J Med Microbiol, 1983 Nov, 16(4), 409 - 15 Inhibitor production by group-G streptococci of human and of animal origin; Tagg JR et al.; Strains of group-G streptococci were tested by a "fingerprinting" method for the production of (P typing) and sensitivity to (S typing) inhibitory agents, and were biotyped . In the standard P-typing test, 28 of 50 strains of human origin, but none of 30 strains of animal origin, showed inhibitory activity . Of the human strains, 12 formed a bacteriocin that was active on group-A streptococci, including three (strains I2, I5 and I8) of the four streptococci of this group among the indicator strains . Sixteen other human strains inhibited the fourth group-A indicator (strain I7), and to a lesser extent strain I2, by lowering the pH of the typing medium . This acid-mediated inhibition was eliminated by testing on a medium containing calcium carbonate 0.5%; the 16 strains were then completely non-inhibitory, and the bacteriocin-forming strains, the typing pattern of which had originally been I2, I5, I7, I8, showed only inhibition attributable to the action of the bacteriocin . Nearly all group-A streptococci were sensitive to the group-G bacteriocin . The indicator strain I7 and several other members of M-type 28 were exceptions, but their resistance was not associated with the presence of R-antigen 28 . Fifteen inhibitor-sensitivity patterns and 12 biotypes were identified among the strains; some of these tended to be associated with either a human or an animal origin . Neither S type nor biotype appeared to correlate with inhibitor production. J Clin Microbiol, 1983 Nov, 18(5), 1138 - 40 Use of the Rapid STREP system for identification of viridans streptococcal species; Ruoff KL et al.; A commercially available streptococcal identification system, Rapid STREP (API System S.A., Montalieu-Vercieu, France), was used to identify 119 viridans strains at the species level . A total of 92% of the strains tested were identified correctly with the Rapid STREP system, and 81% of the correct identifications were made at percentages of identification of 90 or greater . From these data it appears that the Rapid STREP system is a fairly accurate and rapid (24-h incubation) method for identifying species of viridans streptococci. Am Fam Physician, 1983 Nov, 28(5), 169 - 71 Pyogenic liver abscess; Alberti-Flor JJ et al.; The primary source of pyogenic liver abscess is undetermined in about 30 percent of cases . Escherichia coli, microaerophilic streptococci and Bacteroides fragilis are among the common pathogens . Some cases can be treated with antibiotics alone; others require surgical management . With improved methods of diagnosis and therapy, the mortality rate is now 10 percent or less. Antimicrob Agents Chemother, 1983 Nov, 24(5), 702 - 5 Multiply resistant viridans streptococci: susceptibility to beta-lactam antibiotics and comparison of penicillin-binding protein patterns; Farber BF et al.; A unique group of viridans streptococci has been found in South Africa . These organisms were isolated in close temporal and physical proximity to the isolation of penicillin-resistant pneumococci . The strains were resistant to penicillin, oxacillin, the cephalosporins (all generations), piperacillin, azlocillin, and mezlocillin but were susceptible to vancomycin . Penicillin-binding proteins of two penicillin-resistant South African strains of Streptococcus mitis differed markedly from those of two penicillin-susceptible strains but were identical to those seen in a penicillin-resistant strain isolated in Boston . Although both susceptible strains were identified as S . mitis with identical biochemical profiles, their penicillin-binding protein patterns differed from each other . This finding may have significance with regard to the need for additional taxonomic classification of the viridans streptococci. J Dent Res, 1983 Nov, 62(11), 1179 - 81 Use of bacteriophage-resistant mutants to study Actinomyces viscosus cell surface receptors; Tylenda CA et al.; Spontaneously occurring bacteriophage-resistant mutants of Actinomyces viscosus were isolated . The mutants exhibited altered coaggregation patterns with streptococci . From analysis of the data, it appears that a cell surface structure on A . viscosus may function both as a phage receptor and as a binding site for co-aggregation with certain oral streptococci . These mutants will be valuable in the study of surface structures that mediate one type of the cell-to-cell interactions that occur between these two important groups of oral bacteria. Heart Lung, 1983 Nov, 12(6), 656 - 60 Necrotizing fasciitis; Hamelink MC; Necrotizing fasciitis has long been recognized as an acute life-threatening infection requiring aggressive treatment . It generally occurs after minor trauma, but often there is no history of injury . The skin in necrotizing fasciitis is pale or red with no clear line of demarcation between affected and normal skin . There is extensive undermining of the skin with a foul-smelling sanguineous exudate . The superficial fascia and the deep fascia can be easily separated and will appear stringy, ragged, and dull gray to gray-green in color . Muscle, bone, or viseral involvement is not a feature of necrotizing fasciitis . The systemic response is one of an acutely ill patient with prostration and clouding of sensorium . Anemia, low serum calcium level, and fluid volume deficits are commonly seen along with other nonspecific laboratory and clinical findings common to serious acute infections . Necrotizing fasciitis is a polymicrobial disorder and not a specific bacterial infection . Beta-hemolytic streptococci, Staphylococcus aureus, and mixed gram-negative organisms are most frequently reported as etiologic agents, with more recent reports usually demonstrating a combination of anaerobic and facultative anaerobic bacteria . The primary therapy consists of radical surgical debridement of all nonviable tissue with frequent postoperative checks to monitor for further dissection that would require additional surfical debridement . Local wound care consists of diligent cleaning and application of loose gauze soaked with a topical agent . Parenteral antibiotic therapy based upon the Gram stain and further modified on the basis of bacterial culture and sensitivity studies, is started immediately . Management also involves correction of fluid and electrolyte imbalances, correction of anemia, and general supportive care.(ABSTRACT TRUNCATED AT 250 WORDS) Infect Immun, 1983 Nov, 42(2), 531 - 8 Study of heart-reactive antibody in antisera and hybridoma culture fluids against group A streptococci; Cunningham MW et al.; Heart-reactive antibody is known to be produced in animals immunized with group A streptococci . However, the detection and quantitation of these antibodies and their respective antigens have been limited to immunofluorescence or immunoprecipitation tests . In this study a more sensitive technique was used to detect heart-reactive antibody, i.e., the enzyme-linked immunosorbent assay (ELISA) . Countercurrent immunoelectrophoresis and agar gel immunodiffusion were also used to confirm the reactivity of rabbit antisera to group A streptococci and human heart tissue . Human heart tissue antigen was prepared by Triton X-100 extraction, and checkerboard titrations of heart tissue antigen versus streptococcal antisera revealed optimal concentrations of each for the ELISA . When immune rabbit serum was reacted with heart tissue antigen, a 5- to 10-fold increase was observed over the reactions of preimmune sera controls . Streptococcal antiserum was found to have a six- to eightfold greater reactivity with heart tissue antigen than with similar concentrations of kidney and skeletal muscle antigens . Heart tissue antigen was partially purified by DEAE-cellulose chromatography, and quantities of greater than 10 to 100 ng (dry weight) were shown to react with streptococcal antisera in the ELISA . Heart, kidney, and skeletal muscle antigens were subjected to electrophoresis in polyacrylamide gel slabs and blotted onto a nitrocellulose filter . These filter blots reacted with streptococcal antisera and confirmed the tissue antigen specificity observed with the ELISA . In addition, the ELISA was found to be an effective method for the detection of heart-reactive antibodies produced by murine hybridomas that were producing antibody to group A streptococci. J Infect, 1983 Nov, 7(3), 203 - 9 Bacteraemia in streptococcal infections of the throat; Barnham M; In two patients seen recently in North Yorkshire, systemic infection with Streptococcus pyogenes appeared to originate from the upper respiratory tract; such infection is now rarely reported from the more developed countries . A study was arranged to detect bacteraemia in patients with sore throat: of 343 patients tested 93 yielded beta-haemolytic streptococci from the respiratory tract, but streptococcal bacteraemia was detected in none . These results suggest that clinically unsuspected streptococcal bacteraemia is uncommon in such patients. Isr J Med Sci, 1983 Nov, 19(11), 967 - 71 Neonatal septic arthritis; Dan M; To assess and correlate the microbiology of neonatal septic arthritis with the clinical presentation, we reviewed the records of nine infants with neonatal septic arthritis (NSA) diagnosed at Edmonton hospitals between 1964 and 1981, and evaluated 92 other cases reported in the English literature since 1960 . Our analysis revealed that the microbiology of NSA seemed to be dependent on whether it was hospital or community acquired . In the hospital-acquired cases, staphylococci were the predominant isolates (62%), followed by Candida species (17%) and gram-negative enteric bacilli (15%) . Community-acquired arthritis was caused most often by streptococci (52%), followed by staphylococci (26%) and gonococci (17%) . Since 1970, the relative infrequency of staphylococcal (5%) in favor of streptococcal (75%) isolates in community-acquired NSA is even more pronounced. Eur J Obstet Gynecol Reprod Biol, 1983 Nov, 16(3), 167 - 72 Chlorhexidine for prevention of neonatal colonization with group B streptococci . II . Chlorhexidine concentrations and recovery of group B streptococci following vaginal washing in pregnant women; Dykes AK et al.; The effect of a single washing of the urogenital tract with 0.5 g/l chlorhexidine was studied in 6 women in weeks 38-40 of pregnancy, among whom 5 were carriers of group B streptococci in urethra and/or cervix . The chlorhexidine concentrations varied between 25 and 200 mg/l during the first hour after washing in 5 of the 6 women, whereas one patient showed concentrations below 25 mg/l . With the exception of one patient, all individuals showed concentrations less than 25 mg/l at 3-24 h after washing . A clear suppression of the number of colony-forming units of GBS was already apparent after 60 min and was still evident 6 h after chlorhexidine washing. Eur J Obstet Gynecol Reprod Biol, 1983 Nov, 16(3), 157 - 65 Chlorhexidine for prevention of neonatal colonization with group B streptococci . I . In vitro effect of chlorhexidine on group B streptococci; Christensen KK et al.; Forty-three strains of group B streptococci (GBS) of types Ia, Ib, II and III were tested for susceptibility to chlorhexidine in concentrations ranging from 256 to 0.25 mg/l using the agar and tube dilution methods . The strains showed minimum inhibitory concentration (MIC) values ranging from 0.5 to 1 mg/l . Serum added to the test medium (50%) increased the MIC values to 4-8 mg/l, while amniotic fluid (50%) had almost no effect, increasing the values to 1-2 mg/l . The minimum bactericidal concentration (MBC) ranged from 1 to 5 mg/l . The killing kinetics were related to the concentration of chlorhexidine and the length of exposure . For example, at a concentration of 63 mg/l, 7 h were required for a bactericidal effect in broth, as compared to 1 h at 500 mg/l chlorhexidine . 200 mg/l chlordexidine had no effect on the adherence of two GBS strains to vaginal epithelial cells, and no effect on the phagocytosis of GBS with mouse peritoneal macrophages. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1983 Nov, 256(1), 72 - 9 Bacterial interference in the throat flora during a streptococcal tonsillitis outbreak in an apartment house area; Grahn E et al.; During an outbreak of streptococcal tonsillitis in an apartment house area the interfering capacity of alpha-hemolytic streptococci isolated from the inhabitants' throat flora on the beta-hemolytic streptococcal strains recovered during the outbreak was investigated . Strains of alpha-streptococci with an inhibiting capacity on beta-streptococci were isolated mainly from individuals seemingly resistant to streptococcal tonsillitis while patients with repeated tonsillitis often had beta-streptococcal strains inhibiting the growth of the patients own alpha-streptococcal flora . Inhibiting alpha-streptococcal strains were isolated in high frequency in healthy patients that had recently recovered from tonsillitis. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1983 Nov, 256(1), 61 - 71 Morphological evidence for different types of IgG-Fc receptors in group A streptococci; Wagner B et al.; The binding of immunoglobulin G (IgG) from man and 14 animal species to Group A streptococcal cells was studied by electron microscopy . Only the IgGs of rhesus monkey and guinea pig did not bind to any of the streptococcal strains tested . Fc receptors were seen located on filamentous protrusions of the streptococcal cell wall either regularly or in focal distribution . On the inner surface of isolated cell walls no Fc receptors were detected . Both the different labelling patterns for different IgG and the results of inhibition studies with homologous and heterologous IgGs suggested the existence of different types of Fc receptors in the same strain . Further characterization of the receptors, including their location, was performed by studying their susceptibility to several proteolytic enzymes. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1983 Nov, 256(1), 49 - 60 Purification and characterization of erythrogenic toxins of Streptococcus pyogenes . VI . Mitogenic activity of isoelectrically focused erythrogenic toxin preparations and culture supernatants of group A streptococci; Knoll H et al.; Isoelectric focusing (IF) was used to separate erythrogenic toxins (ET) type A, B and C from concentrated culture filtrates of Streptococcus pyogenes strains . The ET's were identified by their mitogenic activity on human lymphocytes in the lymphocyte transformation test: purified ET type A appeared at pH 5.3, ET type C at pH 6.8 and ET type B at pH 7.5 to 8.5; the ET type B was only biologically active when PAGE IF was used . IF on Sephadex G 100 failed to yield active B toxin . The application of as little as 0.1 micrograms ET type A to an isoelectric focusing gel was still sufficient to detect a mitogenic peak in the eluates . ET type A was identified in nine out of 10 culture filtrates, ET type C in 4 out of 10 . Detection of ET type B (identical with streptococcal proteinase proenzyme) in culture filtrates after IF proved to be difficult . Here the pH of cultivation media and the autocatalytic conversion of streptococcal proteinase proenzyme to activated proteinase have to be considered. Jpn Circ J, 1983 Nov, 47(11), 1283 - 6 A follow-up study on epidemic infections of Group A streptococci in a small community; Takeuchi T et al.; The throat carrier rates of Group A streptococci and the antibody titers to 3 antigens of Group A streptococci, i.e., antistreptolysin O (ASO), antideoxyribonuclease B (ADN-B) and antistreptococcal polysaccharide (ASP) were followed up from October, 1980 through November, 1981 for the children living in a religious organization in Kyoto, where epidemic infections of Group A streptococci had occurred from August to October, 1980 . The recovery rate of Group A streptococci from the throat increased throughout the present study period, and the high carrier rate of Group A streptococci was maintained especially for first 8 months after the epidemic infection . Type 4 was present throughout the entire 13-month period . Although the ASO and ADN-B titers, both of which had initially risen, decreased during the present study period, the ASP levels peaked after about 4-8 months and decreased after 13 months . None of the children showed evidence of rheumatic fever with continuous observation. J Clin Microbiol, 1983 Nov, 18(5), 1027 - 31 Clinical laboratory comparison of lysis-centrifugation and BACTEC radiometric blood culture techniques; McLaughlin JC et al.; The lysis-centrifugation technique (ISOLATOR; E . I . du Pont de Nemours & Co., Wilmington, Del.) and the radiometric blood culture technique (BACTEC; Johnston Laboratories, Inc., Cockeysville, Md.) were compared on 1,000 blood cultures . A total of 16 ml of blood was distributed: 8 ml into an ISOLATOR 7.5 microbial tube and 4 ml each into BACTEC 7C and 8B bottles . The concentrate from the ISOLATOR tubes was inoculated under a laminar-flow hood onto two sheep blood agar plates (one incubated in CO2 and one incubated anaerobically), one chocolate agar plate, and one brain heart infusion agar plate . Of 91 blood specimens obtained that yielded clinically significant organisms, 52 were positive by both systems, 27 were positive by the ISOLATOR system only, and 12 were positive by the BACTEC system only . From the positive blood specimens, 97 clinically significant organisms were isolated: 57 by both systems, 27 by the ISOLATOR system only, and 13 by the BACTEC system only . Of the 57 organisms detected by both systems, 28 were detected simultaneously, 13 were detected earlier by the ISOLATOR system, and 16 were detected earlier by the BACTEC system . Isolated colonies were obtained earlier by the ISOLATOR system in 40 cases and by the BACTEC system in 5 cases . Organisms determined to be contaminants by thorough chart review were isolated from 138 ISOLATOR tubes . In 98 instances, these were represented by one colony of Staphylococcus epidermidis, alpha-hemolytic streptococci, or diphtheroids . The ability to determine CFU per milliliter with the ISOLATOR system did not help differentiate clinically significant organisms from contaminants. J Infect Dis, 1983 Nov, 148(5), 810 - 6 Selective intrapartum chemoprophylaxis of neonatal group B streptococcal early-onset disease . III . Interruption of mother-to-infant transmission; Boyer KM et al.; The effect of intrapartum ampicillin treatment on vertical transmission of group B streptococci (GBS) was examined in 575 prenatally colonized parturient women and their 580 newborn infants . Eighty women (43 receiving ampicillin) with premature labor and/or prolonged rupture of amniotic membranes were randomized . The other 495 were stratified into groups of 358 (31 receiving ampicillin) with no perinatal risk factors; 119 (28 receiving ampicillin) with premature labor and/or prolonged membrane rupture; and 23 (18 receiving ampicillin) with intrapartum fever . Ampicillin virtually eliminated vertical transmission in the treatment group with no risk factors and in both treatment groups with premature labor and/or prolonged membrane rupture . GBS colonization of neonates was detected only in women with intrapartum fever or brief (less than 1 hr) duration of treatment prior to delivery . Ampicillin treatment was associated with a highly significant reduction in maternal postpartum vaginal colonization by GBS . There were six group B streptococcal early-onset infections in infants of untreated subjects and no cases in treated subjects. J Infect Dis, 1983 Nov, 148(5), 802 - 9 Selective intrapartum chemoprophylaxis of neonatal group B streptococcal early-onset disease . II . Predictive value of prenatal cultures; Boyer KM et al.; To determine the value of prenatal cultures in defining maternal colonization status at delivery, 5,586 pregnant women were screened at prenatal visits for vaginal and rectal carriage of group B streptococci (GBS) . GBS were isolated from 1,272 (22.8%) . At delivery, semiquantitative cultures were obtained from 393 prenatal carriers, of whom 264 (67.2%) retained carriage at delivery . Seventeen (8.5%) of 200 women with negative prenatal cultures acquired carriage . The predictive value of a positive prenatal culture was highest (72.5%) in women with prenatal vaginal and rectal colonization and lowest (59.7%) in women with only rectal colonization . The predictive value varied inversely with the interval between prenatal sampling and delivery . In mothers with prenatal carriage, density of colonization at parturition was not predicted by the sites of prenatal colonization . Density of colonization, however, strongly influenced rates of vertical transmission to neonates and rates of heavy infant colonization . Ten infants born to prenatally cultured mothers developed group B streptococcal early-onset disease; the mothers of eight (80%) of the 10 had prenatal colonization with the homologous GBS serotype. Ann Microbiol (Paris), 1983 Nov-Dec, 134B(3), 387 - 99 {Fragmentation of the lactose-protease plasmid in lactose-negative derivatives of Streptococcus lactis and S . lactis ssp . diacetylactis}; Ramos P et al.; DNA analysis showed the presence of plasmids in all 29 strains of mesophilic lactic streptococci . Their number ranged from 1 to 9 and their molecular weight extended from 1.8 to 45 megadaltons (Md) . Comparison of the plasmid profiles from 9 strains of Streptococcus lactis, 3 strains of S . lactis ssp . diacetylactis and from their Lac-,Prt-variants was carried out . In most of the strains, a single plasmid of 27 to 45 Md carried both the lactose and protease (lac and prt) determinants . In Lac- variants, this composite plasmid may at times be lost; in most derivatives, this plasmid was fragmented into several smaller plasmids . Fragmentation resulted in the inactivation of lac genes and often of prt genes; sometimes prt genes remained intact in one of these new plasmids . Fragmentation of the plasmid may also take place without inactivation of these metabolic genes . Restriction analysis of the lactose-protease plasmid from 3 strains of S . lactis and from one Lac-variant confirmed the plasmid fragmentation phenomenon, and led to a proposal for physical mapping of the plasmid and preliminary localization of the lac-prt genes. Ann Immunol (Paris), 1983 Nov-Dec, 134D(3), 349 - 71 Grouping of haemolytic streptococci by monoclonal antibodies: determinant specificity, cross-reactivity and affinity; Herbst H et al.; Streptococcal group polysaccharide (CHO), A-, A-variant-, B-, C-, D- and G-specific monoclonal antibodies were prepared by the hybridoma technique employing spleen cells of several inbred mouse strains which are either high or low responders to the group A-CHO . The isotypes of these reagents were restricted to the class mu and IgG subclasses gamma 3 and--in small numbers--gamma 1 . Two distinct categories of antibodies were identified for all but group D specificity: those which agglutinate suspended bacteria but do not precipitate purified soluble antigen, and those which show both agglutinating and precipitating properties . The group D antibodies described here were only of the latter category . The reactions were inhibitable by haptens in as far as these were known . Cross-reactions were observed in group-A-specific antibodies with E and L polysaccharides . Most G-CHO-specific antibodies cross-reacted with B-CHO . Association constants determined by fluorescence quenching measurements were for binding of complete A and C polysaccharides in the range of 10(6) to greater than 10(8) M-1, and for hapten binding by A-, Av- and C-CHO-specific antibodies in the range of 10(3) to 10(4) M-1 . These results support a model of steric arrangements of antigenic determinants on A-variant bacteria and solubilized antigen {42} and allow its extension to streptococcal groups A, B, C and G . This model explains the observed functional differences by postulating single, terminal determinants which interact with the prevailing non-precipitating antibodies and internal repeating determinants which react with precipitins, respectively . No significant differences were found in the reactivity patterns to these streptococcal group antigens between strains of mice in terms of their ability to respond with high or low serum antibody titres to group A-CHO . On the other hand, within high and low responder strains, different kinetics of the optimal timing of fusion after initiation of the secondary immune reaction by boosting was observed . Low responders were most efficiently used for fusion 1.5 days later than high-responder spleen cells . This feature is interpreted to indicate an earlier proliferation of B lymphocytes in high responders, due to either an improved responsiveness to T-lymphocyte help or a reduced reactivity with T suppressor cells in comparison to low-responder B lymphocytes. Vet Microbiol, 1983 Oct, 8(5), 493 - 504 Adherence of Streptococcus equi on tongue, cheek and nasal epithelial cells of ponies; Srivastava SK et al.; Streptococcus equi was found to adhere to tongue, cheek and nasal epithelial cells of ponies, in vitro . Maximum adherence was observed