Microb Pathog, 1987 Nov, 3(5), 339 - 50 Evidence for group A-related M protein genes in human but not animal-associated group G streptococcal pathogens; Simpson WJ et al.; Group G streptococci have on their surface antiphagocytic M protein-like antigens . To determine if these organisms have genes similar to the M protein genes of Streptococcus pyogenes (group A), DNA from independent group G isolates of human and animal origin were tested for homology to probes representing sequences encoding the carboxy-terminus and leader peptide of the type 12 M protein (M12) of group A streptococci . All eight human-associated group G strains tested had DNA homologous to the carboxy-terminal probe . Six of these strains also had DNA that hybridized with the leader peptide probe . Using probes representing the group A M12 gene (emm12) and adjacent 5' sequences, we found that one of these strains, known to produce an M12 antigen, had a nearly complete duplication of the group A emm12 gene, differing only in 0.26 kb of sequence at the 5' end . The other human-associated strains did not hybridize with emm12-specific sequences . None of the group G strains had homology to 5' proximal sequences thought to be associated with group A emm12 regulation, but all the human-associated strains had DNA homology to a 1.5 kb DNA segment which mapped 2.5 kb upstream of the emm12 gene in group A streptococci . None of the twelve animal-associated strains tested hybridized with any of the probes used in this study . These results suggest that human but not animal-associated group G isolates have group A-related M protein genes . We propose that expression of these genes are critical for infection of the human host and that group A and G shared upstream sequences could encode additional virulence factors. Pediatr Med Chir, 1987 Nov-Dec, 9(6), 767 - 70 {Osteomyelitis and arthritis caused by Streptococcus group B in a 40-day-old boy}; Frediani T et al.; Group B streptococci (GBS) have gained much attention in recent years as a cause of serious infection in the newborn . Traditionally two clinical syndromes have been defined as "early onset", with fulminant septicemia, pneumonia and meningitis, and "late onset", with a mild meningitis . More recently some previously unrecognized clinical presentations of GBS disease have been documented . These include asymptomatic bacteremia, septic arthritis, osteomyelitis, ethmoiditis with orbital cellulitis, pneumoniae with empyema, conjunctivitis . The literature to date reports 30 instances of osteomyelitis due to GBS . This report describes a forty days infant with a group B streptococcal osteomyelitis of the proximal humerus . Has been also emphasized the increased frequency and the benign clinical course of streptococcal osteomyelitis in the neonate. Clin Nucl Med, 1987 Nov, 12(11), 850 - 1 Recovery of femoral head perfusion after drainage of septic joint; Mack JM et al.; A 64-year-old woman was febrile and had pain near the right hip . Blood cultures grew beta hemolytic streptococci . A bone scan showed reduced activity in the right femoral head and neck compared with the left femoral head and neck . She was treated with intravenous antibiotics and surgical decompression of a tense and bulging right hip joint . Five days later, a repeat bone scan revealed much of the femoral head activity to have returned . By day 20 after the initial bone image, there was intense activity throughout the femoral head and neck . Prompt relief of a distended hip joint can result in reperfusion of the femoral head and neck. Ann Ophthalmol, 1987 Nov, 19(11), 426 - 7 Periorbital necrotizing fasciitis; Rosenthal WN et al.; Necrotizing fasciitis developed in a 47-year-old woman after head trauma . Bilateral lid infection due to Group A beta-hemolytic streptococci resulted . Local treatment with surgical debridement and systemic management of fluid and electrolyte balance resulted in a favorable outcome from this extremely rare condition. Arch Dis Child, 1987 Nov, 62(11), 1169 - 70 Perianal infection with group A streptococcus; Farmer G; Anal fissure in childhood usually heals quickly after treatment with stool softeners and a local anaesthetic ointment; infection does not usually occur . Two cases are reported in which Lancefield group A beta haemolytic streptococci were isolated from cultures from the perianal skin, which was erythematous and excoriated. Pediatr Res, 1987 Nov, 22(5), 509 - 12 Oxygen delivery, oxygen consumption, and metabolic acidosis during group B streptococcal sepsis in piglets; Meadow WL et al.; The development of metabolic acidosis during neonatal sepsis with group B streptococci (GBS) has been attributed to progressive tissue ischemia resulting from reduced oxygen delivery (QO2) . Using an animal model of GBS disease, we attempted to test this hypothesis by comparing the development of metabolic acidosis in two groups of piglets with comparably diminished systemic QO2, one septic and one not . Eighteen anaesthetized piglets were instrumented to observe aortic pressure, cardiac output, arterial and mixed venous blood gases, oxygen content, and hemoglobin concentration . QO2, oxygen consumption, and oxygen extraction ratio were calculated . Six piglets (group 1) received continuous infusion of live GBS organisms; six piglets (group 2) received continuous infusion of phenylephrine (PE), beginning with 10-micrograms/kg/min and increasing as required to match the PE-induced reduction in QO2 to the fall observed in the group 1 (GBS) piglets at each 30-min interval . Group 3 piglets (n = 6) received 0.9% saline and served as controls . No differences in either cardiac output or QO2 were noted comparing GBS and PE piglets at any time interval from 0-180 minutes . At 120, 150, and 180 minutes, both QO2 and cardiac output were lower in GBS and PE piglets compared to controls . Despite equivalent reductions in cardiac output and QO2, only GBS piglets developed significant metabolic acidosis, while pH and base deficit for PE piglets did not differ from controls . Oxygen consumption did not differ significantly among the three experimental groups at any observation time . Oxygen extraction ratio did not differ comparing PE and GBS piglets at any observation time.(ABSTRACT TRUNCATED AT 250 WORDS) Am J Clin Pathol, 1987 Nov, 88(5), 631 - 4 Comparison of the TestPack Strep A enzyme immunoassay system with anaerobically incubated cultures for detection of group A streptococci from oropharyngeal swabs; Kellogg JA et al.; To find a rapid and sensitive test for detection of Group A streptococci (GABS), the performance of the TestPack Strep A (TPSA; Abbott) was compared with culture with the use of rayon-tipped throat swabs from symptomatic patients six months to 90 years of age . Each swab was first inoculated to a 5% sheep blood agar plate and then tested for GABS antigen with the use of the TPSA and the manufacturer's instructions . Cultures were incubated anaerobically at 35 degrees C for 36-48 hours unless positive results were obtained after one night . GABS were identified with a fluorescent antibody method or a latex antibody test . From 1,616 throat swabs, 296 (18.3%) of the cultures contained GABS . The sensitivity and specificity of the TPSA were 73.3% and 94.8%, respectively, whereas the predictive values of positive and negative results were 75.9% and 94.1%, respectively . Results varied significantly, however, with different production lots of TPSA . The TPSA does not appear to provide a sensitive alternative to an anaerobic culture for detection of GABS. Pediatrics, 1987 Nov, 80(5), 659 - 63 Streptococcal perianal disease in children; Kokx NP et al.; From October 1985 through June 1986, 31 children in a single pediatric practice were treated for perianal signs and symptoms associated with growth of group A beta-hemolytic streptococci from perianal cultures . Signs and symptoms included perianal dermatitis (90%), perianal itching (78%), rectal pain (52%), and blood-streaked stools (35%) . Ages ranged from 7 months to 8 years mean 4.25 +/- 1.8 years) . There were 24 boys (77%) and seven girls (23%) . The 31 cases occurred in 19 families . Intrafamily spread was only to siblings and occurred in 50% of the possible situations . Direct perianal antigen studies had a sensitivity of 89% for predicting positive cultures . Four different T types of group A streptococci were isolated from these cases, but the T type within each family outbreak was identical except in one case . When group A streptococci were found in the pharynx (64% of patients), the T type of the pharyngeal and perianal isolates were identical . Treatment was usually with oral penicillin . Relapses occurred in 39% . Signs of cellulitis were absent in all 31 cases and, therefore, we suggest that the nomenclature for this entity be changed from streptococcal perianal cellulitis to streptococcal perianal disease. Infect Immun, 1987 Nov, 55(11), 2759 - 67 Isolation and characterization of monoclonal antibodies specific for antigen P1, a major surface protein of mutans streptococci; Ayakawa GY et al.; A panel of 15 murine monoclonal antibodies (MAbs; 14 immunoglobulin G1, 1 immunoglobulin G2a) directed against antigen P1, a major surface protein of mutans streptococci, was prepared . All of these MAbs reacted by the enzyme-linked immunosorbent assay with solubilized wall material from Streptococcus mutans Ingbritt 175 (a serotype c strain which retains significant amounts of P1 in its cell wall), culture supernatant fluid from Ingbritt 162 (a strain which excretes large amounts of P1 into the culture medium), and purified P1 . By Western immunoblotting, these MAbs were observed to react with a high-molecular-weight polypeptide which comigrated with antigen P1 . None of these MAbs cross-reacted with human heart tissue or with various eucaryotic proteins . When whole cells of various strains of mutans streptococci were screened against the panel of MAbs, the strongest reactivities were noted with strains of serotype c and e S . mutans, while a serotype f strain of S . mutans, along with S . sobrinus and S . cricetus strains, reacted somewhat more weakly . S . rattus strains were completely negative . Results obtained with bacterial culture supernatants were qualitatively similar . The surface localization of antigen P1 was confirmed by electron microscopy with an indirect immunogold technique . In sectioned S . mutans cells, labeling appeared to be associated with a fibrillar "fuzzy coat" layer, which was far more prominent on cells of Ingbritt 175 than on those of Ingbritt 162. Circ Res, 1987 Nov, 61(5), 659 - 69 Group B streptococcal sepsis in the piglet: effects of fluid therapy on venous return, organ edema, and organ blood flow; Bressack MA et al.; We investigated the physiologic effects of normal saline versus 5% albuminated saline fluid resuscitation on 10-12-day-old piglets infected with group B streptococci for four hours . After intravenously receiving 1 X 10(10) bacteria/kg over 45 minutes, one group was untreated while the two fluid-treated groups received enough intravenous fluid to maintain the baseline cardiac output . An increase in the resistance to venous blood return was the major limitation to cardiac output . The resistance nearly quadrupled in the untreated piglets as shown by a 50% decrease in cardiac output with a nearly doubling of the driving pressure for venous return (mean circulatory pressure was normal and atrial pressures decreased by 70%) . In both fluid-treated groups, resistance doubled as shown by an unchanged cardiac output with a doubling of the driving pressure (mean circulatory pressure increased by 50%) and atrial pressures remained at baseline) . Blood volume was 9% below control in the untreated group and 13% above control in both fluid-treated groups . Much more crystalloid (155 ml/kg) than colloid (58 ml/kg) was necessary to maintain baseline cardiac output; this resulted in a 36% decrease in the plasma protein oncotic pressure of the former group and a 15% increase in the oncotic pressure of the latter group . Organ edema formation (ileum, pancreas, kidney, adrenal gland, lung) occurred only in the saline-treated animals . We conclude that increased resistance to venous return was the primary cause of shock in our model and that this can be effectively treated by giving enough intravenous fluid to elevate the mean circulatory pressure . However, if the plasma protein oncotic pressure is also lowered (saline group), organ edema results. Pediatr Dermatol, 1987 Nov, 4(3), 185 - 8 Impetigo: a reassessment of etiology and therapy; Barton LL et al.; Traditional concepts regarding the bacteriology and therapy of nonbullous impetigo have been reexamined . Although in the United States the disease is considered primarily of streptococcal origin and amenable to penicillin therapy, we found that Staphylococcus aureus was the most common isolate in 71 patients studied . Only two patients yielded pure cultures of group A beta-hemolytic streptococci . All but two isolates of S . aureus were resistant to penicillin; one of these two isolates was also resistant to erythromycin . Erythromycin appeared to be more efficacious than penicillin for the treatment of impetigo. Infect Immun, 1987 Nov, 