J Clin Microbiol, 1988 Oct, 26(10), 2025 - 30 Microtechnique for serum opacity factor characterization of group A streptococci adaptable to the use of human sera; Johnson DR et al.; We have developed a microtechnique for detection of streptococcal serum opacity factor (OF) and for typing of group A streptococci by inhibition of OF . This technique, which involves the use of single wells of standard 96-well tissue culture plates, offers several advantages over previous methods: no advance test preparation is required, allowing tests to be quickly and easily performed; only small quantities of reagents are required; results can be determined visually (qualitative) or by using a photometric enzyme-linked immunosorbent assay plate reader (quantitative); and human serum samples may be quickly and easily screened for OF-inhibitory antibody and subsequently used in place of difficult-to-produce and expensive hyperimmune animal sera for OF characterization of group A streptococci . Fifty-eight samples of normal adult human serum were tested by this new microtechnique for anti-OF antibodies, and 49 (84%) were found to have antibody against 1 or more of the 27 recognized OF-positive serotypes . OF antibodies to M-4, M-2, M-75, and M-48 were most common in these individuals . These 58 human serum samples collectively contained antibody to 25 of the 27 different OF-producing serotypes . Serum samples from four individuals were tested for persistence of OF antibody . OF antibodies to eight different serotypes present in the serum samples collected 7 to 12 years previously were present in the freshly collected sera, indicating that OF antibody persists in human antisera for many years . This new technique has distinct advantages and makes it possible for many laboratories to use this technique to characterize group A streptococci. Pediatrics, 1988 Oct, 82(4), 576 - 81 Rapid group A streptococcal antigen detection kit: effect on antimicrobial therapy for acute pharyngitis; Redd SC et al.; Newly introduced rapid diagnostic tests for group A streptococcal pharyngitis should facilitate appropriate antimicrobial use in patients with group A streptococcal pharyngitis . Because of high rates of acute pharyngitis in Tuba City, AZ, at the Navajo Indian reservation, the use of rapid diagnostic test was prospectively evaluated . The sensitivity and specificity of the test was measured and changes in physician prescribing patterns attributable to use of the test were correlated . Of 320 patients with pharyngitis enrolled during the present 3-week study, 86 met the study's definition of a patient with streptococcal pharyngitis and 163 met the study's definition of a patient with nonstreptococcal pharyngitis . The rapid test was 62.8% sensitive and 96.9% specific in identifying patients from whom group A streptococci were isolated . Although treatment of patients with streptococcal pharyngitis at the time of the first visit increased from 36.5% in a retrospective sample to 72.5% during the study, treatment of patients in whom cultures were negative remained the same . Further analyses showed that physicians tended to treat patients with signs characteristic of streptococcal pharyngitis and, as the study progressed, to rely less on negative rapid test results as a reason to withhold antimicrobial agents . It was concluded that rapid tests with good specificity but limited sensitivity may improve treatment of patients with streptococcal pharyngitis by allowing earlier specific therapy . A more sensitive test with a higher negative predictive value would be necessary to prevent treatment of persons with nonstreptococcal pharyngitis. J Med Microbiol, 1988 Oct, 27(2), 141 - 4 Use of enzymes in typing group A beta-haemolytic streptococci; Brahmadathan KN et al.; A series of 698 strains of group A beta-haemolytic streptococci (GAS) isolated from children with streptococcal pyoderma was tested for production of serum opacity factor (OF) and nicotinamide adenine dinucleotide glycohydrolase (NADase) . OF was produced by 37% of strains and 40% produced NADase . Classification based on various combinations of OF and NADase reactions showed that 58% belonged to enzyme group el and 34% to e2 . Correlation with T and M types showed the possible use of this means of classification as an epidemiological marker for GAS . The specificity of such a system in the further classification of various T types of GAS in epidemiological studies, in the light of antigenic variation among M types, is described. J Hosp Infect, 1988 Oct, 12(3), 199 - 206 Urethral and prostatic colonization and infection in patients undergoing prostatectomy; Morgan MG et al.; We conducted a prospective trial to identify organisms colonizing the urethra and prostate and their role in the aetiology of infection after prostatectomy . Twenty-five patients were studied of whom six developed postoperative infection . The causative organisms were previously recovered from the urethra but not the prostate . There was a high rate of urethral colonization by streptococci (14/25) and a low incidence of prostatic colonization . We describe a novel method of sampling the prostate. J Infect Dis, 1988 Oct, 158(4), 823 - 30 Effects of fibronectin on the interaction of polymorphonuclear leukocytes with unopsonized and antibody-opsonized bacteria; Yang KD et al.; Fibronectin (Fn) affects the interaction of polymorphonuclear leukocytes (PMNLs) with certain bacteria . Fn alone enhanced the response, in a chemiluminescence (CL) assay, of PMNLs to Staphylococcus aureus (P less than .05) and Staphylococcus epidermidis (P less than .01) but had no effect on type III, group B streptococci (GBS) or Escherichia coli . When GBS or E . coli were first preopsonized in antibody, Fn significantly enhanced the CL response of PMNLs (P less than .05) . The intracellular metabolic inhibitor NaN3 but not the extracellular scavengers superoxide dismutase or human serum albumin inhibited Fn-enhanced CL; this fact suggests that enhancement of the respiratory burst by Fn is an intracellular event . We used an acridine orange-crystal violet monolayer assay to examine the effects of Fn on ingestion and intracellular killing of bacteria by PMNLs . Fn alone promoted uptake and killing of S . aureus (P less than .01) and S . epidermidis (P less than .05) by PMNLs but did not enhance monolayer phagocytosis of GBS or E . coli, unless these bacteria were preopsonized in antibody (P less than .01). J Dent Res, 1988 Oct, 67(10), 1300 - 6 Differential modulation of adherence of oral streptococci by human neutrophil myeloperoxidase; Miyasaki KT et al.; In this study, the modulation of adherence of hydrogen peroxide (H2O2)-producing and non-H2O2-producing strains of oral streptococci by the host leukocyte enzyme myeloperoxidase (MPO) was examined . It was found that exposure to MPO decreased adherence of many strains of oral streptococci to saliva-coated hydroxyapatite beads in the presence of exogenous H2O2 and chloride . The MPO-H2O2-Cl-system increased the adherence of one strain . In the absence of exogenous H2O2, the MPO-H2O2-Cl-system decreased the adherence of H2O2-producing strains only . Glucose increased streptococcal H2O2 production and also increased the anti-adhesive activity of MPO in the absence of exogenous H2O2 . We conclude that: (1) host leukocytes can modulate the adherence of oral streptococci via MPO; (2) endogenous production of H2O2 by the oral streptococci can provide sufficient substrate H2O2 to drive this system; and (3) MPO will exert differential modulatory effects on the adherence of oral streptococci, based in part upon the level of endogenous H2O2 production and in part upon the particular characteristics of the adhesins of the bacteria. Biull Eksp Biol Med, 1988 Oct, 106(10), 467 - 9 {Receptors for polysaccharides of group A streptococci on human thymic lymphocytes . Stimulation of their expression by action of adenosine, theophylline and supernatant of thymocytes}; Gnezditskaia EV et al.; It was established by indirect immunofluorescence that thymic lymphocytes bear receptors for polysaccharide of group A streptococci (Rps) . The ability of thymic lymphocytes to express Rps depends on the cAMP concentration in the cell, because the treatment of thymocytes with adenosine and theophylline increases the number of cells with Rps (Tps cells) . Supernatant of thymic lymphocytes is also capable of stimulating expression of Rps . Because the A-polysaccharide has common antigenic determinant with thymus epithelium antigen it can be assumed that A-polysaccharide links with the thymocytes via receptor for this epithelial antigen . This assumption needs a detailed study in view of the hypothesis about the important role of cross-reactive antigens of group A streptococci in generating autoimmune process during rheumatic fever and other streptococcal diseases . It should also be noted that Rps may be a useful marker for identification and studying the changes of Tps subpopulation in the thymus and peripheral lymphoid organs of patient with different streptococcal diseases. Infect Immun, 1988 Oct, 56(10), 2666 - 72 Influence of intranasal immunization with synthetic peptides corresponding to conserved epitopes of M protein on mucosal colonization by group A streptococci; Bessen D et al.; A major virulence factor of group A streptococci is M protein, a surface-exposed fibrillar molecule of which there exist more than 80 distinct serological types . Antigenic variability resides largely in the amino-terminal region of M protein, whereas the carboxy-terminal half of the molecule is highly conserved among different M serotypes . We sought to determine whether mucosal immunization with conserved epitopes of M protein influences the course of mucosal colonization by group A streptococci in a mouse model . Synthetic peptides corresponding to sequences in the conserved region of M protein were covalently linked to the mucosal adjuvant cholera toxin B subunit . Mice were immunized intranasally with the peptide-cholera toxin B subunit conjugate or with cholera toxin B subunit alone and then challenged intranasally with live streptococci . Pharyngeal colonization by streptococci was measured for up to 15 days postchallenge . Mice immunized with synthetic peptides showed a significant reduction in colonization compared with the control group . The data demonstrate that immunity evoked by conserved portions of M protein influences the outcome of group A streptococcal infection at the nasopharyngeal mucosa in a mouse model. Am J Obstet Gynecol, 1988 Sep, 159(3), 579 - 83 Intrapartum treatment of acute chorioamnionitis: impact on neonatal sepsis; Gilstrap LC 3rd et al.; In a study of 312 women with acute chorioamnionitis, 152 women received antibiotics before delivery, 90 received antibiotics after cord clamping, and 70 did not receive antibiotics . Antibiotics were administered during labor rather than after cord clamping if delivery was not imminent . Although endometritis developed more frequently in the patients receiving antibiotics after cord clamping, the difference was not statistically significant (5.6% versus 3.9%, difference not significant) . There were two cases of verified sepsis in the group of infants (35 weeks) born to mothers receiving intrapartum antibiotics and there were eight cases in the no antibiotics group (p = 0.06) . More importantly, in neonates greater than or equal to 35 weeks' gestational age, there was a significant difference in the frequency of positive blood cultures for group B streptococci (0/133 versus 8/140, p less than 0.05) . We conclude that administration of antibiotics to the mother during labor may result in a decreased incidence of neonatal sepsis. J Leukoc Biol, 1988 Sep, 44(3), 172 - 9 Procoagulant synthesis by exudate and bone marrow-derived murine macrophages; Shands JW Jr et al.; Murine exudate macrophages elicited by different stimuli and bone marrow-derived macrophages were studied for their capacity to synthesize factor VII and tissue factor in a basal state and on stimulation with endotoxin (LPS) . Cells elicited by different stimuli varied in their production of both factors . Thioglycollate-elicited cells generally made more, but not significantly more, tissue factor in response to endotoxin than cells elicited with periodate or streptococci . Cells elicited with proteose-peptone, fetal calf serum (FCS), or LPS produced less or very little tissue factor . Thioglycollate-elicited cells and cells elicited with streptococci or proteose-peptone consistently made more factor VII than cells elicited with periodate, FCS, and LPS . Bone marrow-derived macrophages were responsive to LPS by the production of tissue factor by the fifth day of culture, and this rose to a maximum by day 10 . The maximal production of factor VII occurred on day 5 of culture and declined with longer cultivation . Factor VII production was not enhanced by LPS, and prolonged cultivation in the presence of LPS turned off the synthesis of both tissue factor and factor VII . We conclude that exudate cells are heterogeneous in the production of coagulant factors and that the production of these factors varies with the maturity of the cells . In addition, the production of the tissue factor and the factor VII were not necessarily expressed in a coordinate fashion. Infect Immun, 1988 Sep, 56(9), 2484 - 90 Cloning and expression of a Streptococcus sanguis surface