Arch Intern Med, 1988 Mar, 148(3), 727 - 9 Necrotizing fasciitis in adults due to group B streptococcus . Report of a case and review of the literature; Riefler J 3rd et al.; Necrotizing fasciitis is an uncommon severe infection involving subcutaneous tissues and advancing along fascial planes . Group B streptococcal infections occur disproportionately in diabetics and pregnant women . Although fasciitis secondary to group B streptococcus has been described in infants and adult women in the postpartum period, we report the first case, to our knowledge, of group B streptococcal necrotizing fasciitis in an adult diabetic unrelated to obstetric complications. Arch Intern Med, 1988 Mar, 148(3), 641 - 5 Group B streptococcal sepsis in adults and infants . Contrasts and comparisons; Opal SM et al.; Group B streptococcal infection may result in significant morbidity and mortality in both infants and adults . The experience with group B streptococcal disease was analyzed at one medical center over a ten-year period from 1975 to 1984 . Streptococcus agalactiae bacteremia was observed in 29 adults and 26 infants, with an attack rate of 0.2 cases per 1000 adult admissions and 3.2 cases per 1000 live births, respectively . The majority of adult infections apparently occurred as a result of nosocomial acquisition and was associated with a high mortality rate of 38% . Risk factors for group B streptococcal sepsis in adults include diabetes mellitus, malignancy, and hepatic failure . The majority (73%) of neonatal cases occurred within seven days of birth and occurred in a setting of maternal fever, prolonged rupture of membranes, or prematurity . The mortality rate in infants was remarkably low at only 15% . Fatalities occurred in both adults and infants, despite appropriate antimicrobial therapy . Infection control strategies against group B streptococcus must address potential nosocomial dissemination in adults as well as vertical transmission in infants. J Dent Res, 1988 Mar, 67(3), 588 - 91 Streptococcal adherence on various restorative materials; Satou J et al.; The adherence of Streptococcus sanguis ATCC 10556, S . sanguis ATCC 10557, S . mutans Ingbritt, and S . mutans OMZ 176 to the surfaces of composite resins, amalgam alloys, and a Au-Ag-Pd alloy was measured . Adhesion was correlated with values for hydrophobicity and zeta-potential of the bacteria and the restorative materials . The hydrophobicity of the restoratives showed a positive correlation between the numbers of adherent S . sanguis cells, suggesting that hydrophobic interactions are important for the adherence of this bacterial species . In contrast, the numbers of adherent S . mutans cells showed a positive correlation with the zeta-potential of the restoratives, suggesting that electrostatic interactions are important in adherence of this bacterium. J Rheumatol, 1988 Mar, 15(3), 517 - 9 Emphysematous septic arthritis in multiple joints due to Streptococcus milleri; Serushan M et al.; A 26-year-old man with acute leukemia, treated with chemotherapy, developed emphysematous septic arthritis, due to Streptococcus milleri, affecting the right knee and both shoulders . A review of the literature revealed that intraarticular gas formation is a rarely reported complication of septic arthritis . This could be the 2nd reported case of emphysematous septic arthritis due to S . milleri. Biochimie, 1988 Mar, 70(3), 411 - 22 Phage resistance in lactic acid bacteria; Sanders ME; The interactions between lactic acid bacteria and their phages are commercially significant . Current research has focused on the elucidation of the mechanisms and genetics of phage resistance . Phage resistance genes have been linked to plasmid DNA for Streptococcus lactis and Streptococcus cremoris, and preliminary studies suggest the operation of mechanisms such as the prevention of phage adsorption, restriction/modification, and abortive infection . Some phage resistance plasmids can be conjugally transferred, providing a means of dissemination among phage-sensitive strains for the construction of phage-resistant starter cultures. Biochimie, 1988 Mar, 70(3), 375 - 9 Role of malolactic fermentation in lactic acid bacteria; Renault P et al.; Although decarboxylation of malate to lactate by malolactic enzyme does not liberate biologically available energy (e.g., ATP, NADH), the growth rate of many malolactic bacteria is greatly enhanced by malolactic fermentation . The deacidification of the medium due to malate dissipation cannot fully account for this situation . The chemiosmotic theory postulates that another form of energy could generated by translocation of protons through the membrane coupled to end-product efflux . Konings et al . showed that this theory is indeed applicable to lactate efflux in Streptococcus cremoris at pH 7.0 . A similar mechanism could account for the observed increased activity in malolactic bacteria . The study in wild type and mutant strains of Streptococcus lactis unable to carry out malolactic fermentation led us to the following conclusions: (1) under glucose non-limiting conditions, malolactic fermentation helps to maintain pH of the medium at a certain level; (2) during glucose limited growth, malolactic fermentation could be coupled with an energetic process independent from that mentioned above. J Appl Bacteriol, 1988 Mar, 64(3), 227 - 33 Microbial spoilage of pre-cooked potato-topped pies; Thomas CJ et al.; The ecological succession of bacteria which developed in pre-cooked potato-topped pies stored at two different temperatures was examined . Bacillus, Streptococcus and Staphylococcus-Micrococcus spp . were the predominant organisms isolated from freshly prepared pies and those stored at 4 degrees and 37 degrees C . None of these groups of bacteria caused significant biodeterioration of pies held at 4 degrees C, but all groups grew well in pies stored at 37 degrees C and achieved counts of ca 10(8)/g of sample . Bacillus spp . were the first group to grow, followed by Streptococcus and Staphylococcus-Micrococcus spp . Growth which occurred at 37 degrees C did so at the expense of glucose, lactate accumulated and the pH of pie components decreased . Amylase activity detected in all pie components during storage was associated with the growth of Bacillus spp . and probably supplemented glucose already present in pies, by hydrolytic cleavage of potato, flour or binder starches . Spoilage caused by growth and activity of the bacteria isolated was not associated with visual signs of biodeterioration, nor production of 'off' odour usually associated with spoilage of meats . These results suggest that pre-cooked potato-topped pies held at inappropriate temperatures represent a potential public health risk. Antibiot Khimioter, 1988 Mar, 33(3), 203 - 11 {Use of the method of protoplast fusion in the selection of a nisin producer}; Stoianova LG et al.; Experimental data on selection of Streptococcus lactis producing the polypeptide antibiotic nisin with the method of protoplast fusing, one of the modern methods of cell engineering are presented . Four strains of Streptococcus lactis differing in their nisin-producing levels and difficult for protoplasting were used in the study . It was shown possible to transfer them to the protoplast form when respective conditions for their preliminary cultivation and regeneration are provided . Distinctive features of these strains with respect to the antibiotic resistance, sugar fermentation and growth component requirements were revealed . The protoplast fusing yielded hybrids differing from the parent strains by a number of phenotypical features and nisin-synthesizing activity. Int J Food Microbiol, 1988 Mar, 6(2), 107 - 14 Effect of growth of a commercial starter culture on growth of Staphylococcus aureus and thermonuclease and enterotoxins (C1 and C2) production in broth cultures; Otero A et al.; Staphylococcus aureus strains FRI 137 (enterotoxin C1 producer) and FRI 361 and L 2 (enterotoxin C2 producers) were grown alone and in the presence of a mixed commercial starter culture (Streptococcus lactis, Streptococcus cremoris and Streptococcus lactis subsp . diacetylactis) . Lactic acid bacteria had a slight inhibitory effect on S . aureus population and only during the late stages of growth . In contrast, enterotoxin synthesis was strongly inhibited, inhibition at 18 h being 89% (FRI 137), 80% (FRI 361) and 69% (L 2) . Enterotoxin C1 was produced and accumulated during all phases of growth in pure and mixed culture, but associative growth resulted in reduction of enterotoxin C2 after 24-36 h . In mixed culture, high producers of thermonuclease (FRI 137 and L 2) showed an early decrease in enzyme activity followed by an increase, but it never reached levels attained in pure culture . Thermonuclease was detected whenever enterotoxin was detected, but production curves did not parallel each other. Infect Dis Clin North Am, 1988 Mar, 2(1), 85 - 98 Vaccines for prevention of head and neck infections; Scheifele DW; Many current vaccines are directed against pathogens that infect the upper airway on their way to causing greater damage elsewhere in the body . This article focuses on vaccines against pathogens that contribute importantly to infections of the head and neck per se . The discussion includes vaccines for diphteria, mumps, measles, HIB infections, and infections caused by Streptococcus pneumoniae. Infect Dis Clin North Am, 1988 Mar, 2(1), 149 - 62 The sore throat . Pharyngitis and epiglottitis; Todd JK; Sore throat can be caused by different microorganisms and diseases . Most cases of acute pharyngitis are caused by group A streptococcus or viruses; however, uncommon organisms may be suggested by other clinical information or the persistence of symptoms . A thorough history and physical examination are essential for the appropriate selection of diagnostic tests for sore throat . Routine testing for the uncomplicated case should consist of a pharyngeal culture in most patients, with rapid streptococcal antigen testing only for the more severe cases . Those with positive streptococcal tests should be treated to prevent rheumatic fever and mitigate symptoms in severe cases . Sore throat caused by viruses usually resolves spontaneously . Cases that persist should be thoroughly re-evaluated, with alternative causes being considered . Acute epiglottitis is a medical emergency and requires treatment with appropriate antibiotics for Hemophilus influenzae type b and intubation. Can J Microbiol, 1988 Mar, 34(3), 332 - 8 The use of bacterial interference to prevent infection; Sprunt K et al.; For decades, bacterial strains of low virulence were occasionally used in man to replace or to block colonization by the more virulent organisms and thereby prevent bacterial infection . This paper reviews the topic and presents recent information on the implantation of strain 215 alpha-hemolytic streptococcus (alpha-strep) in the nasopharynx of neonates in the intensive care unit . A single inoculation of strain 215 can change abnormal colonization of the pharynx to "normal" (alpha-strep predominant) in 48-72 h in most neonates . Following implantation, alpha-strep with strain 215 like characteristics fluctuate among naturally occurring strains of alpha-strep, sometimes persisting in dominance and sometimes decreasing rapidly as new strains appear . Strain 215 can survive in the pharynx during subsequent antibiotic therapy and can be recalled to dominance by such therapy . It seems remarkably stable in vivo . There is no evidence of its nosocomial spread in the nursery . Streptococcus with strain 215 like characteristics occurred naturally in 1-6% of neonates in our intensive care unit . No infection (disease) attributable to strain 215 occurred in implanted infants. J Dent Res, 1988 Mar, 67(3), 543 - 7 Homology of glucosyltransferase gene and protein sequences from Streptococcus sobrinus and Streptococcus mutans; Russell RR et al.; The sequences of glucosyltransferase genes from Streptococcus sobrinus (gtfI) and Streptococcus mutans (gftB) were compared and show a high degree of homology . There is a 57.7% homology of nucleotides in the genes and a 56.7% homology of amino acids in the deduced protein sequences . The G + C content for the protein-coding region is 43.6% for S . sobrinus and 41.2% for S . mutans . Internal repeating sequences present in both proteins exhibit some difference in sequence pattern. Z Ernahrungswiss, 1988 Mar, 27(1), 48 - 56 {Stepwise study procedure of sugar substitutes--preliminary study with enzymes . 