55(11), 2695 - 700 Intergeneric bacterial coaggregations involving mutans streptococci and oral actinomyces; Crowley PJ et al.; Mutans streptococci (MS) representing eight different serotypes were tested for their ability to coaggregate in vitro with oral actinomyces and other streptococcal species . Of the mutans streptococci tested, only strains of S . cricetus (formerly S . mutans serotype a) displayed pronounced coaggregations and only with certain strains of actinomyces . S . cricetus coaggregated, by lactose nonreversible mechanisms, with serotype 4 Actinomyces naeslundii WVU963 and WVU924 and with serotype 2 Actinomyces odontolyticus WVU758 . The first pair was disaggregated by protein denaturants (e.g., sodium dodecyl sulfate and urea) and EDTA . This coaggregation was inhibited when the streptococcal, but not the actinomyces, partner was pretreated with either heat or protease, suggesting the presence of a protein mediator on only the streptococcal cell surface . The S . cricetus-A . odontolyticus coaggregation appeared to involve protein components on each cell, as shown by the lack of coaggregation after pretreatment of either cell type with heat or proteases . This coaggregation was also reversed by sodium dodecyl sulfate and urea, as well as by sodium deoxycholate, but not by EDTA . The data indicate that different mechanisms may be involved in each of these coaggregations. J Med Microbiol, 1987 Nov, 24(3), 259 - 62 Characterisation of and polysaccharide production by amoxycillin-resistant streptococci; Marsh PD et al.; Small numbers of bacteria capable of growing on agar supplemented with amoxycillin 40 mg/L were isolated from the saliva of 9 out of 20 adult volunteers in a previous study . All the bacteria were identified as Streptococcus sanguis although no strains produced dextran in conventional tests . However, using a specific assay, all the antibiotic-resistant strains were found to secrete glucosyltransferases (GTF), the enzymes that synthesise these extracellular polysaccharides; the production of GTF-S, the enzyme that synthesizes dextran, was 22-43% less than that of an antibiotic-sensitive control strain . Enzyme production by both antibiotic-resistant and sensitive bacteria was markedly inhibited by dextran primer . The amoxycillin-resistant bacteria were resistant to other penicillins; their resistance to erythromycin was variable but they were uniformly sensitive to cephalothin and clindamycin . As dextran production has been proposed as a key factor in the colonisation of damaged heart valves by bacteria such as S . sanguis, these highly resistant bacteria may not pose a threat to the susceptible individual. Infect Immun, 1987 Nov, 55(11), 2562 - 9 Oral immunization of humans with Streptococcus sobrinus glucosyltransferase; Smith DJ et al.; The effect of oral administration of glucosyltransferase (GTF) from Streptococcus sobrinus 6715 on levels of immunoglobulin A (IgA) antibody to GTF in parotid saliva and on the number of indigenous Streptococcus mutans in the whole saliva was studied in young adult males . GTF combined with aluminum phosphate (AP) was administered in capsules to 14 subjects, while sodium phosphate buffer combined with AP was administered in the same way to 11 control subjects . Thirteen administrations were given during the first immunization regimen, and five administrations, approximately 3 months later, constituted the second immunization regimen . All subjects were given professional dental prophylaxis immediately prior to each immunization . Each subject served as his own control by using antibody and bacterial data collected prior to antigen administration for comparison . After the first immunization regimen, the GTF vaccine group exhibited a significantly higher distribution (P less than 0.05) of normalized parotid saliva IgA antibody elevations than observed in the placebo group . Between the first and second immunization regimens a significant increase (P less than 0.05) in parotid salivary anti-GTF activity also occurred in the GTF vaccine but not the placebo group . No significant differences between these two groups were observed on any occasion when serum IgG or IgA antibody to GTF was analyzed . Comparison of the group mean log ratios (post- to prevaccine administration) of S . mutans to total streptococci in whole saliva revealed that the GTF vaccine group values were always lower than those of the placebo group . These differences reached significance (P less than 0.01) on three of the last four sampling occasions (days 21, 35, and 42) following initiation of the first immunization regimen . The mean log ratios of the GTF vaccine group were also lower than those of the placebo group after the second immunization regimen but did not reach significance . These data indicate that oral administration of GTF from the mutans streptococci has the potential to elicit a salivary IgA antibody response when combined with an aluminum-based adjuvant and that this response can interfere with the reaccumulation of indigenous S . mutans following dental prophylaxis. J Immunol, 1987 Nov 1, 139(9), 3084 - 90 Sequence and type-specific immunogenicity of the amino-terminal region of type 1 streptococcal M protein; Kraus W et al.; The NH2-terminal sequence of type 1 M protein was determined by automated Edman degradation of purified polypeptide fragments extracted from whole streptococci by limited digestion with pepsin . Three polypeptide fragments were purified by slab gel electrophoresis on sodium dodecyl sulfate (SDS) polyacrylamide followed by electroelution . The purified fragments migrated as 28-, 25-, and 23.5-kDa fragments, respectively . Each of the fragments inhibited opsonization of a diluted antiserum prepared in rabbits by immunization with whole type 1 streptococci . The amino-terminal sequences of the peptide fragments were confirmed by comparison with the primary structure predicted from the nucleotide sequence of the type 1 M protein structural gene . The 28-kDa fragment contained the NH2-terminal asparagine residue of the processed type 1 M protein, whereas the NH2-terminal sequences of the 25- and 23.5-kDa peptides began at residues 27 and 36, respectively . A seven-residue periodicity with respect to polar and nonpolar residues was observed beginning at residue 22 and, therefore, the secondary structural potential of type 1 M protein is similar to that reported for other M proteins . In contrast to the other M proteins, however, identical repeats were rare, the longest sequence identity consisting of a three-amino acid acid sequence Lys-Asp-Leu at positions 30-32 repeated once at positions 65-67 . A 23-residue synthetic peptide of the amino-terminus of the type 1 M protein evoked opsonic antibodies against type 1 streptococci . These results indicate that the NH2-terminal region of type 1 M protein retains the secondary structural characteristics of other M serotypes . Moreover, it contains epitopes that evoke protective immune responses . Our studies may have bearing in the development of safe and effective vaccines against group A streptococcal infections. Eur J Biochem, 1987 Oct 15, 168(2), 319 - 24 Structure and evolution of the repetitive gene encoding streptococcal protein G; Olsson A et al.; The complete sequence of the structural gene encoding the immunoglobulin G binding protein from Streptococcus G148 has been determined, as well as its 5' and 3' flanking sequences . The sequence reveals an open reading frame encoding a putative preprotein with a relative molecular mass of 63294 . N-Terminal sequencing of the mature protein, spontaneously released from streptococcal cells, demonstrates that the signal peptide consists of 33 amino acids . The DNA sequence reveals extensive internal homologies similar to other cell-wall-bound receptors from gram-positive bacteria . Comparisons with a related gene previously isolated from another strain of streptococci revealed large differences in size, due to variations in the number of internal repeats . The structure of the gene suggests an evolution through multiple duplications. J Biol Chem, 1987 Oct 5, 262(28), 13388 - 91 Definition of IgG- and albumin-binding regions of streptococcal protein G; Akerstrom B et al.; Protein G, the immunoglobin G-binding surface protein of group C and G streptococci, also binds serum albumin . The albumin-binding site on protein G is distinct from the immunoglobulin G-binding site . By mild acid hydrolysis of the papain-liberated protein G fragment (35 kDa), a 28-kDa fragment was produced which retained full immunoglobulin G-binding activity (determined by Scatchard plotting) but had lost all albumin-binding capacity . A protein G (65 kDa), isolated after cloning and expression of the protein G gene in Escherichia coli, had comparable affinity to immunoglobulin G (5-10 X 10(10)M-1), but much higher affinity to albumin than the 35- and 28-kDa protein G fragments (31, 2.6, and 0 X 10(9)M-1, respectively) . The amino-terminal amino acid sequences of the 65-, 35-, and 28-kDa fragments allowed us to exactly locate the three fragments in an overall sequence map of protein G, based on the partial gene sequences published by Guss et al . (Guss, B., Eliasson, M., Olsson, A., Uhlen, M., Frej, A.-K., Jornvall, H., Flock, J.-I., and Lindberg, M . (1986) EMBO J . 5, 1567-1575) and Fahnestock et al . (Fahnestock, S . R., Alexander, P., Nagle, J., and Filpula, D . (1986) J . Bacteriol . 167, 870-880) . In this map could then be deduced the location of three homologous albumin-binding regions and three homologous immunoglobulin G-binding regions. J Antibiot (Tokyo), 1987 Oct, 40(10), 1426 - 30 In vitro and in vivo characterization of novel 8-methoxy derivatives of chlortetracycline; Cacciapuoti A et al.; The in vitro activities of three new 8-methoxychlortetracyclines, Sch 36969, 33256 and 34164 were compared to tetracycline, minocycline and doxycycline . Against aerobic Gram-negative rods Sch 36969 had a geometric mean MIC (GMM) of 4.2 micrograms/ml, about 8-fold more potent than Sch 33256, and similar to all the other compounds . Sch 36969 also had good activity against methicillin-resistant (GMM, 0.21 micrograms/ml) and -susceptible Staphylococci (GMM, 0.14 micrograms/ml), Streptococci (GMM, 0.06 micrograms/ml), and most anaerobic bacteria (GMM, less than 0.5 micrograms/ml) . In general, Sch 36969 was similar to, or more potent than, all the other compounds tested . Serum levels of Sch 36969 in squirrel monkeys were 4-fold lower (AUC, 4.5 micrograms.hours/ml) than those of chlortetracycline (AUC, 16.1 micrograms.hours/ml) . In mouse protection tests (PD50s) against various strains of bacteria, Sch 36969 was similar in activity to tetracycline, but up to 6-fold less active than chlortetracycline . The structure activity relationships for these new chlortetracyclines are described. Epidemiol Infect, 1987 Oct, 99(2), 257 - 64 Group L beta-haemolytic streptococcal infection in meat handlers: another streptococcal zoonosis? Barnham M, Neilson DJ. Group L, beta-haemolytic streptococci can cause infection in dogs, pigs, cattle and sheep but there have been very few reports in man . In studies of skin infection in meat handlers we cultured group L streptococci from clinically infected wounds, impetigo and paronychia of 15 patients involved in the slaughter and processing of chickens and pigs . Staphylococcus aureus was also present in eight (53%) of the lesions . At least five other infections with group L streptococci in meat and animal handlers are known to have occurred in other parts of England in recent years, and brief details are given. Epidemiol Infect, 1987 Oct, 99(2), 249 - 55 Food-borne outbreak of group G streptococcal sore throat in an Israeli military base; Cohen D et al.; A food-borne outbreak of sore throat caused by Lancefield group G beta-haemolytic streptococci and involving 50 persons occurred in May 1983 in an Israeli military camp . All of the patients available for clinical examination had sore throat and difficulty in swallowing . Exudative tonsillitis occurred in 46% of the patients and the body temperature was above 37.5 degrees C in 81% . The pattern of attack was uniform over the base and 37 became ill during the night and morning of the 5 May . Thirty-two (84%) of the throat cultures taken from 37 patients grew group G beta-haemolytic streptococci . Eight of 29 contacts were positive for group G beta-haemolytic streptococci and 6 of the 28 foodhandlers examined had positive cultures of the same group . The organism was also isolated from one food sample . The epidemiological and laboratory investigations indicated that a food handler, a convalescent carrier of group G streptococci, might have been the source of infection . Assumptions on the potential of non-group A streptococci to cause epidemics are discussed. Am J Med, 1987 Oct, 83(4), 626 - 34 Infective endocarditis: clinical features in young and elderly patients; Terpenning MS et al.; The elderly constitute an increasing percentage of patients with infective endocarditis . The disease manifestations and outcomes in 53 episodes of endocarditis in patients over the age of 60 were reviewed and compared with 55 episodes of endocarditis in patients less than 40 years of