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(strĕp'təkŏk`əs), any of a group of gram-positive bacteria, genus Streptococcus, some of which cause disease. Streptococci are spherical and divide by fission, but they remain attached and so grow in beadlike chains. The incidence and severity of streptococcal diseases decreased dramatically after the introduction of antibioticsantibiotic,
any of a variety of substances, usually obtained from microorganisms, that inhibit the growth of or destroy certain other microorganisms. Types of Antibiotics
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 (penicillin, erythromycin, and selected cephalosporins are all effective against the organisms), but the medical community was shaken by the arrival in the late 1980s of several severe forms of streptococcal infection and by the emergence of several drug-resistant strains (see drug resistancedrug resistance,
condition in which infecting bacteria can resist the destructive effects of drugs such as antibiotics and sulfa drugs. Drug resistance has become a serious public health problem, since many disease-causing bacteria are no longer susceptible to previously
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Types of Streptococci

Streptococci are classified into the alpha, beta, or gamma groups, according to their action on blood cells. Streptococci of the alpha group (e.g., the viridans and S. pneumoniae) cause some destruction (hemolysis) of red blood cells. The beta group are more destructive of red blood cells; they also produce toxic substances that affect white blood cells and the clotting properties of blood. Members of these two groups are sometimes called hemolytic (red blood cell–destroying) streptococci. The beta-hemolytic streptococci are often further classified into several lettered groups, called Lancefield groups for R. C. Lancefield, the scientist who originated the scheme in the 1930s. Group A hemolytic streptococci are responsible for most human streptococcal disease; group B hemolytic streptococci can cause serious problems, such as septicemia and meningitis, especially in newborns. The gamma group, or nonhemolytic group, does not affect red blood cells. Enterococci (usually harmless bacteria that inhabit the intestines) and lactococci (bacteria used in starter cultures in the production of fermented dairy products) used to be considered a part of the Streptococcus genus but are now placed in their own genera.

S. pneumoniae and Viridans Infections

The viridans are normal inhabitants of the body and are usually harmless; however, they can contribute to tooth decay. Streptococcus pneumoniae is the most common cause of otitis media in children. It can also cause meningitis and pneumonia. The S. pneumoniae diseases are sometimes referred to as pneumococcal diseases. The development of drug-resistant strains of pneumococci has caused concern in the medical community. Vaccination against pneumococcal pneumonia is recommended for very young children and older persons; the vaccine inoculates against the most prevalent strains of S. pneumoniae.

Group A Streptococcal Infections

Group A hemolytic streptococci cause over a dozen diseases, including some pneumonias, erysipelaserysipelas
, acute infection of the skin characterized by a sharply demarcated, shiny red swelling, accompanied by high fever and a feeling of general illness. The causative agent is the hemolytic streptococcus, which often enters the body through a break in the skin.
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 (a generalized body infection), upper respiratory infections, wound infections, and puerperal fever. Scarlet feverscarlet fever
or scarlatina,
an acute, communicable infection, caused by group A hemolytic streptococcal bacteria (see streptococcus) that produce an erythrogenic toxin.
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 is also a streptococcal, or strep, infection; the rash is a response to a toxintoxin,
poison produced by living organisms. Toxins are classified as either exotoxins or endotoxins. Exotoxins are a diverse group of soluble proteins released into the surrounding tissue by living bacterial cells. Exotoxins have specific reaction sites in the host; e.g.
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 produced by the bacteria that cause strep throat. Rheumatic feverrheumatic fever
, systemic inflammatory disease, extremely variable in its manifestation, severity, duration, and aftereffects. It is frequently followed by serious heart disease, especially when there are repeated attacks. Rheumatic fever usually affects children.
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 follows an initial Group A streptococcal infection: proteins of the streptococcal cells stimulate antibody formation by the body (see immunityimmunity,
ability of an organism to resist disease by identifying and destroying foreign substances or organisms. Although all animals have some immune capabilities, little is known about nonmammalian immunity.
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), and these antistreptococcal antibodies are believed to react with and damage many tissues of the body, especially heart muscle. Kidney disease (acute glomerulonephritis) is another complication of streptococcal infections. Some extremely serious Group A streptococcal infections began to emerge or reemerge in the late 1980s. Streptococcal toxic shock syndrome is a rapidly progressing infection, similar to septicemiasepticemia
, invasion of the bloodstream by virulent bacteria that multiply and discharge their toxic products. The disorder, which is serious and sometimes fatal, is commonly known as blood poisoning.
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 or toxic shock syndrometoxic shock syndrome
(TSS). acute, sometimes fatal, disease characterized by high fever, nausea, diarrhea, lethargy, blotchy rash, and sudden drop in blood pressure. It is caused by Staphylococcus aureus,
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, that usually infects people in their 20s or 30s. It causes blood pressure to fall rapidly and organs to fail. Necrotizing fasciitisnecrotizing fasciitis,
a quickly progressing infection of the skin that spreads along the fascia, the tissue that covers the muscles. (Necrotizing infections that spread along the outer skin layers are known as necrotizing cellulitis.
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 is a quickly spreading infection of the flesh and muscle caused by toxins released by S. pyrogenes. Such bacteria are popularly called "flesh-eating bacteria."

