Streptococcal infection is a number of pathologies of bacterial etiology that have a variety of manifestations. The causative agent of diseases is streptococcus, which can be found in the environment - soil, plants and on the human body.

Hemolytic streptococci cause an infection that causes a variety of pathologies - , erysipelas, abscesses, boils, osteomyelitis, endocarditis, rheumatism, glomerulonephritis, sepsis. These diseases are closely related due to a common etiological factor, similar clinical and morphological changes, epidemiological patterns, and pathogenetic links.

Streptococcus groups

According to the type of hemolysis of erythrocytes - red blood cells, streptococci are divided into:

• Green or alpha-hemolytic - Streptococcus viridans, Streptococcus pneumoniae;
• Beta-hemolytic - Streptococcus pyogenes;
• Non-hemolytic - Streptococcus anhaemolyticus.

Streptococci with beta-hemolysis are medically significant:

Non-hemolytic or viridescent streptococci are saprophytic microorganisms, quite rare disease-causing in a person.

Separately isolated thermophilic streptococcus, which belongs to the group of lactic acid bacteria and is used in Food Industry for the preparation of lactic acid products. Since this microbe ferments lactose and other sugars, it is used to treat individuals with lactase deficiency. Thermophilic streptococcus has a bactericidal effect against certain pathogenic microorganisms, and is also used to prevent regurgitation in newborns.

Etiology

The causative agent of streptococcal infection is beta-hemolytic streptococcus, which can destroy red blood cells. Streptococci are globular bacteria- Gram-positive cocci, located in a smear in the form of chains or in pairs.

Microbial pathogenicity factors:

• Streptolysin is a poison that destroys blood and heart cells,
• Scarlatinal erythrogenin - a toxin that dilates capillaries and contributes to the formation of a scarlatinal rash,
• Leukocidin - an enzyme that destroys white blood cells and causes dysfunction of the immune system,
• Necrotoxin,
• lethal toxin,
• Enzymes that ensure the penetration and spread of bacteria in tissues - hyaluronidase, streptokinase, amylase, proteinase.

Streptococci are resistant to heat, freezing, drying and are highly sensitive to the effects of chemical disinfectants and antibiotics - penicillin, erythromycin, oleandomycin, streptomycin. They can persist for a long time in dust and on surrounding objects, but at the same time they gradually lose their pathogenic properties. Enterococci are the most persistent of all microbes in this group.

Streptococci - facultative anaerobes. These bacteria are immobile and do not form spores. They grow only on selective media prepared with the addition of serum or blood. In sugar broth they form near-wall growth, and on dense media they form small, flat, translucent colonies. Pathogenic bacteria form a zone of transparent or green hemolysis. Almost all streptococci are biochemically active: they ferment carbohydrates with the formation of acid.

Epidemiology

The source of infection is a sick person or an asymptomatic carrier.

Ways of infection with streptococcus:

1. Contact,
2. airborne,
3. food,
4. Sexual,
5. Organ infection genitourinary system in case of non-compliance with the rules of personal hygiene.

The most dangerous for others are patients with streptococcal lesions of the throat. During coughing, sneezing, talking, microbes enter the external environment, dry out and circulate in the air along with dust.

With streptococcal inflammation of the skin of the hands, bacteria often get into food, multiply and release toxins. This leads to the development of food poisoning.

Streptococcus in the nose causes c characteristic symptoms and persistent flow.

Streptococcus in adults

Streptococcal throat infection occurs in adults in the form of tonsillitis or pharyngitis.

Pharyngitis - acute inflammatory disease pharyngeal mucosa of viral or bacterial etiology. Streptococcal pharyngitis is characterized by an acute onset, short incubation, intense.

Pharyngitis

The disease begins with general malaise, subfebrile temperature, chilling. Sore throat is so severe that patients lose their appetite. Perhaps the appearance of signs of dyspepsia - vomiting, nausea, epigastric pain. Inflammation of the pharynx of streptococcal etiology is usually accompanied by coughing and hoarseness.

Pharyngoscopy reveals hyperemic and edematous mucous membranes of the pharynx with hypertrophy of the tonsils and lymph nodes, which are covered with plaque. Bright red follicles appear on the mucous membrane of the oropharynx, shaped like a bagel. Then there is rhinorrhea with maceration of the skin under the nose.

Streptococcal pharyngitis does not last long and goes away spontaneously. It rarely occurs in children under 3 years of age. Usually the disease affects the elderly and young people, whose body is weakened by long-term current ailments.

Complications of pharyngitis are:

1. Purulent otitis media,
2. Sinusitis,
3. Lymphadenitis;
4. Distant foci of purulent inflammation - arthritis, osteomyelitis.

Streptococcus in the throat also causes acute tonsillitis, which, in the absence of timely and adequate treatment, often becomes the cause autoimmune diseases- myocarditis and glomerulonephritis.

Factors contributing to the development of streptococcal tonsillitis:

• Weakening of local immune defense,
• Decrease in the general resistance of the organism,
• hypothermia,
• Negative impact of environmental factors.

Streptococcus enters the mucous membrane of the tonsils, multiplies, produces pathogenicity factors, which leads to the development of local inflammation. Microbes and their toxins penetrate the lymph nodes and blood, causing acute lymphadenitis, general intoxication, damage to the central nervous system with the appearance of anxiety, convulsive syndrome, meningeal symptoms.

Clinic of angina:

1. Intoxication syndrome - fever, malaise, body aches, arthralgia, myalgia, headache;
2. Regional lymphadenitis;
3. Constant pain in the throat;
4. Children have dyspepsia;
5. Edema and hyperemia of the pharynx, hypertrophy of the tonsils, the appearance of purulent, loose, porous plaque on them, easily removed with a spatula,
6. In the blood - leukocytosis, accelerated ESR, the appearance of C-reactive protein.