age and 46 episodes of endocarditis in patients aged 40 to 60 . The percentage of cases caused by staphylococci and streptococci were roughly equal in all groups . Enterococci, Streptococcus bovis, and coagulase-negative staphylococci were more common in the elderly . In the elderly, invasive vascular procedures were the most common source of infection . Endocarditis acquired nosocomially accounted for 23 percent of all episodes in older patients . The elderly reported fewer symptoms and showed a diminished febrile response . Errors in diagnosis were noted in 68 percent of elderly patients, and a delay in initiating appropriate therapy was more common in this age group . The mortality rate was significantly higher in the elderly (45.3 percent) than in the middle-aged (32.6 percent) and young (9.1 percent) . Endocarditis in elderly patients is often nosocomially acquired, is difficult to diagnose, and is associated with a higher mortality than noted in younger patients. J Clin Microbiol, 1987 Oct, 25(10), 1854 - 9 Cross-reactions between pneumococci and other streptococci due to C polysaccharide and F antigen; Sorensen UB et al.; By serological methods, all 83 known types of Streptococcus pneumoniae could be shown to possess C polysaccharide and F antigen . Cross-reactions due to these two antigens between pneumococci and a broad range of most other commonly encountered streptococci were examined . The presence of an antigen closely similar or identical to pneumococcal C polysaccharide was demonstrated in some strains of Streptococcus mitior . Therefore, we conclude that pneumococci cannot be identified serologically from mixed samples without culture . Streptococcal group C antiserum was found to cross-react with pneumococcal F antigen. Infect Immun, 1987 Oct, 55(10), 2341 - 7 Protection of gnotobiotic rats against dental caries by passive immunization with bovine milk antibodies to Streptococcus mutans; Michalek SM et al.; A multivalent vaccine consisting of whole cell antigens of seven strains, representing four serotypes (b, c, d and g), of mutans streptococci was used to hyperimmunize a group of cows . Serum samples from these animals contained immunoglobulin G1 (IgG1) antibody activity to seven serotypes (a to g) of mutans streptococci . Whey obtained from the animal with the highest serum antibody activity, which also contained high levels of IgG1 antibody, was used in passive caries immunity studies . Gnotobiotic rats monoinfected with Streptococcus mutans MT8148 serotype c or Streptococcus sobrinus OMZ176 (d) or 6715 (g) and provided a caries-promoting diet containing immune whey had lower plaque scores, numbers of streptococci in plaque, and degree of caries activity than similarly infected animals given a diet containing control whey obtained from nonimmunized cows . To establish the nature of the protective component(s) present in the immune whey, an ultrafiltrate fraction of the whey was prepared . This preparation contained higher levels of IgG1 anti-S . mutans antibody activity than the immune whey . Rats monoinfected with S . mutans MT8148 and provided with a diet supplemented with 0.1% of this fraction exhibited a degree of caries protection similar to that seen in animals provided a diet containing 100% immune whey . In fact, a diet containing as little as 0.01% of the ultrafiltrate fraction gave some degree of protection against oral S . mutans infection . The active component in the immune whey was the IgG1 anti-S . mutans antibody, since rats monoinfected with S . mutans MT8148 and provided a diet supplemented with purified immune whey IgG1 had significantly reduced plaque scores, numbers of S . mutans in plaque, and caries activity compared with control animals . Prior adsorption of the IgG fraction with killed S . mutans MT8148 whole cells removed antibody activity and abrogated caries protection. Scand J Dent Res, 1987 Oct, 95(5), 369 - 80 Microbiology of the early colonization of human enamel and root surfaces in vivo; Nyvad B et al.; This study describes the predominant early microflora on human teeth on the basis of microbiologic identification of 1742 fresh isolates . The isolates were obtained from four dental students who carried test pieces of enamel and root surface in the oral cavity for 4, 8, 12, and 24 h . During the experimental periods oral hygiene was discontinued . Under equal conditions root surfaces were more heavily colonized than were enamel surfaces . However, the composition of the microbiota was the same . Within the first 24 h the microflora was dominated by streptococci and Gram-positive pleomorphic rods . S . sanguis contributed only 6-18% of the early colonizers whereas S . mitis and S . oralis varied between 24-42% and 1-27% (mean values), respectively . The relative proportion of S . oralis increased significantly within the observation period while the proportion of S . salivarius and arginine-positive S . mitis showed a declining tendency . Actinomyces species adsorbed to the tooth surfaces within the first 4 h but did not increase their relative proportions until after 8-12 h, possibly due to a long doubling time . In one individual, encapsulated bacteria resembling Stomatococcus mucilaginosus were observed among the early colonizers . The time-dependent shifts in the bacterial populations within 24 h corroborate parallel ultrastructural findings. J Appl Bacteriol, 1987 Oct, 63(4), 311 - 8 The hydrophobicity of 'viridans' streptococci isolated from the human mouth; Hogg SD et al.; The hydrophobicity of human oral streptococci was measured with the hexadecane assay modified by the incorporation of polyethylene glycol 6000 . Large variability in the hydrophobicity between cultures of some strains grown on different occasions was observed whereas other strains were less variable . The variation in hydrophobicity was significantly reduced by growing the cells in continuous culture in a chemostat under glucose-limiting conditions . The Streptococcus mutans strains used all had low hydrophobicity and the mean hydrophobicity of this species was significantly lower (P less than 0.05) than the mean hydrophobicity of Strep . salivarius, Strep . sanguis Type I and Strep . sanguis Type II strains . This finding supports the view that hydrophobicity is a contributing factor in the adhesion of viridans streptococci to oral surfaces. Antibiot Med Biotekhnol, 1987 Oct, 32(10), 785 - 9 {Ulcer microflora and its antibiotic sensitivity in gastric and duodenal peptic ulcer}; Veselov AIa et al.; Ulcer microflora from 97 stomachs resected from 28 patients with gastric ulcers, 65 patients with duodenal ulcers and 4 patients with gastric and duodenal ulcers was studied . Various microorganisms were detected in 65.9 +/- 4.8 per cent of the patients with predominance of staphylococci and streptococci . At pH of the gastric juice about 4, the isolation amounted to 61.2 +/- 5.5 per cent, from 4.0 to 7.0-81.8 +/- 11.6 per cent and more than 7.0-100 +/- 4.1 per cent respectively . The levels of associations increased from 27.8 to 83.3 per cent . In patients with hypo- and achlorhydria the frequency of staphylococcus isolation from the ulcers was 2.6 times higher and that of yeast and Candida isolation was 3.7 times higher . Diphtheroids were isolated from the ulcers only of patients with normo- and hyperchlorhydria . The majority of the isolates were sensitive to gentamicin (76.7 +/- 4.6 per cent of the strains) . Multiple resistance to 17-18 antibiotics was observed in enterococci. Mol Immunol, 1987 Oct, 24(10), 1113 - 22 Streptococcal protein G, expressed by streptococci or by Escherichia coli, has separate binding sites for human albumin and IgG; Bjorck L et al.; Protein G is expressed at the cell surface of certain group C and group G streptococcal strains . The protein shows a unique and specific affinity for the Fc region of mammalian polyclonal and monoclonal immunoglobulin G (IgG) . We have cloned the streptococcal gene coding for protein G into E . coli, using phage lambda as the vector . The protein G produced by E . coli infected with this phage was detected and analysed in Western blot experiments using radiolabelled IgG Fc fragments as a probe . Three major IgG Fc-binding bands were obtained corresponding to apparent mol . wts of 47,000, 57,000 and 65,000, respectively . Analysis of the expression in E . coli indicates that this heterogeneity is caused by a post-translational degradation of the molecule before lysis of the lambda infected E . coli cells occurred . The protein G produced in E . coli was purified by affinity chromatography on IgG-Sepharose followed by gel-filtration on Sephadex G-200 . This highly purified E . coli-produced protein G was compared to protein G solubilized by papain from streptococci, in direct binding experiments and in a competitive binding assay . The two protein G variants were found to interact with polyclonal IgG from different species in a similar way . Streptococcal strains expressing protein G also show affinity for human albumin, and at the molecular level protein G was found to be responsible also for the binding of albumin . Thus, both E . coli-produced protein G and the proteolytic fragment of protein G obtained from streptococci, bound albumin . On the protein G molecule, two different and separate sites were found to bind IgG and albumin . Finally, when whole streptococci were incubated with human plasma, the interactions with protein G caused a coating of the bacteria with albumin and IgG, whereas other plasma proteins showed no affinity for protein G. Infect Immun, 1987 Oct, 55(10), 2383 - 6 Comparative analysis of the localization of lipoteichoic acid in Streptococcus agalactiae and Streptococcus pyogenes; Mattingly SJ et al.; The cellular locations of deacylated lipoteichoic acid (dLTA) and lipoteichoic acid (LTA) were examined in late-exponential-phase cells of a serotype III strain of Streptococcus agalactiae (group B streptococci {GBS}) isolated from an infant with late-onset meningitis and compared with a fresh clinical isolate of Streptococcus pyogenes (group A streptococci {GAS}) . LTA and dLTA were found to be associated with the protoplast membranes of both organisms, with only dLTA found in mutanolysin cell wall digests . Both organisms released dLTA during growth, but only the GAS released substantial levels of LTA into the culture medium . However, penicillin treatment (5 micrograms/ml for 60 min) of GBS resulted in the recovery of LTA in cell wall digests as well as in the culture medium . These results suggest that under normal growth conditions, the hydrophobic region (glycolipid) of LTA remains associated with the cytoplasmic membrane of GBS and unavailable for hydrophobic interactions at the cell surface with epithelial cells . In contrast, release of LTA into the environment by the GAS allows the fatty acid moieties to interact with hydrophobic domains on the surface of epithelial cells . These results may help explain the marked differences in the specificity of binding between these two major streptococcal pathogens for human fetal and adult epithelial cells. Clin Pharm, 1987 Oct, 6(10), 761 - 70 Mupirocin: a topical antibiotic with a unique structure and mechanism of action; Parenti MA et al.; The chemistry, mechanism of action, antimicrobial activity, pharmacokinetics, clinical efficacy, adverse effects, dosage, and administration of mupirocin are reviewed . Mupirocin, formerly termed pseudomonic acid A, is a topical antibiotic under investigation for the treatment of impetigo and other superficial primary and secondary skin infections . Mupirocin (Bactroban, Beecham Laboratories) is currently formulated as a 2% ointment in a water-miscible polyethylene glycol base . The drug is a unique antimicrobial agent because of its structure and mechanism of action . Mupirocin apparently exerts its antimicrobial activity by reversibly inhibiting isoleucyl-transfer RNA, thereby inhibiting bacterial protein and RNA synthesis . Mupirocin has excellent in vitro activity against staphylococci and most streptococci but less activity against other gram-positive and gram-negative bacteria . The drug will only be used topically because of its rapid and extensive systemic metabolism . Several controlled clinical trials documented that mupirocin was significantly better than the polyethylene glycol vehicle alone or ampicillin and as effective as cloxacillin, dicloxacillin, or erythromycin in producing clinical and bacteriological cures in patients with impetigo and wound infections caused by gram-positive pathogens . Limited studies suggest that mupirocin may also have a role in eradicating nasal carriage of staphylococci . Reported adverse effects are local and may be related to the polyethylene glycol vehicle base . Mupirocin should be useful for treating patients with impetigo and wound infections caused by Staphylococcus aureus . However, additional controlled, comparative clinical studies are needed to identify the role of mupirocin in treating other primary and secondary skin infections and for eliminating nasal carriage of staphylococci. Eur J Clin Microbiol, 1987 Oct, 6(5), 525 - 9 Concentrations of phenoxymethylpenicillin and cefadroxil in tonsillar tissue and tonsillar surface