at pH 7.5 after one hour of incubation of bacteria with epithelial cells . This adherence was more on epithelial cells from adult animals than from foals . Streptococci exposed to heat (60 degrees C for 10 min) or treated with pepsin or trypsin showed a reduced adherence, whereas an increase occurred on treatment with hyaluronidase . Antibodies against whole S . equi cells or M-like protein blocked the adherence, whereas antibodies against group-specific carbohydrate or lipoteichoic acids did not . Pretreatment of epithelial cells with either the M-like protein or crude extract of S . equi lowered the adherence, whereas an extract of S . zooepidemicus did not . Adherence of S . equi to the epithelial cells was considered to be mediated by structures specific to S . equi. Vet Microbiol, 1983 Oct, 8(5), 485 - 92 The role of lipoteichoic acids on the adherence of Streptococcus equi to epithelial cells; Srivastava SK et al.; The effect of the presence of lipoteichoic acids (LTA) on a strain of Streptococcus equi was investigated . The LTA were extracted in a crude form from the S . equi strain and were found to sensitize sheep red blood cells so that they agglutinated with antibodies specific to purified LTA of group A streptococci . The crude LTA preparation was also able to inhibit the specific haemagglutination reaction involving group A streptococcal LTA and LTA antibodies . Neither the purified LTA from group A streptococci nor the anti-LTA serum interfered with the adherence of S . equi to equine epithelial cells. J Rheumatol, 1983 Oct, 10(5), 817 - 8 Bursitis and tenosynovitis caused by group G streptococci; Meier JL et al.; Two cases of extraarticular Group G streptococcal infection are reported: one patient suffered from tenosynovitis of the extensor digitorum communis tendons of a wrist and the other from a prepatellar bursitis . In both cases penicillin therapy rapidly cleared all signs of infection. Herz, 1983 Oct, 8(5), 241 - 70 {Detection and evaluation of infectious endocarditis}; Rudolph W et al.; Based on the findings of 50 patients with infective endocarditis, 37 affecting the aortic, six the mitral and seven both the aortic and mitral valves, in addition to analysis of predisposing factors, prominent signs and symptoms distinctive for the clinical entity were assessed (Tables 1 to 3) . Preexistent conditions such as aortic valve lesions including bicuspid aortic valve as well as mitral valve lesions including mitral valve prolapse were proven in 66% . Factors which may have compromised host defense mechanisms such as cachexia and chronic alcohol or intravenous drug abuse were present in isolated cases . In 38% of the patients, a diagnostic or therapeutic manipulation, suspected to have given rise to the bacteremia, antedated the onset of endocarditis . Malaise, fatigue and chills were the most frequent symptoms (Table 4) . Fever and cardiac murmurs were observed in all patients, anemia and bacteremia in 74% of the patients, respectively (Tables 4 to 6) . In blood cultures, the most common microorganisms were found to be hemolytic and nonhemolytic streptococci accounting for 65% of positive findings, followed by enterococci and gram-negative bacteria each with 14% respectively (Table 6) . Congestive heart failure predominated among cardiac complications with its occurrence in 84% of the patients . Valvular ring or myocardial abscess, aortic or sinus of Valsalva aneurysm, occasionally with perforation, were found in 24% of our patients . Coronary embolism was documented in 6%; infection-associated pericarditis was observed only rarely (Table 7) . Extracardiac complications involved the skin, central nervous system, spleen and kidneys, respectively, in 20 to 30% of the patients . Complications afflicting the eyes, lungs, gastrointestinal tract and the musculo-skeletal system were seen with a lesser frequency of 0 to 12% (Table 8) . The diagnosis of infective endocarditis, rendered highly-probable by the constellation of fever, cardiac murmur, bacteremia and anemia, necessitates, however, confirmation through cardiac examinations . In this respect, electrocardiographic and radiologic findings are of limited value, although they may be useful in the detection of cardiac complications . In 6% of the patients, positive criteria for myocardial infarction were indicative of coronary embolism and, i 30%, atrioventricular or fascicular block suggested the presence of abscess formation (Table 9) . As radiologic evidence of heart failure, 74% of the patients were found to have pulmonary vascular congestion (Table 10).(ABSTRACT TRUNCATED AT 400 WORDS) Cornell Vet, 1983 Oct, 73(4), 307 - 13 Identification of three new serotypes of group E streptococci isolated from swine; Wessman GE et al.; Evidence is presented for the recognition of 3 new serotypes of Group E Streptococci (GES) . Serological and biochemical characteristics of 3 porcine isolates of GES, that could not be placed in any of the 3 established serotypes, were examined . On the basis of double-diffusion precipitin reactions, the isolates were found to be of 3 distinct, previously unreported serotypes . They were given serotype designations VI, VII, and VIII. Infect Immun, 1983 Oct, 42(1), 414 - 7 Morphological aberrations of nutritionally deficient streptococci: association with pyridoxal (vitamin B6) concentration and potential role in antibiotic resistance; Clark RB et al.; A strain of a nutritionally deficient streptococcus was shown to undergo morphological aberrations according to pyridoxal concentrations in the growth medium . Filamentous rod-shaped cells, observed by electron microscopy, predominated in the presence of decreasing concentrations . Multiple invaginations in the outer cell wall suggested inhibition of binary fission . Penicillin antimicrobial studies performed in the presence of similar pyridoxal concentrations indicated a relationship between filamentous forms and penicillin susceptibility. Infect Immun, 1983 Oct, 42(1), 394 - 401 Cell-free released components of Streptococcus sanguis inhibit human platelet aggregation; Herzberg MC et al.; To study the role of surface components in the selective binding and aggregation of platelet-rich plasma (PRP) by strains of viridans streptococci, we treated the binding, aggregation strain Streptococcus sanguis I 2017-78 by sonication or trypsinization . Morphologically identifiable electron-dense fibrils were released from the cell wall, apparently from an inner electron-dense layer, under conditions that left cells intact . These controlled conditions were determined to cause submaximal loss in adhesion to platelet ghosts and PRP aggregation by treated, washed S . sanguis . Soluble components were recovered from the controlled sonic or L-(tosylamido 2-phenyl)ethyl chloromethyl ketone-trypsin treatments . Each showed dose-response inhibition of aggregation when preincubated with PRP before challenge with fresh, untreated S . sanguis . The time to onset of PRP aggregation was inhibited by 50% with 0.2 mg of TPCK-trypsin peptides or 1.0 mg of the sonicate per ml per 2 X 10(8) platelets . Components of both preparations were immunologically cross-reactive, but lipoteichoic acid was not a major antigen of either . By weight, the TPCK-trypsin peptides were virtually all protein; the sonicate residues identified were about 50% protein and 7% hexose . Each was a complex mixture of components as shown by sodium dodecyl sulfate-polyacrylamide gel electrophoresis . More than 8 TPCK-trypsin peptides and 16 sonicate components were so identified . In contrast, at least four or five components from either preparation were recognized as surface determinants by a rabbit antiserum to whole homologous microbes . Platelet-binding ligands of S . sanguis could be among these determinants. Am J Med, 1983 Oct, 75(4), 561 - 70 Serious infections due to group G streptoccocci . Report of 15 cases with in vitro-in vivo correlations; Lam K et al.; Serious infections due to group G streptococci have been infrequently reported . Fifteen such cases are described . Endovascular infection, particularly endocarditis, and septic arthritis were the most common clinical syndromes observed . Despite exquisite in vitro sensitivity of group G streptococci to penicillin G, the in vivo clinical response was disappointing in six of nine patients with either endocarditis or septic arthritis . The group G streptococcal isolates from the patients in this study were uniformly sensitive to the inhibitory and killing action of penicillin G, ampicillin, cefotaxime, cephalothin, cefoxitin, and vancomycin . In contrast, clindamycin, erythromycin, and chloramphenicol had relatively poor bactericidal activity against these strains, including several "tolerant" strains . Timed-kill studies with penicillin G revealed impaired killing of group G streptococci at in vitro conditions of high inocula and stationary growth phases . This may partially explain the poor clinical responses in cases of group G streptococcal endocarditis. Clin Exp Immunol, 1983 Oct, 54(1), 185 - 93 Immunological studies of post-streptococcal sequelae: serological studies with an extracellular protein associated with nephritogenic streptococci; Ohkuni H et al.; Using the Ouchterlony double diffusion and the crossed-immunoelectrophoresis techniques the reactivity to a purified extracellular product of nephritogenic group A streptococci (NASP) was examined with both acute and convalescent sera obtained from patients with documented post-streptococcal glomerulonephritis and patients with documented acute rheumatic fever . The streptococcal antigen utilized in these studies was first purified on SDS gels and then eluted from the gel, resulting in a single protein band on SDS electrophoresis . Double diffusion studies revealed that only nephritis patients reacted to this extracellular product associated with nephritogenic strains, whereas rheumatic fever sera produced no line of precipitation . An assay of serial bleedings from nephritis patients suggested that the antibody reactive to the NASP was in higher titre in the acute phase of the disease and decreased with convalescence . In confirmation of these findings, crossed-immunoelectrophoresis experiments were conducted with a battery of sera from acute nephritic and non-nephritic patients against the NASP antigen . A striking increase was detected in the reactivity of nephritis patients (96%) compared to non-nephritis sera (15-20%) . Comparison between acute and convalescent sera using this technique confirmed the finding of decreasing antibody titre with resolution of disease . These findings of a specific humoral response in patients with acute post-streptococcal nephritis to the NASP of nephritogenic strains further implicates an aetiological function to this protein. Isr J Med Sci, 1983 Oct, 19(10), 903 - 5 Epidemiology of group B streptococci in an Israeli hospital; Eidelman AI et al.; A technique for the rapid identification and quantification of Group B streptococci (GBS) utilizing timed coagglutination and selective broth media was designed . A prospective study of 283 mothers and 121 newborns based on this methodology revealed a GBS colonization rate of 5.3 and 4.1%, respectively . A retrospective study of 19,875 births revealed a GBS attack rate of 0.2 per 1,000 live births . Both the low colonization and the low attack rates confirm previous anecdotal reports of a low incidence of GBS colonization and disease in Israel . The technique described herein can aid in identifying those infants at risk for invasive disease. Can J Microbiol, 1983 Oct, 29(10), 1445 - 51 M-type 57 group A streptococcus bacteriocin; Simpson WJ et al.; All 40 tested isolates of M-type 57 group A streptococci gave the same, highly characteristic inhibitory pattern (P-type 614) when tested by deferred antagonism using a set of nine indicator strains . One component of this inhibitory activity was attributed to the production of a bacteriocinlike substance, streptococcin A-M57 (SA-M57) . Production of SA-M57 was enhanced by the presence of blood and also by growth at an alkaline pH . Partially purified SA-M57 was obtained from culture supernatants by a combination of ammonium sulphate fractionation and column chromatography . On Sephadex G-100 two different molecular weight forms (SA-M57 alpha, greater than 100 000; SA-M57 beta, 33 000) were demonstrated . Both SA-M57 forms were protease and heat sensitive and had identical inhibitory activity against a collection of indicator bacteria . The adsorption to and rate of kill of sensitive cells by SA-M57 was enhanced in the presence of human plasma . Partially