Complications of streptococcal tonsillitis are divided into purulent - otitis, sinusitis and non-purulent - glomerulonephritis, rheumatism, toxic shock.

Streptococcus in children

Group A hemolytic streptococcus in children usually causes inflammation of the respiratory system, skin and the organ of hearing.

Diseases of streptococcal etiology in children are conditionally divided into 2 large groups - primary and secondary.

Scarlet fever is a childhood infectious and inflammatory pathology, manifested by fever, punctate rash and angina. The symptomatology of the disease is not due to the streptococcus itself, but to the effect of its erythrogenic toxin, which is released into the blood.

Scarlet fever is a highly contagious disease. Infection occurs mainly in kindergartens or schools by airborne droplets from children with angina or bacteria carriers. Scarlet fever usually affects children aged 2-10 years. Pathology is manifested by symptoms of three main syndromes - toxic, allergic and septic.

Forms of scarlet fever:

1. Light - mild intoxication, the duration of the disease is 5 days;
2. Moderate - more pronounced catarrhal and intoxication symptoms, duration of fever - 7 days;
3. The severe form occurs in 2 types - toxic and septic. The first is characterized by pronounced intoxication, convulsions, the appearance of meningeal signs, intense inflammation of the throat and skin; the second - the development of necrotic tonsillitis, severe lymphadenitis, septic, soft palate and pharynx.

Scarlet fever has an acute onset and lasts an average of 10 days.

Symptoms of the disease:

• Intoxication - fever, chills, weakness, weakness, tachycardia, rapid pulse. A sick child becomes lethargic and drowsy, his face is puffy, his eyes shine.
• Children complain of a burning sensation in the throat and have difficulty swallowing.
• Inflamed and swollen glands located under lower jaw, cause pain and do not allow you to open your mouth.
• Pharyngoscopy allows you to detect signs of classic tonsillitis.
• The next day, a small-dotted roseolous or papular rash appears in a patient on hyperemic skin, which first covers upper part torso, and after a couple of days - limbs. It resembles red goose skin.

Manifestations of scarlet fever

• The rash on the bright red skin of the cheeks merges, and they become scarlet.
• The nasolabial triangle in patients is pale, the lips are cherry.
• The tongue with scarlet fever is lined, the papillae protrude above its surface. After 3 days, the tongue self-cleanses, starting at the tip, it becomes bright red with clear papillae and resembles a raspberry.
• Pastia's symptom is a pathognomonic sign of the disease, characterized by the accumulation of an itchy rash in natural folds.
• Severe intoxication is accompanied by damage to the central nervous system and clouding of consciousness.

By the 3rd day of the disease, the rash reaches its maximum and gradually disappears, the temperature drops, the skin becomes dry and rough with pronounced white dermographism. The skin on the palms and soles peels off, starting from the nails, and comes off in whole layers.

Re-infection of a person who has had scarlet fever leads to the development of tonsillitis.

Scarlet fever is a disease that ends safely with proper and timely antibiotic treatment.

If the treatment was not carried out or was inadequate, the disease is complicated by a number of pathologies - purulent inflammation of the ears, lymph nodes, as well as rheumatoid fever, myocarditis and glomerulonephritis.

Pathogenic streptococci often affect newborns. Infection occurs intrapartum. Children develop pneumonia, bacteremia,. In 50% of cases Clinical signs appear on the first day after birth. Diseases of streptococcal etiology are extremely difficult and often end in death. In newborns strep infection showing fever, subcutaneous hematomas, blood secretions from the mouth, hepatosplenomegaly, respiratory arrest.

Streptococcus in pregnant women

The rate of opportunistic streptococci in the analysis of vaginal discharge from a pregnant woman is less than 104 CFU / ml.

Of great importance in the development of pathology of pregnancy are:

1. Streptococcus pyogenes is the causative agent of postpartum sepsis.
2. Streptococcus agalactiae is the cause of infection in premature newborns and mothers.

Streptococcus pyogenes manifests itself in pregnant women with tonsillitis, pyoderma, endometritis, vulvovaginitis, cystitis, glomerulonephritis, postpartum sepsis. Possible intranatal infection of the fetus and the development of neonatal sepsis.

Streptococcus agalactiae causes inflammation in pregnant women urinary tract, endomentritis, and in the fetus - sepsis, meningitis, pneumonia, neurological disorders.

Streptococcus is transmitted during pregnancy by contact, which requires strict observance of the rules of asepsis in childbirth.

Diagnostics

Difficulties in laboratory diagnosis of diseases caused by streptococci are due to the complexity of the etiological structure, the biochemical properties of pathogens, the transience pathological process, poor lighting modern methods diagnostics in the instructive and methodological documentation.

Main diagnostic method streptococcal infection is a microbiological analysis of the discharge of the pharynx, nose, lesion on the skin, sputum, blood and urine.

• A swab is taken from the pharynx with a sterile cotton swab, the test material is inoculated on blood agar, incubated for 24 hours at 37°C and the results are taken into account. The colonies grown on agar are examined under the microscope. Hemolytic colonies are subcultured in sugar or blood broth. Streptococci give a characteristic near-bottom-parietal growth in the broth. Further research is aimed at determining the serogroup by setting up a precipitation reaction and identifying the pathogen to the species.

• A bacteriological blood test is performed if sepsis is suspected. 5 ml of blood is inoculated into vials with sugar broth and thioglycol medium to determine sterility. The cultures are incubated for 8 days with double inoculation on blood agar on days 4 and 8. Normally, human blood is sterile. When growth appears on blood agar, further identification of the isolated microbe is carried out.
• Serodiagnostics is aimed at determining antibodies to streptococcus in the blood.
• Express diagnostics of streptococcal infection - latex-agglutination reaction and ELISA.

Spend differential diagnosis streptococcal and staphylococcal infections.