antigen that interacts with a human salivary agglutinin; Demuth DR et al.; Human saliva contains a high-molecular-weight glycoprotein (agglutinin) which binds to specific streptococci in a calcium-dependent reaction leading to the formation of bacterial aggregates . We report the cloning of a gene encoding a surface antigen from Streptococcus sanguis M5 and show that the expressed protein inhibits agglutinin-mediated aggregation and specifically binds the salivary agglutinin in a calcium-dependent fashion . Clones isolated from the immunological screening of S . sanguis M5 genomic libraries with polyclonal antibodies against whole cells were assayed for the ability to compete with S . sanguis for agglutinin . One clone, pSSP-5, expressed antigens of 165 and 130 kilodaltons (kDa) possessing this activity . A 3-kilobase-pair (kbp) insert fragment from this clone was used to screen a genomic library in lambda EMBL3 which resulted in the isolation of clone SSP-5A . This clone contained an insert of 17 kb and expressed proteins of 170 to 205 kDa that reacted with the anti-S . sanguis antibodies . Subcloning of a 5.3-kbp EcoRI-BamHI fragment from SSP-5A produced pEB-5, which expressed streptococcal components that were indistinguishable from SSP-5A . The streptococcal antigen was purified by gel permeation and ion exchange chromatography and shown to potently compete with S . sanguis M5 cells for agglutinin . The antigen also bound purified salivary agglutinin in the presence of 1 mM CaCl2 . This binding was inhibited by EDTA . Both the SSP-5 antigen and a 205-kDa protein in surface protein extracts from S . sanguis M5 cross-reacted with antibodies directed against antigen B from S . mutans and SpaA from S . sobrinus 6715 . These results indicate that a 205-kDa surface protein that is antigenically related to SpaA and antigen B is involved in the binding of salivary agglutinin to S . sanguis M5. Antimicrob Agents Chemother, 1988 Sep, 32(9), 1375 - 8 Antagonistic effect of chloramphenicol in combination with cefotaxime or ceftriaxone; Asmar BI et al.; We evaluated the in vitro interaction at clinically attainable concentrations of cefotaxime and ceftriaxone with chloramphenicol against 26 clinical isolates of gram-negative rods, group B streptococci, and Staphylococcus aureus . Cefotaxime and ceftriaxone were bactericidal against all 26 organisms (MBC, 0.03 to 4 micrograms/ml) . Chloramphenicol was bacteriostatic against 24 organisms (MBC, greater than or equal to 32 micrograms/ml) and bactericidal against two Escherichia coli isolates (MBC, 8 micrograms/ml) . Checkerboard testing showed chloramphenicol to be antagonistic to the bactericidal activity of cefotaxime and ceftriaxone for all 24 bacteria for which chloramphenicol was bacteriostatic . Time kill curves for selected strains of E . coli and group B streptococci for which chloramphenicol was bacteriostatic showed antagonism of chloramphenicol to both cephalosporins . The combination of chloramphenicol with either cephalosporin was antagonistic in cases in which chloramphenicol was bacteriostatic against the above organisms and should be avoided in the treatment of infections caused by such organisms if bactericidal therapy is desired. J Clin Microbiol, 1988 Sep, 26(9), 1708 - 13 Simple genetic method to identify viridans group streptococci by colorimetric dot hybridization and fluorometric hybridization in microdilution wells; Ezaki T et al.; Simple dot hybridization and fluorometric hybridization methods in microdilution wells were designed and established for rapid and routine genetic identification of viridans group streptococci . Reference DNA extracted from each strain of 24 reference Streptococcus species was fixed both on a nitrocellulose filter and in a microdilution well . A 1-ml portion of the bacterial suspension which matched the turbidity of McFarland no . 2 standard was prepared when a streptococcal strain was isolated . It was lysed with achromopeptidase, and the DNA was quickly labeled with photobiotin under a sunlamp for 15 min . Dot hybridization and fluorometric hybridization were then carried out between the labeled DNA of the unknown organism and 24 unlabeled reference DNAs . Hybridized fragments on a nitrocellulose filter were detected by using alkaline-phosphatase-conjugated streptavidin and analyzed with a color graphic analyzer . Hybridized fragments in microdilution wells were quantitatively detected by using an enzyme, streptavidin-conjugated beta-D-galactosidase, and a fluorogenic substrate, 4-methylumbelliferyl-beta-D-galactoside . Strains belonging to each genetically distinct species could be identified by this dot blot hybridization test . However, some clinical strains cross-hybridized with two or more reference species, and then they were difficult to differentiate by dot blot hybridization . In such a case, fluorometric identification provided reliable results because the fluorometric method was more quantitative than dot blot identification . By these methods, it was possible to determine species assignment within the viridans group. J Antimicrob Chemother, 1988 Sep, 22 Suppl C, 45 - 51 The selection and frequency of streptococci with decreased susceptibility to ofloxacin compared with other quinolones; Piddock LJ et al.; Three strains each of Streptococcus pneumoniae, Lancefield group A streptococci, Lancefield group B streptococci and Lancefield group D streptococci were examined for the frequency of spontaneous mutation to give decreased susceptibility at two, four and six times the minimum inhibitory concentration of ofloxacin, ciprofloxacin, enoxacin and norfloxacin . Any putative mutants were examined for stability of resistance and susceptibility to all quinolones in the study, erythromycin and benzyl penicillin . All strains yielded mutants to twice the MIC of each quinolone at a frequency associated with a mutation at a single gene . Each species in the study responded differently at four and six times the MIC of each quinolone . Group B streptococci yielded most mutants and resistant Str . pneumoniae were the most difficult to select . Most mutants were cross-resistant to quinolones only, probably owing to an altered DNA gyrase . Fewer resistant mutants of Str . pneumoniae were selected using ofloxacin compared to ciprofloxacin. Oral Surg Oral Med Oral Pathol, 1988 Sep, 66(3), 304 - 9 Effect of topical administration of vancomycin versus chlorhexidine on alpha-hemolytic streptococci in oral cavity; Borthen Svinhufvud L et al.; In a crossover study the effect of local vancomycin (paste containing 0.5% vancomycin applied to the gums three times a day for 7 days) versus chlorhexidine mouth rinsing (0.2% chlorhexidine solution twice a day for 7 days) on alpha-hemolytic streptococci in the oral cavity was investigated in eight volunteers . Mixed saliva and dental plaque samples were collected for microbiologic analysis before administration, during treatment, and after withdrawal of the agents . The numbers of different alpha-hemolytic streptococci were determined in the samples . The total numbers of Streptococcus mitior, Streptococcus mutans, and Streptococcus sanguis were significantly reduced by the vancomycin treatment compared with the chlorhexidine treatment (p less than 0.05) after 2 days of administration . Two days after the treatment was stopped the numbers of alpha-hemolytic streptococci had returned to pretreatment levels . Local prophylaxis with vancomycin as a complement to systemic antimicrobial prophylaxis may therefore be useful in the prevention of infective endocarditis. J Med Microbiol, 1988 Sep, 27(1), 65 - 70 Preformed enzyme profiles of reference strains of gram-positive anaerobic cocci; Murdoch DA et al.; The preformed (constitutive) enzyme profiles of 30 type strains and reference strains of gram-positive anaerobic cocci were determined with two commercial systems, RapID ANA and a prototype system from API . Both systems identified Peptostreptococcus anaerobius, Ps . asaccharolyticus, Ps . indolicus, Ps . magnus and Ps . micros accurately, except for one strain of Ps . magnus misidentified as Ps . micros by the RapID ANA system . The indole-negative, butyrate-producing cocci (classified at present as Ps . prevotii and Ps . tetradius) produced several different, unique patterns with the prototype API system, but the results with RapID ANA were often misleading . Eight strains of Hare group cocci produced previously described profiles . Four strains of streptococci produced profiles easily distinguished from those of the gram-positive anaerobic cocci . We conclude that most gram-positive anaerobic cocci can be identified rapidly and reliably to the species level by their preformed enzyme profiles, providing that their underlying classification is sound . Problems were encountered with the butyrate-producing cocci, which appear to be a more heterogeneous group of organisms than is currently acknowledged; further taxonomic studies on these organisms are required. Acta Paediatr Scand, 1988 Sep, 77(5), 705 - 10 Adherence of alpha-hemolytic streptococci to human endocardial, endothelial and buccal cells; Schollin J; Human buccal, endothelial and endocardial cells were prepared and the adherence of different bacteria to these cells was tested in vitro . Buccal cells were scraped off immediately before use in the adherence tests . Endothelial and endocardial cells were prepared from human umbilical vein and human heart valves by using collagenase, and cultured in cell culture medium . Seventeen different bacteria were used in the adherence tests; ten strains of alpha-hemolytic streptococci, five from children with infective endocarditis (IE) and five from healthy carriers, two S . aureus, two N . meningitidis, two N . gonorrhoeae and one E . coli . The five alpha-hemolytic streptococcal strains from patients with IE showed significantly higher adherence values than those from healthy carries as well as in comparison with the remaining seven bacteria . The difference in adherence might be an expression for different bacteria surface properties . These differences might be important in explaining the infective mechanism in infective endocarditis. Am J Vet Res, 1988 Sep, 49(9), 1537 - 9 Sensitivity and specificity of latex agglutination tests used to identify Streptococcus agalactiae and Staphylococcus aureus isolated from bulk tank milk; Hogan JS et al.; Comparisons were made among rapid latex agglutination tests and conventional biochemical tests used to identify Streptococcus agalactiae and Staphylococcus aureus . Ninety-eight streptococci and 149 staphylococci isolated from bulk tank milk were tested . Sensitivity and specificity for the latex agglutination test used for identification of Str agalactiae were 97.6 and 98.2%, respectively . Sensitivity and specificity for the latex agglutination test used for identification of S aureus were 90.2 and 67.5%, respectively . Of 25 staphylococci considered false-positive by the latex agglutination test, 14 (56%) were considered tube coagulase-positive . Fifteen staphylococci considered false-positive by latex agglutination test had biotypes representative of S hyicus of S xylosus. Am J Vet Res, 1988 Sep, 49(9), 1485 - 8 Adherence of streptococcal isolates from cattle and horses to their respective host epithelial cells; Valentin-Weigand P et al.; Adherence of Streptococcus dysgalactiae isolates from cattle and S equi isolates from horses to their respective host epithelial cells was compared with the adherence of S pyogenes to human epithelial cells . The adherence was quantitatively determined by use of fluorescein-labeled streptococci . All 3 streptococcal species adhered selectively to their respective host cells . The mechanism of adherence was evaluated by binding studies with adhesive plasma protein, fibronectin . Although all 3 streptococcal species bound fibronectin, S dysgalactiae and S equi interacted preferentially with a 210-kilodalton (kD) C-terminal fragment of fibronectin, whereas S pyogenes bound only a 29-kD N-terminal fragment . A synthetic peptide Gly-Arg-Gly-Asp-Ser, representing the host cell attachment site of fibronectin, partially inhibited the binding of fibronectin and of its 210 kD fragment to S dysgalactiae, but not to S equi . The binding of fibronectin and its 29-kD fragment to S pyogenes was not inhibited by Gly-Arg-Gly-Asp-Ser . These differences in binding activities corresponded to the ability of fibronectin to mediate the adherence of the streptococci to the epithelial cells: fibronectin strongly inhibited the adherence of S pyogenes and S equi to the epithelial cells, but only weakly inhibited that of S dysgalactiae. Pathol Biol (Paris), 1988 Sep, 36(7), 915 - 9 {Prophylaxis of Gram-positive infections after bone marrow graft . Controlled study of the 6-day administration of vancomycin . Intermediate analysis of 60 patients}; Maraninchi D et al.; We prospectively evaluated after randomization in 60 consecutive recipients of bone marrow transplantation the efficiency of a short administration of vancomycin (10 mg/kg I.V . q 6 H, day -5 to +1) . Thirty-three patients were randomized as controls and 27 were designed to receive vancomycin . Both groups were similar in terms of age, diagnosis, status, allogeneic or autologous graft, in vitro marrow treatment or not . Eighteen patients (30%) experienced bacteremias: 15/18 bacteremias were due to Gram positive organisms, including 