\/wp-content\/uploads\/2018\/01\/Laboratory-diagnosis-Treatment-and-Prevention-of-Streptococcus-pneumoniae.jpg\" alt=\"Laboratory diagnosis, Treatment and Prevention of Streptococcus pneumoniae\" width=\"700\" height=\"400\" \/><\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"treatment-of-streptococcus-pneumoniae\"><\/span><span style=\"color: #000000;\"><strong>Treatment\u00a0of <em>Streptococcus pneumoniae<\/em><\/strong><\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li><span style=\"color: #000000;\">Most pneumococci are susceptible to penicillin.<\/span><\/li>\n<li><span style=\"color: #000000;\">Other antibiotics, such as macrolides or selected fluoroquinolones with activity against pneumococci, are available for patients who are allergic to penicillin.<\/span><\/li>\n<li><span style=\"color: #000000;\">Penicillin-resistant pneumococci are being increasingly documented.<\/span><\/li>\n<li><span style=\"color: #000000;\">The mechanism of this resistance is an alteration of one or more of the bacterium\u2019s penicillin-binding proteins (PBPs) rather than production of beta-lactamase.<\/span><\/li>\n<li><span style=\"color: #000000;\">Most resistant strains remain sensitive to third generation cephalosporins (such as cefotaxime or ceftriaxone), and all are still sensitive to vancomycin.<\/span><\/li>\n<li><span style=\"color: #000000;\">For serious pneumococcal infections, treatment with a combination of antibiotics is recommended. Vancomycin combined with ceftriazone is used commonly for empiric treatment, followed by monotherapy with an effective cephalosporin, fluoroquinolone or vancomycin.<\/span><\/li>\n<li><span style=\"color: #000000;\">Ceftriaxone can be used for meningitis caused by ceftriaxone-susceptible pneumococci.<\/span><\/li>\n<li><span style=\"color: #000000;\">Amoxicillin is the drug of choice for treatment of otitis media, sinusitis, and pneumonia caused by penicillin-resistant pneumococci with intermediate resistance.<\/span><\/li>\n<li><span style=\"color: #000000;\">Ceftriaxone is the drug of choice for non-CNS invasive pneumococcal diseases caused by penicillin- and ceftriaxone resistant pneumococci.<\/span><\/li>\n<li><span style=\"color: #000000;\">Vancomycin is used if the pneumococcus is resistant to ceftriaxone.<\/span><\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"prevention-and-control-of-streptococcus-pneumoniae\"><\/span><span style=\"color: #000000;\"><strong>Prevention and control\u00a0of <em>Streptococcus pneumoniae<\/em><\/strong><\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li><span style=\"color: #000000;\">Pneumococcal vaccines: 23 valent pneumococcal polysaccharide vaccine (PPSV23) and polyvalent pneumococcal conjugate vaccine (PCV13) play an important role in prevention of pneumococcal diseases.<\/span><\/li>\n<li><span style=\"color: #000000;\">Personal hygiene is another important factor.<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Laboratory diagnosis of Streptococcus pneumoniae Specimen: Sputum, blood, endotracheal aspirate, bronchoalveolar lavage, cerebrospinal fluid (CSF), pleural fluid, joint fluid, abscess fluid, bones, and other biopsy material. Microscopy Gram staining of &#8230; <a title=\"Laboratory diagnosis, Treatment and Prevention of Streptococcus pneumoniae\" class=\"read-more\" href=\"https:\/\/microbenotes.com\/laboratory-diagnosis-treatment-and-prevention-of-streptococcus-pneumoniae\/\" aria-label=\"Read more about Laboratory diagnosis, Treatment and Prevention of Streptococcus pneumoniae\">Read more<\/a><\/p>\n","protected":false},"author":1,"featured_media":381,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[364],"tags":[378,31,500,506,507,520,592,126,634,349,357,184,679],"custom":{"td_video":"","featured_image":"https:\/\/microbenotes.com\/wp-content\/uploads\/2018\/01\/Laboratory-diagnosis-Treatment-and-Prevention-of-Streptococcus-pneumoniae.jpg","author":{"name":"Sagar Aryal","avatar":"https:\/\/secure.gravatar.com\/avatar\/862472ea06500d4318f1ad82addb608e?s=96&d=mm&r=g"},"categories":[{"term_id":364,"name":"Bacteriology","slug":"bacteriology","term_group":0,"term_taxonomy_id":364,"taxonomy":"category","description":"<strong>Bacteriology is a branch or discipline of science that studies different characteristics of bacteria and their association with other organisms or disciplines.<\/strong>\r\n<ul>\r\n \t<li>Over the years, the discipline of bacteriology has evolved from the microbiological tests performed only by physicians, the application of the germ theory of disease and economic concerns relating to the spoilage of foods and wine to the use of bacteria to simpler forms of laboratory tests and the production of new nutritious food and antibiotics.<\/li>\r\n \t<li>The study of bacteria began with the discovery of the microscope and was mostly limited to experts and scientists of that time.<\/li>\r\n \t<li>The initial advances in pathogenic bacteriology began with the identification and characterization of bacteria associated with specific diseases.