Streptococci and staphylococci cause the same diseases - tonsillitis, otitis media, pharyngitis, rhinitis, which differ in severity clinical symptoms and the severity of the current.

Streptococcal angina develops earlier than staphylococcal, is more severe and has serious consequences. Staphylococcus aureus often becomes the cause of secondary infection, is difficult to treat and is characterized by more acute symptoms.

Treatment

Patients with scarlet fever and streptococcal tonsillitis are shown bed rest, plentiful drink and a healthy diet. It is recommended to consume pureed, liquid or semi-liquid food with protein restriction. Thermal irritation of the inflamed throat mucosa is prohibited with the complete exclusion of hot and cold dishes from the diet. You can switch to regular food only after subsiding acute symptoms diseases.

Treatment of streptococcal infection should be etiologically and symptomatically justified.

Etiotropic therapy

Patients receive adequate antibiotic therapy. The choice of drug is determined by the results of the analysis of a smear from the throat. After isolating the pathogen and determining its sensitivity to antibiotics, specialists prescribe treatment.

• Antibiotics penicillin series- Ampicillin, Benzylpenicillin,
• "Erythromycin"
• Modern semi-synthetic penicillins - "Amoxiclav", "Amoxicillin",
• Macrolides - Azithromycin, Clarithromycin,
• Cephalosporins - "Cefaclor", "Cefalexin",
• Sulfonamides - "Co-trimoxazole".

To restore the intestinal microflora, pre- and probiotics are used:

1. Linex,
2. "Acipol",
3. "Bifiform".

Symptomatic treatment

• Sick children are prescribed antihistamines- "Suprastin", "Diazolin", "Zodak".
• Immunomodulators of general and local action - "Immunal", "Imunorix", "Imudon", "Lizobakt".
• In severe cases, patients are prescribed streptococcal bacteriophage . This is an immunobiological preparation capable of lysing streptococci. It is used for the treatment and prevention various forms streptococcal infection - inflammation of the respiratory system, hearing aid, skin, internal organs. Before starting treatment, it is necessary to determine the sensitivity of the isolated microbe to the bacteriophage. The method of its application depends on the localization of the focus of infection. In addition to streptococcal bacteriophage, a combined pyobacteriophage is also used.

• Detoxification therapy includes drinking plenty of fluids - 3 liters of liquid: fruit drinks, herbal teas, juices, water.
• In order to strengthen the vascular wall and remove toxins from the body, vitamin C is indicated.
• - furacilin, dioxidine, decoction of chamomile, sage, calendula, propolis tincture.
• Pastilles and - Strepsils, Miramistin, Geksoral.
• At home, children with scarlet fever are given warm linden tea, put on the throat, cold lotions are applied to sore eyes and head, with pain in the ears put. For older children, experts recommend rinsing sore throat warm infusion of sage or chamomile.

Streptococcus treatment - not an easy task, despite the fact that many microbes are not dangerous to humans. With a decrease in immunity, streptococci become the cause serious illnesses.

Prevention

Preventive measures for streptococcal infection:

1. Compliance with the rules of personal hygiene and regular cleaning of the premises,
2. hardening,
3. sports,
4. A complete, balanced diet
5. Fight bad habits
6. Timely treatment of skin lesions with antiseptics,
7. Isolation of patients during treatment,
8. Current disinfection in the room where the patient was,
9. Prevention of nosocomial infection.

Video: streptococcus, "Doctor Komarovsky"

pustules on the skin, erysipelas, omphalitis, tonsillitis, scarlet fever, yellowish fetid discharge from the genital tract, otitis, periodontitis, caries, pneumonia, inflammation of the umbilical cord, peritonitis ... What do you think these diseases have in common? They have a common cause - a microbe called streptococcus.

Where do streptococci live?

Streptococci, which will be discussed in this article, are round-shaped bacteria and are arranged in chains of various lengths. Normally, the mucous membranes of the intestines, human genital organs and skin are inhabited by various microorganisms, including streptococci. Depending on the species, streptococci tend to settle in different parts of the human body: some on the skin, some on the mucous membrane of the respiratory tract, some on the mucous membrane of the genital organs or intestines. This property helps in diagnosing the disease and prescribing the right treatment.

Properties of streptococci

In the human pharynx, 30 to 60% of all microbes fall to the share of streptococcus. healthy body has a strong immunity, which keeps the entire microflora under control, preventing excessive reproduction of any bacteria, and with a decrease in immunity and the appearance favorable conditions for development very quickly, one or another type of microorganisms begins to multiply rapidly, suppressing the normal flora and leading to the occurrence of diseases. Streptococcus is one of these microbes. Its reproduction and distribution in the body can lead to serious diseases, including infectious ones. Due to the large number of cells of this pathogen living on the human body, the number of diseases caused by them reaches 10-15% of total number diseases during the cold season. The course of the disease and its severity are determined both by the type of streptococcus itself and by the ingestion of bacteria and the bacteria produced by them into the blood. toxic substances.

Fortunately, streptococci are unstable in the external environment. For them, it's detrimental. sunlight, disinfectants and antibacterial drugs. Timely treatment of streptococcal infection leads to good results, and neglected, severe forms of the disease can lead to tragedy.

All diseases, one way or another associated with streptococcus, are divided into 2 large groups:

Diseases caused by streptococcus

Diseases caused by streptococcus.

Let's take a look at a few examples of diseases that streptococcus causes.

Angina

Streptococcus infects the tissue of the tonsils, which are located around the pharynx in the form of a ring. If a person has strong immunity, then angina occurs in mild form without high temperature, with a slight coating on the tonsils and a little soreness when swallowing. If the immune system is weak, then severe necrotic inflammation of the tonsils can develop, accompanied by severe sore throat, especially when swallowing, weakness, very high fever, aching all over the body and signs of poisoning. This is due to the production of toxic substances by bacteria that cause purulent fusion of tissues. The decay products and toxins of bacteria poison the human body.