fluid; Stromberg A et al.; Thirty patients who underwent elective tonsillectomy were given phenoxymethylpenicillin (0.8 g) or cefadroxil (1 g) at different times before operation . The concentrations of the antibiotics were analysed in serum, tonsillar tissue, fluid from the surface of the tonsils, and mixed saliva . The concentrations in tonsillar tissue for both drugs were much lower than the corresponding serum concentrations . This apparently low tissue accessibility could be ascribed to the limited intracellular penetration of beta-lactam antibiotics . For both antibiotics the concentrations in the tonsillar surface fluid were higher than the levels in the tissue and well above the minimal inhibitory concentrations for streptococci . This was not due to antibiotics in saliva but probably a result of leakage from the interstitial fluid . Inability to reach active concentrations of phenoxymethylpenicillin or cefadroxil at the site of infection does not therefore seem to be a probable cause for relapse after treatment of streptococcal tonsillitis. Pediatr Res, 1987 Oct, 22(4), 478 - 82 Effect of cyclooxygenase and lipoxygenase products on pulmonary function in group B streptococcal sepsis; Suguihara C et al.; The effects of the cyclooxygenase inhibitor, indomethacin, and the leukotriene receptor antagonist, FPL 57231, on changes in dynamic lung compliance and pulmonary resistance associated with a 1-h infusion of live group B streptococci were evaluated in mechanically ventilated piglets . To define mediators of early changes in lung function, animals were given an infusion of either FPL 57231 or indomethacin beginning 15 min after the infusion of group B streptococci was begun . These groups were compared to an untreated group who received only group B streptococci . Within 15 min of starting the bacterial infusion, all groups showed significant increases in pulmonary artery pressure, pulmonary artery wedge pressure, total pulmonary resistance, transpulmonary pressure, and thromboxane B2, and decreases in tidal volume, dynamic lung compliance, and PaO2 . After treatment with indomethacin there were significant decreases in pulmonary artery pressure (mean +/- SEM; 48 +/- 1 to 22 +/- 3 mm Hg, p less than 0.001), pulmonary artery wedge pressure (7.5 +/- 1.3 to 2.2 +/- 0.4 mm Hg, p less than 0.001) and thromboxane B2 (6.51 +/- 1.56 to 1.01 +/- 0.27 ng/ml, p less than 0.01) and an increase in dynamic lung compliance (1.10 +/- 0.10 to 1.28 +/- 0.14 ml/cm H2O/kg, p less than 0.01) over the study period . Total pulmonary resistance decreased significantly (18.7 +/- 1.8 to 15.7 +/- 1.5 cm H2O/liter/s, p less than 0.02) only at 60 min.(ABSTRACT TRUNCATED AT 250 WORDS) J Clin Microbiol, 1987 Oct, 25(10), 1845 - 50 Comparison of physiologic tests used to identify non-beta-hemolytic aerococci, enterococci, and streptococci; Fertally SS et al.; Twenty-one reference strains and 88 clinical isolates of Aerococcus, Enterococcus, and Streptococcus species were tested for reactions in the Rapid Strep (RS) and modified conventional tests . We conclude that some but not all of the tests in the RS system could be used to substitute for conventional tests . RS tests for hydrolysis of arginine, esculin, L-pyrrolidonyl-naphthylamide, production of acetyl methyl carbinol (Voges-Proskauer), and fermentation of arabinose, lactose, mannitol, raffinose, and sorbitol were satisfactory substitutes for conventional tests . However, the RS tests for hydrolysis of hippurate and starch and fermentation of inulin were not satisfactory substitutes for conventional tests . We also conclude that, of the five test tube Voges-Proskauer tests, the Coblentz modification is the most discriminatory. Oral Surg Oral Med Oral Pathol, 1987 Oct, 64(4), 417 - 20 Development of resistant oral viridans streptococci after administration of prophylactic antibiotics: time management in the dental treatment of patients susceptible to infective endocarditis; Leviner E et al.; The American Heart Association recommends prophylactic administration of penicillin before each dental session to patients susceptible to infective endocarditis . Such preventive treatment, however, may trigger the transient appearance of penicillin-resistant bacterial strains . In order to investigate the behavior of oral streptococci, 29 healthy volunteers who did not harbor penicillin-resistant viridans streptococci received 4 gm of phenoxymethyl penicillin orally over a period of 10 hours . This amount constituted the sole dose of antibiotics administered in the entire experiment . Daily specimens of oral flora were obtained for 14 successive days from each participant and incubated aerobically with a penicillin-saturated disk for 24 hours . Viridans streptococci were considered resistant when bacterial colonies grew adjacent to the disk for 1 day or more . The study population was divided into high- and low-resistance groups, according to the individual antibiograms . Resistant viridans streptococci were already detected at 6 hours after penicillin ingestion in nine (31%) of the subjects . Six months later, oral specimens were taken from ten randomly selected participants; these specimens served as a control . The difference in bacterial resistance between the high- and low-resistance groups was significant for the duration of 9 days, as was that between the high-resistance and control groups (p less than 0.05 in both cases) . In order to minimize the odds that penicillin-resistant bacterial strains will develop in patients susceptible to infective endocarditis, elective dental treatments in these persons should be scheduled in intervals of not less than 10 days. Infect Immun, 1987 Oct, 55(10), 2404 - 8 Interaction of soluble fibronectin with group B streptococci; Butler KM et al.; Fibronectin binds to a variety of bacterial species, and we hypothesized that differential fibronectin binding might influence the invasive potential of group B streptococci (GBS) . Human plasma fibronectin purified by a standard two-step chromatographic procedure was radiolabeled with 3H . Fifty GBS strains (invasive, colonizing, or bovine) representing serotypes Ia (10 strains), Ib (6 strains), Ia/c (6 strains), II (10 strains), III (11 strains), IV (1 strain), and nontypable (6 strains) were tested . No source or serotype variability was detected among GBS strains, and binding was uniformly less than 1.5% of available fibronectin . Lack of detectable binding occurred at both the log and stationary growth phases and persisted despite treatment with trypsin or neuraminidase or opsonization with immunoglobulin G containing high levels (greater than 40 micrograms/ml) of antibody specific for the Ia, II, or III GBS capsular polysaccharides . Incubation with GBS did not inhibit fibronectin binding to the Cowan 1 strain of Staphylococcus aureus . Strain COH 31-15, an isogenic, type III, capsule-deficient mutant of COH 31r/s, also failed to bind fibronectin . In contrast to other streptococci, GBS do not have readily detectable receptors for soluble fibronectin as part of their surface structures . If present, binding sites for soluble fibronectin are deep to surface structures, obscured from host defense systems, or require the presence of other factors to facilitate their recognition of fibronectin . The uniform ability of GBS to resist binding to soluble fibronectin could be a significant virulence factor in the pathogenesis of invasive infections of infants. Acta Pathol Microbiol Immunol Scand {B}, 1987 Oct, 95(5), 303 - 7 Binding of albumin fragments to surface receptor in A, C, and G streptococci; Wideback K; Fragments of human and bovine serum albumin were produced by treatment with trypsin at pH 8.15 and with pepsin at pH 3.5 and 3.7 in the presence of octanoic acid . A large fragment which included the C-terminal part of the native molecule was produced by trypsin treatment . The tryptic digest was subsequently treated with pepsin, resulting in smaller fragments . The ability of the fragments to bind to albumin-receptors on streptococci was investigated . According to Western blots only fragments with a mol . wt . of 23 kDa or more were able to bind to albumin-binding structures obtained from streptococci . The 23 kDa fragment was radiolabelled and tested for binding to whole bacteria . The fragment was capable of binding to albumin-reactive structures on group A, C, and G streptococci with the same species-specificity as native human and bovine serum albumin, respectively . Both the large 45 kDa tryptic fragment and the small 23 kDa fragment could bind to streptococci and could be dissociated by 2 M KSCN. Infect Immun, 1987 Oct, 55(10), 2416 - 9 Monoclonal antibody to human renal glomeruli cross-reacts with streptococcal M protein; Goroncy-Bermes P et al.; Two murine monoclonal antibodies (immunoglobulin M) evoked against human kidney tissue were examined for cross-reactivity with group A streptococci . A glomerulus-specific antibody, PMII.40.H.2, cross-reacted in an enzyme-linked immunosorbent assay with purified pepsin-extracted M proteins from type 6 and 12 streptococci, but not type 1, 3, 5, 19, and 24 M proteins . The cross-reactive monoclonal antibody also opsonized type 6 and 12 streptococci, indicating that it was directed against protective M protein epitopes that were exposed on the surfaces of these organisms . A control antibody, which was tubule specific, did not cross-react with any of the purified M proteins, nor did it opsonize any of the serotypes of streptococci tested . Western immunoblot experiments identified the glomerular cross-reactive antigen as a 43-kilodalton protein . The results demonstrate that M protein of group A streptococci and glomerular antigens of the human kidney possess cross-reactive determinants. Can J Microbiol, 1987 Sep, 33(9), 824 - 7 Environmental pH as a factor in the competition between strains of the oral streptococci Streptococcus mutans, S . sanguis, and "S . mitior" growing in continuous culture; Bowden GH et al.; Strains of Streptococcus mutans (biotype 1), Streptococcus sanguis, and Streptococcus mitior have been grown in mixed continuous culture in a semidefined medium under glucose limitation at a growth rate of D = 0.1 h-1 . The effect of varying the environmental pH on the proportions of the different populations within the community has been determined . Initially the populations were allowed to reach steady state at pH 7.0 when S . sanguis was dominant with S . mutans and "S . mitior" maintaining similar populations . The medium pH was then lowered in steps of 0.5 pH units from pH 7.0 to 4.5, and the community was grown at each step for at least 15 generations . Viable counts of each species were made at 24-h intervals . The population ratios established at pH 7.0 remained relatively stable when the environmental pH was set at pH 6.5 . However, after the medium pH was lowered to 6.0 (days 18-27), the population of S . mutans began to increase and the S . mitior population began to decline . A further change was seen at pH 5.5 (days 27-34) when S . mutans became dominant, S . sanguis declined, and S . mitior was not detectable . At pH 4.5, both S . mutans and S . sanguis were reduced in numbers, but survived until the experimental run was terminated (44 days) . Samples of culture fluid were taken throughout the experiment and analyzed for the presence of the acid products of glucose metabolism . The amounts of lactic acid produced by the community increased as the environmental pH was lowered.