Understanding the Difference Between Streptococcus in the Microbiome and Streptococcal Infections in Children
The human microbiome is a complex ecosystem of trillions of microorganisms that live symbiotically within us, playing an essential role in our overall health. Streptococcus spp. is a group of bacteria commonly found as part of the microbiome, especially in the mouth, throat, and intestines. On the other hand, streptococcal infections caused by pathogenic strains of Streptococcus are a significant concern, particularly for children, leading to conditions such as strep throat or scarlet fever.
Understanding the difference between Streptococcus species that naturally reside in the microbiome and those responsible for infections in children is crucial for parents, caregivers, and healthcare providers. This article will explore the key differences, how these bacteria function, the ways infections occur, and their distinct symptoms.
What Is Streptococcus spp. in the Microbiome?
Streptococcus spp. are commensal bacteria — organisms that naturally live in various parts of the human body without causing harm. They are often found in the mouth, throat, intestines, and even on the skin. Some of these species are beneficial or neutral, while others can become opportunistic pathogens under certain conditions.
Examples of Streptococcus spp. in the Microbiome
- Streptococcus mitis: Commonly found in the oral cavity, playing a role in maintaining oral health.
- Streptococcus salivarius: Found in the mouth and throat, often associated with promoting a balanced oral microbiome.
- Streptococcus thermophilus: Found in the digestive system, this bacterium is often added to probiotic supplements and is considered beneficial for gut health.
Role of Streptococcus in the Microbiome
- Balance and Competition: These commensal Streptococcus species compete with other microorganisms for space and resources, helping to prevent the overgrowth of harmful bacteria.
- Immune System Modulation: Some strains of Streptococcus spp. may contribute to the modulation of the immune system, helping the body respond appropriately to pathogens without overreacting.
- Oral and Digestive Health: In the mouth, certain Streptococcus species aid in maintaining a balanced oral microbiome and can help prevent harmful bacteria from causing cavities or gum disease.
Do These Microbiome Streptococcus Cause Illness?
In a healthy individual, these strains of Streptococcus in the microbiome do not cause illness. However, if the immune system is compromised or there is a significant imbalance in the microbiome (dysbiosis), some strains may become opportunistic pathogens.
However, elevated levels of Streptococcus species in stool samples can indicate poor digestion and hypochlorhydria (low stomach acid). Adequate stomach acid is essential for breaking down food and controlling bacterial populations. When stomach acid levels are low, it can lead to bacterial overgrowth, including Streptococcus species, in the gastrointestinal tract. This overgrowth is associated with various gastrointestinal symptoms and conditions.
What is Pathogenic Streptococcus in Children?
The term "streptococcal infection" commonly refers to infections caused by Group A Streptococcus (GAS), specifically Streptococcus pyogenes, a pathogenic bacterium that causes various infections in children. These infections are completely separate from the commensal Streptococcus species in the microbiome.
Common Streptococcal Infections in Children
- Strep Throat (Pharyngitis): Caused by Streptococcus pyogenes, this infection results in a painful sore throat, fever, and swollen lymph nodes.
- Scarlet Fever: A condition that develops from untreated strep throat, characterized by a red, sandpaper-like rash, fever, and a "strawberry" tongue.
- Impetigo: A skin infection caused by Group A Streptococcus, resulting in red sores, usually around the mouth and nose, that burst and form a yellowish crust.
- PANDAS: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, a condition where strep infections trigger neuropsychiatric symptoms such as OCD or tics in some children.
- Perinatal Strep: This infection occurs around the anus, leading to symptoms like redness, itching, pain, and sometimes a discharge. It's most common in young children and can be uncomfortable and distressing.
How Do Children Get Streptococcal Infections?
- Person-to-Person Contact: Streptococcus pyogenes is highly contagious and spreads through respiratory droplets, direct contact with an infected person, or contact with surfaces contaminated by the bacteria.