The result of untimely started or improper treatment are the following diseases:

Peritonsillar abscess - acute inflammation tissue under the tonsils

Otitis - inflammation of the middle ear

Rheumocarditis is an autoimmune lesion of the heart,

Articular rheumatism is an autoimmune lesion of the tissues of the joints,

Glomerulonephritis is an inflammatory process in the kidney that affects the main instruments for blood filtration and urine formation - the renal glomeruli,

Lymphadenitis - inflammation closest to the throat lymph nodes located on the neck.

Treatment for strep throat infection antibacterial drugs general and local action. There are features in the treatment of adults and children: the treatment of streptococcal infection in the throat in adults is combined with rinsing solutions medicines, decoctions and infusions of herbs, and young children who do not yet know how to gargle are deprived of this component of treatment. For babies, only irrigation of the tonsils with medicinal aerosols is suitable. When treating a streptococcal infection in the throat, please note that after rinsing and / or using an aerosol, it is not recommended to eat or drink for at least one hour so that the medicine does not wash off and act as long as possible.

Caries

Everyone knows the disease. Didn't expect that streptococcus also causes it? These bacteria in the mouth feed on the remnants of food stuck in the interdental spaces. Reproducing there, in the course of their life, microbes secrete lactic acid. It gradually dissolves hard enamel, which is based on calcium. The tooth loses its strength and begins to collapse.

There are few complications, but they are unpleasant:

Pulpitis - inflammation of the base, the core of the tooth, in which the vessels and nerves pass,

Loss of a tooth associated with its destruction.

There is also a disease of the oral cavity - periodontal disease, which also causes streptococcal infection. Its treatment is also necessary, otherwise the troubles associated with inflammation, bleeding gums and loss of teeth cannot be avoided.

streptoderma

This is a streptococcal skin lesion. Infection occurs due to the penetration of the pathogen through minor injuries, cracks, abrasions, cuts. In the lesion, a pink spot appears with uneven edges, up to 30-40 cm in diameter. Depending on the depth of the lesion, the disease is divided into 2 types:

Which is characterized by the rapid appearance of small purulent vesicles on the surface of the skin, which, opening up, quickly dry out and disappear without a trace,

Ecthyma vulgaris is a deep skin lesion. After opening the same bubbles, scars form on the skin, suffers general well-being and the body temperature rises to 38 degrees.

This is how a small microbe leads to a dramatic change in the quality of human life. Due to the small damage, a streptococcal skin infection develops, the treatment of which requires some effort.

Treatment of streptococcal soft tissue infections combines general and local methods. A bandage with an antiseptic solution is applied to the affected area.

Streptococci cause pustules and are smaller than those described above. There are men who like to pull hairs out of their noses instead of cutting them off. So in place of damaged hair follicles, very painful inflamed areas. Most often they pass without suppuration, but if left untreated, purulent vesicles appear. Early treatment for a streptococcal infection in the nose is to apply to the affected area of ​​the nose antiseptic solution, bactericidal ointment.

Inflammation of the genital tract

In 10-30% of healthy women, streptococcus is sown from the mucous membrane of the genital organs. Normally, it does not detect itself in any way, because it is under the control of the immune system. With a decrease in immunity, as well as in cases of infection with streptococcus sexually, women experience burning, itching, pain when urinating, yellowish purulent discharge, pain in the lower abdomen and slight fever.

In the absence of examination and adequate treatment, the situation is aggravated, complications arise in the form of:

Erosion of the cervix, when the epithelium from the uterine cavity appears on her cervix,

Endometritis - inflammation of the endometrium, the inner layer of the uterus,

Polyps, when the layer of epithelium lining them grows excessively on the internal genital organs.

Diagnosis of the disease is carried out at the reception, to clarify the diagnosis, the method of sowing with the determination of sensitivity to antibiotics is used.

Treatment of streptococcal infection in gynecology is a fairly common occurrence due to the wide distribution of this microbe. A small crack, a small wound is enough for him to immediately penetrate not only into the skin or mucous membrane, but also much deeper. There are quite a few situations in which the gates of this infection open: each menstruation, childbirth exposes the uterus from the inside, which becomes a huge wound surface, not to mention damage to the cervix, vagina and perineum. Even sexual intercourse can be accompanied by damage to the mucous membrane and skin.

Diseases caused by streptococcus

They include rheumatism, rheumatoid arthritis and glomerulonephritis.

Rheumatoid arthritis

Occurs due to the formation of immune complexes. In this case, they are deposited in the joint cavity, damage the cartilage and prevent them from fully performing their functions. Inflamed joint cells secrete enzymes that further melt the cartilage, which ultimately leads to its complete destruction. The pathological process mainly involves small joints of the hands, fingers and toes. The patient feels stiffness in the movements of the affected joints, especially in the morning.

Complications are the accumulation of pus in the cavity of the affected joint and renal failure.

Streptococcal infections in children

From the very first days of life, a little man is susceptible to streptococcal infection. Infection can occur in utero through the mother's blood, when passing through the birth canal infected with this microorganism, as well as in the first hours and days of extrauterine life from patients or carriers. Immature the immune system the infant is not able to resist germs.

There are several serious diseases in which the baby suffers greatly and may even die.

Streptoderma and ecthyma vulgaris are skin lesions of a child that leave deep scars on thin, delicate skin. Lymphangitis and lymphadenitis can become a complication of these diseases ( purulent inflammation lymphatic vessels and nodes, respectively).

Sepsis - circulation in large quantities streptococcus in the blood, with the formation of purulent foci in any organs and tissues. The course of the disease is very severe and even with timely medical intervention mortality reaches 20%.