(ABSTRACT TRUNCATED AT 250 WORDS) J Antimicrob Chemother, 1987 Sep, 20 Suppl A, 51 - 70 The role of the laboratory in assisting treatment--a review of current UK practices; Eykyn SJ; A questionnaire concerning the laboratory management of endocarditis was sent to 120 UK microbiologists . The 86 replies received indicated that most microbiologists undertake in-vitro sensitivity tests on both streptococci and staphylococci and nearly all perform serum bactericidal titres . Neither the methods used for these investigations nor the interpretation of the results obtained are uniform . Considerable importance is attached to the serum bactericidal titres and many microbiologists alter the antibiotic regimen on the basis of unsatisfactory results . The serum bactericidal titre obtained in 114 patients with endocarditis seen at St . Thomas' Hospital between 1970 and 1985 were analysed according to the outcome of the infection; this was classified as (i) cure, (ii) bacteriological cure/clinical failure or (iii) failure . There were only six failures, four of which had peak titres less than 1:8 . Trough titres were of no predictive value . Peak titres of greater than 1:8 were reasonably predictive of bacteriological cure but not of clinical outcome . Failure of medical treatment in endocarditis is seldom the result of inappropriate antibiotics, it usually results from late diagnosis or late referral to cardiologists and cardiac surgeons . Critical evaluation of serum bactericidal titres is long overdue. J Antimicrob Chemother, 1987 Sep, 20 Suppl A, 17 - 27 The clinical and echocardiographic diagnosis of infective endocarditis; Bain RJ et al.; We report the results of a series of 75 patients admitted to the East Birmingham Hospital between 1976 and 1984 . Rheumatic heart disease is now an uncommon predisposing factor . The viridans streptococci are a decreasing cause of infection while staphylococcal infections are increasing and often occur on previously normal heart valves . The presenting symptoms of the disease are usually non-specific and the classical physical signs of endocarditis are uncommon . Blood culture and echocardiography are the most useful investigations in establishing the diagnosis . The diagnosis of endocarditis should be considered in all febrile patients, especially if they are ill, who have a cardiac murmur or persistent bacteraemia. Eur J Epidemiol, 1987 Sep, 3(3), 316 - 8 Viridans streptococci septicemia in cancer patients: a clinical study; Menichetti F et al.; Viridans streptococci septicemia was documented in ten cancer patients, 7 of whom were neutropenic (less than 1000/mmc) . Pneumonia was presumed to be the source of bacteremia in six patients . Viridans streptococci isolated from sputum culture in an immunocompromised host must be regarded as the potential etiological agent, then further characterized and checked for antibiotic sensitivity. Am Rev Respir Dis, 1987 Sep, 136(3), 565 - 9 Protected transbronchial needle aspiration and protected specimen brush in the diagnosis of pneumonia; Lorch DG Jr et al.; Protected transbronchial needle aspiration (PTBNA) of pneumonic lung theoretically could bypass dislodged upper respiratory tract flora, a potential source of contamination of protected specimen brush (PSB) cultures . To evaluate the usefulness of PSB and PTBNA in establishing the etiology of pneumonia, we prospectively studied 20 patients with acute bacterial pneumonia not receiving antibiotics . After informed consent, patients had fiberoptic bronchoscopy under fluoroscopy to localize the pneumonia, and specimens were obtained by the PSB . The protective plug of a specially devised needle for PTBNA was pneumatically dislodged and aspiration was performed within the infiltrate under fluoroscopy . Quantitative cultures were plated immediately for aerobes, anaerobes, and Legionella . Greater than 4 X 10(3) organisms/brush or 1 X 10(4) organisms/ml needle aspirate were considered to be consistent with infection . The results using PSB and PTBNA were compared in 15 of 20 patients in whom a definitive diagnosis (positive blood or pleural fluid culture) or presumptive diagnosis (expectorated sputum culture, clinical characteristics, and response to specific therapy) was established . The PSB and PTBNA cultures on uninfected control subjects (n = 5) being bronchoscoped for other reasons were negative . The PSB and PTBNA were each diagnostic in 2 of the 5 patients with definitive diagnoses . In the group with a presumptive diagnosis (n = 10), PSB was diagnostic in 7 of 10 and PTBNA in 9 of 10 . The overall (definitive plus presumptive) diagnostic yield was 60% for PSB and 73% for PTBNA . Multiple organisms were isolated in high concentrations in 53% of the patients . The most common organisms recovered in addition to the primary pathogen was alpha hemolytic streptococci.(ABSTRACT TRUNCATED AT 250 WORDS) Rev Infect Dis, 1987 Sep-Oct, 9 Suppl 5, S475 - 81 Bacterial adherence: the attachment of group A streptococci to mucosal surfaces; Beachey EH et al.; It is now recognized that bacteria bind to and colonize mucosal surfaces in a highly selective manner . After the organisms penetrate the nonspecific mechanical and cleansing forces, ligands (or adhesins) on the surface of the bacteria interact in a lock-and-key (or induced-fit) fashion with complementary receptors on mucosal surfaces of the host . The adhesins are usually composed of proteins in the form of fimbriae or fibrillae and the receptors of glycolipids or glycoproteins . In group A streptococci the adhesin, lipoteichoic acid (LTA), is anchored to one or more proteins on the surface of the bacterial cells and interacts through its lipid moiety with fibronectin molecules deposited on and bound to the epithelial cells . In an attempt to locate the region of fibronectin recognized by LTA and group A streptococci, fibronectin was cleaved with thermolysin and the fragment mixture adsorbed with Staphylococcus aureus or Streptococcus pyogenes . Staphylococci adsorbed several high-molecular-weight fragments as well as a 28-kilodalton and a 23-kilodalton fragment, whereas S . pyogenes cells adsorbed only the 28-kilodalton fragment completely . The adsorption of the fragments by S . pyogenes was blocked by LTA . Antibodies raised against a synthetic peptide copying the NH2 terminus of fibronectin reacted in a western blot with the 28-kilodalton fragment; this result indicated that S . pyogenes and its LTA react with the NH2-terminal region of fibronectin at a site distinct from that at which S . aureus reacts . Our findings are consistent with the idea that LTA mediates the attachment of group A streptococci to fatty acid binding sites of fibronectin deposited on mucosal epithelial cells. Rev Infect Dis, 1987 Sep-Oct, 9(5), 908 - 16 Endocarditis due to nutritionally deficient streptococci: therapeutic dilemma; Stein DS et al.; Three cases of endocarditis due to nutritionally deficient (variant) streptococci are presented and the literature is reviewed . In all of the cases reviewed, the patient presented with an indolent subacute course . Prior heart disease was present in 90% of the patients, embolization occurred in 27%, relapse after therapy in 17%, and death in 17% . Bacteriologic failure occurred in 41% of cases, despite sensitivity of the organisms to the antibiotics used in two-thirds of these cases . Combination therapy with penicillin and an aminoglycoside has been recommended previously; however, in 38% of the cases reviewed, bacteriologic failures occurred and the patients required surgery . The results of in vitro antibiotic-sensitivity testing are difficult to interpret and to apply to the expected response to therapy . Further studies on these organisms are needed to reduce the high rates of failure, relapse, and fatality. J Antimicrob Chemother, 1987 Sep, 20 Suppl A, 71 - 85 Therapy of streptococcal endocarditis: correlation of animal model and clinical studies; Scheld WM; Streptococci (viridans group, Streptococcus bovis, enterococci still account for the majority of cases of infective endocarditis in the non-addict population . Experimental animal models of endocarditis have been used (primarily in rabbits) to delineate the major therapeutic principles of this disease; viz . bactericidal antimicrobial agents must be given parenterally in high dosages for prolonged period of time . Overall, there is a good correlation between results obtained by: (1) in-vitro susceptibility testing (especially killing kinetics in broth); (2) therapeutic comparisons in experimental animal models and (3) clinical trials of different antimicrobial regimens in humans with streptococcal endocarditis . This review contrasts the published results obtained in vivo with experimental animal models to those obtained with various therapeutic approaches to streptococcal endocarditis in humans . The contribution of animal models to current therapeutic recommendations in man is underscored. J Antimicrob Chemother, 1987 Sep, 20 Suppl A, 173 - 80 Prosthetic valve endocarditis; Braimbridge MV et al.; About 2% of patients with a prosthetic valve will develop endocarditis . This may occur within a few weeks of the valve replacement operation (early) or many months or years later (late) . The infecting organisms, pathogenicity and prognosis differ in the two groups . The incidence of early prosthetic valve endocarditis (PVE) is under 1%; the predominant organisms are staphylococci that are acquired in the operating theatre or in the intensive therapy unit . Early PVE usually follows wound sepsis that may initially appear trivial . The mortality rate is around 70%, but such infections should be preventable by stringent antisepsis, good surgical technique and (perhaps) perioperative antistaphylococcal antibiotics . The incidence of late PVE is about 1% per annum . The infecting organisms are similar to those causing native valve endocarditis, predominantly streptococci . The commonest source of these organisms is the mouth and regular dental care and appropriate prophylactic antibiotics should help to prevent infection . The mortality rate of late PVE is around 10% . Failure of medical treatment in PVE is an indication for surgery to remove the infected valve(s) and this should not be delayed . The optimum length of treatment for PVE is unknown but it is seldom necessary to give antibiotics for more than 6 weeks except in Coxiella burnetii infection. J Antimicrob Chemother, 1987 Sep, 20 Suppl A, 147 - 59 Antimicrobial therapy of streptococcal endocarditis; Wilson WR; The majority of patients with endocarditis caused by viridans streptococci or Streptococcus bovis susceptible to less than or equal to 0.1 mg/l of penicillin may be treated successfully for two weeks with penicillin 20 X 10(6) million units intravenously together with streptomycin 7.5 mg/kg body weight intramuscularly twice daily or gentamicin 1 mg/kg body weight intravenously every 8 h . Patients with nutritionally variant viridans streptococcal endocarditis should be treated for four weeks with penicillin combined with an aminoglycoside in dosages as above, which will require adjustment when renal impairment is present . Patients with enterococcal endocarditis should be treated with penicillin together with an aminoglycoside in dosages as above for four to six weeks . Patient with enterococcal endocarditis with symptoms of infection less than three months in duration or with aortic valve endocarditis may be treated successfully for four weeks with antimicrobial therapy; patients with symptoms of infection longer than three months in duration or with mitral valve infection should receive six weeks of antimicrobial therapy . Patients with enterococcal endocarditis who relapse should be treated for six weeks of antimicrobial therapy. Acta Otolaryngol, 1987 Sep-Oct, 104(3-4), 360 - 2 Influence of antibiotic treatment on the isolation rate of group A streptococci from peritonsillar abscesses; Hoffmann S et al.; In a prospective one-year study, group A streptococci were cultured from pus specimens from 13 of 71 patients (18%) with peritonsillar abscesses . The isolation rate was significantly lower (7/57 = 12%) in patients who had received antibiotic treatment before specimen collection than in patients who had not received such treatment (6/12 = 50%) . Group A streptococcus antigen detection tests on pus, using a commercially available diagnostic kit, had a low sensitivity (5/13 = 38%) . It was concluded that in patients treated with antibiotics prior to collection of specimens, the absence of group A streptococcus on culture does not rule out that this organism could have been the principal etiologic agent. Acta Otolaryngol, 1987 Sep-Oct, 104(3-4), 351 - 9 Clinical and laboratory findings in patients with acute tonsillitis; Stjernquist-Desatnik A et al.; In 82 patients with acute tonsillitis studied, beta-hemolytic group A streptococci were isolated from 30 (37%), and group C or G streptococci from 12 (15%) . In the 40 patients with non-streptococcal tonsillitis there was a significantly higher isolation rate of pneumococci, H . influenzae and/or B . catarrhalis, as compared with those with beta-hemolytic streptococci . Patients were classified regarding clinical status according to standardized criteria as severe, moderate, or mild . The patients with group A streptococcal tonsillitis were significantly more often classified clinically as 'severe' and had significantly shorter duration of symptoms before seeking medical care, as compared with those with non-streptococcal tonsillitis . Significant increases in white blood cell count and in anti-DNase B were found in the patients with group A streptococcal tonsillitis, whereas their antistreptolysin O levels did not increase significantly . C-reactive protein concentrations were consistently higher in the patients with group A streptococcal tonsillitis . No evidence of polyclonal beta-lymphocyte stimulation was found when measuring antibodies against pneumococci and group B streptococci . The findings show clinical and simple laboratory tests to be useful aids in distinguishing group A streptococcal tonsillitis from non-streptococcal tonsillitis, and that other bacteria may be involved in non-streptococcal tonsillitis. Scand J Prim Health Care, 1987 Sep, 5(3), 151 - 4 How reliable and useful is the latex agglutination test in diagnosing streptococcal throat infection in general practice? Hjortdahl P, Laerum E, Gaustad P. A rapid latex agglutination test for diagnosing streptococcal pharyngitis in general practice was evaluated on 226 patients with acute throat infection . The test had a sensitivity of 96% and a specificity of 91% regarding group A beta hemolytic streptococci . The test was fairly simple to perform and the result was available before the patient left the office . The test was supplied as a self-contained kit, was safe to handle and economically acceptable . Even through this test is not a reliable as the traditional microbiological culture, it