4 . Glucosyltransferases of Streptococcus mutans AHT}; Forsthuber F et al.; A continuous procedure for the simultaneous enzymatic measurement of the release of free fructose and glucose was adapted to the kinetic conditions of the synthesis of polysaccharides from sucrose by glucosyltransferases from Streptococcus mutans AHT . Initial velocities, Km of sucrose, and the efficiency of the formation of glucans from sucrose can be determined . Longtime incubations with the isolation of soluble and insoluble glucans as an established method were compared with the new procedure . As examples of the effect of sugar substitutes on glucosyltransferases, data on leucrose, nystose, Palatinit, xylitol, leucritol and polyglucose PL-3 are presented . The results provide a preliminary assessment of sugar substitutes such as non-cariogenic sweeteners. J Bacteriol, 1988 Mar, 170(3), 1123 - 8 Localization and enumeration of fimbria-associated adhesins of Bacteroides loescheii; Weiss EI et al.; Monoclonal antibodies that specifically inhibit coaggregation between Bacteroides loescheii PK1295 and its two gram-positive partners Streptococcus sanguis 34 and Actinomyces israelii PK14 were used to enumerate and localize two distinct types of fimbria-associated adhesins on the surface of B . loescheii . Binding studies with radiolabeled monoclonal antibodies indicated that a maximum (Bmax calculated from Scatchard plots) of approximately 400 adhesin molecules specific for S . sanguis and 310 adhesin molecules specific for A . israelii reside on the surface of the cell . Immunoelectron microscopy revealed that the adhesins were not an integral part of the fimbrial subunit; rather, they were usually found on the distal portion of the structures arranged in a random fashion. J Antimicrob Chemother, 1988 Mar, 21(3), 309 - 18 Conjugative acquisition and expression of antibiotic resistance determinants in Listeria spp; Vicente MF et al.; Elements encoding various antibiotic resistances were transferred to Listeria species by conjugation with Streptococcus donor strains . Transfer of a conjugative resistance plasmid, pIP501, and of a conjugative transposon, Tn916, occurred at a frequency of about 10(-6) . A previously described conjugative cryptic plasmid, pRYC16, could mobilize a non-conjugative resistance plasmid, pBD10, between Listeria strains . In all cases the resistance determinants were stably-inherited by Listeria and could be retransferred to other members of this genus and to Streptococcus or Erysipelothrix strains by conjugation . Listeria transconjugants expressed resistance to chloramphenicol, tetracycline, erythromycin, kanamycin, tobramycin and amikacin at similar levels to those observed in other plasmid containing Gram-positive organisms. Appl Environ Microbiol, 1988 Mar, 54(3), 772 - 6 Amylolytic activity of selected species of ruminal bacteria; Cotta MA; A variety of species of ruminal bacteria were screened for the ability to grow in starch-containing medium and produce amylase . Of those tested, the highest levels of amylase were produced by Streptococcus bovis JB1 and Ruminobacter amylophilus H18 . Other strains that grew well on starch and produced amylase included Butyrivibrio fibrisolvens A38 and 49 and Bacteroides ruminicola 23 and B14 . Varying the carbohydrate source provided for growth resulted in changes in the growth rate and level of amylase produced by these strains . All strains grew rapidly in starch-containing medium, and the rates of growth were generally more rapid than those observed for maltose-grown cultures . For S . bovis JB1, B . ruminicola 23 and B14, and B . fibrisolvens 49 and A38, amylase was produced when growth was on maltose or starch, but this activity was greatly reduced in glucose-grown cultures . The distribution of amylolytic activity between cellular and extracellular fractions was sometimes affected by the carbohydrate provided for growth . If S . bovis JB1 and B . fibrisolvens 49 were grown on starch, amylase was largely associated with cell pellets; however, if grown on maltose these strains produced activities that were almost entirely present in the extracellular fluid fractions . Although not as dramatic, a similar shift in the location of amylase activities was noted for the two B . ruminicola strains when grown on the same substrates . Growth on maltose or starch had little influence on either the predominantly cell-associated activity of B . fibrisolvens A38 or the activity of R . amylophilus H18, which was equally divided between cell pellet and extracellular fluid fractions.(ABSTRACT TRUNCATED AT 250 WORDS) Biochemistry, 1988 Feb 9, 27(3), 865 - 72 Lipid requirement of the branched-chain amino acid transport system of Streptococcus cremoris; Driessen AJ et al.; The role of the membrane lipid composition on the transport protein of branched-chain amino acids of the homofermentative lactic acid bacterium Streptococcus cremoris has been investigated . The major membrane lipid species identified in S . cremoris were acidic phospholipids (phosphatidylglycerol and cardiolipin), glycolipids, and glycerophosphoglycolipids . Phosphatidylethanolamine (PE) was completely absent . Protonmotive force-driven and counterflow transport of leucine was assayed in fused membranes of S . cremoris membrane vesicles and liposomes composed of different lipids obtained by the freeze/thaw-sonication technique . High transport activities were observed with natural S . cremoris and Escherichia coli lipids, as well as with mixtures of phosphatidylcholine (PC) with PE or phosphatidylserine . High transport activities were also observed with mixtures of PC with monogalactosyl diglyceride, digalactosyl diglyceride, or a neutral glycolipid fraction isolated from S . cremoris . PC or mixtures of PC with phosphatidylglycerol, phosphatidic acid, or cardiolipin showed low activities . In mixtures of PC and methylated derivatives of PE, both counterflow and protonmotive force-driven transport activities decreased with increasing degree of methylation of PE . The decreased transport activity in membranes containing PC could be restored by refusion with PE-containing liposomes . These results demonstrate that both aminophospholipids and glycolipids can be activators of the leucine transport system from S . cremoris . It is proposed that aminophospholipids in Gram-negative bacteria and glycolipids in Gram-positive bacteria have similar functions with respect to solute transport. J Biol Chem, 1988 Feb 5, 263(4), 2064 - 9 N6-(1-carboxyethyl)lysine formation by Streptococcus lactis . Purification, synthesis, and stereochemical structure; Thompson J et al.; During growth in an arginine-deficient (chemically defined) medium, cells of Streptococcus lactis K1 formed significant amounts of a previously undetected ninhydrin-positive compound . This intracellular compound did not cochromatograph with any of a wide range of amino acids or amino acid analogs tested . However, by two-dimensional thin layer chromatography, the unknown compound migrated close to the recently discovered N5-(1-carboxyethyl)ornithine (Thompson, J., Curtis, M . A., and Miller, S . P . F . (1986) J . Bacteriol . 167, 522-529; Miller, S . P . F., and Thompson, J . (1987) J . Biol . Chem . 262, 16109-16115) . The purified compound behaved as a neutral amino acid and eluted between valine and methionine in the amino acid analyzer . The results of 1H NMR spectroscopy suggested the presence of a lysine backbone and a coupled methyl-methine unit in the molecule, and 13C NMR showed that there were nine carbon atoms, of which two (C-1 and C-7) were carboxyl carbons . The simplest structure compatible with the physicochemical data was that of an alkylated derivative of lysine . The identity of this new amino acid, N6-(1-carboxyethyl)lysine, was confirmed by chemical synthesis . In vivo labeling experiments conducted using L{U-14C}lysine and {epsilon-15N}lysine showed that exogenous lysine served as the precursor of intracellular N6-(1-carboxyethyl)lysine and that the epsilon-amino N atom was conserved during biosynthesis of the lysine derivative . Of the two possible diastereomers (2S,8S or 2S,8R) of N6-(1-carboxyethyl)lysine, comparative 13C NMR spectroscopy established that the amino acid produced by S . lactis K1 was exclusively of the 2S,8S configuration. Proc Natl Acad Sci U S A, 1988 Feb, 85(3), 914 - 8 Molecular evolution of lytic enzymes of Streptococcus pneumoniae and its bacteriophages; Garcia E et al.; A 2.9-kilobase Acc I fragment of the DNA of the pneumococcal bacteriophage Cp-1, containing the cpl gene, hybridizes with the lytA gene encoding the pneumococcal amidase . The nucleotide sequence of the cpl gene of Cp-1, encoding a muramidase (CPL), has been determined . The 3' regions of the cpl and lytA coding sequences show considerable nucleotide sequence homology and the carboxyl-terminal domains of the deduced amino acid sequences of these lysins are quite similar: 73 of the carboxyl-terminal 142 amino acid residues are identical, and of the 69 substitutions, 55 are conservative . Comparisons between CPL, the pneumococcal amidase, and the muramidase of the fungus Chalaropsis sp . (an enzyme that also degrades the pneumococcal cell wall) strongly suggest that the carboxyl-terminal domains of CPL and of the amidase might be responsible for the specific recognition of choline-containing cell walls, as well as for the noncompetitive inhibition of the catalytic activity of these enzymes by the pneumococcal lipoteichoic acid or by high concentrations of choline . In addition, the active center of these enzymes should be located in their amino-terminal domains . Our results suggest an evolutionary relationship between phage and host lysins. J Dairy Res, 1988 Feb, 55(1), 25 - 32 Histochemical localization and possible antibacterial role of xanthine oxidase in the bovine mammary gland; Collins RA et al.; Xanthine oxidase (XO) was demonstrated to be present in the teat canal and secretory tissue of the bovine mammary gland by histochemical techniques . Homogenates of these tissues were able to replace XO in an antibacterial assay with Streptococcus uberis . The action of XO on its substrate hypoxanthine was shown to provide an essential component for anti-streptococcal activity mediated by lactoperoxidase . A mechanism is proposed whereby the interaction of XO, lactoperoxidase and thiocyanate may provide antibacterial activity in the teat canal. Carbohydr Res, 1988 Feb 1, 172(2), 195 - 207 Synthesis of a trisaccharide component of the capsular polysaccharide of Streptococcus pneumoniae type 19F; Sugawara T et al.; 2-O-{4-O-(2-Acetamido-2-deoxy-beta-D-mannopyranosyl)-alpha-D- glucopyranosyl}-alpha,beta-L-rhamnopyranose, a structural component of the capsular polysaccharide of Streptococcus pneumoniae type 19F, has been synthesized by sequential glycosylation reactions using the glycosyl acceptor 2,2,2-trichloroethyl 3,4-di-O-benzyl-alpha-L-rhamnopyranoside (prepared from the known 2-O-acetyl-3,4-di-O-benzyl-alpha-L-rhamnopyranosyl chloride), and the glycosyl donors 4-O-acetyl-2,3,6-tri-O-benzyl-alpha-D-glucopyranosyl chloride and 4,6-di-O-acetyl-2-azido-3-O-benzyl-2-deoxy-alpha-D-mannopyranosyl bromide (prepared in seven steps from the known methyl 2-azido-4,6-O-benzylidene-2-deoxy-alpha-D-altropyranoside) . The corresponding 8-(methoxycarbonyl)octyl glycoside has also been synthesized, by coupling of 8-(methoxycarbonyl)octyl trifluoromethanesulfonate and the sodium salt of 2-O-{4-O-(2-acetamido-4,6-di-O-acetyl-3-O-benzyl-2-deoxy-beta-D- mannopyranosyl)-2,3,6-tri-O-benzyl-alpha-D-glucopyranosyl}-3,4-di-O- benzyl-alpha,beta-L-rhamnopyranose. Appl Environ Microbiol, 1988 Feb, 54(2), 596 - 9 Differentiation of ruminal bacterial species by enzyme-linked immunosorbent assay using egg yolk antibodies from immunized chicken hens; Ricke SC et al.; Cross-reactivity among four species of ruminal bacteria was examined by using egg yolk antibodies from immunized Leghorn laying hens and an enzyme-linked-immunosorbent assay . The effects of the four species on the hens were compared on various days postimmunization . Hens injected with the same bacterial species had similar apparent antibody levels over the entire postimmunization period, but only Bacteroides ruminicola B1(4) and Selenomonas ruminantium D antigens elicited early increases in apparent antibody levels during weeks 2 and 3 . Antibody cross-reactivity was greatly reduced by week 2, except for antibodies against Streptococcus bovis JB1. Infect Immun, 1988 Feb, 56(2), 518 - 22 Effect of nutritional constraints on the biosynthesis of the components of the phosphoenolpyruvate: sugar phosphotransferase system in a fresh isolate of Streptococcus mutans; Rodrigue L et al.; A procedure for the purification of enzyme I (EI) and the protein HPr, the general components of the phosphoenolpyruvate:sugar phosphotransferase system, from Streptococcus mutans serotype c is presented . The method was also applied successfully to the purification of EI and HPr from Streptococcus salivarius, Streptococcus sobrinus, and Streptococcus sanguis . Using specific antibodies obtained against the proteins purified from S . mutans DR0001, we determined quantitatively by rocket electrophoresis the cellular levels of EI and HPr in a freshly isolated strain of S . mutans grown under various conditions in continuous culture . The activity of a few specific EIIs was also determined by an in vitro phosphorylation test . Results indicated that maximum EII activities for glucose, mannose, and 2-deoxyglucose were obtained under conditions of glucose limitation, at pH 7.0 and low dilution rate (D = 0.057/h) . Increasing the amount of glucose or the dilution rate (D = 0.40/h) or decreasing the pH from 7.0 to 5.5 resulted in a 1.4- to 24-fold decrease in these activities . The EII activity for fructose was not influenced by the growth conditions in the same way as the other EIIs . The fructose EII was highest at pH 5.5 and at high dilution rate under conditions of glucose or nitrogen limitation and was always repressed at pH 7.0 and at low dilution rates . The intracellular levels of EI were also dependent on the growth conditions . The highest concentration (0.65 nmol/mg of protein) was observed in cells grown under glucose limitation at pH 7.0 and high dilution rate, and the lowest concentration (0.12 nmol/mg of protein) was found in cells grown under glucose excess at pH 7.0 and high dilution rate . The other general component of the phosphoenolpyruvate:sugar phosphotransferase system, the protein HPr, was not influenced significantly by varying growth conditions. J Infect Dis, 1988 Feb, 157(2), 245 - 55 The contribution of pneumococcal cell wall to the pathogenesis of experimental otitis media; Ripley-Petzoldt ML et al.; We studied the contribution of pneumococcal cell wall to the pathogenesis of otitis media