Meningitis is a purulent inflammation of hard and soft meninges which leads to brain dysfunction. Mortality reaches 15%, and persistent long-term consequences of brain damage occur in another 40% of children.

Pneumonia is a disease of the main organ responsible for saturating the blood with oxygen and removing carbon dioxide. Streptococcus infects the alveoli of the lungs. They become inflamed, swollen and stop performing respiratory function. With the timely start of treatment, the disease can be cured, but still mortality occurs here, reaching 0.5%.

Necrotizing fasciitis is a very serious disease in which connective tissue membranes are affected, in which muscles, neurovascular bundles and internal organs. It manifests itself as a woody compaction of the soft tissues of the baby. With this disease, the mortality rate reaches 25%.

This is how difficult the treatment of which should be started immediately if a streptococcal infection is suspected.

Diagnosis of streptococcal infection

Diagnosis begins at the stage of the visit of a sick person to the doctor.

At the appointment, the doctor examines the patient, collects information about complaints, symptoms of the disease and the duration of their appearance, selects the optimal ones and prescribes treatment.

Laboratory and instrumental methods for diagnosing streptococcal infection

Of course, the doctor will prescribe a study general analyzes blood and urine, but they will not be able to help in the separation of streptococcal infection from any other, therefore, methods of seeding the microbe on a nutrient medium and determining the sensitivity of the microbe to antibiotics are used.

Depending on the focus of the lesion, wound discharge, the contents of abscesses, joints, mucus from the nose, pharynx, vagina, cervical canal and cerebrospinal fluid - liquor.

To determine sensitivity to antibiotics, small discs moistened with different antibiotics, and after 8-10 hours evaluate the results. By the absence of a growth zone or a small number of microbes around the disk, the most destructive antibiotics for streptococci are determined. This method research takes 2-5 days.

Treatment of streptococcal infection

The most reliable, fastest and most effective is antibiotic treatment.

Regardless of the localization of the pathological process, they are necessarily included in the treatment regimen.

If at the appointment the doctor decides that the patient who applied for medical help has a streptococcal infection, treatment is prescribed with one of the drugs from the penicillin or cephalosporin series. In some situations, it is difficult to distinguish the pathogen, since a similar clinic can be caused by staphylococcal and streptococcal infections, treatment in this case is still prescribed with one antibiotic from the two indicated rows.

Once antibiotic susceptibility has been established, if streptococcal infection continues, antibiotic treatment is adjusted.

There are people who categorically refuse antibiotic treatment and use only folk remedies. In this case, it is permissible to use herbs as auxiliary methods of treatment, but not the main ones.

Streptococcal infection is too insidious, treatment with folk remedies without antibiotics leads to life-threatening complications, disability and death.

Treating a streptococcal infection is not that difficult. It is important to seek medical help in time, diagnose and start the right treatment.

Various types of microorganisms inhabit the human microflora, including pathogens. Streptococcal infection is always present in the human body and its number is controlled by the immune system. With reduced immunity different kinds bacteria begin to multiply actively, and their waste products cause diseases. The respiratory, digestive, genitourinary systems mainly suffer, however, with running form colonies of streptococcal infections affect the heart, kidneys, joints.

How is the infection transmitted?

• by airborne droplets;
• by food;
• household way;
• sexually;
• fecal-oral route;
• transplacental route (during childbirth);
• medical way.

Many do not know how the disease caused by colonies of streptococcal infections is transmitted. The airborne route is considered the most popular way of infection. Streptococcal infections are transmitted through coughing and sneezing. Especially dangerous public transport, unventilated public spaces. It is possible to become infected through food, in particular, stitched meat and dairy products, stale salads with mayonnaise, sweets with protein cream, burgers and sandwiches.

Staphylococcus can enter the body through contact with contaminated household items. Infection occurs through damaged mucous membranes of the mouth, nose, or skin. For example, through the use of towels, dishes, bed linen of the patient. Drinking water in company from one cup or from the throat of one bottle is contagious. If there is an infected person in the children's social circle, his toy is dangerous for all the children around him.

It is possible to catch the infection through the genital tract, during intimacy with infected person. You can also get infected if you do not follow the rules of personal hygiene, so you need to wash your hands before eating. At the birth of a child, a mother passes on her microflora to him, therefore, before conception, it is necessary to improve the body. Poorly processed medical instruments or tools of beauty salons, piercings, tattoos can cause infection.

Symptoms of infection

Symptoms of streptococcal infection are diverse and depend on the site of the lesion and the state of immunity. Basically, the patient feels pain in the throat, ears. The timbre of the voice changes, a purulent taste appears in the mouth if the tonsils are affected. Feeling when swallowing foreign body in the throat. A purulent plaque appears on the tonsils. There is pain and swelling of the lymph nodes. At acute form body temperature rises, shivering, muscles and joints ache. The patient has redness on the skin, a rash with blood, the skin itches. There is diarrhea, abdominal pain, nausea and vomiting. Streptococci can spread to the genitals and cause itching on the genitals, pain when urinating, and an enlarged uterus in women.

Complications of streptococcal infection

During treatment, it is very important to eat well.

Streptococcal infection most often gives complications in the presence of chronic diseases. Diseases of a permanent nature weaken the immune system. It should focus on the treatment of existing diseases and strengthen the immune system. In addition, during the treatment period, it is necessary to adhere to certain rules in order to avoid complications. Namely:

• exclude alcohol and other intoxicating substances;
• enough sleep, give the body the opportunity to rest;
• avoid stressful situations;
• stick to balanced nutrition with sufficient content of vitamins and minerals;
• refuse junk food (semi-finished products, preservatives, refined foods);
• do not use antibiotics;
• protect the respiratory tract if working in dusty areas.