represents a significant practical and clinical improvement in the daily management of patients with acute throat infections. Scand J Prim Health Care, 1987 Sep, 5(3), 145 - 50 Rapid throat-culture as diagnostic aid: ineffective in decreasing antibiotic prescriptions; Makela M; An overnight slide-culture for the detection of group A streptococci was introduced in a Finnish health centre . The number of patients from whom a throat culture was obtained increased from 55% to 70% with the new method . Despite this increase, the prescribing habits of primary care physicians did not change . Treatment was in most cases (84-90% of those treated) still initiated before culture results were available, and antibacterial medication was discontinued only occasionally (1-3%) . Physicians usually decided the treatment during the first consultation . These findings contradict earlier studies where prescriptions decreased during rapid culture . Use of throat cultures as diagnostic aid should be reconsidered, especially when more rapid methods now are available. Obstet Gynecol, 1987 Sep, 70(3 Pt 2), 485 - 7 Postpartum group B streptococcal endocarditis associated with mitral valve prolapse; Strasberg GD; Although group B streptococci frequently colonize the birth canal of pregnant women, and cause puerperal sepsis in approximately 0.2% of deliveries, recommendations for endocarditis prophylaxis do not include uncomplicated vaginal delivery . Mitral valve prolapse has been reported to represent a low risk for endocarditis and an uncertain risk/benefit ratio for prophylaxis . As the case presented here illustrates, group B streptococcal endocarditis after uncomplicated vaginal delivery can be associated with mitral valve prolapse; patients with additional risk factors for group B streptococcal infection are at particular risk. J Clin Microbiol, 1987 Sep, 25(9), 1805 - 6 Rapid, cost-effective identification of group A streptococci and enterococci by pyrrolidonyl-beta-naphthylamide hydrolysis; Wellstood SA; Group A streptococci and enterococci were identified by two L-pyrrolidonyl-beta-naphthylamide (PYR) hydrolysis tests . One uses Minitek PYR disks (BBL Microbiology Systems, Cockeysville, Md.); the other uses a swab impregnated with PYR reagent . Both tests and Strep-A-Chek (EY Laboratories, San Mateo, Calif.), a commercially available PYR test, were compared with conventional methods . The PYR methods correctly identified all strains of group A streptococci and enterococci tested. J Clin Microbiol, 1987 Sep, 25(9), 1803 - 4 Streptococcal group B type antigen X in group L streptococci; Lammler C et al.; Extracts from 19 of 29 group L streptococcal cultures reacted distinctly with antiserum against group B streptococcal type antigen X in coagglutination and immunodiffusion tests . The X antigen corresponded to those obtained by streptococci of serological groups B and G. Infect Immun, 1987 Sep, 55(9), 2314 - 6 Transposon mutagenesis of group B streptococcus beta-hemolysin biosynthesis; Weiser JN et al.; Beta-hemolysin production by group B streptococci (GBS) is speculated to be a major virulence factor of the organism . A virulent, beta-hemolytic group B streptococcus strain was mutagenized with the self-conjugative transposon Tn916 to derive isogenic strains with mutations only in the gene(s) responsible for beta-hemolysin biosynthesis . There was no significant difference between the virulence of the parent strain and that of the mutant strains in a neonatal rat sepsis model. Infect Immun, 1987 Sep, 55(9), 2176 - 82 Molecular cloning and characterization of the glucosyltransferase C gene (gtfC) from Streptococcus mutans LM7; Pucci MJ et al.; A glucosyltransferase (GTF) gene, designated gtfC, was cloned from Streptococcus mutans LM7 . Its gene product was detected by screening a bacteriophage lambda library with rabbit antiserum raised against S . mutans LM7 extracellular proteins . DNA isolated from the immunopositive recombinant phage revealed two S . mutans chromosomal EcoRI fragment inserts, 8.1 and 4.7 kilobase pairs in size . Escherichia coli minicell analyses revealed the approximate position and direction of transcription of the gtfC gene . The gene product was determined to be a polypeptide of about 150 kilodaltons which synthesized a water-soluble glucan . Restriction endonuclease mapping and DNA hybridization indicated a repeated region of DNA corresponding to a portion of the coding region of gtfC immediately downstream from the intact gtfC locus on the chromosome . A 300-base-pair gtfC-specific probe showed that the gene and the putative duplicated sequence were present in S . mutans serotypes c, e, and f, but not in other related oral streptococci which had GTF activity . In addition, the gtfC determinant displayed homology to sequences corresponding to the carboxy-terminal coding region of a gene (gtfB) encoding a GTF activity that synthesized water-insoluble glucans . These data suggest that at least one class of GTF genes may be present in multiple copies in S . mutans and, further, that GTF genes may contain conserved sequences internal to their coding regions. J Infect Dis, 1987 Sep, 156(3), 495 - 504 In vivo Streptococcus pyogenes C5a peptidase activity: analysis using transposon- and nitrosoguanidine-induced mutants; O'Connor SP et al.; The streptococcal C5a peptidase removes a six-amino-acid fragment from human C5a and thereby inactivates this chemotaxin . We used transposon and chemical mutagenesis to generate mutants of Streptococcus pyogenes that did not produce C5a peptidase . These mutants showed no alteration in expression of capsule, M protein, streptolysins O and S, or pyrogenic exotoxin C . Serial passage of a peptidase-producing strain in vivo resulted in a 100-fold increase in production of C5a peptidase . The presence of C5a peptidase delayed the accumulation of polymorphonuclear leukocytes (PMNLs) in the peritoneal cavities of mice after intraperitoneal challenge . However, there was no difference in virulence (as evaluated by LD50) between strains that produced and those that lacked C5a peptidase . Although C5a peptidase is expressed on the cell surface, antibody to this enzyme did not opsonize streptococci for phagocytosis in vitro . These studies show that C5a peptidase alters the normal host inflammatory response by delaying the accumulation of PMNLs at the foci of streptococcal infection. Eur J Epidemiol, 1987 Sep, 3(3), 257 - 60 Recent advances in defining the cariogenicity of mutans streptococci: molecular genetic approaches; Kuramitsu HK; The application of molecular genetic approaches with oral mutans streptococci has resulted in the isolation of several genes which may be involved in the cariogenicity of these organisms . Among these are genes coding for cell surface proteins, sucrose metabolizing enzymes, and glycosyltransferase activities . The isolated genes have been utilized to create specific mutants of Streptococcus mutans to assess the potential roles of the gene products in cariogenicity both in vitro and in vivo . These approaches should prove useful in answering some still unresolved questions at the molecular level regarding the cariogenic properties of the organisms. Rev Infect Dis, 1987 Sep-Oct, 9 Suppl 5, S467 - 74 Molecular basis of bacterial adhesion in the oral cavity; Mergenhagen SE et al.; The two varieties of fimbriae identified on oral strains of actinomyces have distinct functional properties . The type 1 fimbriae of Actinomyces viscosus T14V mediate attachment to saliva-treated hydroxyapatite . Type 2 fimbriae--on A . viscosus and the only fimbriae detected on A . naeslundii WVU45--are associated with lectin activity . Interaction of these fimbriae with complementary receptors initiates bacterial attachment to Streptococcus sanguis 34 and sialidase-treated epithelial cells and the killing of actinomyces by polymorphonuclear leukocytes (PMNs) . Galactose, N-acetylgalactosamine (GalNAc), and related oligosaccharides inhibit these processes, and mutants lacking type 2 fimbriae do not participate in them . The actinomyces lectin is similar to lectins from Ricinus communis and Bauhinia purpurea that agglutinate certain strains of oral streptococci, block attachment of actinomyces to epithelial cells, and inhibit killing of actinomyces by PMNs . The S . sanguis receptor for the actinomyces lectin comprises repeating hexasaccharide units with GalNAc termini . Used as probes, the peanut agglutinin, with specificity for Gal(beta-3)GalNAc, and the lectin from B . purpurea detect a 160-kilodalton (kdal) band in SDS-PAGE-separated epithelial cell extracts and a 100-kdal band in PMN extracts . These may be receptors for type 2 fimbriae . A . viscosus genes encoding subunits of types 1 and 2 fimbriae have been cloned in Escherichia coli; the type 1 subunit is 65 kdal and the type 2 subunit is 59 kdal . Submandibular immunization of mice with a mixture of type 1 and type 2 fimbriae evokes the production of IgA and IgG antibodies in serum and saliva that inhibit in vitro adsorption of A . viscosus to SHA . These antibodies may modulate colonization of teeth by this organism. Microbiol Sci, 1987 Sep, 4(9), 263 - 6 Origin, evolution and dissemination of antibiotic resistance genes; Trieu-Cuot P et al.; Comparison of resistance genes from different sources support the hypothesis that the antibiotic-producing microorganisms are the source of resistant determinants present in clinical isolates . There is also evidence that Gram-positive cocci (staphylococci and streptococci) can serve as a reservoir of resistance genes for Gram-negative bacteria. Mol Microbiol, 1987 Sep, 1(2), 229 - 32 Utilization of a mini-mu transposon to construct defined mutants in Streptococcus mutans; Kuramitsu HK; The gtfB gene coding for glucosyltransferase-I (GTF-I) activity previously isolated from Streptococcus mutans GS-5 was insertionally inactivated with the newly constructed transposon MudE in an Escherichia coli background . Insertion of MudE into various regions of the gtfB gene led to inactivation of GTF-I activity . The altered gene was introduced back into S . mutans GS-5 by transformation and produced mutants defective in insoluble glucan synthesis as well as the ability to colonize smooth surfaces in the presence of sucrose . Therefore, the MudE transposon can be utilized to produce specific mutants in oral streptococci as well as in other transformable Gram-positive bacteria expressing an erythromycin-resistance marker. Inflammation, 1987 Sep, 11(3), 253 - 77 Poly L-histidine . A potent stimulator of superoxide generation in human blood leukocytes; Ginsburg I et al.; Poly-L-histidine (PHSTD) of molecular weight 26,000 induced the generation of large amounts of superoxide (O2-) and hydrogen peroxide (H2O2) in human neutrophils (PMNs) . Despite its low solubility at neutral pH, PHSTD was bound very rapidly to the PMN surfaces . Maximal generation of O2- took place with 4-5 X 10(-6) M of PHSTD, starting after a lag of about 25 sec and proceeding for 15-17 min at a rate of 150 nmol/10(7) PMNs/min, suggesting that this polycation is one of the most potent stimulators of O2- generation known, PHSTD was found to be non-toxic for PMNs even at millimolar concentrations . Generation of O2- by PHSTD depended on extracellular calcium; it was inhibited by calcium channel blockers and by trifluoperazine, and it triggered a sharp rise in intracellular calcium as determined by the Quin 2 fluorescence technique . The generation of both O2- and H2O2 by PHSTD was partially inhibited by cytochalasin B or (CYB, CYE) . On the other hand, CYB markedly enhanced the generation of both O2- and H2O2 following stimulation of PMNs either by PHSTD, polyarginine, histone, or by antibody-opsonized group A streptococci . Electron microscopic analysis and NBT reduction tests revealed that both PHSTD and PHSTD-opsonized streptococci were avidly phagocytosed by PMNs . Since CYB totally inhibited internalization of both PHSTD and the PHSTD-opsonized streptococci, it was suggested that these agents stimulated oxygen radical generation mainly on the leukocyte surfaces . Complexes (CX) formed between PHSTD and polyanethole sulfonate (a strong polyanion) or between histone and the polyanion mimicked immune CX in their ability to trigger the generation of large amounts of O2- which were inhibited by CYB . Generation of O2- and chemiluminescence either by PHSTD or by PHSTD-opsonized streptococci were markedly inhibited by poly-L-glutamate, suggesting that PHSTD acted as a cationic agent which interacted via electrostatic forces with some negatively charged sites in the leukocyte membrane . Generation of H2O2 by PHSTD was also markedly inhibited by deoxyglucose, KCN, DASA, as well as by the lipoxygenase inhibitors nordihydroguaiaretic acid, phenidone, and propylgallate . On the other hand, cyclooxygenase inhibitors such as aspirin, indomethacin, and piroxicam were inactive, suggesting that arachidonic acid metabolism via lipoxygenase pathway might have been involved in the activation by PHSTD of the NADPH oxidase in PMNs.