11 streptococci . These infections occurred with a similar frequency in both groups, the relatively low incidence of bacteremias in this study needs further evaluation in new patients to insure the prophylactic effects of a course of vancomycin in bone marrow transplant recipients. Pathol Biol (Paris), 1988 Sep, 36(7), 891 - 5 {Bacteremias after bone marrow grafts in a protected environment: effects, various aspects and prognosis}; Michel G et al.; We evaluated retrospectively the incidence and prognosis of bacteremias after bone marrow transplantation treated in protected environment with intestinal decontamination . Bacteremias are more frequent during the extreme granulopenia (55% of the patients) than during recovery of granulocyte counts greater than 500/mm3 (35% of the patients) . Gram + organisms are more frequently responsible of bacteremias (80%), mainly Staphylococcus epidermidis and Streptococci . Mortality is low (7%) and related to additional factors like GVH, resistant leukemia . These data invite to develop new approaches of prevention of bacterial infection, with measures possibly efficient on Gram + organisms. Antimicrob Agents Chemother, 1988 Sep, 32(9), 1370 - 4 Berberine sulfate blocks adherence of Streptococcus pyogenes to epithelial cells, fibronectin, and hexadecane; Sun D et al.; Berberine sulfate is an alkaloid extracted from the roots and bark of various plants and possesses antibacterial, antifungal, and antiprotozoal activities . Most studies have focused on the bacteriostatic or bactericidal activities of this compound . In this study, we report that berberine sulfate is bacteriostatic for streptococci and that sub-MICs of berberine blocked the adherence of streptococci to host cells, immobilized fibronectin, and hexadecane . Concentrations of berberine below its MIC caused an eightfold increase in release of lipoteichoic acid from the streptococci . Higher concentrations of berberine directly interfered with the adherence of streptococci to host cells either by preventing the complexing of lipoteichoic acid with fibronectin or by dissolution of such complexes once they were formed . Thus, berberine sulfate interferes with the adherence of group A streptococci by two distinct mechanisms: one by releasing the adhesin lipoteichoic acid from the streptococcal cell surface and another by directly preventing or dissolving lipoteichoic acid-fibronectin complexes. Bone Marrow Transplant, 1988 Sep, 3(5), 483 - 93 Control of oral mucositis and candidiasis in marrow transplantation: a prospective, double-blind trial of chlorhexidine digluconate oral rinse; Ferretti GA et al.; Conditioning chemoradiotherapy damages the mucosal barrier of the mouth and throat and often produces severe oral inflammation and infection . In a prospective, double-blind, randomized study, we examined the use of a chlorhexidine digluconate mouthrinse for prophylaxis against oral mucosal complications in 51 bone marrow transplant patients . Use of chlorhexidine mouthrinse produced significant reductions in the incidence and severity of oral mucositis . Mucositis also resolved more quickly in patients receiving chlorhexidine . Concomitant reductions in total oral streptococci (p less than 0.02-p less than 0.001) and oral candida (p less than 0.004) were seen in patients using chlorhexidine . Persistent clinical oral candidiasis (thrush) was observed in 15 to 27 control group patients (56%), but only transiently in two (8%) of 24 patients who used chlorhexidine rinse (p less than 0.001) . Five of 27 control group patients (19%) had candidemia, while no candidemia was observed in the chlorhexidine group (p less than 0.03) . Three deaths from disseminated candidiasis occurred in the placebo group; none occurred in patients who received chlorhexidine . Prophylactic use of chlorhexidine mouthrinse produces reductions in oral soft tissue disease and oral microbial burden in patients undergoing bone marrow transplantation . The reductions in mucositis and in oral candida infections observed with prophylactic chlorhexidine mouthrinse represent a significant advantage for patients undergoing marrow transplantation. Vet Microbiol, 1988 Sep, 18(1), 41 - 50 Ingestion and killing of Streptococcus agalactiae by bovine granulocytes in the presence of natural opsonins; Rainard P et al.; An enzyme-linked immunosorbent assay (ELISA) demonstrated the presence of naturally acquired antibodies against Streptococcus agalactiae in normal bovine serum (NBS) . In milk wheys, ELISA values were much lower than in sera . Pre-colostral calf serum (PCS) was shown to lack antibodies to type II and III S . agalactiae . The opsonic requirements of 10 human and 10 bovine strains were investigated by evaluating the phagocytosis-induced reduction of the incorporation of radiolabeled thymidine by streptococci . Antibodies present in NBS were required for the efficient ingestion of both human and bovine isolates type II by bovine granulocytes . Three out of five type III bovine isolates were opsonized in the absence of specific antibodies (opsonization by PCS) and type II and III bovine isolates did not require complement opsonization . By contrast, inactivation of complement reduced phagocytosis of human isolates and only one type III strain of human origin was opsonized by PCS . These findings suggest that human isolates had higher opsonic requirements . The phagocytic killing of 6 type III strains (5 mastitis isolates and the reference typing strain) was investigated . Opsonization by normal serum enabled bovine blood granulocytes to ingest and kill S . agalactiae . Nevertheless, greater than or equal to 35% of bacteria remained viable at the end of the phagocytosis incubation in 10% NBS . Heat treatment of serum decreased the efficacy of killing for only 3 of the 6 tested strains . An IgG2 fraction of normal adult bovine serum promoted active ingestion, which was still increased in the presence of PCS . Normal wheys displayed large variations in their ability to promote ingestion of S . agalactiae by blood granulocytes . The promoting effect was systematically less than that of serum from the same cow, and this can be related to the lower ELISA values found in wheys. J Clin Periodontol, 1988 Sep, 15(8), 499 - 505 Microbiological effects of mouthrinses containing antimicrobials; Walker CB; A number of mouthrinse formulations containing antimicrobials have been evaluated to determine their effectiveness as antiplaque and/or antigingivitis agents . These have included the bis-biguanides, phenols, quaternary ammonium compounds, oxygenating compounds, plant extracts, fluorides, antibiotics and antimicrobial combinations . These mouthrinses have often been tested as adjuncts to normal oral hygiene procedures as well as in the experimental gingivitis model . 2 agents in particularly, chlorhexidine gluconate and listerine, have been shown to both inhibit or reduce plaque accumulation and the severity of gingivitis . Chlorhexidine has been reported to reduce the accumulation of plaque by approximately 60% and the severity of gingivitis by 50-80% as determined by improvements in clinical indices . A 0.12% chlorhexidine gluconate rinse resulted in significant reductions after both 3 and 6 months use in the numbers of total anaerobes, total aerobes, streptococci, and actinomyces recovered from supragingival plaque . Listerine has been reported to retard the development of plaque by 45 to 56% and to reduce existing plaque by 39 to 48% . Gingivitis scores were reduced as much as 59% . Microbial studies have shown that the effect of listerine is exerted against the total microbial mass and results in an overall decrease in both the biomass and the activity . Long-term use of neither mouthrinse, chlorhexidine or listerine, resulted in the emergence of opportunistic or oral pathogens . Preliminary data obtained following the use of a novel mouthrinse consisting of a combination of povidone-iodine and hydrogen peroxide appears promising . This combination was more effective than was more effective than either single component alone in reducing gingivitis scores.(ABSTRACT TRUNCATED AT 250 WORDS) Hautarzt, 1988 Sep, 39(9), 564 - 8 {Microbial flora and odor of the healthy human skin}; Korting HC et al.; The microflora resident on human skin shows great interindividual and intraindividual differences . It is essentially composed of micrococci, staphylococci, aerobic and anaerobic coryneforms as well as pityrosporum species which, in accordance with the different environment in the different regions of the body, are in a steady state . With increasing age, human skin microflora undergoes qualitative changes: the streptococci, which are found in infants, disappear and coryneform bacteria occur, which are mainly responsible for odor production . Anaerobic propionibacteria are more numerous in juveniles and young adults, a fact that may be explained by increased sebum production . Only the coryneform bacteria are able to produce the typical axillary odor by decomposition of apocrine sweat . Cocci, however, obviously do not have this capacity . It remains to be established which substances participate in odor production . With sensitive chromatographic methods amino acids, steroids and free fatty acids were detected, which could be related to body odor . There are possibly only a few commonly occurring odorous substances . The necessity of analyzing these substances is stressed. J Med Microbiol, 1988 Sep, 27(1), 23 - 31 Experimental arthritis induced by atypical strains of Streptococcus pyogenes; Barridge BD et al.; Experimental arthritis was induced in Sprague-Dawley rats by intraarticular injection of whole-cell sonicates, heat-killed cells and cell-wall preparations of typical and atypical strains of Group-A streptococci (Streptococcus pyogenes) . The non-haemolytic nitrosoguanidine-derived mutant and the naturally occurring Lowry strain induced a similar but less severe form of arthritis . Direct immunofluorescent staining demonstrated maximum fluorescence in the sections of articular joint taken 60 days after injection . The level of immune complexes increased for up to 90 days after injection of cell walls or whole-cell sonicates and correlated well with the development of the chronic stage of arthritis observed in haematoxylin and eosin and fluorescence staining of thin tissue sections. J Med Microbiol, 1988 Sep, 27(1), 17 - 22 Penicillin tolerance among oral streptococci; Holbrook WP et al.; Penicillin tolerance was elicited in 18 of 46 strains of viridans streptococci isolated from the mouths of 19 of 20 healthy subjects and in 31 of 54 consecutive blood-culture isolates of streptococci . Enterococci and Streptococcus sanguis were the organisms most frequently tolerant but the property was also common among isolates of S . mutans, S . mitior and Lancefield Group G streptococci . Pneumococci and S . salivarius were rarely tolerant . When incubated with penicillin at 5 x MIC in batch or continuous cultures, both tolerant and sensitive strains of oral streptococci declined in number less rapidly than S . pyogenes . However, combinations of penicillin and gentamicin killed tolerant and sensitive oral streptococci. Clin Pediatr (Phila), 1988 Sep, 27(9), 431 - 4 Streptococcal pharyngitis . Comparison of latex agglutination and throat culture; White CB et al.; Despite its imperfections, the throat culture remains the "gold standard" against which all rapid streptococcal antigen detection tests are compared . Using triple throat swabs, the accuracy of a rapid latex agglutination (LA) test and back up throat culture was determined and compared with a simultaneously obtained additional throat culture in children with suspected streptococcal pharyngitis . Although there was a 95 percent concordancy between throat cultures, the sensitivity of the throat culture was only 87 percent . Despite the LA test's lower sensitivity (78 percent), in this clinical population with a relatively low prevalence of positive throat cultures (19 percent), the predictive value of a negative LA test was only slightly lower than that of the throat culture (94-95 percent vs . 