Scarlet fever disease

Streptococcal infection is capable of showing complications in the form of a disease such as scarlet fever. The disease is accompanied by high fever and severe headache. The temperature in children can rise to 40 ° C, in adults up to 39 ° C. A small red rash appears all over the body. The patient is shivering, he feels all the manifestations of a sore throat - a sore throat, tonsils and lymph nodes become inflamed. Less symptoms begin to appear after 2-3 days.

angina disease

If a person has immunity against scarlet fever, the bacteria can manifest themselves in an infectious disease - tonsillitis. The disease affects the tonsils and palate, and with unskilled help, the disease affects the heart and kidneys. Therefore, in case of purulent tonsillitis, you should re-take the test to make sure complete cure. The patient feels all the symptoms of a cold, sore throat and nasopharynx, loss of appetite. Due to damage to the nasopharynx, there are pain while swallowing. A purulent plaque appears on the tonsils and palate.

Rheumatism disease

The chronic form of angina can cause inflammation in the joints. The appearance of nodules under the skin in the area of ​​​​the joints, accompanied by pain, weakness, impaired coordination of movement, high temperature, and disturbed heartbeat are the main symptoms of rheumatism. The patient feels pain in the chest when inhaling, a cough appears. The person is pale excessive sweating.

Disease myositis

Inflammation of the muscles accompanied by pain during movement or pressure is called myositis. With a running form, movements in the joints become limited. Constant pain and an inactive lifestyle lead to muscle atrophy. Redness and swelling are visible in the affected area. Myositis poses a great danger, as the affected muscles involve nearby ones. For example, with inflammation of the neck muscles, the respiratory muscles are affected.

erysipelas disease

Microorganisms infect the skin. Infected areas acquire a bright red color with a clear defined border. In places of defeat, a burning sensation is felt, swelling appears. When the form is running, blood comes out of the skin, ichor. Subsequently appears capillary network, dark spots. Symptoms of the disease appear abruptly. The patient feels pain and weakness in the muscles, his temperature rises, he is shivering, vomiting opens.

Disease osteomyelitis

The disease develops very rarely. The patient suffers all skeletal system. Pathogenic bacteria infect the bone marrow. Infection leads to death bone tissue, as a result, an abscess appears, which violates the integrity of the skin and eventually breaks through. The disease can affect nervous system, muscles and blood vessels, as well as deform limbs. Illness starts with feeling severe pain in places of inflammation, the appearance of high temperature, vomiting, loss of consciousness, convulsions. It is very important to provide qualified assistance at the onset of the disease. Complications lead to limb injuries, fractures, bone defects.

Sepsis disease

Sepsis affects all organs human body.

Sepsis is an extreme manifestation of streptococcal infection. Most often occurs due to blood loss, surgical intervention. It occurs due to the development of streptococcal infections, less often pneumococci and Escherichia coli. Bacteria infect all systems and organs, forming abscesses in infected places. A chronic disease can be cured, but often the disease manifests itself quickly and kills a person in 2-3 days. The patient has hemorrhage in all mucous membranes. The temperature fluctuates rapidly from very high to low. A person has high sweating, a disturbed heartbeat, a rash appears on the skin with possible hemorrhages. The patient's skin is pale, slightly yellowish.

Streptococcus is a gram positive anaerobic bacteria. They differ in microscopic dimensions of 2 microns. Bacteria accumulate in pairs or chains. Most representatives of streptococci are immobile. Among them there are causative agents of many diseases associated with disorders in the work of the intestines, stomach, respiratory and genitourinary tract.

Streptococcus is a bacterium with a spherical shape. She is part of normal microflora organism. Under the influence of certain factors, it becomes dangerous for humans. Negative impact susceptible people with weak immunity.

Approximately 60% of streptococci are found in the human pharynx. They enter the body along with food.

Depending on the type of bacteria, the lesion is fixed on the mucous membranes of the respiratory system, stomach, oral cavity, genitals and skin.

Streptococcus

Symptoms of a streptococcal infection appear when the organisms acquire pathogenic properties. They penetrate the bloodstream and lead to the appearance of serious diseases. During the progression of the disease, a person is considered dangerous to the people around him.

Experts distinguish two main ways of infection with streptococcus: autoinfection and infection from the external environment.

In the first group, infection occurs through standard procedures. This can happen during the extraction of a tooth, tonsils, catheterization of the bladder, squeezing acne. Since a certain amount of bacteria is contained in the human body, and when exposed to local immunity, bacteria degenerate into pathogenic microorganisms.

External infection comes from other people. The main source of infection is a sick person or a carrier of bacteria. In the latter case, there are no symptoms of streptococcus in the body.

The mechanism of transmission of pathogenic microorganisms:

• airborne;
• domestic;
• sexual;
• food;
• from mother to child.

The main route of infection is airborne. The release of bacteria into the external environment occurs during coughing, sneezing or when talking. Microorganisms are excreted along with droplets of saliva. Upon contact with a potential patient, they lead to infection of a healthy person.

household way. Infection occurs through saliva, which remains on personal belongings, dishes or settles on dust. Main Feature microorganism is the ability to maintain their vital activity at low and high temperatures. Therefore, regular cleaning is not enough to eliminate bacteria.

Urogenital streptococcus is transmitted through sexual contact. food route of infection associated with the use of products that have not undergone a sufficient level of heat treatment.

From mother to child the infection is transmitted during pregnancy. This phenomenon occurs in 15-35% of cases.

How to identify the presence of streptococcus

Sore throat is one of the symptoms of the presence of streptococcus in the body.

If streptococcus has entered the body, the symptoms in adults depend on the state of the protective functions of the body.

Experts identify a list of common clinical manifestations:

A photo of a viridescent streptococcus that can cause the symptoms described below:

Streptococcus photo

The main distinguishing feature of streptococci of the green type is getting into systemic circulation through minor injuries of the oral mucosa. Bacteria can be detected with an abscess of the liver and brain, sinusitis and in mixed microflora.