- Weakened Immune System: Children are more susceptible to these infections due to their still-developing immune systems.
Typical Symptoms of Streptococcal Infections in Children
- Sore Throat: Sudden onset of a very sore throat without a cough.
- Fever: Often above 101°F (38.3°C), indicating an active infection.
- Swollen Lymph Nodes: Particularly in the neck.
- Rash: In the case of scarlet fever, a rash may develop on the chest, neck, and arms.
- Nausea and Vomiting: Sometimes gastrointestinal symptoms accompany the infection.
- Fatigue and Headache: General symptoms of malaise are also common.
Key Differences Between Microbiome Streptococcus and Pathogenic Streptococcus in Children
Despite belonging to the same genus, the Streptococcus spp. in the microbiome and pathogenic Streptococcus infections in children are very different in terms of their roles in health and disease. Streptococcus spp. on the GI-MAP and pathogenic Streptococcus is key to interpreting results accurately. Streptococcus spp. is a broad category that includes many strains of bacteria, some of which are normal and beneficial residents of the gut microbiome, playing roles in digestion and immune function. On the other hand, pathogenic Streptococcus refers to specific strains, such as Streptococcus pyogenes or Streptococcus pneumoniae, which can cause infections and disease. On the GI-MAP, the detection of Streptococcus spp. may indicate overgrowth or imbalance rather than direct pathogenicity, and it requires context, such as symptoms or co-detected pathogens, to determine its clinical significance.
Microbiome Streptococcus
- Location: Found naturally in the mouth, throat, intestines, and skin.
- Function: Typically, part of a healthy microbial community, helping to maintain balance and prevent the overgrowth of harmful bacteria.
- Impact: Generally harmless unless the immune system is compromised or there is significant dysbiosis.
Pathogenic Streptococcus (Streptococcus pyogenes)
- Location: Invades the throat, skin, or other tissues during infection.
- Function: Causes illnesses such as strep throat, scarlet fever, and impetigo.
- Impact: Can lead to serious illness if untreated, including complications such as rheumatic fever or kidney damage.
Conclusion
Streptococcus in the Microbiome vs. Streptococcal Infections
Understanding the difference between commensal Streptococcus spp. in the microbiome and the pathogenic Streptococcus pyogenes that causes infections is critical for health management. While microbiome Streptococcus species play beneficial roles in maintaining health, Group A Streptococcus is responsible for common childhood infections that require medical treatment.
Parents should be aware that the bacteria naturally living in the microbiome are typically harmless, while external infections with pathogenic streptococci can lead to a range of illnesses. Knowing the difference allows for better health decisions, from supporting the microbiome to recognizing the symptoms of an infection that requires medical intervention.
Author Greer McGuinness, MS, RD, CDN, CLT
Greer McGuinness, MS, RD, CDN, CLT, holds a Master of Science in Nutrition and Dietetics and is a Registered Dietitian, Certified Detox Specialist, Certified Master Herbalist, Certified Lyme Specialist, and Certified Mental Health Specialist. Greer is a member of the Clinical Team at Diagnostic Solutions Laboratory and is passionate about teaching practitioners how to use functional medicine testing to optimize outcomes for their patients.
Greer has made significant contributions to the field of pediatric health. Her expertise lies in detoxifying toxins, enhancing gut health, and optimizing nutrient status. As a published researcher, she has focused on autism spectrum disorder (ASD) and alternative medicine, showcasing her commitment to exploring innovative approaches to healthcare.
Greer is the proud owner of Biomedical Healing for Kids, a virtual private practice in New York.
The opinions expressed in this presentation are the author's own. Information is provided for informational purposes only and is not meant to be a substitute for personal advice provided by a doctor or other qualified health care professional. Patients should not use the information contained herein for diagnosing a health or fitness problem or disease. Patients should always consult with a doctor or other health care professional for medical advice or information about diagnosis and treatment.
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