(ABSTRACT TRUNCATED AT 400 WORDS) J Exp Med, 1987 Sep 1, 166(3), 647 - 56 Protective immunogenicity and T lymphocyte specificity of a trivalent hybrid peptide containing NH2-terminal sequences of types 5, 6, and 24 M proteins synthesized in tandem; Beachey EH et al.; The protective immunogenicity of a hybrid peptide containing tandem copies of types 5, 6, and 24 M protein epitopes was investigated . An NH2-terminal peptide of type 24 M protein was chemically synthesized and then extended to include NH2-terminal peptides of types 6 and 5 M proteins yielding a 34-residue hybrid peptide containing a cysteine residue at its COOH-terminus . When conjugated via the cysteine residue to keyhole limpet hemocyanin (KLH), emulsified in CFA, and injected into rabbits, the synthetic hybrid evoked opsonic antibodies against types 5, 6, and 24 streptococci without stimulating tissue crossreactive immunity . The trivalent hybrid also was capable of priming T lymphocytes in vivo that responded to each of the native serotypes of M protein as well as to the synthetic hybrid peptide in vitro . The primed T cells failed to respond to the individual component peptides contained in the hybrid peptide, suggesting that the hybrid peptide confers conformations resembling the presentations of each of the subpeptides in the respective serotypes of M protein . The brisk immune responses to the type 6 peptide contained in the middle of the tandem hybrid indicates that with judicious placement between proline residues, potentially hidden peptides are readily accessible to the immune system . These results suggest that synthetic tandem peptides can be tailored in a fashion in which each of the component sets of protective epitopes can be made optimally immunoaccessible and immunogenic. J Immunol Methods, 1987 Aug 24, 102(1), 93 - 100 A highly specific two-site ELISA for pneumococcal C-polysaccharide using monoclonal and affinity-purified polyclonal antibodies; Sjogren AM et al.; A two-site ELISA for the detection of pneumococcal C-polysaccharide (PnC) has been developed . A monoclonal antibody directed against the phosphorylcholine residue of the PnC was used as catcher and an affinity-purified polyclonal anti-PnC rabbit antiserum for detection . Polyclonal antibodies against the PnC as well as capsular antigens were obtained by immunizing rabbits with type 1 pneumococci . Antibodies against the phosphorylcholine determinant of PnC could be removed by affinity purification . Remaining antibodies reacted in an ELISA with type 1 capsular polysaccharide as well as with PnC . Only in the fraction with the highest antibody activity against PnC, phosphorylcholine exhibited a slight inhibitory action . It is concluded that the purified antibody preparation reacted with an antigenic determinant shared by the two polysaccharides, in all probability a determinant associated with 2-acetamido-4-amino-2,4,6-trideoxygalactose which is the only monosaccharide component in common between PnC and the type 1 capsular polysaccharide . By the use of this affinity-purified antibody preparation, reactions with alpha-streptococci, occurring with non-purified serum, were abolished . The sensitivity and specificity of the test was determined using capsulated and non-capsulated pneumococci and alpha-streptococci known to cross-react with unpurified serum against the pneumococcal C-polysaccharide. Klin Wochenschr, 1987 Aug 17, 65(16), 773 - 80 High risk of streptococcal septicemia after high dose cytosine arabinoside treatment for acute myelogenous leukemia; Kern W et al.; Twenty-nine adult patients with acute myelogenous leukemia AML who received 40 treatment courses with high dose cytosine arabinoside (HD-A), alone or combined with other cytotoxic drugs, for remission induction (RI) or postremission intensive consolidation (IC) were retrospectively analysed for types and severity of infectious complications . In this paper, we report the unusually high rate of streptococcal septicemia in our patients . Of 13 bacteremic infections in a total of 45 infectious episodes, 10 were caused by streptococci (9 viridans streptococci, 1 group B hemolytic streptococcus) . Three of them were lethal . After reviewing all documented cases of streptococcal septicemia in the same study period, four additional cases among adult patients with AML were identified . Three of them have had antileukemic chemotherapy without HD-A, while one have had HD-A as a conditioning regimen for bone marrow transplantation . Only three cases were documented to occur in adult patients with AML . Patients treated with HD-A for RI or IC had a significantly lower risk of streptococcal septicemia during previous chemotherapy-associated febrile neutropenic episodes (1/55 vs 10/45; P = 0.01) . Neither prophylactic regimens including trimethoprim-sulfamethoxazole nor those without it were effective in preventing streptococcal septicemia . Further studies are needed to confirm these data before the value of additional or alternative prophylactic antibiotics is proven necessary. J Immunol, 1987 Aug 15, 139(4), 1285 - 90 Sequence of protective epitopes of streptococcal M proteins shared with cardiac sarcolemmal membranes; Sargent SJ et al.; Synthetic peptide fragments spanning the entire amino acid sequence of pep M5 were used to detect epitopes cross-reactive with heart tissue components other than myosin . Heart-cross-reactive pep M5 antibodies were affinity purified by absorption to and elution from purified sarcolemmal membranes . Only one of the synthetic peptides, SM5(164-197)C, inhibited reactivity of the affinity-purified antibodies with pep M5 by ELISA . SM5(164-197)C linked to KLH evoked both opsonic and heart-cross-reactive antibodies in rabbits . In addition to type 5, the immune sera opsonized M types 6, 18, 19, and 49 streptococci . The antisera reacted strongly with isolated cardiac sarcolemmal membranes by immunofluorescence . In Western blots of cardiac tissue, the anti-SM5(164-197)C reacted with a 40 kDa protein but not with myosin . The reaction was inhibited by pep M5 and SM5(164-197)C but not by any of the other peptides spanning pep M5 . The cross-reactive anti-SM5(164-197)C affinity purified on sarcolemmal membranes opsonized types 5, 6, and 19 but not type 24 streptococci . These results indicate that SM5(164-197)C contains heart-cross-reactive, opsonic epitopes that are shared among heterologous serotypes of group A streptococci. Acta Pathol Microbiol Immunol Scand {B}, 1987 Aug, 95(4), 241 - 4 Immunological relation between serum antibodies against pneumolysin and against streptolysin O; Kanclerski K et al.; The immunological relation between serum antibodies to pneumolysin and to streptolysin O was studied in patients with pneumococcal pneumonia (n = 40), patients with infections due to beta-haemolytic streptococci (n = 35), healthy human controls (n = 60) and in rabbits immunized with pneumolysin . There was no correlation between anti-pneumolysin and anti-streptolysin O titers (r = -0.279) . The distribution of anti-pneumolysin titers in patients with high anti-streptolysin O titers did not differ from healthy controls . However, there was a tendency to increased or rising anti-streptolysin O titers in patients with pneumococcal infection . Antibodies obtained during pneumococcal infection might thus give false-positive reactions in the streptolysin O neutralization test . Serum antibodies to streptolysin O do not cross-react with pneumolysin in an ELISA . The pneumolysin ELISA for detection of pneumococcal disease will therefore not be disturbed by false-positive reactions due to antibodies directed against beta-haemolytic streptococci. J Appl Bacteriol, 1987 Aug, 63(2), 133 - 7 Cell surface proteins of encapsulated Streptococcus cremoris: identification and immunochemical characterization; Kontusaari S et al.; Cell surface proteins of two slime-forming, encapsulated Streptococcus cremoris strains, MLS96 and T5 from the fermented milk product viili, were extracted with the non-ionic detergent Triton X-100 . The isolated protein antigens were characterized by sodium dodecyl sulphate polyacrylamide gel electrophoresis and immunoblotting with antisera produced against whole Strep . cremoris cells . When protein profiles of these strains were compared, seven prominent polypeptides were found common to both and were recognized by both antisera . Five of these polypeptides with molecular weights of 70,000, 54,000, 50,000, 47,000 and 40,000 were identified as cell wall components . The remaining two polypeptides with molecular weights of 42,000 and 26,000 are being studied further in connection with slime formation for which modified Triton X-100 extraction provides a suitable method for isolation of the surface-associated antigens of lactic streptococci. J Clin Microbiol, 1987 Aug, 25(8), 1359 - 63 Isolation of Stomatococcus mucilaginosus from drug user with endocarditis; Coudron PE et al.; Stomatococcus mucilaginosus was isolated from the blood of a patient with endocarditis and a past history of drug abuse and aortic valve replacement . At autopsy, Gram stain of the aortic valve revealed gram-positive cocci . Our isolate was atypical for S . mucilaginosus in that colonies were nonmucoid and nonadherent to agar surfaces . Cellular capsules were demonstrated by light and electron microscopy . Phenotypic characteristics identified by conventional methods as well as profile numbers obtained by using two commercial identification systems for staphylococci, the API Staph-Ident and the dms Staph Trac, are presented . Practical tests that differentiate S . mucilaginosus from the genera Micrococcus and Staphylococcus include growth on nutrient agar containing salt and lysostaphin susceptibility . Additional tests that helped differentiate our isolate from group D streptococci included hydrolysis of L-pyrrolidonyl-beta-naphthylamide and streptococcal serogrouping. Postgrad Med, 1987 Aug, 82(2), 126 - 8, 130-2, 134-40 Pneumonias acquired from others . 1 . History, examination, laboratory findings; Cunha BA; Differential diagnosis of community-acquired pneumonia can be elusive, even though the disease remains a frequent cause of admission to the hospital . The familiar organisms--pneumococci, group A streptococci, Staphylococcus aureus, Klebsiella pneumoniae, and Hemophilus influenzae--are still often the cause . However, less common organisms, in particular Pneumocystis carinii, which is associated with acquired immunodeficiency syndrome, are being seen more often . Data gathered from a thorough history, physical examination, laboratory testing, and sputum evaluation must be considered as a body of evidence, and a pattern often emerges that suggests a particular clinical picture. Eur J Clin Microbiol, 1987 Aug, 6(4), 428 - 9 Streptococcal protein G: a sensitive tool for detection of antibodies to human immunodeficiency virus proteins in Western blot analysis; Bjorck L et al.; Protein G is a cell wall protein of group C and G streptococci which binds human IgG antibodies of all four subclasses with high affinity . This property of the molecule was utilized to develop a sensitive Western blot assay to detect antibodies against HIV proteins in patient sera. Zh Mikrobiol Epidemiol Immunobiol, 1987 Aug, (8), 23 - 9 {Effect of the influenza A virus on the sensitivity of mice to infection caused by Streptococcus group B}; Bulgakova TN et al.; Study of the capacity of group B streptococci for causing the development of infection in mice has revealed the virulence of the cultures for mice to be determined by the serovar of the streptococcus, the infective dose, and the amount of type-specific polysaccharide . Under the conditions of mixed viral-bacterial infection, influenza A virus was shown to influence the development of bacterial infection in the animals in two ways: to increase the virulence of an avirulent strain and to decrease the pathogenicity of a virulent one in streptococcal monoinfections . Simultaneously with viral infection, the stimulation of the multiplication of an avirulent strain in the lungs of mice was observed, while in the control groups of the animals the elimination of bacteria from the lungs was registered . No additional accumulation of the infective virus in the lungs of mice in the presence of streptococci was found. Antimicrob Agents Chemother, 1987 Aug, 31(8), 1204 - 9 Response of Streptococcus pyogenes to therapy with amoxicillin or amoxicillin-clavulanic acid in a mouse model of mixed infection caused by Staphylococcus aureus and Streptococcus pyogenes; Boon RJ et al.; The response of Streptococcus pyogenes to amoxicillin or amoxicillin-clavulanic acid (Augmentin; Beecham Group) therapy of a mixed streptococcal-staphylococcal infection was studied in a surgical wound in mice . A superficial wound was produced on the backs of anesthetized mice, and a suture infected with S . pyogenes, Staphylococcus aureus, or a mixed inoculum of both organisms was inserted . Oral therapy was started 4 h after infection and continued for 3 days . Both amoxicillin and amoxicillin-clavulanic acid were effective in eliminating the streptococci from the pure wound infection . In contrast, amoxicillin failed to eliminate the streptococci from a mixed infection in which a beta-lactamase-producing strain of S . aureus was also present, wound counts reaching 10(7) streptococci per wound by 80 h, whereas amoxicillin-clavulanic acid reduced