Chapter 6 : Variable Capacity for Persistent Infection and Complications of Gram-Positive Cocci: Streptococci and Staphylococci

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This chapter focuses on two clinically important gram-positive genera, and , and the complications and persistent infections caused by these bacteria. Many streptococci are part of the normal flora of the mouth, skin, intestine, and upper respiratory tract. In the clinical laboratory, streptococci are differentiated based on their hemolytic properties on blood agar plates. Beta-hemolytic streptococci fully break down red blood cells, leaving a clear zone of true hemolysis around colonies. Beta-hemolytic streptococci are further divided into separate groups based on their Lancefield antigens. As with other streptococci, peptidoglycan and teichoic acid are the principal constituents of the pneumococcal cell wall. Non-dextran-producing streptococci may produce infective endocarditis (IE) in humans and adhere to artificial fibrinplatelet surfaces in vitro, which suggests that other characteristics are required. Ubiquitous colonizers of the skin and mucosa of most animals, the staphylococci are gram-positive cocci found singly, in pairs, or in grape-like clusters. Persistent infection is heavily mediated by the ability to elaborate biofilm. Biofilm-producing staphylococci are described primarily as coagulase-negative staphylococci (CoNS), and they are implicated in colonization and persistence on catheters and other prosthetic materials. Prosthetic devices can become contaminated with staphylococci at the time of insertion or due to contiguous spread of infection or through hematogenous seeding at the time of bacteremia. The most important predictors of complicated infection include persistent fever or bacteremia.

Citation: Ferguson B, Woods C. 2009. Variable Capacity for Persistent Infection and Complications of Gram-Positive Cocci: Streptococci and Staphylococci, p 87-106. In Fratamico P, Smith J, Brogden K (ed), Sequelae and Long-Term Consequences of Infectious Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555815486.ch6
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Figure 1.

Electron micrograph of glomerular capillary wall in acute poststreptococcal glomerulonephritis showing hemispherical electron-dense deposit (“humps”) in subepithelial space. (Courtesy of David Howell.)

Citation: Ferguson B, Woods C. 2009. Variable Capacity for Persistent Infection and Complications of Gram-Positive Cocci: Streptococci and Staphylococci, p 87-106. In Fratamico P, Smith J, Brogden K (ed), Sequelae and Long-Term Consequences of Infectious Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555815486.ch6
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Table 1.

Diagnosis of acute rheumatic fever: the Jones criteria ( )

Citation: Ferguson B, Woods C. 2009. Variable Capacity for Persistent Infection and Complications of Gram-Positive Cocci: Streptococci and Staphylococci, p 87-106. In Fratamico P, Smith J, Brogden K (ed), Sequelae and Long-Term Consequences of Infectious Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555815486.ch6

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