purified SA-M57 preparations were devoid of M-type 57 protein and curing studies showed that loss of SA-M57 did not correlate with loss of M protein production. J Sch Health, 1983 Oct, 53(8), 487 - 90 An epidemic of group A, type 4 streptococcal carriers among school children and their desk location at school; Fukuda K; During a follow-up study of pharyngeal carrier of beta-hemolytic streptococci among school children in three classes (ages 8-9) in Sapporo City, an epidemic of group A, T4 streptococcal carrier was observed . The epidemic started in February 1978 in class II (35 pupils) and spread to class I (36 pupils) in May . Class III developed only three carriers during the course . Information on the desk location of those children at school and those on some host factors or on several environmental factors were collected . Monthly sociometric tests were performed on those pupils and corresponding sociograms were constructed . New T4 carrier rate by month was calculated for class I and class II by pupil's desk location (adjacent vs . remote) or by degree of pupil's friendship (best friends vs . others, based on the sociogram) . More new carriers were detected from susceptibles adjacent to previous carriers then from those remote to them . There was no significant difference with carrier rate between best friends and others . The T4 carriers did not significantly differ from the remaining noncarriers in terms of status with host or environmental factors examined. Pediatr Res, 1983 Oct, 17(10), 795 - 9 The effect of hybridoma antibody administration upon neutrophil kinetics during experimental type III group B streptococcal sepsis; Christensen RD et al.; Groups of newborn rats were transthoracically inoculated with 1 X 10(6) type III group B streptococci/g body wt, either alone or in combination with 1.5 microgram/g body wt of type-specific antibody derived from hybridoma cell lines . Ninety-four percent of the animals who received bacteria alone died . In contrast, none of those treated with antibody died (P less than 0.005) . Kinetic studies suggested that antibody may have offered protection, In part, by facilitating the neutrophil response . Animals who received only bacteria exhibited a marked neutropenia (20 +/- 18/mm3, mean +/- S.E.M.) whereas infected animals treated with antibody did not (3800 +/- 30/mm3, P less than 0.001) . Furthermore, within 2 h of inoculation, antibody-treated animals mobilized and stored neutrophils, whereas significant neutrophil mobilization did not occur in the animals which received bacteria alone until 6 h . In the animals receiving bacteria alone, exhaustion of the neutrophil supply quickly occurred (remaining storage neutrophils at 6 h, 0.2 +/- 0.1 X 10(6) cells) . In contrast, animals, which received antibody, maintained an adequate supply of stored neutrophils (7.0 +/- 0.4 X 10(6) P less than 0.001) . The migration of neutrophils to the site of inoculation was measured by assaying the lungs' content of myeloperoxidase, a marker enzyme for granulocytes . The right and left lungs of animals not receiving antibody accumulated the same quantity of neutrophils, with peak pulmonary neutrophil accumulation occurring 6 h after the infection . In antibody recipients, however, the inoculated lung accumulated significantly more neutrophils than the opposite lung and peak pulmonary neutrophil accumulation occurred at 2 rather than 6 h. J Clin Microbiol, 1983 Oct, 18(4), 961 - 7 Biochemical markers of the penicillin-induced L phase of a group B, type III Streptococcus sp; Flores AE et al.; The penicillin-induced L phase of growth of the group B, type III streptococcal strain 76-043 was examined for biochemical properties used for the identification of group B streptococci . After numerous serial subcultures in the cell wall-defective state, this stable L phase continued to produce hemolysin, hippuricase, and CAMP factor in addition to the group- and type-specific antigens . Hemolysin production by the L-phase cells was observed on solid and in liquid media containing sheep erythrocytes . Washed whole L-phase cells hydrolyzed hippuric acid . CAMP factor was detected by the characteristic hemolysis produced on blood agar by L-phase cells or filtered culture supernatants . CAMP factor activity was quantitated by an agar well diffusion system and a macrotube assay with partially purified preparations of CAMP factor and staphylococcal beta-hemolysin . Hyperimmune cow serum neutralized the CAMP activity of the L phase and parent bacterial phase to the same degree, suggesting identity of the CAMP factors . Production of hemolysin, hippuricase, and CAMP factor confirmed the bacterial origin of this L phase . Assay for these biological markers could be used to identify L-phase organisms derived from group B streptococci. Am J Obstet Gynecol, 1983 Oct 1, 147(3), 247 - 50 Inhibition of group B streptococci by amniotic fluid from patients with intra-amniotic infection and from control subjects; Blanco JD et al.; This study describes the inhibition of group B streptococci by amniotic fluid from 50 patients with intra-amniotic infection and 50 matched, noninfected control subjects . Patients were matched for gestational age, time from rupture of membranes to delivery, and time from rupture of membranes to collection of the sample of fluid . Study patients had the clinical diagnosis of intra-amniotic infection and greater than or equal to 10(2) colony-forming units of a high-virulence organism per milliliter . None of the control patients became infected or received antibiotics . We collected the amniotic fluid in the study patients prior to antibiotic therapy . A comparison of bacterial growth in the amniotic fluid versus the amniotic fluid plus phosphate showed that only eight (16%) of the intra-amniotic infection samples of fluid were inhibitory, whereas 18 (36%) of the control samples of fluid were inhibitory (X2 = 5.20, p less than 0.02) . However, a comparison of group B streptococci growth in amniotic fluid and Todd-Hewitt broth did not show a statistically significant difference . We conclude that the amniotic fluid bacterial inhibitory assay with group B streptococci is technically more difficult to perform and interpret. Infect Immun, 1983 Oct, 42(1), 326 - 32 Electron microscopic localization of receptors for aggregated beta 2-microglobulin on the surface of beta-hemolytic streptococci; Wagner M et al.; The presence and location of receptors for aggregated human beta 2-microglobulin (beta 2m) on the surface of group A, C, and G streptococci were studied by electron microscopic techniques . Ferritin-conjugated aggregates of human beta 2m were used in direct binding experiments . Ferritin-conjugated antibodies against beta 2m were employed in a two-step indirect binding assay where the streptococci were incubated with unlabeled beta 2m aggregates before the addition of antibodies . Similar results were obtained with these two methods . Among tested group C and G strains, some showed binding of beta 2m, whereas others were negative . In group A streptococci, beta 2m binding was localized to filamentous structures typical of M protein . In two M protein-negative group A strains, the reactivity was heterogeneous, revealing a majority of unlabeled, but also some heavily labeled streptococci . Morphologically, these beta 2m-binding bacteria exhibited M protein-like projections in contrast to the smooth surfaces of unlabeled cells. Infect Immun, 1983 Oct, 42(1), 141 - 51 Isolation and characterization of type III group B streptococcal mutants defective in biosynthesis of the type-specific antigen; Yeung MK et al.; Four classes of mutants of type III group B streptococcus were isolated by serial subculture of the wild-type strain in the presence of type III-specific rabbit antiserum . Class I mutants no longer synthesized sialic acid but still elaborated the core antigen . Class II mutants maintained the ability to synthesize sialic acid but could not attach it to the core antigen . Class III mutants did not produce the core antigen but still synthesized intracellular sialic acid . Class IV mutants synthesized the complete antigen; however, only approximately 4% of the antigen synthesized was found associated with the cell wall peptidoglycan (in the wild-type strain greater than 85% of the antigen synthesized is covalently attached to the cell wall peptidoglycan), whereas greater than 90% of the antigen was secreted into the growth medium . Production of other components (CAMP factor, group B antigen, beta-hemolysin, neuraminidase) by these mutants appeared similar to those of the wild-type strain . Mouse lethality studies of these strains indicated that all four classes have greater than 3 log10-higher 50% lethal dose values than that of the wild-type strain . To understand the basis for this variation, the invasive ability of the wild-type strain and the sialic acid-deficient mutant strain M-10 (class I) was examined . Mice received 10(5) CFU of each organism; they were then sacrificed at various times postinoculation, and viable group B streptococci from different organs were enumerated . Mice were able to clear M-10 more efficiently, with greater than 80% of M-10 cells being phagocytized by macrophages within 1 h, whereas the wild-type strain was able to evade phagocytic killing and disseminate to other tissues . These data, therefore, strongly indicate that the sialic acid moiety greatly enhances the virulence of the type III antigen . In addition, the level of cell-associated type-specific antigen appears to contribute significantly to the pathogenicity of the organism. Br Med J (Clin Res Ed), 1983 Sep 10, 287(6394), 739 - 41 Prosthetic valve endocarditis; Moore-Gillon J et al.; During 1965 to 1982, 32 episodes of infective endocarditis on prosthetic valves in 30 patients were treated at this hospital . In early endocarditis (presenting within four months of operation) staphylococci were the organisms most commonly responsible . Early endocarditis appears to be declining in incidence and is largely preventable; sternal sepsis was the main predisposing factor, requiring urgent and effective treatment . Streptococci were the most common organisms in late onset disease, but as with natural valve endocarditis a wide range or organisms was responsible . All but one of the patients with early onset disease were treated conservatively, but mortality was high; prompt surgical replacement of infected prostheses is probably indicated in such patients . Medical management was effective in most patients with late onset disease, and for them early surgical intervention may not be justified. J Bacteriol, 1983 Sep, 155(3), 1372 - 81 Streptococcus pneumoniae proteins released into medium upon inhibition of cell wall biosynthesis; Hakenbeck R et al.; Inhibition of murein biosynthesis in Streptococcus pneumoniae by either penicillin or bacitracin leads to an increase in the amount of protein secreted into the medium . This process was studied in wild-type cells grown under lysis-permissive conditions as well as in an autolysin-deficient mutant . The time course of secretion did not follow cellular lysis but commenced immediately after the addition of the cell wall inhibitor in a manner similar to that described recently for cell wall and membrane components in various tolerant streptococci . Sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that this increase was not due to the stimulation of release of three protein components which are secreted under normal growth conditions; rather, a complex set of cellular proteins escaped from the antibiotic-treated pneumococci . The proteins released during bacitracin treatment was slightly different from those observed when penicillin was used . Analysis on sucrose gradients indicated that the secreted proteins were membrane bound rather than soluble . Membrane vesicles could indeed be detected by electron microscopy of negative-stained secreted material. Z Geburtshilfe Perinatol, 1983 Sep-Oct, 187(5), 235 - 8 {Incidence of Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma species, Streptococci of the Lancefield group B and Candida species in newborn infants during the first week of life}; Martius J et al.; In a total of 200 children born at Wurzburg University Gynecological Clinic, culture and in some cases microscopic investigations were performed in the first week of life to identify chlamydia trachomatis, ureaplasma urealyticum, mycoplasma species, Lancefield group B streptococci and candida species . Chlamydia trachomatis was isolated in one symptom-free neonate, while ureaplasma urealyticum was found in 31 (15%) of