Diplococcus Pneumoniae
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''Streptococcus pneumoniae'', or pneumococcus, is a Gram-positive, spherical bacteria, alpha-hemolytic (under aerobic conditions) or beta-hemolytic (under anaerobic conditions), aerotolerant anaerobic member of the genus Streptococcus. They are usually found in pairs ( diplococci) and do not form spores and are non motile. As a significant human pathogenic bacterium ''S. pneumoniae'' was recognized as a major cause of pneumonia in the late 19th century, and is the subject of many
humoral immunity Humoral immunity is the aspect of immunity that is mediated by macromolecules - including secreted antibodies, complement proteins, and certain antimicrobial peptides - located in extracellular fluids. Humoral immunity is named so because it in ...
studies. ''Streptococcus pneumoniae'' resides asymptomatically in healthy carriers typically colonizing the respiratory tract, sinuses, and nasal cavity. However, in susceptible individuals with weaker immune systems, such as the elderly and young children, the bacterium may become pathogenic and spread to other locations to cause disease. It spreads by direct person-to-person contact via respiratory droplets and by auto inoculation in persons carrying the bacteria in their upper respiratory tracts. It can be a cause of
neonatal infection Neonatal infections are infections of the neonate (newborn) acquired during prenatal development or in the first four weeks of life (neonatal period). Neonatal infections may be contracted by mother to child transmission, in the birth canal dur ...
s. ''Streptococcus pneumoniae'' is the main cause of community acquired pneumonia and
meningitis Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, headache, and neck stiffness. Other symptoms include confusion or ...
in children and the elderly, and of sepsis in those infected with HIV. The organism also causes many types of pneumococcal infections other than pneumonia. These invasive pneumococcal diseases include bronchitis, rhinitis,
acute sinusitis Sinusitis, also known as rhinosinusitis, is inflammation of the mucous membranes that line the sinuses resulting in symptoms that may include thick nasal mucus, a plugged nose, and facial pain. Other signs and symptoms may include fever, headac ...
, otitis media, conjunctivitis,
meningitis Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, headache, and neck stiffness. Other symptoms include confusion or ...
, sepsis, osteomyelitis, septic arthritis, endocarditis, peritonitis,
pericarditis Pericarditis is inflammation of the pericardium, the fibrous sac surrounding the heart. Symptoms typically include sudden onset of sharp chest pain, which may also be felt in the shoulders, neck, or back. The pain is typically less severe when sit ...
, cellulitis, and brain abscess. ''Streptococcus pneumoniae'' can be differentiated from the viridans streptococci, some of which are also
alpha-hemolytic Hemolysis (from Greek αιμόλυση, meaning 'blood breakdown') is the breakdown of red blood cells. The ability of bacterial colonies to induce hemolysis when grown on blood agar is used to classify certain microorganisms. This is particular ...
, using an
optochin Optochin (or ethylhydrocupreine hydrochloride) is a derivative of quinine introduced in 1911 by Morgenroth and Levy with the intention to treat pneumococci infection. In very high dilutions, it inhibits the growth of representatives of all four gr ...
test, as ''S. pneumoniae'' is optochin-sensitive. ''S. pneumoniae'' can also be distinguished based on its sensitivity to
lysis Lysis ( ) is the breaking down of the membrane of a cell, often by viral, enzymic, or osmotic (that is, "lytic" ) mechanisms that compromise its integrity. A fluid containing the contents of lysed cells is called a ''lysate''. In molecular bio ...
by
bile Bile (from Latin ''bilis''), or gall, is a dark-green-to-yellowish-brown fluid produced by the liver of most vertebrates that aids the digestion of lipids in the small intestine. In humans, bile is produced continuously by the liver (liver bile ...
, the so-called "bile solubility test". The encapsulated, Gram-positive,
coccoid Coccoid means shaped like or resembling a coccus, that is, spherical.The noun coccoid or coccoids may refer to: * a level of organization, characterized by unicellular, non-flagellated, non-amoeboid organisms, with a definite shape, in general b ...
bacteria have a distinctive morphology on Gram stain, lancet-shaped diplococci. They have a
polysaccharide Polysaccharides (), or polycarbohydrates, are the most abundant carbohydrates found in food. They are long chain polymeric carbohydrates composed of monosaccharide units bound together by glycosidic linkages. This carbohydrate can react with wa ...
capsule that acts as a virulence factor for the organism; more than 100 different
serotype A serotype or serovar is a distinct variation within a species of bacteria or virus or among immune cells of different individuals. These microorganisms, viruses, or cells are classified together based on their surface antigens, allowing the epi ...
s are known, and these types differ in virulence, prevalence, and extent of drug resistance.