97 percent) . Backup throat cultures are commonly recommended for patients with initially negative LA test results, but 10 percent of the patients with group A beta-hemolytic streptococci-positive throat cultures would have been undetected using this approach. Carbohydr Res, 1988 Aug 15, 179, 61 - 75 Synthesis of a di-, tri-, and tetra-saccharide unit of the group B streptococcal common antigen; Pozsgay V et al.; Condensation of methyl 2,3-O-isopropylidene-alpha-L-rhamnopyranoside with methyl 3,4,6-tri-O-acetyl-2-deoxy-2-phthalimido-1-thio-beta-D-glucopyranoside activated by nitrosyl tetrafluoroborate gave an excellent yield of the protected disaccharide 9, which was transformed into glycosyl acceptor 11 . Methyl 2,3,4,6-tetra-O-acetyl-1-thio-beta-D-galactopyranoside, obtained from D-galactose penta-acetate and methyl trimethylsilyl sulfide, under catalysis by boron trifluoride etherate, was converted into glycosyl donor 25, which was condensed with 11 under halide-ion catalysis to give the trisaccharide derivative 26 . Rhamnosylation with 28 of 27, obtained by selective deprotection of 26, gave the protected tetrasaccharide 29 . Deprotection of 10, 26, and 29 gave di- (2), tri- (3) and tetra-saccharide (4) methyl glycosides which form part of the group-specific polysaccharide antigen of Group B Streptococci. J Bacteriol, 1988 Aug, 170(8), 3752 - 5 Factors influencing cell shape in the mutans group of streptococci; Tao L et al.; Electron and light microscopic and growth studies of representatives of the diverse species of mutans streptococci revealed the cells to be either bacillary or coccoid in shape . Some strains changed from bacillary to coccoid if the HCO3-/K+ ratio of the media was increased and from coccoid to bacillary if the ratio was decreased . Doubling times of rods and cocci were the same despite an HCO3-/K+ ratio change between 0.008 and 2.84 . For strain 10449S, no tested anions or cations substituted for HCO3- or K+ to produce this effect, except for B4O7(2-) . Strain 10449S grown at a high B4O7(2-)/K+ ratio became ellipsoid, and this phenomenon was associated with slower doubling times . Up to three incomplete septa could be observed in one rod, but no more than one incomplete septum could be observed in either ellipsoid or spherical cells . Interseptal distances were greatest in rods, shorter in spheres, and shortest in ellipses . All of the above differences were statistically significant (P less than 0.001). Laryngoscope, 1988 Aug, 98(8 Pt 1), 877 - 80 Presentation and management of neck abscess: a retrospective analysis; Tom MB et al.; A retrospective analysis of deep neck abscesses managed at the Los Angeles County-USC Medical Center was performed . Fifty-one patients met the criteria and were reviewed as to presentation, etiology, location, and microbiology . Hemolytic streptococci and anaerobic species, especially Bacteroides and peptostreptococci, were the most common organisms isolated . Intravenous drug abuse was the most common etiology, and was an important source of primary carotid space infection . This group was most commonly infected with Streptococcus species (50%). Infect Immun, 1988 Aug, 56(8), 2174 - 9 Cloning and expression of the CAMP factor of group B streptococci in Escherichia coli; Schneewind O et al.; The genetic determinant of the CAMP factor from a strain of group B streptococcus (GBS; Streptococcus agalactiae) was cloned in Escherichia coli . Total cell DNA from the GBS strain R268 was used to construct a gene bank with bacteriophage lambda EMBL4 in the E . coli K-12 strain LE392 . Recombinant phage plaques were detected by immunoblots by using a specific antiserum raised against purified CAMP factor . Two hybrid phages showing expression of CAMP factor were identified . Subcloning the CAMP gene (cfb) into the high-copy-number vector pUC8 resulted in highly unstable plasmids . Therefore, subcloning was performed with the low-copy-number vector pLG339 resulting in the stable recombinant plasmids pCO61 and pCO62 which lead to expression of CAMP protein first identified by colony immunoblotting . Western blot (immunoblot) analysis revealed a similar CAMP protein pattern in lambda EMBL4 recombinant phage lysates (molecular weight, 22,000 to 24,000) as compared to that obtained from a GBS culture supernatant (molecular weight, 22,000 to 26,000) but a different CAMP protein pattern (molecular weight, 20,000 to 23,000) from lysates of E . coli carrying pCO61 or pCO62 . To study the excretion of the CAMP protein we performed a semi-quantitative dot blot analysis of proteins recovered from cell fractions and supernatants of the E . coli recombinant clones . In contrast to GBS R268, where the CAMP factor is readily excreted, the CAMP protein is not excreted in E . coli clones containing pCO61 and pCO62 but is found associated with the cell fractions. Am J Dis Child, 1988 Aug, 142(8), 831 - 3 Group A beta-hemolytic streptococci as a cause of bacteremia in children; Wong VK et al.; The clinical manifestations of patients with group A beta-hemolytic streptococcal (GAS) bacteremia presenting to an urban children's hospital were reviewed . Group A beta-hemolytic streptococci were isolated from blood cultures from 17 children over a three-year period . Systemic illnesses that may have predisposed these children to GAS bacteremia were identified in seven patients: preceding varicella infection (four patients) or malignant neoplasm/immunosuppressive therapy (three patients) . Possible sources of GAS included compromised integument (seven patients), the oropharynx (six patients), or the lower respiratory tract (two patients) . The clinical manifestations of GAS sepsis included the following: fever (15 patients); arthritis or arthralgias (four patients); cellulitis (three patients); maculopapular eruption (one patient); petechial or pustular exanthems (three patients); osteomyelitis (two patients); cervical adenitis (one patient); empyema (one patient); and meningitis with multiple brain abscesses (one patient) . Two patients died of apparent overwhelming GAS sepsis while at home . Group A beta-hemolytic streptococcal bacteremia can present with a wide range of clinical manifestations and cause mild to fulminant disease in children. Int J Food Microbiol, 1988 Aug, 7(1), 63 - 72 Occurrence and significance of streptococci in fermented Italian type dry sausage; Holley RA et al.; Commercial cultures used in Canada for the manufacture of Italian dry sausage were examined to determine their microbial composition and suitability for low temperature (less than or equal to 20 degrees C) meat fermentations . Temperature optima in both laboratory media and commercial meat mixtures were generally too high to allow these cultures to be of substantial advantage in this application . In addition, media used currently for the enumeration of streptococci and related organisms from fermented meat products were found to be inadequately specific and often required confirmatory inspection of colonies by conventional phase contrast microscopy . Streptococci were isolated from Italian dry sausage manufactured commercially with and without added starter cultures . Streptococci persisted in sausages produced by both techniques with slightly higher numbers present in starter-acidulated sausages . About 55.5% of the 312 streptococci studied were enterococci (Lancefield's Group D) . Streptococci were found in several samples of commercial starter cultures but it was felt that elevated ripening temperatures used for sausage manufactured by the starter-mediated process and meat handling practices were more important factors influencing streptococci recovery from sausage material. J Nutr Sci Vitaminol (Tokyo), 1988 Aug, 34(4), 423 - 32 Optimal protein intake estimated by the resistance to streptococcal infection and the nutritional indices in mice; Yamamoto S et al.; Effects of dietary protein levels on the resistance against a bacterial infection and on the nutritional status were studied in mice to obtain basic data for the estimation of an optimal protein intake . Female DDY strain weanling mice were fed 5, 7, 10, 20, 30, or 40% casein diet . At 2 or 4 weeks on the diets, the mice were injected intraperitoneally with 5 x 10(3) or 5 x 10(4) group B streptococci/g body weight and their survival rates were observed for the following 10 days . Nutritional indices and cell numbers of thymus and spleen were also measured . The survival rate was higher in the order of 7, 10, 20, 30, 5, 40% casein diet group . Significant differences were observed between the 7% group and the 30, 5, or 40% group, and between the 10% group and the 5 or 40% group . The nutritional indices and cell numbers of the thymus and spleen were similar among the 20, 30, and 40% casein diet groups and decreased in the order of 10, 7, 5% casein diet groups . From the results, protein levels were categorized into 4 groups: severe protein deficiency with low resistance (5% casein diet), moderate protein deficiency with high resistance (7 and 10% casein diets), normal protein intake with normal resistance (20% casein diet), and high protein intake with low resistance (30 and 40% casein diets) . This grouping suggests that when the relation between immunocompetence and nutritional status is considered, both high and low protein intakes are undesirable and the optimal level of dietary protein will be limited to a narrow range. J Dairy Res, 1988 Aug, 55(3), 309 - 14 Use of California Mastitis Test, N-acetyl-beta-glucosaminidase, and antitrypsin to diagnose caprine subclinical mastitis; Maisi P et al.; Analysis of 448 milk samples (11 herds) from caprine udder halves showed that microorganisms were isolated from 21.8% of the samples . California Mastitis Test (CMT) and N-acetyl-beta-glucosaminidase (NAGase) were superior to antitrypsin in detecting subclinical infections . Coagulase-negative staphylococci and micrococci were the main species isolated from halves showing no clinical disease . Coagulase-positive staphylococcal infections were associated with a significant increase of all inflammatory parameters . Significantly increased CMT and NAGase occurred when streptococci, other staphylococci or micrococci were present . Infection within one half was reflected as an increase in the inflammatory parameters in the milk of the infected half as well as a slight increase in the inflammation parameters in the adjoining half. Infect Immun, 1988 Aug, 56(8), 2114 - 9 Molecular cloning and expression of a Streptococcus mutans major surface protein antigen, P1 (I/II), in Escherichia coli; Lee SF et al.; Antigen P1, also called I/II, is one of the most abundant cell wall proteins of the mutans streptococci . It has been suggested that P1 may be involved in cell adherence to tooth surfaces and in sucrose-induced cell aggregation . As a first step toward fully understanding its biological functions, the P1 gene, which has been designated spaP1, from Streptococcus mutans NG5 (serotype c) has been cloned into Escherichia coli JM109 by a shotgun procedure with pUC18 as the vector . The recombinant strain expressing P1 carries a 5.2-kilobase DNA insert whose restriction map has been determined . This map is completely different from that of spaA of Streptococcus sobrinus (serotype g), even though P1 and SpaA are antigenically related . Southern hybridization revealed that DNA sequences closely homologous to spaP1 were present in serotypes c, e, and f, and similar sequences also existed in strains of serotypes a and d . The expression of the cloned spaP1 was found to be independent of the lac inducer and the orientation of the DNA insert, suggesting that it carries its own promoter . Western blotting (immunoblotting) revealed at least 20 bands reacting with a mixture of three anti-P1 monoclonal antibodies . The highest-molecular-weight reactive band was comparable in size to the parent P1 (185 kilodaltons {kDa}); however, the major reactive bands were smaller (approximately 160 kDa) . Expression of cloned P1 in E . coli LC137 (htpR lonR9) resulted in the increased prominence of the 185-kDa protein reactive band . Ouchterlony immunodiffusion showed partial identity between the parent and cloned P1 . In E . coli, P1 was detected primarily in the periplasm and extracellular fluid. Crit Care Med, 1988 Aug, 16(8), 773 - 8 Oxygen transport in newborn piglets with pulmonary hypertension; Hammerman C et al.; Because of the neonate's susceptibility to pulmonary hypertension (PHN) and his inefficiency in invoking the compensatory mechanisms often used by adults to maintain stable levels of O2 consumption (VO2) in the face of changes in O2 delivery (DO2) and metabolic demand, we have attempted to define the O2 handling capabilities of the newborn piglet affected with various types of pulmonary vasoconstriction . Hemodynamically similar levels of PHN were generated in 18 newborn piglets (six through group B beta-hemolytic Streptococci infusion; six through hypoxia; six through hypercarbia) and O2 transport was studied . At 60 min VO2 was similar in all groups, although DO2 was different (10.7 +/- 6.7, 7.2 +/- 1.6, and 21.7 +/- 8.9 ml/kg.min, in the septic, hypoxic, and hypercarbic groups, respectively) . Extraction efficiency varied in an inverse fashion (43 +/- 12%, 72 +/- 12%, and 27 +/- 16%, in the septic, hypoxic, and hypercarbic groups, respectively) . Supply dependency and a critical DO2 were observed in the septic and hypoxic PHN groups (18.4 and 12.2 ml/kg.min, respectively) . Both of these were elevated as compared to healthy adult levels . Hypercarbic pulmonary hypertension was supply independent at the levels studied; however, DO2 remained elevated in these animals and may never have reached the critical DO2 level. Q J Med, 1988 Aug, 68(256), 603 - 13 Streptococcus pyogenes bacteraemia in Cambridge--a review of 67 episodes; Francis J et al.; Sixty-seven episodes of bacteraemia due to Lancefield Group A streptococci occurred in patients admitted to or autopsied at Addenbrooke's Hospital, Cambridge from July 1974 to June 1986 . Ninety-two per cent of infections were acquired in the community and 71 per cent of patients were adults . The overall mortality rate was 48 per cent and 15 per cent of cases died at home shortly after the onset of illness . Thirty-eight per cent of the patients had underlying disease and sixty-one per cent of these died compared with 40 per cent of those without underlying disease . Presentation in shock was the major predictor of mortality (79 versus 16 per cent) and was commoner in adults . Clinical features were variable and led to incorrect initial diagnosis in some cases . A localized site of infection was not recognized initially in 37 per cent of cases but the commonest evident site of entry was the skin . Annual incidence varied with age from 0.71 to 4.16/100,000 population and cases were commonest in the young and those over 50 . The fulminating onset of community-acquired streptococcal infection in some adults emphasizes the importance of early treatment of suspected cases with penicillins. Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi, 1988 Aug, 21(3), 188 - 90 {A modified medium, bile esculin-pyrrolidonyl-beta-naphthylamide, for rapid differentiation between enterococci and nonenterococci}; Wu SJ et al.; A new medium was developed by adding 40 mg pyrrolidonyl-beta-naphthylamide (PYR) to 1 l bile esculin (BE) agar, and was named as BE-PYR agar . To evaluate the efficacy of BE-PYR agar in differentiating enterococci from nonenterococci, we inoculated 207 strains of group D streptococci (including 157 enterococci and 50 nonenterococci) to BE-PYR agar . After incubating overnight at 35 degrees C incubator, following by applying the PYR reagent to test the color change of colonies, results indicate that the accuracy of BE-PYR agar in the differentiation of enterococci from nonenterococci reaches to 100% . Therefore, BE-PYR agar was considered to be an effective laboratory tool in further differentiation of group D streptococci. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1988 Aug, 269(2), 168 - 78 Electron microscopic localization of lipoteichoic acid on group A streptococci; Ryc M et al.; The location of lipoteichoic acid (LTA) on the surface of group A streptococci was studied by immunoelectron microscopic and ultrastructural cytochemical methods, i.e . by means of LTA antibodies labelled with ferritin, or concanavalin A labelled with ferritin or colloidal gold . All these methods proved the LTA to be located on the outer cell surface of most group A streptococcus strains . The differences in the intensity of labelling paralleled the hydrophobicity of the strains, being substantially higher in the strains exhibiting a high degree of hydrophobicity . Treatment of streptococci with pronase or trypsin led to a complete loss of surface-located LTA . On the other hand, pepsin treatment of streptococci under mild conditions resulted in an increased amount of surface-located LTA in some strains . On the isolated cell walls, LTA could be demonstrated only on the outer surface of the walls . These findings correlated well with the presumed role of group A streptococcus LTA in the adherence of streptococci to the epithelial cells which is accomplished with the aid of surface-located LTA molecules. J Am Vet Med Assoc, 1988 Aug 1, 193(3), 323 - 8 Prevalence of udder infections and mastitis in 50 California dairy herds; Gonzalez RN et al.; The California mastitis test (CMT) and bacteriologic culture were performed on samples of bulk-tank milk and cow-composite milk (n = 23,138 cows) from 50 California dairies, 19 of the 50 with known mastitis problems . Thirty-eight (76.0%) bulk-tank milk samples and 12,334 (53.3%) cows were positive by results of the CMT . Potential mastitis agents were isolated from 5,085 (22%) cows . Staphylococcus aureus was isolated from all 50 herds, Streptococcus agalactiae was isolated from 47 herds, and Mycoplasma sp was isolated from 24 herds . For cow-composite milk samples, the prevalences were 9.3% for Str agalactiae, 9.1% for S aureus, 0.9% for Mycoplasma sp, 1.2% for coliform bacteria, 0.9% for other streptococci, 0.8% for coagulase-negative staphylococci, and 1.3% for other organisms . The relative sensitivity and the relative specificity of the CMT performed on cow-composite milk samples were 83.4% and 55.2%, respectively, and the predictive value of positive CMT results was 34.2%. J Surg Res, 1988 Aug, 45(2), 222 - 7 Enhancement of growth of aerobic, anaerobic, and facultative bacteria in mixed infections with anaerobic and facultative gram-positive cocci; Brook I; The potential for mutual enhancement of growth of seven strains of anaerobic and facultative gram-positive cocci (AFGPC), seven aerobic and facultative organisms, and two Bacteroides spp . commonly isolated with AFGPC in mixed infection was evaluated . Enhancement was studied by measuring the relative increase in the colony-forming units of the two bacterial components inducing subcutaneous abscesses in mice . Of the 56 combinations, AFGPC were enhanced in 6 and inhibited in 1 . The aerobic and facultative bacteria were enhanced in 32 of the 42 combinations and depressed in none . The Bacteroides spp . were enhanced in 12 of the 14 combinations and suppressed in none . The organisms uniformly enhanced by AFGPC were Group A streptococci, Pseudomonas aeruginosa, and Bacteroides fragilis (all seven instances), followed by Escherichia coli (six of seven instances), Bacteroides asaccharolyticus and Klebsiella pneumoniae (five instances each), Staphylococcus aureus (four instances), and Group D streptococci (three instances) . It is apparent that in mixed infection with AFGPC the rate of growth of Bacteroides spp . and facultative and aerobic bacteria is enhanced much more than the rate of growth of AFGPC. Am J Pathol, 1988 Aug, 132(2), 258 - 64 Mast cell activation by group A streptococcal polysaccharide in the rat and its role in experimental arthritis; Dalldorf FG et al.; Acute edematous responses were induced in Sprague-Dawley rats by the intravenous injection of group-specific polysaccharide (PS) isolated from group A streptococci . Thirty minutes after the intravenous injection of PS there was marked degranulation of subcutaneous and periarticular mast cells in all 4 feet, carbon particle labeling of adjacent venules, and an 8-fold increase in Evans blue dye content of the extremities . This acute reaction to PS was completely blocked by pretreatment with compound 48/80, but the polyarticular relapsing arthritis following the systemic injection of an arthropathic dose of streptococcal cell wall fragments containing large, covalently bound peptidoglycan-polysaccharide (PG-PS) was not blocked. Proc Natl Acad Sci U S A, 1988 Aug, 85(15), 5714 - 7 Expression of streptococcal M protein in mammalian cells; Hruby DE et al.; The M protein encoded by group A streptococci is a cell-wall polypeptide that has the property of enabling these organisms to evade the phagocytic cells of the human host . Therefore, the M protein plays a major role in the pathogenesis of streptococcal diseases . As an initial step toward the use of this protein as a target antigen for the production of protective anti-streptococcal immunity, a live vaccinia virus recombinant containing the M-protein gene has been constructed (VV:M6 delta) . The bacterial M-protein DNA sequence is stable within this genetic context and is actively transcribed by viral RNA polymerase . Furthermore, high levels of immunoreactive M protein were detected in vivo when the VV:M6 delta recombinant was used to infect mammalian cells in culture . Thus, in addition to providing a powerful approach for dissecting the immunodominant domains of the M protein, the VV:M6 delta recombinant appears to be an excellent candidate vaccine for animal trials. Am J Clin Pathol, 1988 Aug, 90(2), 210 - 2 A comparison of the identification of group A streptococci and enterococci by two rapid pyrrolidonyl aminopeptidase methods; Gordon DB et al.; Group A streptococci and enterococci can be differentiated from other streptococci by their ability to cleave L-pyrrolidonyl-beta-napthylamide (PYR) . The authors evaluated two pyrrolidonyl aminopeptidase (PYRase) systems--Minitek (BBL Microbiology Systems, Cockeysville, MD) and Identicult-AE (Scott Laboratories, Inc., Fiskeville, RI)--for the presumptive identification of Group A streptococci and enterococci . Eighty-three Group A streptococci, 77 beta-hemolytic non-Group A streptococci, 74 enterococci, 56 nonenterococcal non-beta-hemolytic streptococci, 1 Streptococcus pneumoniae, and 1 Aerococcus were tested . Compared with results obtained with reference methods (bile esculin agar and 6.5% {w/v} sodium chloride for identification of enterococci, and latex agglutination tests by Streptex {Burroughs Wellcome, NC} for grouping of beta-hemolytic streptococci) both the Identicult-AE and MInitek systems were 100% sensitive and specific for identification of both enterococci and Group A beta-hemolytic streptococci . Advantages of the Identicult-AE system compared with Minitek were the use of a smaller inoculum for which subculture was not necessary, incubation at room temperature rather than at 37 degrees C, and lower cost . Both PYRase kits tested, and in particular the Identicult-AE system, were very easy to use and should be considered as rapid, reliable, and cost-effective alternative methods for the presumptive identification of Group A streptococci and enterococci in the clinical laboratory. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1988 Aug, 269(2), 237 - 44 Isolation and characterization of a specific receptor for human albumin on a group L Streptococcus; Lammler C; Certain group L streptococci demonstrate surface receptors for human albumin . Binding of 125I-albumin to group L streptococci could be inhibited by unlabelled albumin preparations from humans, dogs, mice and bovines, but not by albumin from rabbits . The albumin-binding proteins (ABP) could be solubilized from the streptococcal surface by hot acid treatment of the bacteria and isolated by affinity chromatography on human-albumin sepharose . ABP and specific antisera produced against ABP inhibited 125I-albumin binding to group L streptococci . The molecular weight of ABP determined by SDS-PAGE and Western blotting, was approximately 48,000 Dalton . ABP preparations of group G streptococci isolated from bovines and humans demonstrated cross reactivity with antiserum produced against group L streptococcal ABP. J Bacteriol, 1988 Aug, 170(8), 3435 - 42 Restriction and modification activities from Streptococcus lactis ME2 are encoded by a self-transmissible plasmid, pTN20, that forms cointegrates during mobilization of lactose-fermenting ability; Higgins DL et al.; A self-transmissible (Tra+) plasmid encoding determinants for restriction and modification activities (R+/M+) from Streptococcus lactis ME2 was isolated and characterized . The 28-kilobase (kb) plasmid (pTN20) was detected in lactose-fermenting (Lac+) transconjugants generated from matings between S . lactis N1, and ME2 variant, and a plasmid-free recipient, S . lactis LM2301 . The plaquing efficiencies of prolate- and small isometric-headed phages were reduced on transconjugants containing either pTN20 (R+/M+ Tra+) or 100-kb plasmids encoding Lac+, R+/M+, and Tra+ . Lac+ transconjugants which harbored pTR1040 (Lac+) and pTN20 (R+/M+) were phenotypically R-/M- and transferred Lac+ at low frequency in subsequent matings to give rise to 100-kb R+/M+ plasmids . R+/M+ activities and high-frequency conjugal transfer ability were detected in Lac+ transconjugants that contained pTR1041 (Lac+) and pTN20 (R+/M+) . No 100-kb R+/M+ plasmids were recovered after these matings, suggesting that pTR1041 was mobilized by pTN20 through a process that resembled plasmid donation . pTR1041 was identical to pTR1040 but contained an additional 3.3-kb DNA fragment . These data suggested that phenotypic expression of R+/M+ and Tra+ is affected by coresident Lac+ plasmids . Restriction enzyme analysis and hybridization reactions demonstrated that the 100-kb R+/M+ plasmid was formed by a cointegration event between pTR1040 (Lac+) and pTN20 (R+/M+ Tra+) during conjugal transfer via a conductive-type process . This is the first report that defines self-transmissible restriction and modification plasmids in the lactic streptococci. Infect Immun, 1988 Aug, 56(8), 2198 - 204 Conservation of protective and nonprotective epitopes in M proteins of group A streptococci; Miller L et al.; Carefully controlled hybridization experiments with probes from a cloned serotype 5 M protein (M5) gene (smp5) were performed with DNA isolated from heterologous M types of group A streptococci, and the homologies detected by hybridization were compared with the ability of anti-pepM5 serum to cross-opsonize heterologous M types . As previously reported (J.R . Scott, S.K . Hollingshead, and V.A . Fischetti, Infect . Immun . 