in chinchillas after middle ear inoculation of killed, encapsulated type 7F Streptococcus pneumoniae; killed, unencapsulated R6 S . pneumoniae; and isolated R6 pneumococcal cell wall . Ears inoculated with encapsulated and unencapsulated pneumococci had significantly higher concentrations of polymorphonuclear and mononuclear leukocytes and lysozyme in middle ear fluid and developed more epithelial metaplasia and granulation tissue than did saline-inoculated ears . The mean concentration of lysozyme in middle ear fluid was higher in ears inoculated with killed, unencapsulated than encapsulated pneumococci . The middle ear mucoperiosteum of ears inoculated with pneumococcal cell wall showed significantly more polymorphonuclear leukocytes, epithelial metaplasia, subepithelial congestion, and granulation tissue than did control ears . Because nonviable, unencapsulated pneumococci and pneumococcal cell wall caused middle ear inflammation in the chinchilla model of otitis media, it is possible that cell envelope and cell wall components released during bacterial lysis may contribute to chronic otitis media with effusion in humans. J Dairy Sci, 1988 Feb, 71(2), 505 - 12 Effect of mastitis on proteolytic activity in bovine milk; Saeman AI et al.; Proteolytic activity of milk was studied before, during, and after experimental-induced mastitis . An inoculum of Streptococcus agalactiae was infused into one quarter of each udder of six cows to elicit an infection . Bacteriological cultures and SCC of milk were used to monitor infection status . Sodium dodecyl sulfate-PAGE was used to measure proteolytic activity of milk . Inhibitor 6-amino-n-hexanoic acid was used to determine the relative proportion of plasmin and nonplasmin proteolytic activity of milk . Somatic cell count, total milk proteolytic activity, and nonplasmin proteolytic activity were higher in infected quarters than in quarters preinfection . After elimination of infections, SCC and nonplasmin proteolytic activity decreased to preinfection amounts . Total proteolytic activity of milk decreased after infections were cured but remained significantly higher than preinfection activity . This postinfection proteolytic activity in milk may be due to an increase in milk plasmin activity . Our data suggest that detrimental effects of mastitis on milk quality can continue after infection has been eliminated and milk SCC have returned to low values. Jpn J Antibiot, 1988 Feb, 41(2), 180 - 95 {Bacteriological, pharmacokinetic and clinical studies on the use of ceftriaxone in the perinatal period}; Cho N et al.; Laboratory studies and clinical evaluation of ceftriaxone (CTRX) were carried out with mothers and infants in perinatal period . The presence of synergistic effect between CTRX and amniotic fluid were studied using a broth dilution method . Stronger effects were recognized when both agents were present together compared to each agent alone by the fact that values of MIC and MBC became closer together for Escherichia coli as well as for Streptococcus agalactiae . Against the growth of E . coli, a synergism was observed, but for S . agalactiae, only an additive effect was found . The placental transmission of CTRX upon the administration was rapid, and the blood CTRX level reached its peak shortly after the intravenous administration of the drug . The transport of the drug into the fetus through placenta was excellent and one dose of 1 g of CTRX gave drug concentrations in the umbilical cord serum and amniotic fluid higher than MIC's against main pathogenic organisms . According to these results, it should be possible to treat or prevent perinatal infections by a dose of one gram per day of CTRX, once or twice daily . Cases of perinatal infections were treated with CTRX . An effective treatment without side effects was obtained . No physical abnormalities nor unusual laboratory test results were recognized in neonates delivered from mothers who received CTRX administration . The penetration of CTRX into mothers' milk was low, thus the drug transfer into neonates through the breast-feeding should not be a problem . It appears, from the above study, that CTRX is a clinically useful antibiotic for the prophylaxis and the treatment of perinatal infections. Jpn J Antibiot, 1988 Feb, 41(2), 133 - 43 {Fundamental and clinical evaluations of ceftriaxone in neonates}; Sunakawa K et al.; The antibacterial efficacy of ceftriaxone (CTRX) against group B Streptococcus and its clinical efficacy in newborns were examined, and the results obtained are summarized as follows . 1 . MIC's of CTRX against 55 strains of B group Streptococcus from the pregnant vagina were 0.10 micrograms/ml or lower . 2 . Efficacies of CTRX were good to excellent in 8 cases administered for treatment, 3 cases for prophylaxis and 1 for observation of adverse reactions . Observed adverse reactions included diarrhea in 4 cases and vomiting in 2 cases . As abnormal laboratory parameters, eosinophilia and thrombocytosis were observed in 1 case each . 3 . An examination of intestinal bacteria in 9 cases revealed that CTRX gave as much influence to the flora as other third-generation cephems . 4 . An examination for the vitamin K deficiency in 11 cases found a prolongation of prothrombin time (PT) in 3 cases and protein induced by vitamin K absence (PIVKA) II positive in 2 cases . 5 . Testing of platelet aggregation with adenosine diphosphate (ADP) in 7 cases showed little influence of CTRX. Am J Clin Pathol, 1988 Feb, 89(2), 238 - 42 Penicillin-resistant Streptococcus pneumoniae . Report of a case and results of a clinical laboratory proficiency survey in Minnesota; Brummitt CF et al.; An elderly woman with Streptococcus pneumoniae meningitis relatively resistant (minimum inhibitory concentration, {MIC} = 0.12 micrograms/mL) to penicillin is reported . The occurrence of penicillin-resistant pneumococcal infections is reviewed and management discussed . Because of the importance of recognition of resistant pneumococci, a state-wide clinical laboratory survey was conducted to determine the accuracy of susceptibility testing for this isolate . Of 111 laboratories completing the survey, only 26 performed the 1-microgram oxacillin disk test as recommended by the National Committee for Laboratory Standards (NCCLS) . When laboratories were analyzed according to hospital size, the proficiency in performing the proper susceptibility testing was 55% (6 of 11) for hospitals with more than 400 beds versus 3% (2 of 58) for hospitals with fewer than 100 beds (P less than 0.0001 by Fisher's exact test) . This contrasts with reported surveys by the College of American Pathologists (CAP), and reasons for this are explored . Guidelines for laboratory testing of S . pneumoniae are reviewed, and additional study of clinical proficiency with attention to laboratory size is recommended. J Immunol, 1988 Feb 1, 140(3), 954 - 61 Heart-reactive antibodies in rabbit anti-Streptococcus mutans sera fail to cross-react with Streptococcus mutans; Swartzwelder FJ et al.; Immunization of rabbits with Streptococcus mutans antigens results in the production of serum antibodies that bind in vitro to human, rabbit, and monkey cardiac muscle . Antibodies to heart, however, have also been reported to occur at lower titers in the sera of unimmunized rabbits . In this study, the specificities of heart-reactive antibodies (HRA) in sera of unimmunized and S . mutans-immunized rabbits were compared using indirect immunofluorescence, Western blot, and Bio-Dot immunoassays . Both groups of sera gave striational indirect immunofluorescence-staining patterns on thin sections of native human and monkey cardiac muscle . Western blot analyses revealed that antibodies in normal sera bound 9 to 20 components of human, rabbit, and monkey heart . The major bands had Mr of 205,000, 160,000, 135,000, and 70,000 . Several of the normal sera did not have antibody activity to S . mutans antigens, indicating that these HRA do not cross-react with these bacteria . Although immunization of rabbits with S . mutans caused increased titers of HRA (two to three doubling dilutions), Western blot assays using anti-S . mutans sera showed banding patterns qualitatively similar to those of normal sera on heart extracts . Antibodies to skeletal muscle myosin were detected in both serum groups . Of eighteen normal rabbit sera sixteen had antimyosin titers of 10 to 40, whereas all eighteen anti-S . mutans sera had titers of 10 to 160 . Affinity-purified antimyosin antibodies isolated from anti-S . mutans serum did not bind to S . mutans components . Conversely, affinity-purified antibodies to S . mutans antigens did not bind to myosin or to other cardiac muscle components . Among these were antibodies to the 185-kDa cell wall protein (also known as B, I/II, IF, Spa A, and P1) previously believed to possess antigenic mimicry . HRA were removed from anti-S . mutans sera by absorption with S . mutans but this effect was not specific, because a non-cross-reactive internal standard antibody was also absorbed to the same extent . Because previous evidence for antigenic mimicry between S . mutans and cardiac muscle was based on serum cross-absorption experiments, this immunologic relationship is not substantiated . These results indicated that naturally occurring antibodies to cardiac muscle components are present in the sera of unimmunized rabbits and that immunization with S . mutans does not stimulate production of new heart-reactive antibody, but rather serves to boost antibody production by preexisting clones of self-reactive B-lymphocytes. Obstet Gynecol, 1988 Feb, 71(2), 198 - 202 Group B streptococcus and preterm rupture of membranes; Newton ER et al.; The effect of cervical group B streptococcus on the conservative management of preterm premature rupture of membranes was examined in 140 consecutive patients . Upon the patient's admission, we obtained cervical cultures for group B streptococcus, genital mycoplasmas, and chlamydia . Patients with and without group B streptococcus were compared . Group B streptococcus patients had earlier rupture of membranes (30.7 versus 31.6 weeks) and shorter latent periods (76.8 versus 138.5 hours) . Intra-amniotic infection (six of 16 versus 26 of 120) and endometritis (four of ten versus three of 94) were significantly more common in group B streptococcus patients . Neonates of mothers positive for group B streptococcus were smaller (1749 +/- 844 versus 2100 +/- 779 g) and more likely to have infectious complications (eight of 16 versus 29 of 120; P less than .01) . Control for the presence of mycoplasmas, chlamydia, listeria, or gonorrhea failed to change the significance of these results . The usual policy was to use intrapartum ampicillin prophylaxis in asymptomatic group B streptococcus patients . However, only four of 16 remained asymptomatic and had latent periods long enough for the results of cultures obtained on admission to be available . We conclude that group B streptococcus significantly complicates the conservative management of preterm premature rupture of membranes and that the effectiveness of intrapartum prophylactic ampicillin may be compromised by awaiting the results of conventional cultures to define colonized patients. J Infect Dis, 1988 Feb, 157(2), 256 - 63 Nasopharyngeal carriage of antibiotic-resistant pneumococci by children in group day care; Henderson FW et al.; We compared rates of antibiotic resistance in strains of Streptococcus pneumoniae recovered from nasopharyngeal secretions of a group of children studied longitudinally in a research day care center between 1978 and 1985 and recovered from usually sterile body fluids of patients at a tertiary care hospital between 1981 and 1985 . The prevalence of trimethoprim-sulfamethoxazole (TMP-SMZ) resistance was 11.5% in isolates from the hospital, whereas 30.0% of episodes of nasopharyngeal carriage of S . pneumoniae studied in day care children included TMP-SMZ-resistant isolates . The proportion of episodes of colonization with TMP-SMZ-resistant isolates in the day care study increased from 5.4% before 1981 to 39% between 1981 and 1985 . Isolates of S . pneumoniae relatively resistant (MIC greater than or equal to 0.125 micrograms/mL) to penicillin G, amoxicillin, or cefuroxime accounted for 8% of isolates from the hospital and 11.9% of episodes of nasopharyngeal colonization in children in day care . Pneumococci with reduced susceptibility to either TMP-SMZ or a beta-lactam antibiotic were recovered from 68% of 72 children in the day care study. Eur J Clin Microbiol Infect Dis, 1988 Feb, 7(1), 69 - 71 Evaluation of roxithromycin (RU-965) versus cephradine in pneumococcal pneumonia; Zeluff BJ et al.; One hundred and sixty black South African gold miners with acute pneumococcal pneumonia were enrolled in a prospective randomized double-blind trial comparing roxithromycin (150 mg 2 X day) with cephradine (1.0 g 2 X day) . Ninety patients with pneumonia caused by Streptococcus pneumoniae were treated for 5-10 days . Forty-three of 46 (93.4%) of the roxithromycin and all 44 (100%) of the cephradine treated groups had satisfactory clinical responses . In eight of the 46 (17%) roxithromycin treated patients and 10 of the 44 (23%) cephradine treated patients, Streptococcus pneumoniae was not eradicated from sputum cultures by the tenth day . Side effects in 18 patients (20%) were mild and were usually manifested by elevation of the transaminases; these were more common in the cephradine group (12) than in the roxithromycin group (5) . Roxithromycin appears to be a safe and effective oral antibiotic for treatment of patients with mild to moderate pneumococcal pneumonia. Eur J Clin Microbiol Infect Dis, 1988 Feb, 7(1), 56 - 7 Vaginitis caused by nutritionally variant Streptococcus pyogenes; Pulvirenti J et al.; A nutritionally variant Streptococcus pyogenes was isolated from a vaginal specimen . The organism was isolated in essentially pure culture with a few colonies of normal vaginal flora . The bacterium was identified as Streptococcus pyogenes with the use of rapid test kits and the presence of group A antigen. J Antimicrob Chemother, 1988 Feb, 21 Suppl B, 19 - 27 Enoxacin-induced modification of the susceptibility of bacteria to phagocytic killing; Pruul H et al.; The effect of enoxacin upon the interaction in vitro of human polymorphonuclear leucocytes with Streptococcus pneumoniae and Pseudomonas aeruginosa was examined . Synergistic killing of these two species of bacteria was observed in the presence of neutrophils and concentrations of enoxacin above the MIC . Enoxacin was able to kill intracellular Str . pneumoniae and Staphylococcus aureus . The activity of glucose-glucose oxidase, an oxygen-dependent bactericidal system which mimics part of the bactericidal system of human neutrophils, was enhanced by pretreatment with enoxacin and several other antibiotics . The effect of antibiotic pretreatment upon the bactericidal activity of an acid extract of neutrophil granules was variable. J Bacteriol, 1988 Feb, 170(2), 700 - 7 Relation of growth of Streptococcus lactis and Streptococcus cremoris to amino acid transport; Poolman B et al.; The maximum specific growth rate of Streptococcus lactis and Streptococcus cremoris on synthetic medium containing glutamate but no glutamine decreases rapidly above pH 7 . Growth of these organisms is extended to pH values in excess of 8 in the presence of glutamine . These results can be explained by the kinetic properties of glutamate and glutamine transport (B . Poolman, E . J . Smid, and W . N . Konings, J . Bacteriol . 