the count to less than 33 streptococci per wound by 24 h . Numbers of S . aureus were also reduced by amoxicillin-clavulanic acid therapy, controlling the infection, whereas amoxicillin was ineffective . Also of significance was the fact that successful therapy was achieved with blood and tissue concentrations of amoxicillin and clavulanic acid of the same order as those measured in humans . These results show that amoxicillin therapy failed to eliminate S . pyogenes from a wound infection in the presence of a beta-lactamase-producing strain of S . aureus and suggest the potential of amoxicillin-clavulanic acid in the treatment of mixed bacterial skin infections involving beta-lactamase-producing organisms. J Clin Microbiol, 1987 Aug, 25(8), 1555 - 6 Serogrouping single colonies of beta-hemolytic streptococci with achromopeptidase extraction; Slifkin M et al.; Achromopeptidase (TBL-1; Wako Chemicals, USA, Inc., Dallas, Tex.) prepared as a 2,000-U/ml solution will extract the serogroup antigens from single colonies of groups A, B, C, F, and G streptococci in 1 min at room temperature . This enzyme extraction is not effective for the serogrouping of all group D streptococcus species . Achromopeptidase extracts can be used with latex or coagglutination reagents. Am J Obstet Gynecol, 1987 Aug, 157(2), 341 - 2 A screening test (GBS-Test) for urogenital carriage of group B streptococci; Christensen K et al.; A commercial kit for the detection of group B streptococci (GBS-Test) is described . The test is based on orange pigment production after 2 days' incubation at 37 degrees C . It showed a 100% specificity and a sensitivity superior to that of a conventional selective broth method. J Med Microbiol, 1987 Aug, 24(1), 83 - 7 Relationship between pigment production and haemolysin formation by Lancefield group B streptococci; Tapsall JW; Group B streptococci produce both a pigment and a haemolysin . The requirements of group B streptococci for the formation and release of pigment and haemolysin are similar and have been examined to extend observations on the relationship between the two products . The amount of pigment and haemolysin extractable from actively metabolising washed-cell suspensions of group B streptococci varied with the atmosphere of incubation, the pH at which the extraction was carried out and the presence of Mg2+ ions . Both pigment and haemolysin were produced in significant amounts in all phases of the growth cycle . When conditions were established for obtaining maximum yields of haemolysin, its production correlated closely with pigment yields, but pigment did not function as a carrier for haemolysin . Formation of pigment, but not of haemolysin, increased in the presence of trimethoprim or higher concentrations of glucose . The composition of pigment produced in different conditions differed qualitatively and different strains of group B streptococci formed pigment of different appearance, suggesting that group B streptococcal pigment is composed of several different substances. J Infect Dis, 1987 Aug, 156(2), 344 - 9 Hybridoma antibodies to the lipid-binding site(s) in the amino-terminal region of fibronectin inhibits binding of streptococcal lipoteichoic acid; Stanislawski L et al.; In this report, we present evidence to suggest that streptococci and lipoteichoic acid (LTA) interact with a fatty acid binding site located near the NH2-terminus of fibronectin . The evidence is based on the following observations . Antibodies directed against a synthetic peptide (residues 1-30 of the amino-terminus of fibronectin) reacted with the two thermolysin-generated peptides (24 and 28 kilodaltons {kDa}) that were adsorbed by and eluted from streptococci . The adsorption of the 24- and 28-kDa peptides to streptococci was inhibited by LTA . The two monoclonal antibodies that inhibited the binding of LTA to fibronectin reacted only with the 24- and 28-kDa fragments of fibronectin . Conversely, LTA, as well as lauric acid and oleic acid, blocked the binding of the same monoclonal antibodies to fibronectin . LTA had no effect on the binding of hybridoma antibodies directed against the collagen or cell-binding domain. Infect Immun, 1987 Aug, 55(8), 1743 - 50 Mechanisms of platelet aggregation by viridans group streptococci; Sullam PM et al.; The direct aggregation of platelets is thought to be an important event in the pathogenesis of viridans streptococcal endocarditis, but the mechanisms for platelet activation are unknown . We evaluated the processes by which two endocarditis-producing strains of viridans group streptococci activated human platelets in vitro, as measured by platelet cyclooxygenase activity, secretion, and aggregation . Addition of either streptococcal strain to platelets suspended in whole plasma resulted in a mean lag phase of 15.3 min, followed by platelet secretion and brisk aggregation . The lag phase duration was dependent on the platelet donor and appeared to be a function of direct platelet-bacterial interaction . Aggregation was partially inhibited by 20 muM {corrected} indomethacin and blocked completely by 1 mg of apyrase, an extracellular ADP hydrolase, per ml . Neither strain aggregated washed platelets suspended in Tyrode solution alone . However, both strains produced maximal aggregation when the platelet suspension was supplemented with 10% (final concentration) normal plasma . Studies with factor-deficient plasmas demonstrated that exogenous fibrinogen was required for aggregation . One or more additional plasma components were needed, which eluted with a molecular weight of 67,000 to 130,000 on gel permeation chromatography . These cofactors have not been described for other platelet agonists, which suggests that viridans streptococci may aggregate human platelets by a novel mechanism. Infect Immun, 1987 Aug, 55(8), 1914 - 8 Identification of a specific receptor for plasmin on a group A streptococcus; Lottenberg R et al.; Certain group A streptococci demonstrate surface receptors that bind selectively to the key fibrinolytic enzyme, plasmin . These bacteria show no reactivity with the zymogen protein plasminogen or with other serine class proteases, such as trypsin or urokinase . Bacterium-bound plasmin retains its ability to cleave synthetic substrates and its ability to hydrolyze a fibrin clot . The bacterium-bound plasmin is not effectively regulated by its physiological regulator, alpha 2-plasmin inhibitor . This study is the first report of a bacterium-associated receptor for plasmin. J Antimicrob Chemother, 1987 Aug, 20(2), 155 - 64 A comparison of the responses of staphylococci and streptococci to teicoplanin and vancomycin; Greenwood D et al.; Continuous turbidimetric monitoring of cultures of staphylococci and streptococci exposed to teicoplanin or vancomycin revealed considerable inhibitory activity at concentrations below the conventionally-determined minimum inhibitory concentration . Teicoplanin was more active than vancomycin against low inocula, but exhibited a larger inoculum effect . A modest decline in susceptibility to teicoplanin and vancomycin could be induced by sequential exposure to the drugs . Such variants gradually reverted to susceptibility on passage in antibiotic-free broth . The morphological consequences of exposure to the two antibiotics were similar as judged by scanning electron microscopy. J Antimicrob Chemother, 1987 Aug, 20(2), 213 - 21 The effect of cultural conditions on the activity of LY146032 against staphylococci and streptococci; Andrew JH et al.; The antibacterial activity of LY146032 was greatly potentiated in the presence of calcium ions . In the presence of a physiological concentration of calcium (ca 100 mg/l: 2.5 mM) the new compound was more active than vancomycin or teicoplanin against a selection of clinical isolates of staphylococci and streptococci . The requirement for calcium could not be satisfied by magnesium . The activity of LY146032 varied when tested in different culture media, including batches of Mueller-Hinton agar from different manufacturers . The highest minimum inhibitory concentrations of LY146032 were observed in tests on Iso-Sensitest agar, which contains little calcium . Supplementation of Iso-Sensitest agar with increasing concentrations of calcium caused a proportionate fall in the MIC of LY146032 . Saponin-lysed horse blood; incubation in a CO2-rich atmosphere; and an increase in the bacterial inoculum from 10(3) to 10(6) cfu/spot had little effect on the activity of LY146032 in the presence or absence of calcium. Zh Mikrobiol Epidemiol Immunobiol, 1987 Aug, (8), 67 - 71 {The role of non-type-specific protein antigens of the cell wall in Streptococcus group A in developing delayed hypersensitivity}; Bazanova EA et al.; The role of the type-nonspecific (TNS) cell-wall antigens of group A streptococci has been determined . The study has been made on guinea pigs sensitized with whole microbial cells or HCl extracts containing TNS antigens . To determine delayed hypersensitivity, the in vitro cytotoxic test on adhering lymph-node cells in the autologous system has been used . The study has shown that sensitization with group A streptococci of different types or with TNS antigens induces the development of delayed hypersensitivity to TNS antigens (or antigen), common for different types of group A streptococci, but specific for this group . HCl extracts containing TNS antigens can be recommended as the preparation for testing delayed hypersensitivity to antigens, specific for group A streptococci. J Bacteriol, 1987 Aug, 169(8), 3691 - 5 Novel complex formed between a nonproteolytic cell wall protein of group A streptococci and alpha 2-macroglobulin; Chhatwal GS et al.; Binding of 125I-labeled alpha 2-macroglobulin (alpha 2M) to streptococci belonging to serological groups A, B, C, and G was studied . Streptococci of groups A and G interacted only with native alpha 2M, and those of group C reacted only with alpha 2M-trypsin complex . Binding of alpha 2M to group A streptococci was saturable and reversible . The dissociation constant was 2.02 X 10(-7) M, and the number of binding sites was calculated to be 18,000 per streptococcus . The alpha 2M-binding protein could be solubilized by treatment of group A streptococci with a murolytic enzyme and subsequently purified by affinity chromatography and high-pressure liquid chromatography . The purified protein was homogeneous on sodium dodecyl sulfate-polyacrylamide gel electrophoresis and had a molecular weight of 78,000 . It possessed no proteolytic activity and interacted with native alpha 2M in Western blots (immunoblots) . Interaction of purified binding protein with alpha 2M led to a change in the conformation of alpha 2M similar to that obtained by alpha 2M-protease complexes . Reversible binding of a nonproteolytic streptococcal component of alpha 2M is thus a novel feature of alpha 2M reactivity. Infect Immun, 1987 Aug, 55(8), 1878 - 83 Specific binding of the human S protein (vitronectin) to streptococci, Staphylococcus aureus, and Escherichia coli; Chhatwal GS et al.; Specific binding of the 125I-labeled human S protein (vitronectin) which has been shown to be identical with serum-spreading factor, was observed with group A, C, and G streptococci as well as with Staphylococcus aureus and Escherichia coli . The specific binding of S protein to group A, C, and G streptococci was high, whereas the binding to S . aureus and E . coli cultures was moderate . In contrast, group B streptococci and a number of other bacterial species tested did not interact with S protein . The binding of S protein to bacteria was saturable and could be inhibited only by unlabeled S protein but not by albumin . Trypsinization and heat treatment of bacteria destroyed the S-protein binding capacity for group G streptococci, S . aureus, and E . coli but not for group A and C streptococci . Likewise, unlabeled human fibronectin and heparin inhibited the binding of labeled S protein to group G streptococci, S . aureus, and E . coli, but did not influence the binding to group A and C streptococci . Double-reciprocal plots of S-protein binding to group G streptococci indicated that fibronectin inhibited the binding in a competitive manner, while heparin acts in a noncompetitive manner . Moreover, the binding of S protein to G streptococci could be partially by the synthetic peptide Gly-Arg-Gly-Asp-Ser, which contains the cell attachment site of S protein . Trypsin-treated S protein had similar binding activity as untreated S protein for group G streptococci, S . aureus, and E . coli, but showed reduced binding to group A and C streptococci . The present data are indicative of two different types of bacterial binding sites in S protein . The binding to group G streptococci, S . aureus, and E . coli is mediated in part through a domain in the S protein containing the sequence Arg-Gly-Asp, whereas a different site is responsible for the binding to group A and C streptococci. J Laryngol Otol, 1987 Jul, 101(7), 746 - 8 Actinomycotic osteomyelitis in a child; Thisted E et al.; Contrary to what used to be the case, actinomycosis is now a rare disease and only infrequently mentioned in otolaryngological textbooks (Ballantyne, J . and Groves, J . 1979) . Th