A child presents with infective skin lesion of the leg. Gram stain from the specimen shows pus cells with gram+ve cocci in chains and culture is done which shows hemolytic colonies. The test to confirm the organism is –
## **Core Concept**
The question describes a clinical scenario suggestive of a skin infection caused by a gram-positive coccus that appears in chains. The organism grows in a hemolytic pattern on culture, which is a key characteristic for identifying certain bacteria. The likely pathogen here is *Streptococcus* species, commonly causing skin infections.
## **Why the Correct Answer is Right**
The description points towards *Streptococcus pyogenes*, a Group A beta-hemolytic streptococcus (GABHS), which is a common cause of skin infections like impetigo or cellulitis. The organism's identification can be confirmed by a test that specifically detects its cell wall carbohydrate antigen. The **Bacitracin sensitivity test** is used for this purpose; *S. pyogenes* is sensitive to bacitracin. This test helps differentiate Group A streptococci from other beta-hemolytic streptococci.
## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is incorrect because it does not specify a test commonly used for identifying streptococcal species based on the given description.
- **Option B:** This could potentially refer to a variety of tests but is not specific or commonly associated with confirming *Streptococcus pyogenes* directly from the given clinical and lab information.
- **Option D:** This option does not directly relate to a commonly used confirmatory test for *Streptococcus pyogenes* based on standard microbiological practices.
## **Clinical Pearl / High-Yield Fact**
A key clinical pearl is that *Streptococcus pyogenes* infections can lead to significant morbidity, including post-streptococcal glomerulonephritis and rheumatic fever. Rapid identification and treatment are crucial. The bacitracin sensitivity test is a practical and commonly used method in clinical microbiology labs to quickly confirm the presence of Group A streptococci.
## **Correct Answer:** B. Bacitracin sensitivity test.