the infants . Statistically, premature rupture was significantly more frequent (29%) in the ureaplasma-urealyticum-positive group than among the ureaplasma-urealyticum-negative infants (11%) (p less than 0.05) . Mycoplasma species was detected in one newborn, Lancefield group B in 3 (1.5%) . In 7 of the infants (3.5%) Candida species was isolated. Acta Paediatr Scand, 1983 Sep, 72(5), 671 - 7 Immunoglobulin concentrations and bacterial antibody titres in breast milk from mothers of 'preterm' and 'term' infants; Suzuki S et al.; IgA, IgM and IgG concentrations and their bacterial antibodies to E . coli, group B streptococci and Brucella abortus were measured in human breast milk collected from the 1st to 10th day post-partum from mothers delivered of 'preterm' infants (Premature Breast Milk or PBM) and from mothers delivered of term infants (Term Breast Milk or TBM) . Reverse passive haemagglutination tests (RPH), rocket immuno-electrophoresis and mixed reverse passive antiglobulin haemagglutination tests (MRPAH) were employed . PBM at 2-5 days post-partum (though not beyond this period) contained higher IgA levels than did TBM, and this difference persisted even when total IgA was expressed as a proportion of total milk protein: in contrast the IgM and IgG contents of PBM and TBM were the same at both these postnatal ages . The titre of IgA antibody to E . coli, which was absorbable only by the corresponding bacteria, showed no significant difference between PBM and TBM, whereas the titres of IgA reacting with Br . abortus and, to a lesser extent group B streptococci, were higher in PBM than those in TBM . However the IgA which reacted with Br . abortus and group B streptococci was not specific to those organisms but was absorbed by all three bacteria studied . It is speculated that the high IgA content of early preterm milk and perhaps the presence of especially high titres of what appears to be a non-specific or cross-reacting bacterial IgA in such milk, may be immunologically advantageous to low birthweight infants fed on their own mother's milk. Rev Infect Dis, 1983 Sep-Oct, 5(5), 876 - 84 Tubo-ovarian abscess: contemporary approach to management; Landers DV et al.; Two hundred and thirty-two patients with tubo-ovarian abscesses (TOAs) were evaluated . Ruptured TOAs were documented in seven (3%) of the patients . One hundred and seventy-five patients with TOAs were treated with antibiotics alone; for 15 of these patients, TOAs were confirmed by laparoscopy . The remaining 57 patients required surgical intervention: drainage (five patients), unilateral salpingo-oophorectomy (19) and total abdominal hysterectomy and bilateral salpingo-oophorectomy (33) . A unilateral TOA was present in 163 patients (70%) . Seventy-six patients with TOAs used intrauterine contraceptive devices, and in this group, 54 (71%) patients had unilateral TOAs . The most common microorganisms that were recovered from these TOAs were Escherichia coli, Bacteroides fragilis, Bacteroides species, Peptostreptococcus, Peptococcus, and aerobic streptococci . Sixty-eight percent of the patients treated with an antimicrobial regimen that included clindamycin had a decrease in the size of the TOA, while only 36.5% of those receiving antimicrobial regimens without clindamycin had a decrease in the size of the TOA (P less than .01) . Long-term follow-up information (two to 10 years) was available for 58 of the patients treated with antibiotics alone . Eighteen (31%) required subsequent surgery; 12 had persistent TOAs; and six, chronic salpingo-oophoritis . Intrauterine pregnancy was documented in eight (13.8%) patients . Of the 19 patients treated with unilateral adnexectomy, two ultimately required hysterectomy and contralateral adnexectomy, while three patients in this group subsequently became pregnant (one ectopic and two intrauterine). J Infect Dis . 1983 Sep;148(3):608. Serology of Staphylococcus aureus infections using multiple antigens and serial serum samples; Verbrugh HA et al.; The detection of antibody to S aureus in human serum can aid in the management of staphylococcal diseases {1} . RIAs and ELISAs can detect low levels of antibody and demonstrate increased antibody production during serious staphylococcal infections {2,3} . We compared four S aureus constituents--cell-wall peptidoglycan and teichoic acid, and extracellular alpha-toxin and nuclease--as antigens in a sensitive ELISA . The value of testing more than a single serum sample was also determined . Elevated IgG antibody to peptidoglycan, present in one or more serum samples of 13 (50%) of 26 patients with complicated bacteremia, was found to be the most sensitive test . All 26 patients had a significant IgG antibody response to peptidoglycan . Three (27%) of 11 patients with uncomplicated bacteremia had elevated levels of antibody to peptidoglycan in their serum, and seven (64%) showed a significant change in titer when serial serum samples were tested . Maximum detection rates for the other antigens in complicated and uncomplicated bacteremia were, respectively, 62% and 37% for teichoic acid, 38% and 37% for nuclease, and 54% and 13% for alpha-toxin . In single serum samples, the detection rate for all four antigens marginally improved the results, with detection rates of 62% and 36% for complicated and uncomplicated bacteremia, respectively . Cross-reactive antibody to peptidoglycan but not to the other three antigens was present in six (75%) of eight patients with long-standing subacute bacterial endocarditis due to either viridans streptococci or Staphylococcus epidermidis (data not shown).(ABSTRACT TRUNCATED AT 250 WORDS) J Dent Res, 1983 Sep, 62(9), 946 - 51 Comparative growth responses of oral streptococci on mixed saliva or the separate submandibular and parotid secretions from caries-active and caries-free individuals; Cowman RA et al.; Growth of S . mutans on mixed or parotid saliva from CF individuals may be influenced by the availability of growth-supportive proteins or the inhibitory activity present in parotid saliva . A deficiency in growth-supportive proteins may explain the limited growth of S . sanguis on mixed or submandibular saliva from these individuals. Appl Environ Microbiol, 1983 Sep, 46(3), 549 - 52 Simple and rapid method for isolating large plasmid DNA from lactic streptococci; Anderson DG et al.; A procedure for the rapid isolation of plasmid DNA larger than 30 megadaltons from lactic streptococci is described . This protocol can be used on a preparative scale to isolate sufficient quantities of plasmid DNA required for restriction analysis, cloning, or transformation experiments . A scaled-down protocol is very useful for rapidly screening the plasmid content of streptococcal strains . With this methodology, previously undetected large plasmids were observed. J Clin Microbiol, 1983 Sep, 18(3), 680 - 2 Effects of trimethoprim-sulfamethoxazole and incubation atmosphere on isolation of group A streptococci; Libertin CR et al.; The effects of selective media and incubation atmosphere on the isolation of group A beta-hemolytic streptococci were evaluated . A higher percentage of group A streptococci was isolated on sheep blood agar incubated in air than in CO2 or anaerobic atmospheric conditions . Fewer non-group A beta-hemolytic streptococci were isolated on sheep blood agar incubated in air than in CO2 or anaerobically . Group A streptococcal isolation was not significantly affected by different incubation atmospheres on sheep blood agar containing trimethoprim-sulfamethoxazole, but detection time was longer than on sheep blood agar alone . No significant difference was found between isolation of group A streptococci on sheep blood agar incubated in air and that on sheep blood agar containing trimethoprim-sulfamethoxazole and incubated in 5 to 10% CO2; however, more group A streptococci were isolated on sheep blood agar in air within 24 h . Sheep blood agar incubated at 35 degrees C in air is, therefore, recommended for the isolation of group A streptococci from throat swabs. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1983 Sep, 255(2-3), 214 - 20 {Stimulation of human and bovine lymphocytes by various Streptococcus species}; Hahn G et al.; Concerning the question of species specifity of lymphokines in the presented examination the effect of the leukocyte migration inhibition factor (LIF) secreted by human and bovine lymphocytes was tested using PMN leukocytes of man and different animal species as indicator cells . The method was the so called indirect leukocyte migration inhibition test according to Clausen . As antigens for stimulating the lymphocytes cell wall preparations of group A- and B-Streptococci and as a mitogen Concanavalin A was used . From the results the following facts can be stated: --Human LIF has no inhibiting effect on the migration of leukocytes from cattle, sheep and pigs--independent of the way of stimulation by specific antigens or by the mitogen . --A corresponding factor to human LIF can be demonstrated from bovine lymphocytes which, however, inhibits only the migration of bovine indicator cells . This phenomenon is also independent of the kind of stimulation . --Migration inhibiting substances from bovine lymphocytes are only produced after stimulation with group A- and B-streptococci cell walls if the donor animals have been sensitized with these antigens . --The interaction between LIF and indicator leukocytes obviously is dependent on host specifity and not on a peculiar relation of macro- and microorganisms. Zh Mikrobiol Epidemiol Immunobiol, 1983 Sep, (9), 21 - 4 {Choice of nutrient media for the laboratory diagnosis of Streptococcus group B}; Igonina IuA et al.; The comparative study of a large assortment of liquid and solid culture media used for the cultivation of streptococci in laboratory practice in the USSR and abroad was carried out with the aim of selecting the optimal media for the laboratory diagnosis of group B . streptococci . Liquid media were tested with the use of 7 streptococcal reference strains, and some of these media, found to yield the best results, were selected for tests on clinical material . The use of liquid accumulation media was shown to permit the isolation of group B . streptococcal strains which could not be detected by the direct inoculation of clinical material into dishes with blood agar . The character of hemolysis induced by group B . streptococci in solid media with 5% of blood added was found to depend on the composition of the medium and the conditions of cultivation. Rev Infect Dis, 1983 Sep-Oct, 5 Suppl 4, S723 - 32 Streptococcal toxins; Wannamaker LW; Few of the cellular components of group A streptococci appear to be directly toxic for animals or humans . Some preparations of M protein produce an immunotoxic effect on human platelets and neutrophils . Cell wall fragments produce a chronic multinodular inflammatory lesion of dermal connective tissue . The peptidoglycan component of cell walls has many of the biologic features of endotoxins . The exotoxins of group A streptococci include the erythrogenic toxins (pyrogenic exotoxins) and the cytolytic toxins (streptolysins S and O) . The high prevalence of erythrogenic, toxin-producing strains is difficult to reconcile with the epidemiologic behavior of scarlet fever; the variations may be due to quantitative differences in toxin production or to a shift from the early scarlet fever-associated strains that produce A toxin to the currently prevalent strains that produce B and C toxins . Experiments with animals suggest that a positive Dick test and the rash of scarlet fever result not from a direct toxic effect but rather from enhancement by pyrogenic exotoxin(s) of acquired hypersensitivity to diverse streptococcal products . The mechanism of toxigenic phage conversion is not clear . The pyrogenic exotoxins are associated with the enhancement of endotoxin shock and a wide variety of other biologic properties . Streptolysin S is a nonantigenic polypeptide associated with various stabilizing carrier molecules . It lyses a wide range of mammalian cells, influences T lymphocyte functions, and is probably responsible for the leukotoxic property of group A streptococci . Rheumatic fever has been associated with a streptococcal outbreak due to a nonhemolytic (streptolysin S-negative) strain . Streptolysin O is an oxygen-labile (thiol-activated) cytolysin . It is inhibited by nonesterified cholesterol and binds to cholesterol in the membranes of mammalian cells and organelles, an interaction producing ring-like and C-shaped structures demonstrable by electron microscopy . Streptolysin O affects