169:2755-2761, 1987) . At alkaline pH the rate of growth in the absence of glutamine is limited by the capacity to accumulate glutamate due to the decreased availability of glutamic acid, the transported species of the glutamate-glutamine transport system . Kinetic analysis of leucine and valine transport shows that the maximal rate of uptake of these amino acids by the branched-chain amino acid transport system is 10 times higher in S . lactis cells grown on synthetic medium containing amino acids than in cells grown in complex broth . For cells grown on synthetic medium, the maximal rate of transport exceeds by about 5 times the requirements at maximum specific growth rates for leucine, isoleucine, and valine (on the basis of the amino acid composition of the cell) . The maximal rate of phenylalanine uptake by the aromatic amino acid transport system is in small excess of the requirement for this amino acid at maximum specific growth rates . Analysis of the internal amino acid pools of chemostat-grown cells indicates that passive influx of (some) aromatic amino acids may contribute to the net uptake at high dilution rates. Biotechniques, 1988 Feb, 6(2), 130 - 6 Selective colony blotting to expand bacterial surface receptors: applications to receptors for rat immunoglobulins; Reis KJ et al.; Many bacterial surface receptors demonstrate a heterogeneous expression pattern among individual colonies . Methods have been developed to select bacteria expressing high levels of a stable surface receptor . This process is illustrated using a Streptococcus zooepidemicus isolate demonstrating a high level of Fc receptors for rat immunoglobulins . This strain was selected and expanded to obtain a bacterial isolate demonstrating approximately 100 fold greater reactivity with rat immunoglobulins than protein A positive Staphylococcus aureus or 30-40 fold higher reactivity for rat IgG than type III Fc receptor positive streptococcal group G strains . The optimal pH for rat IgG binding and the reactivity with rat IgG subclasses and certain rat monoclonal antibodies is described . The potential application and limitations of the selected rat Fc receptor positive bacterial strain to immunoassays based on the specificity of rat monoclonal and polyclonal antibodies is discussed. Ophthalmic Surg, 1988 Feb, 19(2), 119 - 23 The intraocular penetration and retinal toxicity of teicoplanin; Carney M et al.; We investigated the intraocular penetration and retinal toxicity of teicoplanin, a relatively new glycopeptide antibiotic with activity similar to vancomycin when used to inhibit staphylococci and other gram positive organisms, particularly Streptococcus faecalia . Topically administered teicoplanin penetrated poorly into the aqueous and vitreous in rabbit eyes . Subconjunctival injection of the drug yielded aqueous levels above the minimum inhibiting concentration (3.1 micrograms/ml) only at one hour after injection . In the vitreous, drug levels were above the mean inhibitory concentration at 30 minutes after the subconjunctival injection, but rapidly declined thereafter . The maximum nontoxic, single-dose, intravitreal injection was 750 micrograms/0.1 ml . Rabbits received 8 micrograms/ml of teicoplanin in an intravitreal infusion solution without demonstrable retinal toxicity. J Bacteriol, 1988 Feb, 170(2), 810 - 6 Sequence analysis of the Streptococcus mutans fructosyltransferase gene and flanking regions; Shiroza T et al.; The nucleotide sequence of the ftf gene from Streptococcus mutants GS-5 was determined . The deduced amino acid sequence indicates that the unprocessed fructosyltransferase gene product has a molecular weight of 87,600 . A typical streptococcal signal sequence is present at the amino terminus of the protein . The processed enzyme is relatively hydrophilic and has a pI of 5.66 . An inverted repeat structure was detected upstream from the ftf gene and may function in the regulation of fructosyltransferase expression . Sequencing of the regions flanking the gene revealed the presence of four other putative open reading frames (ORFs) . Two of these, ORFs 2 and 3, appear to code for low-molecular-weight proteins containing amino acid sequences sharing homology with several gram-positive bacterial DNA-binding proteins . In addition, ORF 3 is transcribed from the ftf DNA coding strand . Partial sequencing of ORF 4 suggests that its gene product may be an extracellular protein. J Bacteriol, 1988 Feb, 170(2), 630 - 7 Genetic transformation in Streptococcus pneumoniae: molecular cloning and characterization of recP, a gene required for genetic recombination; Rhee DK et al.; A 225-base-pair fragment of a recombination gene was identified by insertion-duplication mutagenesis and used as a radioactive probe to clone the corresponding rec locus from Streptococcus pneumoniae in Escherichia coli plasmid vectors . Attempts to clone large pieces of this locus were unsuccessful, but small pieces of DNA from this region were cloned in the E . coli transcriptional terminator vectors pKK232-8 and pJDC9 . The extent of the rec region, 2.1 to 2.2 kilobases, was defined by determining the competence phenotype of insertion mutations constructed in vitro . A deletion of the rec locus showed it to be necessary for chromosomal integration but not for plasmid establishment . A plasmid carrying the entire locus encoded a 72-kilodalton polypeptide in a cell-free E . coli transcription-translation system. Infect Immun, 1988 Feb, 56(2), 505 - 12 Adherence of Streptococcus agalactiae to synchronously growing human cell monolayers without lipoteichoic acid involvement; Miyazaki S et al.; Freshly isolated virulent and nonvirulent strains of Streptococcus agalactiae type III were used to study differences in coccal adherence to synchronously dividing, subconfluent human embryonic amnion and fetal lung monolayers in vitro . The adherence frequency by virulent isolates of mid-logarithmically growing cocci to amnion cells varied markedly with host cell age, being highest shortly after eucaryotic cell division . This variation was not observed with lung cell monolayers, suggesting that cyclic production or exposure of coccal receptor sites on the eucaryotic cell surface with age is not a common property of all primary human cells in vitro . However, and regardless of age, not all cells within these synchronously dividing populations bound virulent cocci, indicating that a very small segment of a population may always be unresponsive to host cell interactions with a coccal pathogen . By comparison, adherence of nonvirulent coccal isolates to amnion and lung cells remained constant and of a very low order, regardless of host cell age . Maximal adherence of virulent S . agalactiae to young host cells occurred at early and mid-logarithmic phases of growth . However, at the late stationary growth phase, adherence was reduced to almost that of nonvirulent isolates . Pretreatment of virulent S . agalactiae with anti-lipoteichoic acid (LTA) serum failed to inhibit coccal adherence to these different host cells . Heat negated adherence . Group B coccal LTA was cytotoxic for these host cells . However, pretreatment of amnion and lung cells with nontoxic levels of this amphiphile did not prevent attachment of virulent cocci . Finally, coccal pretreatment with pronase abrogated adherence to either host cell even though surface-exposed LTA was uneffected, as observed by the indirect fluorescent-antibody procedure . Likewise, no observable difference in surface LTA was detected when fresh isolates of virulent and nonvirulent coccal strains were compared by this procedure . These studies suggest that protein involvement, rather than LTA, is primarily responsible for mediating virulent S . agalactiae type III attachment to these synchronously growing, subconfluent eucaryotic monolayers in vitro. Biochem Biophys Res Commun, 1988 Jan 29, 150(2), 687 - 93 A novel glucosyltransferase from Streptococcus mutans produces oligo-isomaltosaccharides; Yamashita Y et al.; Streptococcus mutans secretes a sucrose-independent branalphang enzyme that utilizes isomaltosaccharides as donors for branalphang formation on dextran . Although the branching enzyme is necessary for the formation of extracellular polysaccharide complexes, the source of the donor for the enzyme is unknown . In this study, we purified a novel glucosyltransferase from S . mutans and characterized its properties . The glucosyltransferase was primer independent 1,6-alpha-D-glucan synthase, which produced oligo-isomaltosaccharides . The enzyme was thought to be a source of donor for the branching enzyme in S . mutans. J Immunol Methods, 1988 Jan 21, 106(1), 101 - 7 Measurement of the humoral immune response against Streptococcus pneumoniae type 3 capsular polysaccharide and oligosaccharide containing antigens by ELISA and ELISPOT techniques; Zigterman GJ et al.; A sensitive ELISA has been developed to study immune responses in mice against Streptococcus pneumoniae type 3 capsular polysaccharide (S3PS) and hexasaccharide (HS)-protein conjugates derived therefrom . An advantage of the described system is that the same microtiter plates can be used for both ELISA and ELISPOT tests with a standardized washing procedure and diluent composition . S3PS induced predominantly IgM antibodies and minute amounts of IgG as measured by ELISA in serum . This was accompanied by large numbers (greater than 14000) of IgM spot-forming cells in the spleen . A shift towards IgG production was achieved by addition of lipid A . HS-protein conjugates induced predominantly IgG antibodies after booster immunization(s) . Furthermore these conjugates induced large numbers (greater than 40000) of IgG spot-forming cells (SFC) in the spleen . ELISA and ELISPOT assays on microtiter plates are both reliable and highly reproducible assays for the evaluation of immune responses to S . pneumoniae antigens. Eur J Biochem, 1988 Jan 15, 171(1-2), 219 - 24 Penicillin-degrading activities of peptides from pneumococcal penicillin-binding proteins; Ellerbrok H et al.; Trypsin treatment of native penicillin-binding proteins (PBPs) 1a, 2b and 3 from Streptococcus pneumoniae resulted in the formation of stable peptides containing the beta-lactam-binding site with molecular masses ranging from 26 kDa to 36 kDa . Whereas the PBP 1a peptide (Ia) was enzymatically rather unstable, the PBP 2b peptide (IIb) and the PBP 3 peptide (III) were able to bind and release beta-lactams with similar rates compared to the intact PBP, the turnover rate of fragment II b was even twice as fast as that observed with PBP 2b . Analysis of the turnover products by thin-layer chromatography revealed that PBP 2b and 3 produced penicilloic acid as well as phenylacetylglycine . On the other hand, with the corresponding tryptic fragments only the hydrolysis product penicilloic acid was obtained. J Periodontol, 1988 Jan, 59(1), 40 - 5 An in vitro model to study bacterial invasion of periodontal tissues; Winkler JR et al.; In periodontal disease, the abilities of bacteria to adhere to and degrade in vivo basement membranes should be considered as two of the rate-limiting steps for the potential active or passive invasion of gingival connective tissues . To study these mechanisms in greater detail, we used the PF HR-9 basement-membrane-like matrix to establish an in vitro model of bacterial invasion and degradation . Three gram-negative anaerobic periodontopathic organisms, Bacteroides gingivalis, Fusobacterium nucleatum, and Actinobacillus actinomycetemcomitans, bound in considerably higher numbers to the HR-9 matrix than did 6 strains of gram-positive facultative organisms typically associated with periodontal health . In a further experiment with B . gingivalis, the organism rapidly degraded Type IV collagen, the major macromolecular component constituting