History

In 1881, the organism, known later in 1886 as the pneumococcus for its role as a cause of pneumonia, was first isolated simultaneously and independently by the U.S. Army physician George Sternberg. and the French chemist
Louis Pasteur Louis Pasteur (, ; 27 December 1822 – 28 September 1895) was a French chemist and microbiologist renowned for his discoveries of the principles of vaccination, microbial fermentation and pasteurization, the latter of which was named afte ...
.. The organism was termed ''Diplococcus pneumoniae'' from 1920 because of its characteristic appearance in Gram-stained
sputum Sputum is mucus that is coughed up from the lower airways (the trachea and bronchi). In medicine, sputum samples are usually used for a naked eye examination, microbiological investigation of respiratory infections and cytological investigations ...
. It was renamed ''Streptococcus pneumoniae'' in 1974 because it was very similar to
streptococci ''Streptococcus'' is a genus of gram-positive ' (plural ) or spherical bacteria that belongs to the family Streptococcaceae, within the order Lactobacillales (lactic acid bacteria), in the phylum Bacillota. Cell division in streptococci occurs ...
. ''Streptococcus pneumoniae'' played a central role in demonstrating that genetic material consists of DNA. In 1928, Frederick Griffith demonstrated transformation of life turning harmless pneumococcus into a lethal form by co-inoculating the live pneumococci into a mouse along with heat-killed virulent pneumococci. In 1944, Oswald Avery, Colin MacLeod, and Maclyn McCarty demonstrated that the transforming factor in Griffith's experiment was not protein, as was widely believed at the time, but DNA. Avery's work marked the birth of the molecular era of genetics.


Genetics

The genome of ''S. pneumoniae'' is a closed, circular DNA structure that contains between 2.0 and 2.1 million
base pair A base pair (bp) is a fundamental unit of double-stranded nucleic acids consisting of two nucleobases bound to each other by hydrogen bonds. They form the building blocks of the DNA double helix and contribute to the folded structure of both DNA ...
s depending on the strain. It has a core set of 1553 genes, plus 154 genes in its virulome, which contribute to virulence and 176 genes that maintain a noninvasive phenotype. Genetic information can vary up to 10% between strains. The pneumococcal genome is known to contain a large and diverse repertoire of antimicrobial peptides, including 11 different lantibiotics.


Transformation

Natural bacterial transformation involves the transfer of DNA from one bacterium to another through the surrounding medium. Transformation is a complex developmental process requiring energy and is dependent on expression of numerous genes. In S. pneumoniae, at least 23 genes are required for transformation. For a bacterium to bind, take up, and recombine
exogenous DNA Exogenous DNA is DNA originating outside the organism of concern or study. Exogenous DNA can be found naturally in the form of partially degraded fragments left over from dead cells. These DNA fragments may then become integrated into the chromoso ...
into its chromosome, it must enter a special physiological state called
competence Competence may refer to: *Competence (geology), the resistance of a rock against deformation or plastic flow. *Competence (human resources), a standardized requirement for an individual to properly perform a specific job *Competence (law), the me ...
. Competence in ''S. pneumoniae'' is induced by DNA-damaging agents such as mitomycin C, fluoroquinolone
antibiotic An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention of ...
s ( norfloxacin, levofloxacin and moxifloxacin), and topoisomerase inhibitors. Transformation protects ''S. pneumoniae'' against the bactericidal effect of mitomycin C. Michod et al. summarized evidence that induction of competence in ''S. pneumoniae'' is associated with increased resistance to oxidative stress and increased expression of the RecA protein, a key component of the recombinational repair machinery for removing DNA damages. On the basis of these findings, they suggested that transformation is an adaptation for repairing oxidative DNA damages. ''S. pneumoniae'' infection stimulates
polymorphonuclear leukocytes Granulocytes are cells in the innate immune system characterized by the presence of specific granules in their cytoplasm. Such granules distinguish them from the various agranulocytes. All myeloblastic granulocytes are polymorphonuclear. They hav ...
(granulocytes) to produce an oxidative burst that is potentially lethal to the bacteria. The ability of ''S. pneumoniae'' to repair the oxidative DNA damages in its genome, caused by this host defense, likely contributes to this pathogen's virulence. Consistent with this premise, Li et al. reported that, among different highly transformable ''S. pneumoniae'' isolates, nasal colonization fitness and virulence (lung infectivity) depend on an intact competence system.


Infection

''Streptococcus pneumoniae'' is part of the normal upper respiratory tract flora. As with many natural flora, it can become pathogenic under the right conditions, typically when the immune system of the host is suppressed.
Invasins Invasins are a class of protein, proteins associated with the penetration of pathogen, pathogens into host cell (biology), cells. Invasins play a role in promoting entry during the initial stage of infection. In 2007, Als3 was identified as a fun ...
, such as
pneumolysin Pneumolysin is a virulence factor of the Gram-positive bacteria ''Streptococcus pneumoniae''. It is a pore-forming toxin of 53 kDa composed of 471 amino acids. It has a range of biological activity, including the ability to lyse and interfere wi ...
, an anti phagocytic capsule, various
adhesins Adhesins are cell-surface components or appendages of bacteria that facilitate adhesion or adherence to other cells or to surfaces, usually in the host they are infecting or living in. Adhesins are a type of virulence factor. Adherence is an essent ...
, and immunogenic cell wall components are all major virulence factors. After ''S. pneumoniae'' colonizes the air sacs of the lungs, the body responds by stimulating the inflammatory response, causing plasma, blood, and white blood cells to fill the alveoli. This condition is called pneumonia.