a number of leukocyte functions . It produces profound electrocardiographic changes in experimental animals and toxic effects on pulsating heart cells in tissue culture . The observation that rheumatic fever is not associated with infection of the skin due to group A streptococci has suggested that nonesterified cholesterol in the epidermis may inhibit a toxic effect of streptolysin O, an effect necessary for the development of rheumatic fever. Rev Infect Dis, 1983 Sep-Oct, 5 Suppl 4, S670 - 7 Attachment of Streptococcus pyogenes to mammalian cells; Beachey EH et al.; Accumulated evidence indicates that lipoteichoic acid (LTA) is centrally involved in the attachment of group A streptococci to epithelial cells of the host . The binding of LTA to a variety of host cells is mediated by the glycolipid end of the LTA molecule, which can form ionic complexes with streptococcal surface proteins, permitting the reorientation of the LTA to expose some of its lipid ends toward the surface of the organism . The ability of albumin to block the adherence of streptococci to epithelial cells and to bind to LTA-M protein but not deacylated LTA-M protein complexes supports the idea that the lipid ends remain free to interact with cell membrane receptors . The cell membrane receptors appear to consist of a lipid-binding region(s) on fibronectin molecules on the surfaces of oropharyngeal epithelial cells . Although streptococci exhibit LTA-sensitive binding to phagocytic cells in a serum-free system, in the presence of serum, they do not; rather, complement bound to the streptococcal cell surface is required for recognition by phagocytes . The binding of fibrinogen to the M protein on the surface of M-rich streptococci specifically blocks the recognition of the organisms by opsonic complement components . The attachment of M-rich streptococci to phagocytic cells requires the development of antibodies directed specifically toward regions of M protein not blocked by fibrinogen. J Clin Microbiol, 1983 Sep, 18(3), 558 - 60 Rapid identification of pregnant women heavily colonized with group B streptococci; Jones DE et al.; Pregnant women admitted to Tampa General Hospital, Tampa, Fla., were cultured for group B streptococci (GBS) . Culture swabs were placed into enriched, selective Todd-Hewitt medium and were quantitated for GBS . The broth cultures were tested by slide coagglutination before incubation and after 5 and 20 h of incubation . Fifty-four (27%) of the 201 maternity patients cultured were positive for GBS and were identified as such by slide coagglutination . A strong correlation was found between the magnitudes of colonization and the times required to identify the broth cultures as GBS positive . Cultures from mothers heavily colonized (mean concentrations of 3 X 10(4) GBS per culture swab or greater) were identified after 5 h or less of incubation . Mothers lightly colonized with GBS (mean concentrations of 2 X 10(2) GBS per culture swab) were identified only after their broth cultures had been incubated for 20 h. J Clin Microbiol, 1983 Sep, 18(3), 526 - 8 Elimination of multiple reactions of the Phadebact Streptococcus coagglutination test; Jones DE et al.; Strong multiple reactions often occur with the Phadebact Streptococcus test when the culture contains blood . These reactions interfere with the identification of the Lancefield groups of streptococci . Group B streptococci from the vagina of pregnant women are difficult to identify by slide coagglutination because of the frequent presence of blood on culture swabs . Elimination of these multiple reactions caused by blood would permit rapid identification of group B streptococci in pregnant women . Vaginal broth cultures were examined to determine the cause of multiple reactions with slide coagglutination and to eliminate them from the testing procedure . Of 245 maternal broth cultures, 135 (55%) yielded multiple reactions when tested by coagglutination . Such reactions were either eliminated or greatly diminished by heating the broth sample to 90 degrees C for 10 min . It was also found that globulins in the serum may be responsible for multiple reactions with blood . This heating protocol will permit vaginal broth cultures to be rapidly tested for group B streptococci by slide coagglutination. J Infect Dis, 1983 Sep, 148(3), 488 - 91 Use of penicillin-gradient and replicate plates for the demonstration of tolerance to penicillin in streptococci; Kim KS et al.; A new method was developed for the demonstration of tolerance to penicillin in streptococci of groups B and D . The sequential use of penicillin-gradient and replicate plates was simple, reliable, and less time-consuming than conventional methods for the measurement of ratios of minimal bactericidal to minimal inhibitory concentrations and rates of bacterial killing . This method promises to be of value in the further characterization and understanding of penicillin tolerance in vitro and in vivo. Jpn Circ J, 1983 Sep, 47(9), 1121 - 7 Medical treatment of infective endocarditis and its limitations; Matsumoto S et al.; In an attempt to establish an appropriate management program for patients with active infective endocarditis, 30 patients treated during the past 20 years were studied retrospectively . Microorganisms were confirmed in 27 of the 30 patients (90%) (86.7% by culture and 3.3% at surgery) . Among these 27 patients, viridans streptococci were confirmed in 23 (85.2%), aureus staphylococci in 2 (7.4%), epidermidis staphylococci in one (3.7%) and candida albicans in one (3.7%) . Twenty of the 23 patients (87%) with viridans streptococcal endocarditis were treated medically with good success, but 2 patients (8.7%), who developed severe congestive heart failure (NYHA 3-4 degrees), underwent emergency surgery, and one of them (4.3%) died from severe heart failure . The synergistic effects of the combined antibiotic therapy were not ascertained in the present series . It was noteworthy that a bolus intravenous administration of penicillin was more effective than its continuous drip infusion . Both patients with aureus staphylococcal endocarditis died before surgery . One patient with prosthetic valve endocarditis due to candida died after a second operation . It is concluded that most patients with active infective endocarditis can be medically treated successfully, but surgery should be performed urgently for patients with severe heart failure, poor response to antibiotics, aureus staphylococcal and candida endocarditis and prosthetic valve endocarditis. Antonie Van Leeuwenhoek, 1983 Sep, 49(3), 283 - 95 The bacteriophages of lactic acid bacteria with emphasis on genetic aspects of group N lactic streptococci; Teuber M et al.; The paper reviews the bacteriophages of the group N lactic streptococci centering on isolation, ultrastructure and morphology, phage receptors, the structure of the genome, protein components, the phenomenon of the lysogenic state, restriction-modification systems and genetic exchange by transfection and transduction . The resulting consequences on industrial fermentations are briefly discussed. Antonie Van Leeuwenhoek, 1983 Sep, 49(3), 259 - 74 Functional properties of plasmids in lactic streptococci; McKay LL; Plasmid biology has become an important area of investigation in dairy starter cultures since it now appears that some properties, vital for successful milk fermentations, are coded by genes located on plasmid DNA . Some of these metabolic properties observed in lactic streptococci have been clearly established as being plasmid-mediated . Examples would be lactose utilization and in Streptococcus lactis subsp . diacetylactis the ability to produce a bacteriocin-like substance . Phenotypic and physical evidence for plasmid linkage has been obtained for other traits such as citrate, sucrose, galactose, glucose, mannose, and xylose utilization, proteinase activity, modification/restriction systems, as well as for nisin production . Further genetic evidence is now needed to confirm plasmid association to these properties . For some characteristics the association with plasmids is highly speculative and is solely based on the phenotypic loss of a metabolic property . In this category would be sensitivity to agglutinins, sensitivity to the lactoperoxidase-thiocyanate-hydrogen peroxide inhibitory system, arginine hydrolysis, and slime production . Other properties which appear plasmid-mediated in lactic streptococci and which will be discussed include inorganic ion resistance, drug resistance, and diplococcin production. Antonie Van Leeuwenhoek, 1983 Sep, 49(3), 247 - 57 Energy transduction and solute transport in streptococci; Konings WN et al.; Metabolic energy in lactic streptococci can be generated by substrate level phosphorylation and by efflux of end-products in symport with protons . During growth on lactose or glucose Streptococcus cremoris maintains a high proton motive force and phosphate potential . Both energy intermediates dissipate rapidly when the energy supply stops . In the initial phase of starvation the internal phosphoenolpyruvate (PEP) pool increases rapidly and this enables the organism for a prolonged period during starvation to accumulate the energy source via a PEP-dependent uptake system. Yale J Biol Med, 1983 Sep-Dec, 56(5-6), 377 - 83 Evolution of mycoplasmas and genome losses; Neimark H; Streptococci and acholeplasmas have a close evolutionary relationship . We examined their genomes to determine what chromosomal losses occurred to produce the smaller acholeplasma genomes and found by RNA-DNA hybridization that Streptococcus cremoris and S . lactis possess at least five or at least six ribosomal RNA gene sets, respectively, while acholeplasmas have only two rRNA gene sets . Other important deficiencies identified in mycoplasmas are associated with envelope or RNA genes, and analysis of these chromosomal deletions may lead to an understanding of how mycoplasmas evolved from walled bacteria. J Exp Med, 1983 Sep 1, 158(3), 1006 - 11 Protection of mice from experimental infection with type III group B Streptococcus using monoclonal antibodies; Egan ML et al.; Mouse hybridoma antibodies of several major classes against group B streptococcus type III have been produced . Mice were immunized with either whole heat-killed or acid-treated organisms to obtain antibodies against both the complete (sialated) or incomplete (nonsialated) forms of the type III polysaccharide . Resulting monoclonal antibodies showed exclusive specificity for either the complete or incomplete antigen . The ability of these antibodies to protect mice from a lethal challenge of live type III organisms was tested with a mucin model that permitted use of very small inocula given intraperitoneally with antibody and mucin . Antibodies specific for the nonsialated antigen were not protective, whether of IgM, IgG2a, or IgG3 isotypes . Antibodies specific for the complete antigen were, however, highly protective, including monoclonals of IgM, IgG2a, and IgA isotypes . These mouse monoclonal antibodies against group B streptococci that are directed against either complete or incomplete antigenic determinants, and include isotypes other than IgM, should be particularly useful for studying the mechanism of protection against experimental infection. Infect Immun, 1983 Sep, 41(3), 959 - 64 Characterization of binding of human alpha 2-macroglobulin to group G streptococci; Chhatwal GS et al.; An interaction was observed between human alpha 2-macroglobulin (alpha 2M) and streptococci belonging to group A, C, and G . Of 27 group C and 19 group G streptococcal cultures, 13 and 14, respectively, bound 125I-labeled alpha 2M . Some group A streptococci also interacted with alpha 2M . A number of other bacterial species tested did not react with alpha 2M . The binding of 125I-labeled alpha 2M to group G streptococci was time dependent, saturable, and could be inhibited by unlabeled alpha 2M . Inhibition experiments indicated that the streptococcal binding site for alpha 2M differed from the receptors for immunoglobulin G, fibrinogen, aggregated beta 2-microglobulin, albumin, and fibronectin . The alpha 2M binding activity was remarkably sensitive to trypsin and heat treatment indicating its protein nature . Kinetic analysis indicated a homogenous population of binding sites . The number of binding sites per bacterial cell was estimated to be approximately 20,000. South Med J, 1983 Aug, 76(8), 964 - 5 Activity of rifampin against viridans streptococci; Stamm AM et al.; Optimal antimicrobial therapy for viridans streptococcal endocarditis remains controversial . Rifampin was