52:609-612, 1986), extensive structural homologies exist among the 3' ends of heterologous M protein genes, but there appears to be an increase in sequence variation as one moves towards the 5' ends . However, a clear, predictive correlation between the hybridization patterns and cross-opsonization was not observed . Antibodies raised to a synthetic peptide corresponding to central, conserved sequences adjacent to the C-terminal sides of the pepsin cleavage sites in M5, serotype 6 M protein, and serotype 24 M protein cross-reacted with heterologous acid-extracted M antigens but were not protective and did not bind to intact streptococcal cells, indicating that these epitopes are inaccessible on the intact cell surface . Removal of the N-terminal half of M5, serotype 6 M protein, or serotype 24 M protein by pepsin exposed the conserved epitope on the cell surface . These results suggest that immunoaccessible protective epitopes are confined to the highly variable N-terminal halves of M proteins and that a single, broadly conserved protective M protein epitope does not exist. J Am Vet Med Assoc, 1988 Jul 15, 193(2), 242 - 4 Pathogenic bacteria and fungi associated with external ocular diseases in dogs: 131 cases (1981-1986); Gerding PA Jr et al.; Medical records of 131 dogs with external ocular diseases were reviewed . Bacteriologic culture of swab specimens from 151 eyes revealed 100 eyes (66.2%) were considered positive for potentially pathogenic microorganisms . Of 127 species of microorganisms (bacterial and fungal) isolated, 50 (39.3%) were Staphylococcus spp (S intermedius, 17.3%) . Streptococcus spp were the next most frequently isolated organism at 32 (25.2%), (Str canis, 16.5%) . beta-Hemolytic streptococci (17%) were isolated more frequently than were alpha-hemolytic streptococci (9%), and coagulase-positive staphylococcal species (29%) were isolated almost 3 times as often as were coagulase-negative species (11%) . Fungal and yeast organisms were isolated from 4.6% of the eyes . In vitro, most Staphylococcus spp were susceptible to cephalothin, bacitracin, and gentamicin, whereas most Streptococcus spp were susceptible to chloramphenicol, erythromycin, carbenicillin, and cephalothin . Pseudomonas spp were sensitive to tobramycin, gentamicin, and amikacin. J Clin Microbiol, 1988 Jul, 26(7), 1335 - 8 Evaluation of several commercial biochemical and immunologic methods for rapid identification of gram-positive cocci directly from blood cultures; Rappaport T et al.; To develop laboratory methods for the rapid identification of gram-positive cocci from blood cultures, several commercial immunological and biochemical tests for identifying staphylococci and streptococci from two different blood culture systems (Thiol/TSB, Difco Laboratories; BACTEC, Johnston Laboratories, Inc.) were evaluated and compared with conventional identification methods . A total of 44 cultures contained Staphylococcus aureus as determined by conventional methods . Commercial immunological methods (six tested) ranged in overall sensitivity from 38.6 (Staphyloslide; BBL Microbiology Systems) to 77.3% (Staphaurex; Wellcome Diagnostics) . All methods tested had 100% specificity . A total of 30 isolates of group D streptococci were tested with immunological and biochemical identification systems . The overall sensitivity ranged from 14.2% (Phadebact Group D; Pharmacia Diagnostics) to 100% with Streptex (Wellcome; immunological) and Identicult A-E (Scott Laboratories, Inc.; biochemical) . The results of this study suggest that some reagents can be used to provide rapid identification of gram-positive cocci from blood cultures 24 h earlier than standard methods. Am J Clin Pathol, 1988 Jul, 90(1), 87 - 91 Identification of viridans streptococci by three commercial systems; Peterson EM et al.; The API 20S (Analytab Products, Plainview, NY), the GPI card (Vitek Systems, St . Louis, MO) and the RapSTR system (Innovative Diagnostics, Atlanta, GA) were compared with conventional biochemicals for the identification of viridans streptococci . One hundred nine clinical isolates were tested that included the following species: intermedius (38) sanguis II (20), bovis (variant) (14), mitis (14), salivarius (11), sanguis I (6), constellatus (3), mutans (2), and uberis (1) . With initial testing, a correct species call was made with 72% of the isolates with the GPI card, 62% with the RapSTR, and 50% with the API 20S . Identifications of viridans streptococci group or those that needed additional biochemicals for species identification occurred with 28% of isolates with the API 20S, 8% with the RapSTR, and 9% with the GPI card . Incorrect identifications occurred with 6% of the isolates tested by the GPI card, 20% with the API 20S, and 30% with the RapSTR . Most discrepancies with the RapSTR were with 66% of the intermedius isolates, whereas most, 55%, of misidentifications with the API 20S were with sanguis II isolates . No identifications were made with 2% and 13% of isolates with the API 20S and GPI, respectively. Arch Intern Med, 1988 Jul, 148(7), 1601 - 3 Hospital-acquired infective endocarditis; Terpenning MS et al.; Nosocomial endocarditis occurred in 22 patients who were discharged from a university hospital, a veterans' hospital, and a community hospital during the period of January 1976 to December 1985 . Nosocomial episodes were 14.3% of the total endocarditis cases seen . Fourteen (63.6%) of 22 nosocomial endocarditis episodes occurred in patients over the age of 60 years, compared with 39 (29.5%) of 132 episodes of community-acquired endocarditis during the same period . Nosocomial endocarditis was due predominantly to Staphylococcus aureus or coagulase-negative staphylococci (77.4%) and, less often, to streptococci (13.6%) . Intravascular devices were the source of bacteremia in ten (45.5%) of the nosocomial endocarditis episodes . The overall mortality rate was 40.9%, 50% in patients over the age of 60 years . Improved care of intravascular devices or prophylaxis before procedures could probably have prevented endocarditis in 12 of the 22 patients. Arch Dermatol, 1988 Jul, 124(7), 1047 - 51 Bacteriology and antibiotic treatment of perineal suppurative hidradenitis; Highet AS et al.; A plausible bacterial pathogen (Streptococcus milleri, Staphylococcus aureus, anaerobic streptococcus, or Bacteroides species) was isolated at least once in 26 of 32 patients with active perineal suppurative hidradenitis . The main pathogen was S milleri, whose presence was significantly associated with disease activity and whose disappearance significantly correlated with clinical improvement; S aureus nd anaerobic streptococci were also implicated. Diagn Microbiol Infect Dis, 1988 Jul, 10(3), 139 - 44 Time kill curve analysis of vancomycin and rifampin alone and in combination against nine strains of nutritionally deficient streptococci; Stein DS et al.; Endocarditis caused by nutritionally deficient streptococci has a high bacteriologic and clinical failure rate, despite appropriate antimicrobial therapy . We investigated by time kill curve methodology nine clinical endocarditis isolates of nutritionally deficient streptococci to determine the in vitro efficacies of vancomycin and rifampin alone and in combination . The combination of vancomycin and rifampin demonstrated synergy and bactericidal activity in five of the strains . In one strain, this combination inhibited growth by greater than 2 log10 CFU/ml when compared to the growth control or either antibiotic alone, but it failed to be bactericidal . Indifference, defined as less than or equal to 2 log10 CFU per milliliter increase in killing of the combination compared to the next most active single agent, was demonstrated with the remaining three isolates . Changing the antibiotic concentrations in the time kill curve studies for these latter strains failed to demonstrate synergistic activity of the antibiotic combination . The vancomycin and rifampin combination may be a promising therapeutic modality for which in vivo correlation is indicated. Geburtshilfe Frauenheilkd, 1988 Jul, 48(7), 469 - 78 {Genital infections and the course of pregnancy: a prospective study}; Fischbach F et al.; The reported study investigates the relationship of genital infections, pathobiochemical findings and demographic data to preterm labor, premature rupture of membranes (PROM) and premature delivery . The predictability of chorioamnionitis, puerperal and neonatal infections by these parameters was evaluated concurrently . 301 patients were included in this study between July 1985 and June 1986 . 147 of these patients were studied longitudinally during pregnancy, delivery and puerperium (longitudinal group) . A second group consisted of 154 women who presented themselves on start of labor to the labor and delivery unit of our Department (peripartal group) . The incidence of preterm labor and of PROM was 26% . The incidence of premature delivery, chorioamnionitis, puerperal and neonatal infection was 11.4%, 5.5%, 7.6% and 3% respectively . Cervical colonization with Mycoplasma hominis correlated positively with PROM (relative risk 2.2), premature delivery (3.9) and neonatal infection (6.9) . Chorioamnionitis, premature delivery and puerperal infection were also significantly increased in patients with positive vaginal Ureaplasma urealyticum cultures during pregnancy and delivery . Premature delivery (2.8) and puerperal infection (4.0) were associated with a vaginal group B-Streptococci (GBS) colonization during pregnancy, as was a positive GBS culture during delivery associated with puerperal infection . Bacterial vaginosis also correlated positively with premature delivery (5.6) and puerperal infection . Preterm labor correlated negatively with the socioeconomic level, PROM correlated negatively with the marital status, positively with age, a history of cervical cerclage, conization or PROM during former pregnancies . Sexual intercourse more often than once weekly during the last month of pregnancy was also associated with an increased number of PROM . Gardnerella vaginalis, Candida and Trichomoniasis during pregnancy and delivery were associated with preterm labor and puerperal infections . Levels of maternal plasma fibrinogen concentrations in patients with PROM were elevated 48 hours after delivery in accordance to the characteristics of acute phase proteins . In contrast, the maternal PMN-granulocyte-elastase concentration was significantly elevated at time of delivery and 24 hours thereafter in those patients who developed puerperal infections . The derived positive predictive value was 26%, the negative 94.7%, respectively . The overall accuracy of the prediction was 83.1% . Six out of seven mothers with neonates treated because of neonatal infection showed significantly elevated plasma concentration of PMN-granulocyte-elastase.(ABSTRACT TRUNCATED AT 400 WORDS) Immunobiology, 1988 Jul, 177(3), 220 - 32 Morphological differentiation of human lymphocyte subpopulations following polyclonal stimulation with bacteria and lectin; Braun MG et al.; Mononuclear cells (MNC) were stimulated with different heat-treated gram-positive and -negative bacteria, and the lymphocyte subpopulation interaction, the proliferative response, and the immunoglobulin secretion were analyzed . It can be demonstrated that beta haemolytic streptococci and Staphylococcus aureus have a similar stimulation pattern: early stimulation of helper T cells, cell contacts of helper T cells and B cells, maximum proliferation on day 5 and 7, and Ig secretion peak on day 7 . Klebsiella pneumoniae and Yersinia enterocolitica do not cause proliferation, while Ig secretion is seen on day 5 . No cell contacts and no T cell stimulation are seen in the Klebsiella culture, whilst Yersinia causes slight helper T cell activation . In contrast, PHA induces strong T cell stimulation, proliferation and expansion of the suppressor T cell subpopulation . Leu 7-positive lymphocytes are not activated by any of these stimulants. Rev Infect Dis, 1988 Jul-Aug, 10 Suppl 2, S367 - 71 Immunochemical characterization of the polysaccharide antigens of group B streptococci; Pritchard DG et al.; Mouse monoclonal antibodies were used in the immunochemical characterization of the polysaccharide antigens of group B streptococci (GBS) . Monoclonal antibodies specific for the sialylated form of the GBS type III polysaccharide were highly protective in a mouse model of GBS type III infection, whether of IgM, IgG2a, or IgA isotypes, but monoclonal antibodies specific for the nonsialylated form of the type III antigen were not protective, regardless of isotype . Monoclonal antibodies reacting with the type II polysaccharide antigen could be divided into two general antigen binding groups on the basis of the ability of beta-methylgalactopyranoside to inhibit their binding to purified type II antigen . Various proportions of antibodies with the two specificities were observed in rabbit and human sera . Although it was previously reported that rabbit antisera could not distinguish between the sialylated and nonsialylated forms of the type Ib polysaccharide, mouse monoclonal antibodies were found to exhibit exclusive specificity for one or the other form of the antigen . Only monoclonal antibodies specific for the sialylated Ib polysaccharide were protective in a mouse model. Zentralbl Bakteriol Mikrobiol Hyg {B}, 1988 Jul, 186(4), 344 - 59 {Use of UV rays for the disinfection of water . II . Microbiological studies of surface water}; Martiny H et al.; Untreated surface water of a total bacterial count of approximately 10(4) cfu/ml was contaminated additionally with suspensions of E . coli and S . faecium, which contained about 10(6) cfu/ml . At flow rates of 7.2 m3/h, 4.0 m3/h and 2.0 m3/h the survival of bacteria as a function of exposure to radiation was measured with two different U.V.