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Streptococcus pneumoniae can be differentiated from the viridans streptococci, some of which are also alpha-hemolytic, using an optochin test, as S. pneumoniae is optochin-sensitive. S. pneumoniae can also be distinguished based on its sensitivity to lysis by bile, the so-called "bile solubility test".
The system, created by Rebecca Lancefield, was historically used to organize the various members of the family Streptococcaceae, which includes the genera Lactococcus and Streptococcus, but now is largely superfluous due to explosive growth in the number of streptococcal species identified since the 1970s. [2]
Main Streptococcus groups are included as "Strep." at bottom left. In clinical practice, the most common groups of Streptococcus can be distinguished by simple bench tests, such as the PYR test for group A streptococcus. There are also latex agglutination kits which can distinguish each of the main groups seen in clinical practice.
Further identification can be done serologically to test for the presence of capsular antigen, which is the dominant structure on the surface of S. pneumoniae. [2] [5] Bile solubility can be used to further distinguish S. pneumoniae from viridans streptococci as S. pneumoniae are bile soluble and viridans streptococci are not. [6]
For decades, Streptococcus pneumoniae has been considered susceptible to optochin; but some strains have been found to be resistant to optochin in laboratory testing. This is notable because the emergence of optochin-resistant strains would invalidate the distinguishing test described above.
This phenomenon is the mechanism behind the CAMP test, [2] a test that was historically used for the identification of Streptococcus agalactiae and Listeria monocytogenes. [3] A modified version of this test called the reverse CAMP test, utilizing S. agalactiae instead of S. aureus, can also be used to identify Clostridium perfringens.
The quellung reaction, also called the Neufeld reaction, is a biochemical reaction in which antibodies bind to the bacterial capsule of Streptococcus pneumoniae, Klebsiella pneumoniae, Neisseria meningitidis, Bacillus anthracis, Haemophilus influenzae, [1] Escherichia coli, and Salmonella.
Colonial morphology serves as the first step in the identification of microbial species from clinical samples. [10] Based on the visual appearance of the colonies, microbiologists can narrow down the list of possible organisms, allowing them to select appropriate tests to provide a definitive diagnosis.
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