bactericidal at less than 0.2 micrograms/ml for ten strains of viridans streptococci isolated from patients with endocarditis . Administration of rifampin to one endocarditis patient already receiving penicillin and gentamicin increased the serum bactericidal activity fourfold . Rifampin has been effective in combination therapy for serious staphylococcal and enterococcal infections . The combination of penicillin and rifampin may be an effective, less toxic alternative to penicillin and streptomycin for the treatment of viridans streptococcal endocarditis. Infect Immun, 1983 Aug, 41(2), 691 - 7 Prevalence, distribution of serotypes, and cariogenic potential in hamsters of mutans streptococci from elderly individuals; Fitzgerald DB et al.; The prevalence of mutans streptococci (Streptococcus mutans, Streptococcus cricetus, Streptococcus sobrinus, and Streptococcus rattus) was determined in the salivas of 169 elderly individuals ranging in age from 60 to 87 years . Approximately 40% of these individuals were edentulous and wore full upper and lower dentures . With the exception of a higher proportion of saliva counts below 1,000 CFU/ml in the full-denture wearers, the prevalence and the serotype and species distributions of the mutans streptococci were similar in the denture wearers and individuals with natural teeth only . The species and serotype distributions of mutans streptococci in this elderly population were also consistent with reported observations of other workers on younger, more caries-prone populations . A total of 87 representative isolates of the mutans streptococci were tested for cariogenic potential in a hamster model system . A considerable degree of variation in virulence between different strains was observed . However, these differences were not relatable to individual species or serotypes or to whether the organisms were isolated from denture wearers or naturally dentate subjects . The results of our studies indicate that elderly individuals with either natural or artificial dentitions may be a hitherto unrecognized reservoir of mutans streptococci having varying degrees of potential cariogenicity . Hence, in close family situations they could serve, along with parents and siblings, as vectors in the initial transmission of cariogenic microorganisms to young children. Clin Immunol Immunopathol, 1983 Aug, 28(2), 229 - 42 Serologic cross-reactions among streptococcal group A, A-variant, and C polysaccharides; Shulman ST et al.; Serologic cross-reactions among streptococcal groups A, A-variant (A-V), and C cell wall polysaccharides were found previously in studies employing capillary or quantitative precipitin techniques . Similar cross-reactions occur with radioimmune precipitation using extrinsically labeled 125I-streptococcal antigens . This study was performed to determine the degree of cross-reactivity when intrinsically labeled 14C-polysaccharide antigens were used in the radioimmune precipitin assay . Unadsorbed antisera from rabbits immunized with group A streptococci bound 3-5% as much 14C-A-V antigen as homologous A carbohydrate but undetectable amounts of C polysaccharide . Similarly, A-V antisera bound 3-5% as much 14C-A or 14C-C carbohydrate as A-V antigen . Group C antiserum bound 1-2% as much A and A-V antigens as C carbohydrate . Thus, less than 3% of intrinsically labelled 14C-A or 14C-C carbohydrate represents exposed A-V antigenic sites, i.e., exposed polyrhamnose backbone . Otherwise, group A, C, or A-V carbohydrates failed to exhibit heterologous determinants . Anti-peptidoglycan antibodies in antisera did not result in serologic cross-reactivity . These data suggest that formamide-extracted streptococcal group-specific polysaccharides, intrinsically labeled with 14C, may possess greater group specificity than 125I-carbohydrates and yield only negligible cross-reactivity with heterologous antisera . This degree of cross-reactivity does not appear to be sufficient to account for the persistently elevated serum levels of antibody to group A carbohydrate in patients with rheumatic heart disease. Vet Microbiol, 1983 Aug, 8(4), 373 - 87 Jaw disease in macropod marsupials: bacterial flora isolated from lesions and from the mouths of affected animals; Samuel JL; Bacterial infections of the jaws are a common cause of death in macropods . Lesions and oral cavities from 50 affected animals yielded wide ranges of aerobic and anaerobic organisms . The most frequent isolate from lesions (81%) was Fusobacterium necrophorum, generally combined with other bacteria, but in 5 lesions, in pure culture . It was also isolated from 61% of mouths and this was the chief difference between the oral flora of affected and normal macropods . Other groups of organisms isolated from over 50% of lesions were: Gram-negative aerobic and anaerobic rods, streptococci, anaerobic Gram-positive cocci . Actinomycetes were isolated from 29% of lesions and from one lesion in pure culture . Differences in the flora were detected between lesions in bone and soft tissue and between closed and open lesions . Antibiotics were given to 22 animals, but without significant differences in frequencies of isolation of organisms between treated and untreated groups, and with no permanent elimination of infection . It was concluded that, while different organisms might be present in the complex of "jaw disease", the pathogenic agent in the majority of cases was F . necrophorum . Actinomycetes were capable of producing lesions in bone, but their role in "jaw disease" remains undefined. Gan To Kagaku Ryoho, 1983 Aug, 10(8), 1850 - 7 {Experimental and clinical effect of hypertransfusion and OK-432 on granulocyte recovery}; Nomura T et al.; The experimental and clinical studies were carried out to alleviate the bone marrow suppression by antineoplastic drugs . Faster recovery of granulopoiesis was observed by pretreating recipients with RBC hypertransfusion and/or OK-432 (Picibanil, biological products of beta-streptococci.) In experimental mice, higher granulocyte counts could be maintained with hypertransfusion in the peripheral blood, and the recovery of granulopoietic series and CFU-S of bone marrow cells were found to be more rapid after cyclophosphamide administration . OK-432 also resulted in higher peripheral granulocyte, whereas the total nucleated cell counts and CFU-S were decreased in the bone marrow, suggesting sparing bone marrow granulocyte reserve and its migration to the peripheral blood . The mechanism of higher granulocyte count after hypertransfusion was not clearly explained but it was considered that erythroid suppression caused colateral flow of multipotential stem cells to granulopoiesis . The effect of both combinations was unexpectedly less significant in the recovery of granulopoiesis, but it was thought that the optimal time interval should be sought between pretreatment and the administration of anti-neoplastic agents . The clinical use of hyper transfusion and OK-432 also proved the alleviation of granulocytopenia, and rapid granulocyte recovery at the time of consolidation therapy among children with AML. J Antimicrob Chemother, 1983 Aug, 12(2), 141 - 6 Resistance in oral streptococci after repeated two-dose amoxycillin prophylaxis; Southall PJ et al.; Twelve normal volunteers received two doses of 3 g amoxycillin at weekly intervals on up to five occasions . Amoxycillin-resistant oral streptococci were not isolated from any subject beforehand, but they had appeared in all eleven subjects (who could be included in the analysis) by the end of the investigation, and in one subject after one administration of double dose amoxycillin . Resistant streptococci were undetectable in all volunteers 13 weeks after their last dose of amoxycillin . All resistant streptococci identified were Streptococcus sanguis (non-dextran-producing), many were highly resistant to amoxycillin and some were also moderately resistant to erythromycin . The minimum bactericidal concentrations for the most resistant streptococcal strains isolated were less than the peak serum amoxycillin concentrations expected following a 3 g oral dose of amoxycillin . In the majority of volunteers the counts of oral resistant streptococci had greatly declined by about 6 weeks following the last administration of a double dose of amoxycillin . If further dental treatment liable to cause bacteraemia is required within six weeks of double dose amoxycillin prophylaxis an alternative regimen should be sought. Infect Immun, 1983 Aug, 41(2), 501 - 6 New Actinomyces and Streptococcus coaggregation groups among human oral isolates from the same site; Kolenbrander PE et al.; The coaggregation properties of recent human oral streptococcal and actinomyces isolates from the same site were determined and compared with the coaggregation properties of well-characterized stock strains of these two kinds of bacteria . Streptococcus sanguis, Actinomyces viscosus, Actinomyces naeslundii, and phenotypically similar strains of actinomyces were isolated from subgingival samples from periodontally healthy older individuals, from persons participating in an experimental gingivitis study, and from young persons with localized (juvenile) and generalized (severe) periodontitis . All 34 of the actinomyces isolates coaggregated with reagent strains of S . sanguis that represented the four streptococcal coaggregation groups . Most of these actinomyces exhibited coaggregations identical to those of actinomyces stock strains . However, five isolates of an Actinomyces WVa-963 serovar exhibited a coaggregation pattern different from any previously described, which was used to define coaggregation group F . All coaggregations with members of this group were lactose inhibitable . Only 57% (8 of 14) of the recent S . sanguis isolates coaggregated with actinomyces reagent strains . But when the nonreactive streptococcal isolates were tested for their ability to coaggregate with actinomyces from the same patient, a new, highly specific coaggregation pattern (group 6) for S . sanguis was discovered . Coaggregation of these streptococci was observed only with certain isolates of A . naeslundii (members of coaggregation group D) from the same site, and none of these coaggregations were inhibited by lactose . Subsequent testing revealed that streptococci of group 6 coaggregated with group D actinomyces from other sources but not with actinomyces of other coaggregation groups . Only two strains of S . sanguis failed to coaggregate with any strain of actinomyces tested . These results indicate that nearly all fresh isolates of these species obtained from both diseased and healthy sites exhibit specific, nonrandom patterns of coaggregation and suggest the widespread occurrence of in vivo cell-to-cell recognition between oral actinomyces and streptococci. Infect Immun, 1983 Aug, 41(2), 449 - 52 Prevalence of viridans streptococci exhibiting lactose-inhibitable coaggregation with oral actinomycetes; Kolenbrander PE et al.; Fresh oral isolates from human dental plaque were selected on the basis of their spherical morphology . In a double-blind experiment, their species identity and ability to coaggregate with human oral Actinomyces viscosus and Actinomyces naeslundii were determined . Of the 110 isolates characterized, 30 were identified as either Streptococcus mutans, Streptococcus anginosus-constellatus, or Veillonella parvula; none of these coaggregated with the actinomycetes . The remaining 80 isolates were identified as Streptococcus sanguis, Streptococcus mitis, Streptococcus MG-intermedius, or Streptococcus morbillorum . Of these 49 isolates (61%) coaggregated with actinomycetes, and nearly 90% (43 of 49 isolates) exhibited lactose-inhibitable coaggregations . Compared with previously characterized coaggregation properties determined with stock culture strains of streptococci, 82% of the fresh isolates exhibited identical coaggregations . The other 18% made up a new coaggregation group that possessed a related lactose-inhibitable coaggregation pattern . Thus, most fresh isolates that coaggregated exhibited lactose-inhibitable coaggregations with human oral actinomycetes . It is suggested that these coaggregations are mediated by a network of lectin-carbohydrate interactions similar to those already characterized in previous studies with stock cultures of actinomycetes and streptococci. Acta Pathol Microbiol Immunol Scand {C}, 1983 Aug, 91(4), 271 - 81 Effect of early penicillin treatment on the development of experimental poststreptococcal glomerulonephritis; Bergholm AM et al.; A newly developed experimental model in which poststreptococcal