<\/li>\r\n \t<li>Nowadays, however, bacteriology is used in various other fields like food, pharmaceuticals, agriculture, and the environment.<\/li>\r\n \t<li>Significant advances made in bacteriology over the last century have resulted in the development of many useful vaccines like pneumococcal polysaccharide vaccine, diphtheria toxoid as well as antibiotics.<\/li>\r\n \t<li>At present, most bacterial diseases in humans and their infectious agents have been identified, although significant variants continue to evolve and sometimes emerge.<\/li>\r\n \t<li>Studies made in bacteriology have also allowed the use of gene recombination technology in bacteria to produce improved bacterial strains that can then be used in various areas.<\/li>\r\n \t<li>The importance of bacteriology continues to grow throughout the years as many diseases and disorders associated with almost all living beings are caused by bacteria.<\/li>\r\n \t<li>Studies of non-pathogenic bacteria that exist in a symbiotic relationship with plants and animals are even beneficial to said organisms.<\/li>\r\n \t<li>The identification and classification of bacteria into different groups have allowed for a convenient way of studying these bacteria and the formation of a separate branch, systemic bacteriology, that deals with taxonomy.<\/li>\r\n \t<li>Besides, bacteriological studies, subsequently, have also been divided into different areas like soil bacteriology, public-health bacteriology, industrial bacteriology, etc.<\/li>\r\n \t<li>Bacteriological studies have been the focal point for disease diagnosis and treatment, and their importance continues to grow with the emergence of new bacteria and associated diseases.<\/li>\r\n<\/ul>","parent":0,"count":124,"filter":"raw","cat_ID":364,"category_count":124,"category_description":"<strong>Bacteriology is a branch or discipline of science that studies different characteristics of bacteria and their association with other organisms or disciplines.<\/strong>\r\n<ul>\r\n \t<li>Over the years, the discipline of bacteriology has evolved from the microbiological tests performed only by physicians, the application of the germ theory of disease and economic concerns relating to the spoilage of foods and wine to the use of bacteria to simpler forms of laboratory tests and the production of new nutritious food and antibiotics.<\/li>\r\n \t<li>The study of bacteria began with the discovery of the microscope and was mostly limited to experts and scientists of that time.<\/li>\r\n \t<li>The initial advances in pathogenic bacteriology began with the identification and characterization of bacteria associated with specific diseases.<\/li>\r\n \t<li>Nowadays, however, bacteriology is used in various other fields like food, pharmaceuticals, agriculture, and the environment.<\/li>\r\n \t<li>Significant advances made in bacteriology over the last century have resulted in the development of many useful vaccines like pneumococcal polysaccharide vaccine, diphtheria toxoid as well as antibiotics.<\/li>\r\n \t<li>At present, most bacterial diseases in humans and their infectious agents have been identified, although significant variants continue to evolve and sometimes emerge.<\/li>\r\n \t<li>Studies made in bacteriology have also allowed the use of gene recombination technology in bacteria to produce improved bacterial strains that can then be used in various areas.<\/li>\r\n \t<li>The importance of bacteriology continues to grow throughout the years as many diseases and disorders associated with almost all living beings are caused by bacteria.<\/li>\r\n \t<li>Studies of non-pathogenic bacteria that exist in a symbiotic relationship with plants and animals are even beneficial to said organisms.<\/li>\r\n \t<li>The identification and classification of bacteria into different groups have allowed for a convenient way of studying these bacteria and the formation of a separate branch, systemic bacteriology, that deals with taxonomy.<\/li>\r\n \t<li>Besides, bacteriological studies, subsequently, have also been divided into different areas like soil bacteriology, public-health bacteriology, industrial bacteriology, etc.<\/li>\r\n \t<li>Bacteriological studies have been the focal point for disease diagnosis and treatment, and their importance continues to grow with the emergence of new bacteria and associated diseases.<\/li>\r\n<\/ul>","cat_name":"Bacteriology","category_nicename":"bacteriology","category_parent":0}]},"_links":{"self":[{"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/posts\/465"}],"collection":[{"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/comments?post=465"}],"version-history":[{"count":0,"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/posts\/465\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/media\/381"}],"wp:attachment":[{"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/media?parent=465"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/categories?post=465"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/tags?post=465"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}