-disinfection units . In surface water, -without an additional contamination -minimum doses of radiation up to 74 mWs/cm2 were necessary to cause a reduction of 99.99% for total bacterial counts and counts of lactose-positive colonies . When suspensions of E . coli or S . faecium were added, a reduction of 99.99% for total bacterial count was attainable with minimum doses up to 71 mWs/cm2 . To reduce the number of lactose-positive colonies or the number of D-streptococci to 99.99% a minimum dose up 56 mWs/cm2 or 18 mWs/cm2 was necessary. Rev Infect Dis, 1988 Jul-Aug, 10 Suppl 2, S363 - 6 Surface-localized protein antigens of group B streptococci; Ferrieri P; There are three major surface-localized protein antigens of group B streptococci: c, R, and X . Their precise role in human immunity to group B streptococci has not been defined . Studies of the c protein suggested that type II strains possessing both trypsin-resistant and trypsin-sensitive components of the c protein were less easily killed in vitro and were more virulent in an infant rat model of infection as compared with type II strains that do not bear these proteins . The c protein components were immunogenic in mice and rabbits . Polyclonal rabbit antisera were protective in the infant rat model of bacteremia/sepsis and facilitated killing of type II strains bearing the c protein in an in vitro opsonophagocytic bacterial killing assay . The role of the IgA-binding capacity of the c protein in altering the interaction of group B streptococcal strains with host defenses remains undefined at this time. Rev Infect Dis, 1988 Jul-Aug, 10 Suppl 2, S345 - 50 Gram-positive bacteria: an overview and summary of session; Anthony BF et al.; The more pathogenic gram-positive bacteria present a complex array of surface structures to the human or animal host . The cell wall of Staphylococcus aureus has a pattern of surface proteins; the predominant one is protein A . Virulent S . aureus strains may also produce polysaccharide capsules in vivo that impede opsonization and phagocytosis in the absence of anticapsular antibody . Coagulase-negative staphylococci commonly elaborate an exopolysaccharide slime that may promote adherence to plastic surfaces and interfere with host responses . Structure-function relationships for some antiphagocytic M proteins of group A streptococci are now well understood, and recombinant techniques offer the prospect of multivalent vaccines . The best known surface protein of group B streptococci is the c (Ibc) protein, which stimulates protective antibody in animals and may be an important virulence factor . Monoclonal antibodies to types Ib, II, and III group B streptococci have also confirmed the presence of multiple immunodeterminants on these antiphagocytic polysaccharides . A protein on the surface of pneumococci has been shown to induce protective antibody and to enhance pneumococcal virulence in mice, suggesting a potential alternative or adjunct to pneumococcal polysaccharide vaccines . Listeria also possess a variety of cell surface structures important in pathogenesis . Surface components are, therefore, critical determinants of the interaction of gram-positive bacteria with the host. Ann R Coll Surg Engl, 1988 Jul, 70(4), 217 - 9 Loss of split thickness skin grafts due to non-group A beta-haemolytic streptococci; Wilson GR et al.; Over a 17-month period 77 patients requiring a split skin graft for a burn injury have suffered loss of previously well taken graft due to the growth of a beta-haemolytic streptococcus . Of these only 42 were streptococci of Lancefield group A (Streptococcus pyogenes); 16 were group B, 3 group C and 16 group G . Some strains of groups B, C and G produce cytopathic and spreading factors capable of destroying the new skin graft and regenerating epithelium . We suggest that the non-group A streptococci may be more pathogenic than previously recognised in this particular respect. J Appl Physiol, 1988 Jul, 65(1), 137 - 45 Surfactant therapy of newborn rabbits impairs lung macrophage bactericidal activity; Sherman MP et al.; Because in vitro studies indicate that pulmonary alveolar macrophages (PAM's) filled with phospholipid vesicles have depressed microbicidal capacity, we tested the intrapulmonary bactericidal activity of newborn PAM's after surfactant treatment . Term newborn rabbits received intratracheally either homologous surfactant or one of two artificial phospholipid vesicle preparations followed by pulmonary aerosol infection with group B streptococci (GBS) . Four hours after lung infection, phagocytic killing of GBS was reduced by 70-90% in animals treated with the homologous and one of the artificial surfactants compared with untreated animals or animals that received intrapulmonary injections of the surfactant vehicle (P less than 0.02) . The other artificial phospholipid preparation decreased intrapulmonary inactivation of GBS by 30-40% compared with the controls . The phospholipid vesicles in the three preparations were avidly ingested and processed by newborn PAM's . The diminished in vivo killing of GBS was not attributed to decreased viability or phagocytic behavior of the PAM's toward GBS . The bactericidal defect that was evident in the newborn PAM's appeared related to the uptake of large phospholipid vesicles in the preparations rather than to the phospholipid content of the surfactants themselves . When in vitro conditions that stimulated the alveolar environment were used, the natural surfactant preparation promoted GBS proliferation, whereas the artificial preparations did not . Our findings indicate that surfactant administration reduces the bactericidal activity of neonatal PAM's . We conclude that additional investigations are needed to ascertain the effect of surfactant replacement therapy on lost defenses of the lung. Microb Pathog, 1988 Jul, 5(1), 19 - 27 Characterization of the interaction of human plasmin with its specific receptor on a group A streptococcus; Broeseker TA et al.; Certain Group A beta-hemolytic streptococci express a receptor that is capable of specifically binding the human plasma protease plasmin . Once bound, plasmin remains enzymatically active and is unregulated by its naturally occurring inhibitor alpha-2-antiplasmin (Lottenberg, R., C . C . Broder and M . D . P . Boyle, 1987 . Infect . Immun . 55: 1914-1918) . In this study certain characteristics of the interaction between plasmin and the receptor expressed on a group A beta-hemolytic streptococcus, strain 64/14, were examined . Binding occurred optimally at physiologic pH and ionic strength . The KD was 5 x 10(-11) M and there were approximately 800 receptors per bacterium . Mouse passage of strain 64 had no significant effect on the KD of the receptor . Binding of plasmin to the bacteria was inhibited by lysine and epsilon-aminocaproic acid in a concentration dependent manner . Similarly these amino acids would displace pre-bound plasmin from the bacteria . These findings suggest a role for plasmin's high affinity lysine binding site in the interaction of plasmin with the bacteria. N Z Med J, 1988 Jun 8, 101(847 Pt 2), 401 - 2 Rapid detection of group A streptococcal antigen for the clinician and the epidemiologist: accurate? cost-effective? useful? Kaplan EL. Reviewing the literature describing rapid antigen detection for the diagnosis of group A streptococcal upper respiratory tract infections, one can conclude that the rapid aspect of these tests is clearly advantageous . To be able to have an answer in 5-20 minutes has distinct advantages with regard to therapy for patients . The specificity of most of these tests is acceptable for group A streptococci, although one must recognise that group C and group G streptococci can cause upper respiratory tract infection, and would not be detected by any group A antigen test . A remaining problem appears to be that of sensitivity . Although the range of sensitivity with various techniques and in the hands of different investigators may vary, it is difficult to ignore the fact that the sensitivity for many tests does not appear to be optimal . Furthermore, appropriate technical skill is required before these tests can be recommended for use in the hands of inadequately trained individuals, either in an office laboratory or in peripheral health care stations . There is also the concern that the cost for these diagnostic tests, unless purchased in large quantities, generally is greater than for the throat culture . This could have significant implications in some health care situations . One potential alternative for the office practitioner to consider is that if a rapid antigen test is negative, he or she should also perform a throat culture . This is the routine carried out in many practising clinicians' offices.(ABSTRACT TRUNCATED AT 250 WORDS) J Dairy Sci, 1988 Jun, 71(6), 1616 - 24 Characterization and identification of streptococci isolated from bovine mammary glands; Watts JL; A total of 317 gram-positive, catalase-negative cocci isolated from bovine mammary glands were characterized and identified using current species descriptions . Two hundred eighty-seven isolates (90.5%) could be placed in 11 distinct species . Streptococcus uberis was the most frequently encountered species and could be separated into two previously described genetic types based upon sucrose utilization . Streptococcus dysgalactiae and a newly described species, Streptococcus saccharolyticus, were the most frequently isolated organisms from teat canal swabs . Thirty isolates could not be placed in currently described species . A proposed identification scheme based upon serological grouping and seven biochemical tests would permit 24 h identification of streptococci isolated from bovine mammary glands. Br J Urol, 1988 Jun, 61(6), 538 - 9 Fournier's gangrene following vasectomy; Chantarasak ND et al.; PIP: Routine vasectomy was performed on a 29-year old man for whom rheumatoid arthritis had been diagnosed 4 years previously and treated with nonsteroidal anti-inflammatory drugs . The man experienced a flare-up of arthralgia in the wrists 2 weeks prior to the vasectomy . He was treated with a single course of parenteral methyl prednisolone and was in remission at the time of the surgery . On the day following the vasectomy, the patient noticed some erythema around the wound and felt unwell but did not seek medical advice until 4 days later . He was clinically toxic when he presented and experiencing painful gangrene of the scrotum . Treatment was begun immediately with parenteral benzyl penicillin, tobramycin and metronidazole plus aggressive debridement; 30 ml of pus drained and beta hemolytic streptococci Group A, sensitive to penicillin, were cultured . Within a few hours, further spread of gangrene along the penile shaft was noted . He was given hyperbaric oxygen treatment for 3 days followed by secondary debridement . No further spread of the gangrene occurred . 1 week later there was a good tranulating bed over the anterior scrotum . Meshed split skin graft was applied with tie-over dressings . An almost 100% take was achieved 4 weeks later . If hyperbaric oxygen had been employed immediately after surgery, spread of the gangrene might have been avoided . The use of hyperbaric oxygen should be considered as a firstline treatment . Ann Plast Surg, 1988 Jun, 20(6), 562 - 5 Fatal necrotizing fasciitis following suction-assisted lipectomy; Alexander J et al.; Forty-eight hours following extensive blunt suction lipectomy with 3,000 cc of tissue removed, a 36-year-old woman presented to an emergency room with necrotizing fasciitis of both lower extremities extending over the buttock and to the lower third of the back . Tissue cultures and blood culture grew out a pure culture of beta-hemolytic streptococci . The patient rapidly progressed into a comatose state and, despite extensive debridement and appropriate antibiotic therapy, in addition to hyperbaric oxygen treatments, she died on day 9 of her hospitalization (day 11 following the suction lipectomy) . To our knowledge this is the first published mortality reported in the United States following this procedure. J Clin Microbiol, 1988 Jun, 26(6), 1142 - 6 Immunologic and genetic comparison of Streptococcus equi isolates from the United States and Europe; Galan JE et al.; A series of isolates of Streptococcus equi from the United States and Europe were compared by the bactericidal test, immunoblotting, DNA restrictions, and Southern hybridization analysis . All isolates tested were sensitive to the same bactericidal serum . In addition, immunoblotting revealed no differences in M proteins prepared by acid or mutanolysin extraction . Immunoblotting of acid extracts of the isolates with mucosal nasopharyngeal mucus from a convalescent horse revealed the presence of the 41,000- and 46,000-Mr polypeptide fragments of the M protein of S . equi known to be important in stimulating mucosal nasopharyngeal immune responses . DNA restriction analysis of total cell DNA digests, as well as Southern hybridizations using an S . equi M protein gene probe, did not detect any differences among these isolates . Our results, therefore, confirm the antigenic homogeneity of the M proteins of S . equi isolates and suggest that variation in this antigen is not a reason for the failure of commercial vaccines in the field . Interestingly, the protoplast M proteins of all isolates showed remarkable size homogeneity, in contrast to the size variation reported in M proteins of group A streptococci. Pediatrics, 1988 Jun, 81(6), 849 - 56 Peritonitis in children with nephrotic syndrome; Gorensek MJ et al.; In a retrospective review of 214 children with nephrotic syndrome seen at Children's Medical Center and Parkland Memorial Hospital in Dallas throughout the 20-year period from 1967 to 1986, 62 cases of primary peritonitis were identified in 37 patients (17.3% rate) . Streptococcus pneumoniae was the major pathogen, accounting for 38% of the cases . An additional 27% of patients had negative culture results but were clinically responsive to penicillin . Gram-negative organisms were cultured from only 3% of