Group B Streptococcal Infections

Group B streptococci are a common cause of infection in babies, pregnant women, the elderly, and immunologically compromised adults. They are especially serious in newborns, in whom they can cause sepsis, meningitis, or pneumonia. Group B streptococci are often present in people who show no symptoms of disease; these people are said to be "colonized." Many infants are colonized before or during birth by mothers who unknowingly carry the bacteria. A small percentage of these develop disease, which can be life-threatening or can lead to lifelong neurological problems.


See M. P. Starr et al., ed., The Prokaryotes: A Handbook on Habitats, Isolation and Identification of Bacteria (1981).


A large genus of spherical or ovoid bacteria that are characteristically arranged in pairs or in chains resembling strings of beads. Many of the streptococci that constitute part of the normal flora of the mouth, throat, intestine, and skin are harmless commensal forms; other streptococci are highly pathogenic. The cells are gram-positive and can grow either anaerobically or aerobically, although they cannot utilize oxygen for metabolic reactions. Glucose and other carbohydrates serve as sources of carbon and energy for growth. All members of the genus lack the enzyme catalase. Streptococci can be isolated from humans and other animals.

Streptococcus pyogenes is well known for its participation in many serious infections. It is a common cause of throat infection, which may be followed by more serious complications such as rheumatic fever, glomerulonephritis, and scarlet fever. Other beta-hemolytic streptococci participate in similar types of infection, but they are usually not associated with rheumatic fever and glomerulonephritis. Group B streptococci, which are usually beta-hemolytic, cause serious infections in newborns (such as meningitis) as well as in adults. Among the alpha-hemolytic and nonhemolytic streptococci, S. pneumoniae is an important cause of pneumonia and other respiratory infections. Vaccines that protect against infection by the most prevalent capsular serotypes are available. The viridans streptococci comprise a number of species commonly isolated from the mouth and throat. Although normally of low virulence, these streptococci are capable of causing serious infections (endocarditis, abcesses).



a spherical bacterium (0.6–1 microns in diameter) that reproduces by cell division in one plane, resulting in a chain of cells of different lengths. Streptococci are nonsporeforming, nonmotile, and gram-positive and grow well on agarculture mediums. They ferment sugars and alcohols. Some streptococcal species are of practical importance; for example, Streptococcus lactis, which ferments lactose to form lactic acid, is used to obtain clabber and other sour-milk products. Some species form the polysaccharide dextran, which is used to produce a blood substitute. Pathogenic streptococci may cause tonsillitis, erysipelas, suppuration, and blood infections. Some are capable of dissolving erythrocytes (hemolysis).

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