The risk group includes people passing through preventive therapy using trimethoprim. Development risk unpleasant symptoms persists with damage to the mucous membranes and deep neutropenia.

Streptococcus viridans are resistant to penicillins, which complicates the process of its destruction. It can provoke the development of meningitis. This phenomenon is common among people involved in pig farming.

Symptoms of viridescent streptococcus the following:

To diagnose the presence of this type of bacteria in the body, you can only through special laboratory research . When confirming the diagnosis, the specialist prescribes a complex.

The lack of impact on the bacterium leads to an aggravation of the situation and the involvement of other organs and systems of the body in the process.

Streptococcus is a microorganism that can lead to the development severe consequences. It negatively affects almost all organs and systems of the body. The bacterium firmly settles in the genitourinary and respiratory system, digestive tract. Timely treatment avoid serious consequences and eradicate pathogens.

In contact with

In the comments, they asked to write an article about hemolytic streptococcus. I decided to do general review on streptococci and provide links to more detailed information on hemolytic streptococcus.

Classification of cocci

cocci are spherical bacteria. Depending on the structural features of their cell wall, Gram stain(the method was proposed in 1884 by the Danish physician G.K. Gram) cocci turn blue or red. If bacteria turn blue, they are called gram-positive(gram+). If they turn red, then gram-negative(gram-). Gram staining in microbiology was done by every medical student.

GRAM-POSITIVE cocci:

• staphylococci (from staphylo- bunches) - have the shape of grape bunches,
• streptococci - look like chains,
• enterococci - arranged in pairs or short chains. They cause infective endocarditis (in 9% of cases), lesions of the genitourinary system and intestinal dysbacteriosis.

Genus streptococci and genus enterococci belong to the same family Streptococcaceae [Streptococcus Acee], because they are very similar to each other, including the lesions caused.

GRAM-NEGATIVE cocci:

• Neisseria (usually arranged in pairs):
  • gonococci (Neisseria gonorrhoeae) - causative agents of gonorrhea,
  • meningococci (Neisseria meningitidis) - causative agents of nasopharyngitis, meningitis and meningococcemia.

A common property of cocci is that they are aerobes(i.e. they use oxygen for development) and do not know how to form spores (i.e. it is easier to destroy cocci than resistant to external factors environment spore-forming bacteria).

Classification of streptococci into serogroups A, B, C, ...

By the proposal Rebecca Lancefield(1933), according to the presence of specific carbohydrates in cell wall streptococci are divided into 17 serogroups(the most important are A, B, C, D, G). Such a separation is possible with the help of serological (from lat. serum- serum) reactions, i.e. by determining the required antigens by their interaction with known antibodies of standard sera.

Group A Streptococcus

Most human diseases are caused β-hemolytic streptococci from serogroup A. Almost all of them belong to the same species - S. pyogenes(Streptococcus pyogenes, pyogenic streptococcus, read [Streptococcus pyogenes]). It's streptococcus in honey. literature is sometimes referred to as an abbreviation BGSA - beta-hemolytic streptococcus serogroup A. In the cold season, its carriage in the nasopharynx of schoolchildren reaches 20-25% .

S. pyogenes has been known since antiquity, but its incidence peaked in the 19th century. It calls:

Early Complications caused by the introduction of infection into other parts of the body through the blood (hematogenous) and lymphatic (lymphogenic) pathways. Any dangerous infection can spread this way, not just streptococci.

Late Complications are associated with systemic inflammation and an autoimmune mechanism, that is, the immune system begins to destroy its own healthy tissues and organs. About this mechanism - next time.

For more information on lesions caused by GABHS, I advise you to read on the website antibiotic.ru: infections caused by group A beta-hemolytic streptococcus.

Instructive and dramatic story postpartum sepsis(puerperal fever), the victims of which were hundreds of thousands of mothers and the founder of antiseptics ( infection control science) - Hungarian obstetrician Ignaz Philip Semmelweis(Semmelweis). I can't help but tell you more.

The young doctor Semmelweis, after graduating from the University of Vienna, remained working in Vienna and soon wondered why the mortality rate during childbirth in the hospital reached 30-40% and even 50%, far exceeding the mortality rate during home births. In 1847, Semmelweis suggested that this phenomenon was somehow related to the transmission of infection (" cadaveric poison”) from the pathoanatomical and infectious diseases departments of the hospital. In those years, doctors often practiced in morgues (“anatomical theaters”) and often resorted to delivering directly from a corpse, wiping their hands with new handkerchiefs. Semmelweis ordered hospital staff to first dip their hands in bleach solution and only then approach a woman in labor or a pregnant woman. Mortality among women and newborns will soon decreased by 7 times(from 18% to 2.5%).

However, Semmelweis's idea was not accepted. Other doctors openly laughed at his discovery and at himself. The head physician of the clinic where Semmelweis worked forbade him to publish statistics on the decrease in mortality, threatening that “ considers such a publication a denunciation”, and soon fired Semmelweis from work altogether. Trying to somehow convince his colleagues, Semmelweis wrote letters to leading doctors, spoke at medical conferences, organized “master classes” on his own money to teach his method, and in 1861 published a separate work “ Etiology, essence and prevention of puerperal fever', but it was all useless.

Even the death of a German doctor Gustav Michaelis did not convince the then medical community. Michaelis also laughed at Semmelweis, but nevertheless decided to test his method in practice. When the mortality of patients fell several times, the shocked Michaelis could not stand the humiliation and committed suicide.

Hounded and misunderstood during his lifetime by his contemporaries, Semmelweis went mad and spent the rest of his days in a psychiatric hospital, where in 1865 he died of the same sepsis from which women in childbirth died before its discovery. Only in 1865, 18 years after the discovery of Semmelweis and, coincidentally, in the year of his death, did an English doctor Joseph Lister offered to fight the infection with phenol (carbolic acid). It was Lister who became the founder of modern antiseptics.