the HR-9 matrix . Streptococcus mitis, the nonperiodontopathic bacterium tested, did not degrade this model matrix . This study provides evidence that B . gingivalis, a periodontopathic bacterium, is able to adhere to and degrade basement membranes, whereas nonperiodontopathic organisms appear not to share in these abilities. Scand J Infect Dis, 1988, 20(3), 345 - 6 Clinical features and management of two cases of Streptococcus milleri chest infection; Brook MG et al.; We report 2 cases of Streptococcus milleri infection of the lung . One patient, a 58-year-old woman, presented with a large abscess in a previously normal lung, the other, a 53-year-old man, had a secondary infection of lung previously scarred by tuberculosis and surgery . Both patients had severe dental caries . Four weeks of therapy with high dose antibiotics and physiotherapy were required . Invasive techniques were needed to isolate the organism. J Arthroplasty, 1988, 3(2), 97 - 102 Outcome of infected total hip arthroplasty . An inclusive, consecutive series; Goodman SB et al.; Twenty-one infected total hip arthroplasties in 19 patients performed between 1971 and 1982 were prospectively followed, using a computerized standard orthopaedic arthritis record . These cases represent an inclusive and unselected, consecutive series . The mean follow-up period from time of infection was 4.8 years (range, 1.2-11.7 years) . Infection was diagnosed by positive bacteriologic culture . Ten hips grew a staphylococcal species, 5 a single gram-negative organism, 1 a Streptococcus, and 5 multiple organisms . At final follow-up evaluation, only three hips (14%) had the previously infected prosthesis still in situ, and these had no evidence of ongoing deep infection . Five additional hips (24%) were successfully salvaged after one- or two-stage prosthetic exchange . Two hips (10%) have an infected prosthesis in situ . Eleven hips (52%) had resection arthroplasty, three after attempts at prosthetic reinsertion . Therefore, at final follow-up evaluation, only 8 of the 21 hips (38%) have an apparently infection-free salvaged or reinserted prosthesis in place . Good prognostic factors for prosthetic salvage/successful reinsertion include Staphylococcus epidermidis infection and a traumatic etiology necessitating later hip arthroplasty . Poor prognostic factors include infection with Staphylococcus aureus or multiple organisms and a preoperative diagnosis of avascular necrosis. Pathology, 1988 Jan, 20(1), 45 - 7 Serotyping of Streptococcus pneumoniae by latex agglutination; Kaldor J et al.; A simple method is presented for serotyping Streptococcus pneumoniae which uses easily prepared sensitized polystyrene latex particles . The technique is simple, fast and reliable and can detect pneumococcal antigens in body fluids. Microbiol Immunol, 1988, 32(1), 25 - 31 Effects of panose on glucan synthesis and cellular adherence by Streptococcus mutans; Koga T et al.; The effects of panose on glucan synthesis and sucrose-dependent cellular adherence by Streptococcus mutans were investigated . Panose effectively inhibited glucan synthesis from sucrose by glucosyltransferases from S . mutans strain 6715, but increasing amounts of panose increased the release of fructose from sucrose by the enzymes . On the other hand, production of a series of oligosaccharides of increasing size by the enzymes was markedly enhanced in the presence of panose . These results indicate that panose activates the enzymes and that the inhibition of glucan synthesis by panose is due to the transfer of the glucosyl group of sucrose to panose . Sucrose-dependent adherence of cells of various S . mutans strains to a glass surface was also inhibited by panose. Acta Paediatr Scand, 1988 Jan, 77(1), 125 - 31 Epidemiology of Schönlein-Henoch purpura; Nielsen HE; The purpose of this study was to determine if Schonlein-Henoch purpura represents an abnormal host response to microorganisms . Among 1,222 cases, representing all new Danish cases in children during the years 1977-84, there was no tendency for the cases to cluster; this means that the disease is not caused by a single, contagious agent . In a smaller sample of 281 children examined in detail, a higher number than expected attended day nursery or nursery school and 17% had received antibiotic treatment during the week prior to admission . The latter findings, together with the seasonal variation of the incidence and the activation of the immune apparatus in many cases, suggest that Schonlein-Henoch purpura may be triggered by infection with several different microorganisms, but there is no evidence that a single one such as the streptococcus is the major offender. Ann Clin Lab Sci, 1988 Jan-Feb, 18(1), 39 - 45 Chorioamnionitis: a study of organisms isolated in perinatal autopsies; Madan E et al.; The purpose of this study was to determine the validity of postmortem cultures in perinatal autopsies; in particular, those cases where there is gross or histologic evidence of chorioamnionitis . Lung, liver, blood, and placental cultures were obtained from 159 neonatal autopsies with histologic evidence of chorioamnionitis at Magee-Women's Hospital between January 1980 and July 1985 . The criterion for chorioamnionitis was a polymorphonuclear leukocytic infiltrate in the placental membranes . The neonates studied were 63 percent white and 36 percent black; the male to female ratio was 83 to 76 . Intrauterine fetal death occurred in 43 percent of the cases . The mean gestational age was 24 weeks . Premature labor occurred in 64 percent of the cases, and 70 percent of the cases presented with premature rupture of fetal membranes . Congenital pneumonia (defined by the presence of polymorphonuclear leukocytes in the alveolar spaces) was present in 45 percent of cases . The lung was the most frequent site cultured; the four most frequently isolated organisms were: Staphylococcus epidermidis--18 percent; Beta Streptococcus Group B--13 percent; E . coli--nine percent; Ureaplasma urealyticum--nine percent . Negative cultures from multiple sites occurred in seven percent of cases . The results of this investigation indicate that multi-organ cultures help in defining the role of a particular bacteria as a pathogen, and that Staphylococcus epidermidis may be a true fetal pathogen under certain conditions . It is recommended that cultures for Chlamydia trachomatis not be done on fetal tissues. Rev Infect Dis, 1988 Jan-Feb, 10(1), 131 - 7 Meningitis caused by Streptococcus suis in humans; Arends JP et al.; Between 1968 and 1984, 30 strains of Streptococcus suis causing meningitis were isolated in the Netherlands . Twenty-eight strains were type 2, one was type 4, and one was untypable . The average age of the patients infected with these strains was 49 years (range, 21-76 years); the male-to-female ratio was 6.5 . Twenty-five patients (83%) were employed in the pork industry . Two patients (7%) died . In seven cases (23%), predisposing factors were identified . The most frequent sequela was hearing loss (54% of surviving patients) . The data for these 30 patients were compared with those for 30 patients from outside the Netherlands whose cases of meningitis due to S . suis type 2 were described between 1968 and 1985 . No differences were found . The estimated annual risk of developing S . suis meningitis among Dutch abattoir workers and pig breeders was approximately 3.0/100,000--a rate 1,500 times higher than that among persons not working in the pork industry. Br Heart J, 1988 Jan, 59(1), 62 - 8 Infective endocarditis: incidence and mortality in the North East Thames Region; Skehan JD et al.; A survey of infective endocarditis in the North East Thames Regional Health Authority was carried out over a period of 30 months from 1982 to 1984 . The incidence, clinical characteristics, and in-hospital mortality were studied . Important causes of endocarditis were dental treatment, the presence of dental disease, drug abuse, and cytoscopy . The omission or incorrect administration of antibiotic prophylaxis in patients with valve disease was noted, but failure of correctly prescribed antibiotic prophylaxis was not recorded . Adverse prognostic features were increased age, prosthetic valve infection, Gram negative or staphylococcal infections, and aortic valve involvement . In contrast, mortality was lower in patients with mitral valve prolapse, ventricular septal defect, and streptococcus viridans infection . Deaths were usually attributable to irreversible complications present at the time of diagnosis . Vegetations were detected on the echocardiogram in half of those studied and mortality was higher in those with vegetations than without . Operation for native valve infection was associated with a low mortality and it is likely that the overall mortality for infective endocarditis has been improved by surgical intervention. J Cardiovasc Surg (Torino), 1988 Jan-Feb, 29(1), 60 - 2 Massive atheromatous emboli to both kidneys: a fatal complication following aortic surgery; Mashiah A et al.; A patient with severe and diffuse ulcerative atherosclerotic arterial disease developed acute renal failure and anuria during insertion of an aortobifemoral graft . Postoperative septicemia, with Pseudomonas aeruginosa and Streptococcus fecalis, led to a deterioration in his condition and death . At autopsy the Dacron bifurcation graft showed no sign of infection, but massive atheromatous emboli of recent origin were found in both kidneys . We suggest using an extra-anatomic approach in reconstructive surgery for occlusive disease of the abdominal aorta in patients with ulcerative atheroma. Am Rev Respir Dis, 1988 Jan, 137(1), 138 - 43 IgA-driven antibacterial activity against Streptococcus pneumoniae by mouse lung lymphocytes; Sestini P et al.; To investigate the role of lung lymphocytes (LL) in the local defense mechanisms, we studied the natural antibacterial (NA) activity of mouse LL with an in vitro assay using S . pneumoniae type 3 as target . In parallel, natural killer (NK) activity against YAC-1 tumor cells was investigated . Lung cells obtained by enzymatic digestion were found to exert detectable NA and NK activities, which were further increased after purification of LL (greater than 90% lymphocytes) by carbonyl iron and magnet treatment . Depletion experiments with antibodies and complement indicated that the effector cell of NA activity was a Thy 1.2+, L3T4+, aGM1+ lymphocyte, whereas the effector of NK activity was found to have a Thy 1.2-, aGM1+ phenotype . Preincubation of LL with anti-IgA antibodies, but not with anti-IgG, completely inhibited NA activity, suggesting that it was mediated by preexisting IgA bound to the LL surface . Furthermore, purified IgA from S107 plasmacytoma with specificity for phosphorylcholine, a component of the outer wall of S . pneumoniae, was able to enhance the antibacterial activity of LL and to restore their activity after treatment with anti-IgA . In addition, S107 antibodies were found to specifically induce antibacterial activity against S . pneumoniae in resident alveolar macrophages (AM) and peritoneal exudate cells, which did not express NA activity . We conclude that mouse LL include a subset of IgA-bearing lymphocytes with the phenotype of helper-T cells, which are able to exert NA activity against pneumococcus through an IgA-driven mechanism.(ABSTRACT TRUNCATED AT 250 WORDS) Ann Emerg Med, 1988 Jan, 17(1), 66 - 8 Tracheitis: the 'other' cause of upper airway obstruction; Campbell TP et al.; A 22-year-old woman presented to an ear, nose, and throat clinic with an upper respiratory infection and sudden stridorous respirations . Aerosolized isoethrane therapy was beneficial and fiber-optic nasolaryngoscopy revealed a normal supraglottis and purulent intratracheal secretions . Secretions were cultured and grew Staphylococcus aureus and alpha hemolytic Streptococcus . IV cefazolin was initiated and the patient recovered without sequelae . This case illustrates a rare cause of upper airway obstruction, tracheitis . Tracheitis has been found in the pediatric literature . This is the first adult case reported in the literature. Infect Immun, 1988 Jan, 56(1), 64 - 70 Streptococcus sanguis surface antigens and their interactions with saliva; Lamont RJ et al.; Saliva-binding molecules of Streptococcus sanguis and their receptors were investigated . Streptococcal cell surfaces were extracted with a barbital buffer and examined immunochemically . Strains G9B and Blackburn, which adhere specifically to saliva-coated hydroxyapatite via immunologically related adhesins, possess 80-, 62-, and 52-kilodalton (kDa), and 52-, 42-, and 29-kDa polypeptides, respectively, which correlate with adhesion to saliva-coated hydroxyapatite . Nonadherent strains Adh- and M-5 lack these antigens . In an immunoblot overlay, the putative adhesins bound to a 73-kDa receptor present in submandibular saliva but not in parotid saliva . G9B also contains a 160-kDa surface protein which bound to an unidentified receptor in both submandibular and parotid saliva samples . Blackburn barbital-extracted components bound to 78- and 70-kDa receptors in parotid saliva . These bacterial-salivary interactions may be important in the regulation of oral ecology. Cancer Detect Prev, 1988, 11(3-6), 397 - 403 Histological changes caused by intralesional injection of a streptococcal preparation into bladder cancer; Fujita K; OK-432, a lyophilized preparation of Streptococcus pyogenes, was cystoscopically injected into bladder cancer to destroy cancer cells and to prevent recurrences . Marked reactions occurred such as stromal edema, vascular dilation, cancer cell exfoliation, and polymorphonuclear cell infiltration, succeeded by monocyte and lymphocyte infiltration with occasional lymph follicle formation . Cancer cells were sometimes intermingled in microscopic necrotic foci . Foamy granuloma was another characteristic finding . The postoperative follow-up study showed a significantly low recurrence rate. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1988 Jan, 267(3), 404 - 13 Investigations on the binding of erythrogenic toxin A of Streptococcus pyogenes on human peripheral blood lymphocytes . II . Identification of toxin-binding lymphocytes and characterization of the receptor; Wagner B et al.; Gold complexes of erythrogenic toxin A (ETA) of Streptococcus pyogenes (strain NY-5) were bound to human lymphocytes that could be characterized as T cells by rosetting or labelling with OKT 3 antibody and anti-mouse-IgG-gold . Using OKT 4 and OKT 8 antibodies, respectively, it was demonstrated that binding of ETA was confined to the T helper/inducer cell subpopulation . Treatment of lymphocytes with neuraminidase enhanced the binding of ETA-gold, whereas trypsin treatment resulted in its reduction . Gangliosides of type II or type III and D-galactose only slightly decreased the ETA-gold binding . Preincubation of living lymphocytes with the mitogens concanavalin A or the Lens culinaris-lectin enhanced the binding of ETA-gold. J Dairy Sci, 1988 Jan, 71(1), 261 - 5 Determination of teat dip germicidal activity using the excised teat model; Watts JL et al.; Fifteen postmilking teat antiseptics were evaluated in seven trials using the excised teat model . All products were tested against Staphylococcus aureus Newbould 305 and Streptococcus agalactiae Cornell 48 . Eight of nine iodophor products provided log reductions greater than 3 against Staph . aureus and Strep . agalactiae . A .045% iodophor product was ineffective . A .5% chlorhexidine product yielded a log reduction of 3.22 against Staph . aureus but only 2.92 against Strep . agalactiae . Two products containing fermented milk emulsified in detergent were tested upon receipt and after 1 yr storage . Fresh product provided log reductions greater than 3 against both pathogens . Storage for 1 yr resulted in minimal loss of germicidal activity . Three products containing 1, .5, and .2% dodecylaminoalkyl glycine provided log reductions greater than 3.5 against Staph . aureus and greater than 4 log reduction against Strep . agalactiae. Oncology, 1988, 45(3), 224 - 9 Effects of PSK on resistance to bacterial infection in splenectomized mice; Ando T et al.; Nontumor-bearing C3H/He mice were splenectomized and intravenously inoculated 7 days later with Streptococcus pneumoniae, Pseudomonas aeruginosa, or Escherichia coli . The survival rate was reduced by splenectomy in the animals inoculated with S . pneumoniae, but did not change in those inoculated with P . aeruginosa or E . coli . When splenectomy was performed 2 days after transplantation of X5563, and bacteria were inoculated 7 days after the operation, the survival rate was reduced even in those inoculated with P . aeruginosa or E . coli, and elimination of the bacteria from the blood and liver was delayed . This reduction in resistance to infection was alleviated by oral administration of PSK after the splenectomy. Br J Cancer, 1988 Jan, 57(1), 70 - 3 Antitumour effects of streptococcal lipoteichoic acids on Meth A fibrosarcoma; Usami H et al.; The antitumour effects of lipoteichoic acids (LTA) extracted from Streptococcus pyogenes were studied in comparison with other streptococcal cellular components . LTA suppressed the tumour growth of both solid- and ascites-type Meth A fibrosarcoma as did the whole cells of S . pyogenes (OK-432) . No other cellular components, such as cell wall peptidoglycan, group-specific C-carbohydrate or type-specific M protein, suppressed the growth of Meth A . LTA, but not the other cellular components, induced tumour necrosis factor (TNF) in Propionibacterium acnes-primed mice . LTA had no direct killing effects on Meth A cells . These results indicate that LTA may be an important antitumour component of OK-432 and that one of the antitumour mechanisms by this streptococcal preparation is the induction of TNF. Rev Infect Dis, 1988 Jan-Feb, 10 Suppl 1, S212 - 7 Quinolones in the treatment of bronchopulmonary infections; Thys JP; The role of the new fluoroquinolones in the treatment of lower respiratory tract infections is still difficult to assess . These compounds can be successfully used in the treatment of acute exacerbations of chronic bronchitis but do not seem superior to older drugs; moreover, bacteriologic persistence and even treatment failures in infections due to Streptococcus pneumoniae can be a problem . Because of the poor activity of fluoroquinolones against S . pneumoniae, these compounds do not appear to be the first choice in the empiric treatment of community-acquired pneumonia . Ciprofloxacin is apparently valuable for the treatment of pseudomonas infections in patients with cystic fibrosis: clinical results seem comparable to those obtained with conventional intravenous treatments . More clinical experience is needed to compare the role of fluoroquinolones with that of beta-lactam and aminoglycoside antibiotics in the treatment of nosocomial gram-negative pneumonia. Appl Environ Microbiol, 1988 Jan, 54(1), 239 - 44 Deletion analysis of the proteinase gene of Streptococcus cremoris Wg2; Kok J et al.; The Streptococcus cremoris Wg2 proteinase gene, cloned in S . lactis, specified a proteinase which exhibited the same specificity toward casein as did the proteinase isolated from the original host . Although the cloned gene lacked the last 130 codons, the proteinase still specifically degraded beta-casein . Deletion of the C-terminal 343 amino acids from the proteinase did not influence this specificity . Cell-free transcription-translation studies of plasmids carrying deletion derivatives of the proteinase gene showed that the 100-kilodalton C-terminally truncated proteinase still exhibited proteolytic activity . Crossed immunoelectrophoresis revealed that proteins A and B identified in the proteolytic system of S . cremoris Wg2 are both encoded by the proteinase gene . A working model based on integration of available genetic, immunological, and biochemical data is presented to explain this result. Appl Environ Microbiol, 1988 Jan, 54(1), 231 - 8 Nucleotide sequence of the cell wall proteinase gene of Streptococcus cremoris Wg2; Kok J et al.; A 6.5-kilobase HindIII fragment that specifies the proteolytic activity of Streptococcus cremoris Wg2 was sequenced entirely . The nucleotide sequence revealed two open reading frames (ORFs), a small ORF1 with 295 codons and a large ORF2 containing 1,772 codons . For both ORFs, there was no stop codon on the HindIII fragment . A partially overlapping PstI fragment was used to locate the translation stop of the large ORF2 . The entire ORF2 contained 1,902 coding triplets, followed by an apparently rho-independent terminator sequence . The inferred amino acid sequence would result in a protein of 200 kilodaltons . Both ORFs have their putative transcription and translation signals in a 345-base-pair ClaI fragment . ORF2 is preceded by a promoter region containing a 15-base-pair complementary direct repeat . Both the truncated 33- and the 200-kilodalton proteins have a signal peptide-like N-terminal amino acid sequence . The protein specified by ORF2 contained regions of extensive homology with serine proteases of the subtilisin family . Specifically, amino acid sequences involved in the formation of the active site (viz., Asp-32, His-64, and Ser-221 of the subtilisins) are well conserved in the S . cremoris Wg2 proteinase . The homologous sequences are separated by nonhomologous regions which contain several inserts, most notably a sequence of approximately 200 amino acids between the His and Ser residues of the active site. JPEN J Parenter Enteral Nutr, 1988 Jan-Feb, 12(1), 58 - 9 Management of catheter-related infections in pediatric patients; Nahata MC et al.; Broviac catheters are commonly used to provide parenteral nutrition and access for infusion of blood products and drugs to pediatric patients . Sepsis is the most common serious complication of continued catheter use . Although removal of the catheter is generally recommended when it becomes contaminated, it may not be feasible to do so without compromising patient care . We evaluated the management of catheter-related infections in pediatric patients with and without removal of catheter . Seventy-seven episodes of catheter sepsis were evaluated in 61 pediatric patients; 24 were neonates and 37 were older children . The catheters were used for multiple purposes in 75% of cases . The most common microorganisms isolated were Staphylococcus epidermidis in 26%, Klebsiella pneumoniae in 9%, and Streptococcus viridans in 8% of cases; other pathogens included group D Enterococcus, Staphylococcus aureus, and Escherichia coli . Pseudomonas aeruginosa was isolated in four older children . Thirty-five patients were treated with antibiotics without catheter removal . Thirty patients received appropriate antibiotic therapy based on the susceptibility data . Twenty-six of these 30 patients responded within 5 days of therapy whereas the others required 15-39 days of treatment . Lack of response was mainly associated with the presence of abscess, immunocompromised status, and organisms P . aeruginosa and Candida albicans . Based on the sensitivity and minimum inhibitory concentration data, a combined regimen of gentamicin and vancomycin would be an effective initial therapy . These findings suggest that (1) catheter sepsis can be managed with appropriate antibiotics, and (2) when continued use of Broviac catheter is desired, a trial of antibiotic therapy should be attempted before catheter removal. Pediatr Res, 1988 Jan, 23(1), 31 - 4 Functional activity of class-specific antibodies to type III, group B streptococcus; Campbell JR et al.; The functional activity of naturally acquired IgG and IgM with specificity for the capsular polysaccharide of type III, group B Streptococcus (III-GBS) was compared . Sera collected during convalescence from 14 infants who had developed specific antibodies following III-GBS infection were employed for separation of IgG from IgM by ion-exchange chromatography . Bactericidal killing of III-GBS was similar for IgG- and IgM-rich samples (37 and 42%, respectively) in reactions containing a mean of 1.0 or 1.9 micrograms/ml of III-GBS specific IgG or IgM antibody . Purified IgA lacked opsonophagocytic activity for III-GBS . These results indicate that III-GBS-specific IgG and IgM antibodies in infant sera promote opsonophagocytosis at low concentrations, and that their functional capacity is comparable. Am J Med Sci, 1988 Jan, 295(1), 52 - 4 Bacteremia and ecthyma caused by Streptococcus pyogenes in a patient with acquired immunodeficiency syndrome; Hewitt WD et al.; Ecthyma is an ulcerated form of impetigo due to Streptococcus pyogenes, seen primarily in children with poor hygiene . The authors report a homosexual man with acquired immunodeficiency syndrome (AIDS) who developed severe ecthyma and bacteremia caused by S . pyogenes . Opsonizing antibody to the M protein of S . pyogenes is important in immunity to this organism . Patients with AIDS may have defective humoral immunity as well as defective cellular immunity, and such a defect may have rendered this patient abnormally susceptible to severe infection with S . pyogenes. J Infect Dis, 1988 Jan, 157(1), 91 - 100 Lung antibacterial defense mechanisms in infant and adult rats: implications for the pathogenesis of group B streptococcal infections in the neonatal lung; Martin TR et al.; We investigated factors that may contribute to lung infections in infants by studying the intrapulmonary responses to aerosols of three different types of organisms--group B streptococcus with and without type-specific capsule, Pseudomonas aeruginosa, and Staphylococcus aureus--in infant (12-h-old or 24-36-h-old) and adult (150 g, 6-w-old) rats . After aerosol exposure, the lung clearance rate of each organism varied inversely with the age of the animals, and the magnitude of the clearance defect was related more strongly to animal age than to the bacterial species . Fewer alveolar macrophages from infant animals phagocytosed each type of organism in vivo, and the rate of neutrophil accumulation in the lungs of infant animals was delayed . The neonatal lung functioned effectively, however, as an antibacterial barrier, as newborn animals survived an aerosolized inoculum that exceeded the LD50 by the subcutaneous route. Clin Ther, 1988, 10(2), 178 - 82 Once-daily cefadroxil versus oral penicillin in the pediatric treatment of streptococcal pharyngitis; Goldfarb J et al.; Thirty-two patients with pharyngitis were randomly assigned to receive either 30 mg/kg of cefadroxil every 24 hours orally or 15 mg/kg of penicillin V potassium every eight hours orally for ten days . Sera for antistreptolysin-O, streptozyme, and anti-DNAase were compared before and after treatment . Twenty patients finished the study and had a confirmed throat culture for the group A streptococcus and at least one fourfold antibody rise . Of these 20 patients, seven of eight in the penicillin group and all 12 in the cefadroxil group were cured at the end of therapy . One patient in the penicillin group had a positive culture at the end of therapy; one patient in each group was recolonized at follow-up culture 10 to 20 days after ending therapy . Seven other patients who finished the study had a positive throat culture but no antibody response and were presumed carriers; these included five in