Diseases and symptoms

Pneumonia is the most common of the ''S. pneumoniae'' diseases which include symptoms such as fever and chills, cough, rapid breathing, difficulty breathing, and chest pain. For the elderly, they may include confusion, low alertness, and the former listed symptoms to a lesser degree. Pneumococcal meningitis is an infection of the tissue covering the brain and spinal cord. Symptoms include stiff neck, fever, headache, confusion, and photophobia. Sepsis is caused by overwhelming response to an infection and leads to tissue damage, organ failure, and even death. The symptoms include confusion, shortness of breath, elevated heart rate, pain or discomfort, over-perspiration, fever, shivering, or feeling cold.


Vaccine

Due to the importance of disease caused by ''S. pneumoniae'', several vaccines have been developed to protect against invasive infection. The World Health Organization recommends routine childhood pneumococcal vaccination; it is incorporated into the childhood immunization schedule in a number of countries including the United Kingdom, the United States, and South Africa.


Biotechnology

Components from ''S. pneumoniae'' have been harnessed for a range of applications in biotechnology. Through engineering of surface molecules from this bacterium, proteins can be irreversibly linked using the sortase enzyme or using the SnoopTag/SnoopCatcher reaction. Various glycoside hydrolases have also been cloned from ''S. pneumoniae'' to help analysis of cell
glycosylation Glycosylation is the reaction in which a carbohydrate (or ' glycan'), i.e. a glycosyl donor, is attached to a hydroxyl or other functional group of another molecule (a glycosyl acceptor) in order to form a glycoconjugate. In biology (but not al ...
.


Interaction with ''Haemophilus influenzae''

Historically, '' Haemophilus influenzae'' has been a significant cause of infection, and both ''H. influenzae'' and ''S. pneumoniae'' can be found in the human upper respiratory system. A study of competition '' in vitro'' revealed ''S. pneumoniae'' overpowered ''H. influenzae'' by attacking it with hydrogen peroxide. However, in a study adding both bacteria to the nasal cavity of a
mouse A mouse ( : mice) is a small rodent. Characteristically, mice are known to have a pointed snout, small rounded ears, a body-length scaly tail, and a high breeding rate. The best known mouse species is the common house mouse (''Mus musculus' ...
within two weeks, only ''H. influenzae'' survives; further analysis showed that neutrophils exposed to dead ''H. influenzae'' were more aggressive in attacking ''S. pneumoniae''.Full text
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Diagnosis

Diagnosis is generally made based on clinical suspicion along with a positive culture from a sample from virtually any place in the body. ''S. pneumoniae'' is, in general,
optochin Optochin (or ethylhydrocupreine hydrochloride) is a derivative of quinine introduced in 1911 by Morgenroth and Levy with the intention to treat pneumococci infection. In very high dilutions, it inhibits the growth of representatives of all four gr ...
sensitive, although optochin resistance has been observed. The recent advances in next-generation sequencing and
comparative genomics Comparative genomics is a field of biological research in which the genomic features of different organisms are compared. The genomic features may include the DNA sequence, genes, gene order, regulatory sequences, and other genomic structural lan ...
have enabled the development of robust and reliable molecular methods for the detection and identification of ''S. pneumoniae''. For instance, the ''Xisco'' gene was recently described as a biomarker for PCR-based detection of ''S. pneumoniae'' and differentiation from closely related species. Atromentin and leucomelone possess antibacterial activity, inhibiting the enzyme
enoyl-acyl carrier protein reductase Enoyl-acyl carrier protein reductase (or ENR) (), is a key enzyme of the type II fatty acid synthesis (FAS) system. ENR is an attractive target for narrow-spectrum antibacterial drug discovery because of its essential role in metabolism and its seq ...
, (essential for the
biosynthesis Biosynthesis is a multi-step, enzyme-catalyzed process where substrates are converted into more complex products in living organisms. In biosynthesis, simple compounds are modified, converted into other compounds, or joined to form macromolecules. ...
of fatty acids) in ''S. pneumoniae''.


Resistance

Resistant pneumococcal strains are called penicillin-resistant pneumococci (PRP), penicillin-resistant ''Streptococcus pneumoniae'' (PRSP), ''Streptococcus pneumoniae'' penicillin resistant (SPPR) or drug-resistant ''Strepotococcus pneumoniae'' (DRSP). In 2015, in the US, there were an estimated 30,000 cases, and in 30% of them the strains were resistant to one or more antibiotics.


See also

* Transformation (genetics) *
Pneumococcal Awareness Council of Experts The Pneumococcal Awareness Council of Experts (PACE) is a project of the Sabin Vaccine Institute and is composed of global experts in infectious diseases and vaccines. Established in December 2006, The Council seeks to raise awareness among policy ...


References


External links


GAVI Alliance

PneumoADIP

PATH's Vaccine Resource Library pneumococcal resources
*
Type strain of ''Streptococcus pneumoniae'' at Bac''Dive'' - the Bacterial Diversity Metadatabase
{{Taxonbar, from=Q221179 Bacteria described in 1884 Gram-positive bacteria Pathogenic bacteria Pneumonia Polysaccharide encapsulated bacteria Streptococcaceae