patients; 5% were caused by alpha-streptococci and 2% each by enterococcus and anaerobes . In 23% of cases the cause was unknown . Our findings differ from the recent trend in the literature in which Gram-negative organisms associated with these infections are increasingly implicated . The incidence and bacteriology of peritonitis do not appear to have changed significantly during the 20-year period . Clinically, peritonitis was characterized by abdominal pain (98%), fever (95%), rebound tenderness (85%), and nausea and vomiting (71%) . A total of 79% of patients were either in relapse or receiving steroid therapy at the time peritonitis was diagnosed; 13% had infiltrates visible on their chest radiographs . Based on our data, it seems reasonable to initiate antimicrobial therapy in nephrotic children with suspected peritonitis using a combination of penicillin plus either an aminoglycoside or a cephalosporin . This regimen should continue until culture results are available, unless Gram-positive diplococci are identified in a Gram-stained specimen of peritoneal fluid, in which case penicillin alone should suffice. Pediatr Infect Dis J, 1988 Jun, 7(6), 393 - 8 Performance of a solid phase enzyme immunoassay for detection of group A streptococci in a pediatric office laboratory as refereed by a hospital laboratory; Yuckienuz SA et al.; We evaluated the performance of a new rapid solid phase enzyme immunoassay, SUDS Group A Strep (MUREX Corp., Norcross, GA) for the detection of Group A beta-hemolytic streptococci in a pediatric office practice . Duplicate throat swabs were obtained from 341 children with pharyngitis . One swab was used in the SUDS test and the other was cultured in the office laboratory . Office SUDS and culture (sheep blood agar plate, aerobic 24-hour incubation) were compared with culture using reference techniques (sheep blood agar plate, anaerobic 48-hour incubation) in a hospital laboratory . Compared with hospital laboratory culture, the sensitivity of office SUDS (73.8%) was superior to that of office culture (66.6%) at P = 0.05 . Specificities were 93.1 and 98.6%, respectively; positive predictive values were 86.1 and 96.6%; and negative predictive values were 85.9 and 83.5% . The sensitivity and specificity of SUDS compared with office culture were 88.5 and 87.8%, respectively, but would have been 93 and 94% had hemolyzed media not been used on several occasions in the office culture procedure . We conclude that SUDS Group A Strep was significantly more sensitive than throat cultures as performed in a typical pediatric practice although the performance of office cultures could have been improved by standard quality control techniques. J Med Microbiol, 1988 Jun, 26(2), 147 - 52 Prospective addition of beta-lactamase to blood culture medium; Brown DF et al.; The value of adding beta-lactamase to bottles of blood-culture medium before their distribution to wards was investigated . Significantly more bottles containing beta-lactamase were culture-positive than those without (p less than 0.002) . In another series, when the enzyme was added to both bottles in each set there was no significant difference in isolation rates between the two bottles . The groups of organisms which were isolated more readily when beta-lactamase was present were staphylococci and streptococci . Storage of beta-lactamase (Genzyme broad-spectrum mixture) in blood-culture medium at room temperature resulted in rapid loss of cephalosporinase activity, whereas little decline in penicillinase activity was noted over a period of 118 days. J Exp Med, 1988 Jun 1, 167(6), 1945 - 50 Passive acquired mucosal immunity to group A streptococci by secretory immunoglobulin A; Bessen D et al.; We present a model in which animals are passively immunized at a mucosal site, allowing one to evaluate immunological protection at the mucosal level only . Affinity-purified, anti-M protein sIgA administered intranasally protected mice against systemic infection after intranasal challenge with group A streptococci . In contrast, anti-M protein serum Ig administered intranasally was not protective at this site, although it neutralized the antiphagocytic property of M protein and promoted phagocytosis . Protection by sIgA occurred despite the lower immunoreactivity of sIgA to purified M protein compared with serum Ig . The data suggest that sIgA can protect at the mucosa and may preclude the need for opsonic IgG in preventing streptococcal infection. Pediatr Clin North Am, 1988 Jun, 35(3), 625 - 36 Current concepts in the pathogenesis and management of brain abscesses in children; Patrick CC et al.; Brain abscesses represent the most frequent intracranial suppurative process occurring in children . Improved bacteriologic techniques for isolating anaerobic microorganisms have shown that anaerobes play a major role in brain abscesses in conjunction with aerobic organisms such as alpha-streptococci . Computerized tomography has improved the diagnosis of brain abscesses and has changed the management in certain circumstances . Although surgical drainage still remains the definitive treatment modality, conservative medical management with serial CT scans has been successful . Still, the mortality and morbidity of brain abscesses remain substantial. Pediatr Clin North Am, 1988 Jun, 35(3), 535 - 42 The rapid identification of group A beta-hemolytic streptococci in the upper respiratory tract . Current status; Kaplan EL; Rapid detection of group A beta-hemolytic streptococcal antigen on throat swabs has become more popular in the management of patients with pharyngitis . Although the specificity of these commercially available kits usually has been satisfactory, the sensitivity has varied considerably . Currently most physicians accept a positive rapid test result but frequently require culture confirmation of a negative rapid antigen detection test on a throat swab. Arch Surg, 1988 Jun, 123(6), 745 - 50 Hand infections . Bacteriology and treatment: a prospective study; Dellinger EP et al.; In a prospective, double-blind study, 193 patients hospitalized for established hand infections were randomized to receive either cefamandole intravenously followed by cephalexin by mouth or methicillin intravenously followed by dicloxacillin by mouth . Careful aerobic and anaerobic cultures were performed . Multiple organisms grew in cultures from 84% of the patients (over three isolates per infection on average) . Human bite wounds contained anaerobes 43% of the time compared with 12% for other wounds . The majority of wounds (72%) required operative treatment . In 128 patients assessable for treatment outcome, results were unsatisfactory in 11 (9%) . There was no difference in outcome between cefamandole (6/59, 10%) and methicillin (5/59, 8%) . The presence of anaerobes, Eikenella corrodens, human bites, or an increasing number of organisms was associated with an unsatisfactory response . The presence of Staphylococcus aureus and/or beta-hemolytic streptococci was associated with a favorable response . The incidence of antibiotic-resistant isolates did not correlate with outcome. J Antimicrob Chemother, 1988 Jun, 21(6), 711 - 20 In-vitro microbiological activities of DuP 105 and DuP 721, novel synthetic oxazolidinones; Brumfitt W et al.; DuP 105 and 721, synthetic antibiotics belonging to a totally novel chemical class (oxazolidinones), have been found to be active in vitro against a wide range of Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus . DuP 721 had geometric mean MICs ranging from 1.1 to 16 mg/l against 167 strains of Staph . aureus, Staph . epidermidis, Staph . saprophyticus, streptococci of Groups A, B and D and diphtheroids . DuP 105 was between 1.5 and eight-fold less active . Bacteroides fragilis strains were also susceptible to the DuP compounds (mean MICs being 8.3 and 14.9 mg/l for DuP 721 and 105, respectively), but other Gram-negative species and yeasts were not inhibited by concentrations in excess of 100 mg/l . Both compounds had a predominantly bacteriostatic action . No primary resistance was found, and the incidence of resistant variants in 105 strains tested was less than 1 per 10(8) bacteria. Pathol Biol (Paris), 1988 Jun, 36(5 Pt 2), 626 - 31 {Resistance of nongroupable streptococci to beta-lactams . Detection by antibiogram and the activity of combinations of penicillin G and gentamicin}; Leclercq R et al.; Expression of disk-diffusion method of the activity of penicillin G against 68 strains of ungroupable streptococci susceptible to this drug (MIC less than or equal to 0.12 mg/l), 30 strains with a reduced susceptibility ("s") (0.25 mg/l less than or equal to MIC less than or equal to 1 mg/l), and 16 resistant (R) (MIC greater than or equal to 2 mg/l) has been studied . Generally, the R strains exhibited reduced inhibition zone diameters around the penicillin G disks but were best screened with an oxacillin disk (5 micrograms) as it has been proposed for the pneumococci . The study of the relations between the MICs of penicillin G and zone diameters obtained with oxacillin disks showed that the strains with oxacillin zones of less than 21 mm were R or "s" . The strains with oxacillin zones less than 26 mm should be tested for sensitivity to penicillin by measurement of MIC . The resistance was crossed towards amoxicillin, cefotaxime, and at a lower degree imipenem . However, the routine test of amoxicillin and cefotaxime did not allow the detection of the resistance to these drugs . Amoxicillin and cefotaxime might not be tested by disk-diffusion method because of the cross resistance to penicillin G . Combinations of penicillin G with gentamicin resulted in bactericidal effects in 6 h or less for 6 of 7 strains tested. Ultraschall Med, 1988 Jun, 9(3), 116 - 20 {Streptococcal abscesses of the liver: diagnosis and therapy using ultrasound controlled puncture}; Schmudderich W et al.; Three male patients without accompanying diseases, 27, 47, and 52 years of age, were admitted with fever of unknown origin . Focal liver disease was seen on ultrasound and the diagnosis of an abscess was confirmed by sonographically-guided fine-needle puncture . Microaerophilic streptococci were found in two cases, streptococcus viridans once . Two patients had cryptogenic abscesses; one had previously undergone surgery for a rectal abscess . All three patients were cured of their condition by appropriate antibiotic coverage and evacuation of the abscess by needle aspiration. Immun Infekt, 1988 Jun, 16(3), 100 - 3 {Pathogenesis of glomerulonephritis following streptococcal infection}; Goroncy-Bermes P et al.; Group A streptococci are responsible for the induction of serious pyoderma and pharyngitis in humans . The nonsuppurative sequelae "acute rheumatic fever" (ARF) and "acute poststreptococcal glomerulonephritis" (APGN) do very often occur with variable attack rates in epidemics with these microorganisms . At present, immune complex formation in the blood circulation system, in situ complex formation within the glomeruli, antibody cross-reactions between beta-hemolytic group A streptococci and human kidney tissue as well as tissue damage independent of specific antibodies are intensively discussed to explain the pathogenesis of acute poststreptococcal glomerulonephritis . However, the pathophysiological course of APGN has not yet been precisely identified. Oral Surg Oral Med Oral Pathol, 1988 Jun, 65(6), 750 - 3 The flare-up phenomenon in endodontics: a clinical perspective and review; Matusow RJ; The acute endodontic cellulitis exacerbation, which can be potentially fatal, is a definitive entity in endodontic flare-ups . Aerobic microbes, particularly streptococci, are the predominant causative microbes isolated . There was a noticeable absence of obligate anaerobes . This is significant for the selection of an antibiotic for therapy . Treatment parameters were presented . An endodontic cellulitis exacerbation is most unlikely with obligate anaerobes . An endodontic flare-up perspective was attempted with some clinical parameters . The proponents of routine one-visit endodontic treatment with prophylactic drugs to prevent cellulitis exacerbations do not appear to offer any advantage to the more traditional approaches to endodontic treatment of the patient, which may be more beneficial. Zh Mikrobiol Epidemiol Immunobiol, 1988 Jun, (6), 20 - 3 {Virulence of Streptococcus pneumoniae strains belonging to different serovars}; Reztsova IuV; The study of the virulence of 352 S . pneumoniae strains isolated from patients with inflammatory lung diseases revealed that their virulence depended, to a certain extent, on the state of the polysaccharide capsule of streptococci, as among 299 typed cultures 38.1% were virulent, while out of 53 nontypable strains of these bacteria only 8 strains (15.1%) proved to be highly pathogenic for white mice and all S . pneumoniae R-forms proved to be avirulent . All 11 S . pneumoniae strains under study belonging to serovars 1 and 2 and 87% of the cultures belonging to serovar 3, isolated from patients with inflammatory lung diseases in Leningrad, were highly virulent . The characteristic feature of S . pneumoniae cultures of other serotypes was their wide spectrum of pathogenicity . S . pneumoniae cultures isolated from the spinal fluid of patients with pneumococcal meningitis also differed in their pathogenicity levels but strains highly pathogenic for mice prevailed.