the penicillin and two in the cefadroxil group . One of these presumed carriers had a persistent infection and relapsed two days after the end of therapy . Both therapies appeared to be equally successful and no serious side effects occurred. Laryngoscope, 1988 Jan, 98(1), 93 - 8 The immunology of tonsils in children: the effect of bacterial load on the presence of B- and T-cell subsets; Brodsky L et al.; Tonsil core specimens of 54 children, (3 to 12 years) with clinical evidence of chronic tonsillitis and/or "idiopathic" tonsillar hypertrophy, were studied for the effect of the magnitude of aerobic bacterial load on tonsil size and the absolute numbers of B- and T-cell subsets . Tonsillar core specimens obtained from ten children with no history of ear, nose, or throat infections and normal appearing tonsils served as controls . The findings of this study indicate that tonsil size was directly proportional to the mean bacterial load in colony forming units/g tonsil (CFU/g) even in the absence of a clinical history of infection (p less than 0.01) . A mean bacterial load of 2.4 +/- 2.1 X 10(5) CFU/g tonsil was seen in diseased tonsils as compared to 1.6 +/- 2.4 X 10(4) CFU/g tonsil in normal controls (p less than 0.01) . Hemophilus influenzae (type B and non-B), Staphylococcus aureus, Streptococcus pneumoniae and Streptococcus pyogenes were the most common pathogens recovered in the largest numbers from diseased tonsils; control tonsils harbored few bacteria in their cores . The absolute number of immunocompetent cells/g tonsil including T-helper, T-suppressor and B-cells (S-Ig+), were significantly greater in diseased tonsils than in controls (p less than 0.001) . Increasing microbial load (CFU/g tonsil) correlated with increased numbers of T-helper (p less than 0.01) and B-cells (p less than 0.01) . These data strongly support a bacterial etiology for chronic tonsillitis as well as "idiopathic" tonsillar hypertrophy . Bacterial induced proliferation of immunocompetent cells may be one underlying mechanism for chronic tonsillar disease in children. Trans R Soc Trop Med Hyg, 1988, 82(6), 911 - 3 Nasal and hand carriage of Streptococcus pneumoniae in children and mothers in the Tari Basin of Papua New Guinea; Pickering H et al.; Nasal and hand carriage of Streptococcus pneumoniae was looked at in 55 families . Overall nasal carriage was 61% (83% in children and 33% in mothers) . Hand carriage was 14% . Just over half of the mothers who carried pneumococcus were concordant with their infants. Arch Oral Biol, 1988, 33(6), 395 - 401 Interaction between wild-type, mutant and revertant forms of the bacterium Streptococcus sanguis and the bacterium Actinobacillus actinomycetemcomitans in vitro and in the gnotobiotic rat; Hillman JD et al.; In vitro, Streptococcus sanguis inhibits the growth of Actinobacillus actinomycetemcomitans, a presumed aetiological agent of localized juvenile periodontitis . When provided with glucose and good aeration, a growing culture of Strep . sanguis was found to produce hydrogen peroxide at concentrations in excess of the maximum LD50 reported for strains of A . actinomycetemcomitans . This concentration of hydrogen peroxide also inhibits the growth of the producer organism . A mutant of Strep . sanguis was isolated that lacked the ability to produce alpha-haemolysis on blood agar . This mutant had less than 3 per cent of its parent's level of pyruvate-oxidase activity, and made no detectable hydrogen peroxide . In vitro, the mutant had also lost the ability to inhibit the growth of A . actinomycetemcomitans . A spontaneous revertant, isolated by its ability to produce alpha-haemolysis, was found to have regained parental levels of pyruvate-oxidase activity and hydrogen-peroxide production and could inhibit the growth of A . actinomycetemcomitans in vitro . A gnotobiotic rat model was used to demonstrate that Strep . sanguis and A . actinomycetemcomitans interact in vivo and that this interaction depends on hydrogen-peroxide production by Strep . sanguis. Acta Otolaryngol Suppl, 1988, 454, 163 - 6 Role of attachment for the virulence of Streptococcus pneumoniae; Andersson B et al.; Adherence of microorganisms to mucosal surfaces is a general phenomenon among microorganisms infecting the human host . Its role for persistence and colonization as well as production of local inflammation is well established . This paper describes the adhesion of Streptococcus pneumoniae to human epithelial cells . Strains from various anatomical sites or diseases are compared for attaching capacity . Isolates from the same host but at different times are also compared . The molecular mechanisms, the so-called adhesin-receptor interactions, are partially described . The pneumococcus recognizes a sugar sequence; GlcNAc beta 1-3Gal; on the surface of the host epithelial cell . Glycoconjugates containing this disaccharide act as receptors for adhering pneumococci . The adhesin in pneumococcal attachment is less well characterized . It is a heat and trypsin sensitive component, most likely a peptide, which forms a bridge between the receptor and an anchoring site in the pneumococcal cell wall . Receptor active saccharides are part of the adhesion-inhibitory activity found in human milk. Caries Res, 1988, 22(6), 342 - 7 Monobacterial and mixed bacterial plaques of Streptococcus mutans and Veillonella alcalescens in an artificial mouth: development, metabolism, and effect on human dental enamel; Noorda WD et al.; To gain greater understanding of the role of Streptococcus mutans and Veillonella in the caries process, studies of both aerobically and anaerobically grown plaques of S . mutans C67-1 and V . alcalescens V-1 on human enamel slabs were carried out in an artificial mouth . Plaque development, acid production, and demineralization were measured . Early plaque development of monobacterial and mixed bacterial plaques started from randomly adhering cells on day 1 to confluent multilayered microcolonies on day 4 . Differences were observed in viable cell counts, total cell mass, and in acid production . In most cases CFU, DNA and acid production were higher in the mixed bacterial plaque, especially in the anaerobic mixed plaque . Lactic acid was the predominant acid in all cases following the supply of sucrose to the plaque . No decisive role could be found for acetic, formic, and propionic acid . No inhibition of demineralization was observed in the enamel slabs inoculated with both aerobic and anaerobic mixed plaques . Demineralization ranged from the more classical picture of lesion development in the aerobic monobacterial plaque-treated samples to an aggressive etching of the enamel surface in the anaerobically mixed treated slabs. Caries Res, 1988, 22(6), 327 - 36 Suitability of human, bovine, equine, and ovine tooth enamel for studies of artificial bacterial carious lesions; Edmunds DH et al.; The progress of artificial caries-like lesions created in human, bovine, equine, and ovine enamel has been studied . Lesions were produced by exposure to an acid gel system or by 5-day exposure to a sequential batch culture technique using Streptococcus mutans NCTC 10832 . Longitudinal ground sections were prepared . The lesions were of similar appearance in all species when examined in polarized light . The depth in human enamel was approximately half that in the animal species . Microradiography confirmed subsurface demineralization in all four species . Similar depth ratios were seen in the scanning electron microscope, but there were structural differences between lesions in human and animal teeth . Lesions in bovine teeth were more like those in human, but lesions in equine and ovine teeth were markedly different . Substitution of these animal enamels for human enamel in caries experiments demands that these differences be taken into account . Scanning electron microscopy is capable of resolving features in artificial caries lesions which cannot be differentiated by polarized light techniques . The latter will demonstrate generalized mineral loss, but scanning electron microscopy is required to characterize the sites of mineral loss. Microbiol Immunol, 1988, 32(8), 785 - 94 Maternal transmission and dental caries induction in Sprague-Dawley rats infected with Streptococcus mutans; Ooshima T et al.; Thirty-four female rats (18 days old) were infected with Streptococcus mutans MT8148R (serotype c) or 6715 (g) . Diets containing different proportions of sucrose were used to prepare the dams which harbored various levels of S . mutans in their oral cavity . Around 66 days of age, the female rats were bred and 34 dams subsequently bore 322 offspring . The dams were killed upon weaning (20 days of age) of their respective litters . There were positive correlations between the recovery of inoculated S . mutans and the caries incidence in the dams . Transmission of S . mutans from a dam to her offspring was studied in 10-, 15-, 20-, 27-, 34-, 41-, 48-, and 55-day-old rats by evaluating the recover of S . mutans from the offspring . Positive correlation between the magnitudes of recovered S . mutans MT8148R from dams and their offspring was found in all ages of young rats examined . Furthermore, caries incidence in young rats was found to be positively correlated with the recovery of both strains of S . mutans as well as with incidence of caries in their respective dams. Arch Oral Biol, 1988, 33(1), 33 - 9 Antibodies to the oral bacterium Streptococcus mutans and the development of caries in children in relation to maternal dental treatment during pregnancy; Aaltonen AS et al.; These factors were studied in 50 children, aged 3.6 to 5.9 years . Children of mothers who had no dental treatment during pregnancy (NTP-group, n = 25) had significantly (p less than 0.02) more serum IgG antibodies reactive with Strep . mutans than those of mothers who received such treatment (TP-group, n = 25) . The children in the NTP-group had fewer Strep . mutans, a higher proportion of intact dentitions, lower dmfs/DS-index and lower caries incidence than those in the TP-group . Over one year of follow-up, a significantly greater proportion of children in the TP- than in the NTP-group developed new caries (p less than 0.05) . Thus, maternal dental treatment during pregnancy may affect caries development in the primary dentition of the child, possibly via transplacental immune mechanisms. Caries Res, 1988, 22(5), 283 - 7 Ultrastructure, growth, and adherence of Streptococcus mutans after treatment with chlorhexidine and fluoride; Meurman JH; Ultrastructure, growth, and adherence to hydroxyapatite of Streptococcus mutans ATCC 27351 was studied after treating bacterial suspensions for 1 h with 0.1% chlorhexidine gluconate (CHX), 0.1% sodium fluoride (F), or a combination of these two (CHX + F) . Cells treated with 0.1 M phosphate-buffered saline were used as controls . Electron microscopy revealed that the treatment with CHX or CHX + F caused disruption of streptococcal cells with vacuolization and sloughing and leakage of cytoplasmic constituents . The F-treated specimens appeared the same as the controls, where the ultrastructure was mostly normal . In the adherence assay, radiolabelled bacteria attached themselves in 77.9% to hydroxyapatite in the control series . Treatment with F reduced the adsorption to 63.7%, and treatment with CHX and CHX + F to 57.4 and 43.4%, respectively . The reduction in CHX and CHX + F series when compared with the controls was statistically highly significant . The synergistic effect of CHX and F was further verified in minimum inhibitory concentration titrations where total inhibition was observed at 0.5% F and 0.1% CHX, respectively, while CHX + F inhibited growth at 0.05% . Thus, F does not interfere with the toxic effect of CHX on S . mutans cells, but, on the contrary, the two chemicals seem to exert a synergistic mode of action. APMIS Suppl, 1988, 3, 104 - 6 The nature of ulcerative keratitis in Kuwait (clinical and microbiological study); Ammous MW et al.; A retrospective clinico-microbiological study of 83 patients with corneal ulcers due to bacterial infection was performed . Positive cultures of corneal ulcer samples were obtained from 57% of all patients . A high incidence of Staphylococcus epidermidis was isolated from ulcer patients; Pseudomonas, Streptococcus and Streptococcus pneumonia were the next most frequent pathogens . Of some help in identifying the causative organism were the locations of the ulcers, the presence or absence of hypopyon and the frequency of perforation . Gentamycin, cephaloridine and polymyxin were found to be the most effective therapies . Gram stains of ulcer samples were positive for organisms in only 11% of patients and accordingly were not considered useful in determining the appropriate initial therapy of ulcers . It was concluded that treatment should be started with a broad combination of antibiotics while awaiting the culture results. Geogr Med, 1988, 18, 157 - 69 Antibiotic spectrum of isolated germs in the vaginal smear of Nigerian women; Ecker-Eckhofen C et al.; The bacteriological research of 534 vaginal smears of pregnant women and patients of the gynaecological ward in Abeokuta showed in 21.6% beta-hem . Streptococcus group D, in 10.9% Staphylococcus epidermidis, in 5.3% Escherichia coli, in 3.6% Staphylococcus aureus, in 1.3% beta-hem.Streptococcus group B and in 7.8% yeasts . 