Group B Streptococcus

This includes S. agalactiae[Streptococcus agalactie], which lives in the gastrointestinal tract and in the vagina of 25-45% of pregnant women. When the fetus passes through birth canal mother is colonized. S. agalactiae causes bacteremia and neonatal meningitis with a mortality rate of 10-20% and residual effects in half of the survivors.

In young people and adults, S. agalactiae often causes streptococcal pneumonia as a complication after SARS. By itself, S. agalactiae does not cause pneumonia, but after the flu - easily.

S. pneumoniae (pneumococcus)

Non-hemolytic (green) streptococci

In addition to the classification mentioned above Rebecca Lancefield(for serogroups A, B, C, ...), classification is also used Brown(1919), which is based on the ability of streptococci to cause hemolysis (destruction) of red blood cells when growing on media with ram's blood. According to Brown's classification, streptococci are:

• α-hemolytic: cause partial hemolysis and greening of the environment, therefore α-hemolytic streptococci are also called green streptococci. They do not interact with Lancefield group sera.
• β-hemolytic: complete hemolysis.
• γ-hemolytic: invisible hemolysis.

The group of viridescent streptococci is sometimes combined under the general name S. viridans.

Non-hemolytic (α-hemolytic, green) streptococci include S. anginosus, S. bovis, S. mittis, S. sanguis and others. They live in the oral cavity, where they make up to 30-60% of the entire microflora, and also live in the intestines.

Typical lesions - bacterial endocarditis (inflammatory processes in the endocardium of the heart valves). Viridescent streptococci account for 25-35% of all pathogens of bacterial endocarditis. Since there are so many green streptococci in the mouth, they easily enter the bloodstream (this is called bacteremia) when dental procedures, brushing teeth, etc. Passing through the cavities of the heart, green streptococci often settle on the heart valves and lead to their malignant lesions.

The frequency of bacteremia (figures from a lecture at BSMU):

• with periodontal intervention - in 88% of cases,
• when removing a tooth - 60% of cases,
• tonsillectomy (removal of the tonsils) - 35%,
• bladder catheterization - 13%,
• tracheal intubation - 10%.

Bacterial (infectious) endocarditis is a type of sepsis (« blood poisoning»; Unlike bacteremia in sepsis, bacteria multiply in the bloodstream rather than just circulating). Treatment of endocarditis is very difficult, and without antibiotic treatment, mortality from bacterial endocarditis within a year is close to 100%. used long-term use high doses antibiotics. If the patient has heart defects, has artificial heart valves, or has had bacterial endocarditis in the past, the risk of reinfection becomes too great. Such people are assigned prophylactic dose antibiotic before visiting the dentist. In lectures on internal diseases at BSMU we were given the following scheme:

• inside 2 g amoxicillin 1 hour before the procedure,
• alternative drugs inside - cephalexin, clindamycin, azithromycin, clarithromycin,
• if swallowing is impossible - 2 g ampicillin intramuscularly or intravenously 0.5 hours before the procedure.

Non-hemolytic streptococci also include the bacterium S. mutans[streptococcus mutans], widely known for which is the causative agent of caries. This bacterium ferments the sugar that enters the mouth into lactic acid. Lactic acid causes demineralization of teeth. In principle, many bacteria in the mouth can ferment sugar to lactic acid, but only S. mutans and lactobacilli are able to do this when low values pH, that is acidic environment. Therefore, after eating, it is recommended to brush your teeth or at least rinse your mouth thoroughly. Scientists do not give up hope to create a vaccine against S. mutans, which will simultaneously become a vaccine against caries.

Features of antibacterial therapy for streptococci

As I mentioned, everything streptococcal tonsillitis require the prescription of antibiotics. It is curious that despite the long-term use of penicillins, pyogenic streptococcus has not yet developed resistance to beta-lactam antibiotics - penicillins and cephalosporins, which are usually prescribed for a period of 10 days for tonsillitis and scarlet fever. Even if the next day from the start of treatment nothing bothers you, the course cannot be interrupted. If the patient is allergic to penicillins, then they are prescribed macrolides, although in 30% or more cases, streptococcus is resistant to them. Used for macrolide resistance lincomycin.

You can read more about antibiotic treatment in the article Antibacterial therapy for streptococcal tonsillitis and pharyngitis.

Asymptomatic carriage of group A beta-hemolytic streptococcus is not considered to require antibiotic treatment.

curious to know

Similarly, until resistance to penicillins develops and pale treponema(pale spirochete) - the causative agent of syphilis. Syphilis is treated in much the same way as many years ago. True, the doses of penicillin have since increased significantly.

Unlike pyogenic streptococcus Pneumococcus is often resistant to a number of beta-lactam antibiotics.

Streptokinase

Group A beta-hemolytic streptococcus, in addition to other pathogenicity factors, produces a protein streptokinase, which dissolves blood clots and allows bacteria to spread throughout the patient's body. On the basis of streptokinase in domestic medicine, a drug is used to restore blood flow in a thrombosed vessel with acute infarction myocardium, however, it is highly allergenic and can lead to severe allergic reactions especially when reapplied.

In world practice, instead of streptokinase, for example, alteplase(actilyse) - a recombinant drug (obtained using genetic engineering). It is safer and gives less side effects, but it is much more expensive and therefore rarely used.

Update March 9, 2013

The other day I saw it on sale in pharmacies in Moscow rapid test "Streptatest", which allows to detect the presence of group A beta-hemolytic streptococcus in throat infections in 10 minutes. "Streptatest" allows you to distinguish streptococcal infection, which requires antibiotics, from sore throats of other origins, when antibiotics are not needed. See website for details http://streptatest.ru/.