48% of all smears remained sterile . The antibiotics with the least effect were Tetracyclines and Penicillines . Trimethoprim and Sulfonamid, Ticarcillin and Netilmycin were able to prevent the bacterial growth by at least 89% . Isolated germs of private patients showed higher resistance against Tetracycline and Chloramphenicol than those of non-private patients. Caries Res, 1988, 22(4), 232 - 6 Effect of fluoridated sucrose on rat caries; Mundorff SA et al.; The present study was designed to test the effect of frequent pulses of low fluoride levels on rat caries when supplied in a standardized cariogenic rat diet containing 67% sucrose (MIT-200) . The test diets were variants of Diet MIT-200 in which the sucrose component had been fluoridated with NaF solution resulting in total concentrations of 0 (control), 2, 3, 5, 10, or 20 ppm fluoride in the final diets . Rats received one of the test lots 17 times daily in a programmed feeding machine beginning at age 22 days, and were inoculated with Streptococcus mutans at age 23, 24, and 25 days . After 5 weeks, the rats were sacrificed and their mandibular molars scored for number and severity of sulcal, buccolingual, and proximal caries . Frequent daily pulses of as little as 2 ppm fluoride in dietary sucrose were effective in significantly (p less than 0.01) reducing buccolingual rat caries. Caries Res, 1988, 22(4), 204 - 9 Demineralization potential of different concentrations of gelatinized wheat starch; Brudevold F et al.; Six subjects wore intraoral devices carrying bovine enamel blocks covered with a layer of Streptococcus mutans . They swished solutions of 5% glucose or maltose, or sols or gels of 3, 5, 10, 15, or 20% gelatinized wheat starch in the mouth for 3 X 1 min . Demineralization was measured after 45 min by determining the change in iodide permeability (delta Ip) of the enamel . Spittings of the administered materials and samples of saliva, taken at intervals during the test, were analyzed for maltose, and the time of clearance was calculated . Demineralization was greatest for glucose followed by maltose, the starch gels, and the sols . The latter gave close to zero scores . The salivary clearance time increased with increase in concentration of the starch . Although the starch was hydrolyzed rapidly in the mouth, its oral retentiveness was greater than that of the maltose rinse . Demineralization was closely correlated with the final pH of the S . mutans cell layer . The data indicate that the starch in baked or cooked foods may have a significant demineralization potential and that it enhances oral retentiveness. Caries Res, 1988, 22(4), 193 - 8 Increased permeability of enamel to iodide ions following the ingestion of cookies varying in sucrose or fat content; Kashket S et al.; Experiments showed that the intraoral iodide permeability (Ip) method can be used in a reproducible and sensitive manner with solid foods . Ingestion of 5-gram portions of cookies made with defined concentrations of sucrose or fat led to an increased Ip (due to demineralization) of Streptococcus mutans-covered bovine enamel blocks in vivo . Demineralization increased with time to a maximum of 45 min, and the pH of the plaque dropped accordingly . Continued exposure in the mouth beyond 45 min led to an elevation of the pH and a decrease in delta Ip consistent with remineralization of the enamel . Control blocks worn without ingestion of cookies exhibited negative delta Ip values . Demineralization increased with increasing sucrose content of the cookies and reached a plateau when cookies containing 1.08 g sucrose per morsel were administered . Cookies prepared without added sucrose gave a high delta Ip . High fat content raised the delta Ip when sucrose was low . These findings are consistent with clinical and other observations, and emphasize the complex relation between foods and enamel demineralization. Caries Res, 1988, 22(3), 187 - 92 Effect of professional flossing with chlorhexidine gel on approximal caries in 12- to 15-year-old schoolchildren; Gisselsson H et al.; The aim of the investigation was to evaluate the effect of chlorhexidine gel treatment on caries development of approximal tooth surfaces and on salivary counts of Streptococcus mutans . 220 12-year-old schoolchildren, divided into three groups, participated: (1) chlorhexidine gel group (n = 72), (2) placebo gel group (n = 77), and (3) control group (n = 71) . The study was carried out double blind with respect to the two gel groups . Group 1 was treated 4 times/year with 1% chlorhexidine gel and group 2 with a placebo gel . Approximately 1 ml of gel was applied interdentally by means of a flat dental floss . The control group did not receive any gel treatment or flossing . Number of S . mutans in the saliva was estimated on five occasions during the study with the spatula method . After 3 years, the mean approximal caries increment, expressed as new DFS, was 2.50 in the chlorhexidine gel group and 4.30 in the placebo gel group (p less than 0.05) . The corresponding figure in the control group was 5.25 (p less than 0.001 when compared to group 1) . 44% of the children in the chlorhexidine gel group and 32% in the placebo gel group did not develop any new approximal caries lesion during the 3-year observation period compared to 18% in the control group (group 1-3 p less than 0.001; group 2-3 p less than 0.05) . The number of new approximal fillings (FS) was 0.24 in the chlorhexidine gel group, 0.75 in the placebo gel group and 0.82 in the control group (group 1-3 p less than 0.01; group 2-3 p less than 0.05) . There was no statistically significant difference between the groups with respect to numbers of S . mutans in saliva . However, there were more individuals with low numbers of S . mutans in the chlorhexidine gel group at the final examination compared to the baseline level (p less than 0.05). Caries Res, 1988, 22(3), 177 - 80 Sulcal plaque pH and remineralization of sulcal caries in rats exposed to dietary and water fluoride; Firestone AR et al.; After being inoculated with Streptococcus (mutans) sobrinus 6715 and fed a mildly caries-promoting diet for 14 days, sulcal plaque pH response to topical application of a 10% sucrose solution was measured in two groups of rats . The first group (experimental) was then fed diet and drinking water to which 1 mmol (20 ppm) fluoride had been added (0.5 mmol for 7 days and 1 mmol for 14 days) and pH measurements were repeated . The second group was held as a control and a third group was sacrificed to provide baseline caries scores . There was no difference in the fall in pH after topical application of 10% sucrose solution between the control and experimental group, nor between the pre- and postfluoride measurements for the experimental group . Sulcal caries incidence in the experimental group was significantly lower than in the control group . The results of this experiment emphasize the importance of a cariostatic mechanism of action for fluoride based on remineralization of enamel lesions and do not support the in vivo adaptation to fluoride by oral microorganisms. Caries Res, 1988, 22(3), 166 - 73 Influence of xylitol on growth, establishment, and cariogenicity of Streptococcus mutans in dental plaque of rats; Beckers HJ; The influence of xylitol on glucose metabolism of Streptococcus mutans C67-1S was studied in vitro and in rats in vivo . In vitro there was an inhibition by xylitol of the growth rate and acid production of S . mutans C67-1S, but in vivo no effect on the initial growth rate could be demonstrated . In vivo there was a delay in the start of growth of S . mutans which resulted in a 10-day delay of establishment . The isolated xylitol-resistant mutant of C67-1S, S . mutans C67-1S XR, showed no difference in glucose metabolism in batch cultures . S . mutans C67-1S and S . mutans C67-1S XR were both used to study caries development in SPF Osborne Mendel rats . The rats were housed under programmed feeding conditions and were fed a glucose or a glucose-xylitol diet . In the case of S . mutans C67-1S, there was a remarkable inhibition of fissure caries lesions in the presence of xylitol compared to the glucose group . But also in the S . mutans C67-1S XR groups there were fewer lesions in the presence of xylitol . These results indicated that the anticariogenic properties of xylitol do not only depend on an inhibition of bacterial metabolism, but in part on other mechanisms. Nahrung, 1988, 32(6), 539 - 43 Proteolysis and electrophoretic pattern of casein of some fermented milks; Hegazi FZ; Proteolysis and electrophoretic pattern of casein were determined in Friesian cows' skim milk, buffaloes' skim milk and in these milks fermented spontaneously (leben rayeb) and by Streptococcus lactis subsp . diacetylactis DRC3 (nonfat buttermilk) or by zabadi starter (zabadi) . The highest proteolysis, as evidenced by the amount of released leucine, occurred in zabadi and the lowest in leben rayeb . The highest amount of tyrosine was liberated in the nonfat buttermilk . Proteolysis seems not to depend on the kind of milk used . A band of a relatively high density appeared to be released from alpha s-casein by the cell-wall proteinase of the microflora of raw milk and by heating at 90 degrees C for 1 min . Cows' skim milk, raw or heated, showed the presence of 2 probable proteose-peptone components; buffaloes' skim milk 3 and 2 . These components underwent slow or rapid degradation, depending on the type of fermented milk during skim milk coagulation. Microb Pathog, 1988 Jan, 4(1), 33 - 43 Purification and immunological characterization of neuraminidase produced by Streptococcus pneumoniae; Lock RA et al.; Previous workers have suggested that Streptococcus pneumoniae, the pneumococcus, produces multiple forms of the enzyme neuraminidase . By serial chromatography on DEAE-cellulose, Sephacryl S-200, Amicon Red-A gel and hydroxylapatite we have purified to electrophoretic homogeneity a pneumococcal neuraminidase with an apparent molecular weight of 86,000 (as determined by sodium dodecyl sulphate polyacrylamide gel electrophoresis) . Mouse antiserum raised against the purified material reacted with a single species with molecular weight 107,000 (107K form) in crude pneumococcal cell lysate . During the purification procedure this species was progressively degraded to the molecular weight 86,000 (86K) form whilst retaining enzyme activity . Degradation of neuraminidase was inhibited by phenylmethylsulphonylfluoride (PMSF) and ethylenediaminetetraacetic acid (EDTA) . Purification of the enzyme in the presence of these protease inhibitors permitted the isolation of the 107K species substantially undegraded and greater than 98% pure . Our findings on the degradation of neuraminidase during its purification account for previous reports of multiple neuraminidase isoenzymes in Streptococcus pneumoniae. J Basic Microbiol, 1988, 28(1-2), 55 - 61 Expression of the human interferon-alpha 1 gene under transcriptional and translational control of the speA gene; Laplace F et al.; The human gene for mature interferon-alpha 1 (IFN-alpha 1) was inserted in a new transcription-translation fusion vector system based on the expression and secretion signals of the gene for type A streptococcal pyrogenic exotoxin, speA . As deduced from the known nucleotide sequences of the component elements, the encoded IFN-alpha 1 was a fusion protein carrying an N-terminal extension of 17 amino acids . When inserted in appropriate vectors capable of replication in Escherichia coli, Bacillus subtilis and Streptococcus sanguis, this expression configuration directed the synthesis of antiviral activity in all 3 organisms, as judged by the cythopathic effect inhibition assay of Vesicular Stomatitis Virus . In E . coli JM101, IFN activity was found mainly in the cytoplasmic protein fraction whereas in the gram-positive hosts, it was completely secreted into the culture medium. Drugs, 1988, 35 Suppl 2, 163 - 8 Impact of cefotaxime and ceftriaxone on the bowel and vaginal flora after single-dose prophylaxis in vaginal hysterectomy; Brautigam HH et al.; The aim of this randomised controlled study was to investigate the effect of a preoperative, single dose, intravenous injection of ceftriaxone 2g and cefotaxime 2g in 2 groups of 30 patients who underwent vaginal hysterectomy . The parameters were: efficacy and tolerance; impact on the aerobic bowel and vaginal flora; and serum concentrations . There were no significant differences in efficacy, haematology or clinical chemistry parameters . In the ceftriaxone group 2 patients had exanthemas, 2 had diarrhoea . In the cefotaxime group no such side effects occurred . Serum concentrations were 9.75 and 0.07 mg/L for ceftriaxone and cefotaxime, respectively, after 24 and 12 hours, respectively . Ceftriaxone had a pronounced and continuous effect on the bowel flora: Streptococcus faecium and Candida spp . increased, reaching counts of 10(8) and 10(7) organisms/g faeces, respectively, at day 10 . Under cefotaxime no dramatic alteration was determined and growth of Candida spp . was not influenced . Growth of Escherichia coli and other bacteria of the vaginal flora was not influenced by either drug . Overgrowth of Candida spp . under ceftriaxone was significant (p less than 0.05) compared with that under cefotaxime . The results of this study indicate that the high biliary excretion of ceftriaxone (45%) and its long acting properties are responsible for the high selection pressure and overgrowth of Candida . Cefotaxime, a drug with low biliary excretion (5%) and shorter action, had only a negligible effect on the microflora with quick normalisation . The observed overgrowth of Candida spp., even after a single injection of ceftriaxone, could cause problems when this drug is being used for surgical prophylaxis or treatment . This applies especially to immunocompromised patients. Eur J Clin Pharmacol, 1988, 34(2), 201 - 5 N-acetylcysteine added to saliva does not affect IgA concentration or the agglutination of