glomerulonephritis (PSGN) was established in rabbits utilizing viable group A streptococci, was used to study the possibility of hindering the development of renal disease by early penicillin treatment . The development of renal injury was followed by proteinuria, creatinine clearance, histological and immunological examinations of the kidneys . Therapy within the first 3 days of infection with i.m . pc-G prevented the nephritic process. Acta Pathol Microbiol Immunol Scand {B}, 1983 Aug, 91(4), 231 - 4 Ibc proteins as serotype markers of group B streptococci; Bevanger L; A collection of 106 clinical isolates of group B streptococci were type classified by a direct fluorescent antibody test (FAT) . In all, 99 of the isolates were typable and belonged to the serotypes Ia (8 strains), Ib (9 strains), Ic (30 strains), II (15 strains), or III (37 strains) . The presence of Ibc proteins was demonstrated in 60 of the strains, including 6 of the non-typable isolates . Indirect FAT was performed to test whether the bacteria produced the alpha and beta antigens of the Ibc protein fraction, using specific anti-alpha and anti-beta sera . Both alpha and beta were produced by 22 strains, only alpha by 33 strains, and only beta by 5 strains . The results show that the alpha and beta antigens can be used as markers to detect serovars among group B strains which carry identical serotype-specific carbohydrate antigens, or strains listed as nontypable according to the classification currently used. J Dairy Sci, 1983 Aug, 66(8), 1790 - 4 Mastitis control: a discussion; Smith KL; Methods of mastitis control that are effective against Streptococcus agalactiae and Staphylococcus aureus have been developed and proven successful . These control procedures, however, are not as effective against the environmental pathogens . Environmental pathogens are predominantly the coliform bacteria and species of streptococci other than Streptococcus agalactiae . The total extent of their present involvement in mastitis is not well documented, and this is due in part to differences in the nature of infection by environmental pathogens compared to Streptococcus agalactiae and Staphylococcus aureus infections . Concern regarding the importance of environmental pathogens in mastitis is increasing . This concern is based, first, on current trends of dairy cattle housing and management that increase exposure to teat ends to environmental pathogens and, second, on a reduction of prevalence of Streptococcus agalactiae and Staphylococcus aureus infected quarters . The latter is a result of the effectiveness of postmilking teat end disinfection and dry cow therapy . Development of equally effective control methods for the environmental pathogens will be an important area of future mastitis research. J Clin Microbiol, 1983 Aug, 18(2), 318 - 20 Rapid diagnosis of group A streptococcal antigen extracted directly from swabs by an enzymatic procedure and used to detect pharyngitis; Otero JR et al.; Coagglutination after enzymatic digestion is a widely used, rapid procedure for serogrouping isolated colonies of beta-hemolytic streptococci . We tried to determine whether the same procedure could be used for the detection of group A streptococcal antigen directly from swabs used to take throat samples . This was achieved by incubating the swabs immersed in a small quantity of lytic extract obtained from cultures of the Maxted strain of Streptomyces griseus and testing the supernatant fluid by coagglutination . Of 538 throat swabs tested, blindly comparing the results of conventional cultures and rapid antigen detection, both tests were negative in 480 and both were positive in 49 swabs . In six cases, culture was positive and the rapid test was negative, but only one swab was from a patient with acute pharyngitis . In three cases, cultures were negative but the rapid test showed a strongly positive reaction . No special instructions were given to the physicians taking the samples . We conclude that this rapid antigen detection test, giving results in approximately 1 h, is an economic and reliable procedure for the detection of group A streptococcal antigen directly from throat samples. J Hyg (Lond), 1983 Aug, 91(1), 71 - 6 Type 49 Streptococcus pyogenes: phage subtypes as epidemiological markers in isolates from skin sepsis and acute glomerulonephritis; Skjold SA et al.; Studies of group A, M type 49 streptococci from England, Trinidad and Alaska indicate that isolates of this serotype often differ with respect to phage subtype from one geographical area to another, but are generally homogeneous in one place at one time . The findings support the conclusion that acute glomerulonephritis can be associated with a variety of phage subtypes of M type 49 streptococci . In outbreaks of skin sepsis without nephritis in England, the phage subtypes of M type 49 streptococci isolated from skin lesions of meat handlers were the same as those recovered from skin lesions of non-meat handlers in the same community . The findings on the Trinidad isolates suggest that M type 49 streptococci of one phage subtype may persist in a population for 9 years and may result in a second outbreak of acute glomerulonephritis . In an Alaska Eskimo population in whom acute glomerulonephritis was occurring, most of the M type 49 isolates available for testing were of a single phage subtype . Equally prevalent in this population were group A streptococci that exhibited the same T antigen as the type 49 isolates but differed in their serum opacity reaction and phage subtype . This apparently related strain was not typable with available M antisera but showed functional evidence of M protein and is probably a new M type. Infect Immun, 1983 Aug, 41(2), 618 - 23 Lethal synergism induced in mice by influenza type A virus and type Ia group B streptococci; Jones WT et al.; Intranasal inoculation of CD-1 or BALB/c mice with low doses of influenza A/PR8/34 (HON1) virus followed 48 h later by intranasal inoculation of low doses of type Ia group B streptococci effected a lethal synergism . At a constant input dose of virus, a direct relationship between input dose of bacteria and percent mortality was observed; the converse was also true . An inverse relationship between input dose of group B streptococci, but not input dose of virus, and mean time to death was observed in CD-1 but not in BALB/c mice . The kinetics of influenza A/PR8/34 virus and group B streptococcal replication in singly and dually infected BALB/c mice was determined by assaying samples from the lungs, liver, spleen, and blood for viable group B streptococci and infectious influenza A/PR8/34 virus . No significant difference in virus replication in the lung was observed between singly and dually infected mice . Extrapulmonary dissemination of virus was not observed . Concurrent virus infection effected a 10,000- to 100,000-fold increase in the levels of type Ia group B streptococci in the lung . Potentiation of group B streptococcal infection of the lung was not associated with bacteremia or infection of the liver or spleen, a finding contrary to previous observations of fulminant septicemia after intranasal inoculation of mice with input doses of group B streptococci less than one-tenth of the pulmonary levels observed in the present study. Infect Immun, 1983 Aug, 41(2), 527 - 34 Isolation, chemical composition, and molecular size of extracellular type II and type Ia polysaccharides of group B streptococci; De Cueninck BJ et al.; Polysaccharides carrying the type II- and type Ia-specific determinants of Lancefield group B streptococci were isolated and purified by anion-exchange chromatography and gel filtration from the supernatant culture medium after growth of strain 18RS21/67/1 (type II) and strain DS/1204/78 (type Ia), respectively . The average molecular weights of these polysaccharides were 97,000 (type II) and 94,000 (type Ia), as determined by reducing end group analyses . These molecular weights were in reasonably good agreement with molecular weights determined by gel filtration at high ionic strength on calibrated columns . The polysaccharides did not cross-react with antisera specific for the other type-specific determinants or with group B-specific antisera . Their content of galactose, glucose, glucosamine, and neuraminic acid (the last two calculated as N-acetyl derivatives) accounted for over 96% of their dry weight . The two polysaccharides differed from each other (and from type III polysaccharide) in their relative content of these monosaccharides . The molar ratios of galactose, glucose, and neuraminic acid to glucosamine were 3.3:2.3:1.35:1.0 for the type II polysaccharide and 2.0:0.8:1.4:1.0 for the type Ia polysaccharides . The results obtained indicate that these extracellular type II and Ia polysaccharides contain larger amounts of neuraminic acid than can be accounted for by previously proposed structures of their repeating units. Boll Soc Ital Biol Sper, 1983 Jul 30, 59(7), 995 - 9 {Comparison of different methods for the identification of groups of streptococci}; Ceddia T et al.; The Streptococci, isolated from 500 mucus-pharyngeal tampons, have been tested, for a group identification, by means of four different techniques in order to value the specificity and reliability in comparison with more traditional and, sometimes, more complex tests; such as Maxted and Lancefield . The most suitable method for routine researchers of microbiology laboratories is the one based on the extraction, by means of enzyme obtained from Streptomyces Griseus, of streptococci antigens before starting their serum identification, possible for A-B-C-D-F-G groups (Streptex) . On the contrary, the method based on the links of group-specific antibodies with the A protein of the surface of Staphylococci Cowan I, has resulted more defective because Streptococci D and F cannot be grouped, and less specific because of frequent co-agglutinations. J Reticuloendothel Soc, 1983 Jul, 34(1), 1 - 11 Glucan alteration of pulmonary antibacterial defense; Kimura A et al.; Particulate yeast glucan, prepared by the methods of Northcote and Horne and Peat et al, was studied in rats and mice to determine its protective capacity in respiratory infection . Glucan was administered intravenously to rodents prior to infection with aerosols of bacteria . Glucan-treated rats had significantly increased rates of phagocytosis and killing of Staphylococcus aureus immediately after infection and minimal increases at 4 h . In contrast, pulmonary killing of Klebsiella pneumoniae in rats was markedly enhanced by glucan at 4 h . Glucan treatment of mice provided only transient protection against pulmonary infection with group C streptococci . Histological studies demonstrated greatly increased numbers of macrophages in the lungs of glucan-treated rats; the lungs of glucan-treated mice appeared normal . These results show that glucan can enhance intrapulmonary bacterial killing . In rats, this is due to the ability of glucan to increase the number of lung macrophages resulting in increased bacterial ingestion . Glucan-induced protection in mice is less clear. Infect Immun, 1983 Jul, 41(1), 162 - 8 Interaction of human plasma fibronectin with cariogenic and non-cariogenic oral streptococci; Babu JP et al.; The interaction of purified human plasma fibronectin (Fn) with bacteria was studied with a variety of oral streptococci . Each of the strains of Streptococcus mutans, Streptococcus salivarius, Streptococcus sanguis, and Streptococcus mitis tested was aggregated by Fn to various degrees, depending on the concentration of Fn added to the test mixtures . Binding assays performed with radiolabeled Fn and various strains of streptococci demonstrated various capabilities to bind Fn, and the amount of Fn bound by each strain was paralleled by its Fn-induced aggregation, with S . mutans 6715 giving the highest values in both assays . Because of the avid binding of Fn by certain strains of potentially cariogenic streptococci, we investigated the possibility that Fn may be present in human saliva and may be adsorbed from saliva onto artificial tooth pellicles . Immunoreactive Fn was detected in paraffin-stimulated whole saliva by enzyme-linked immunosorbent assays of saliva adsorbed onto gelatin-coated cuvettes and by immunoelectroblots (Western blots) of salivary components separated on sodium dodecyl sulfate-polyacrylamide slab gels . Furthermore, immunoreactive Fn was found to be present in artificial tooth pellicles formed by incubating hydroxyapatite beads with whole human saliva . These results demonstrate that certain strains of oral streptococci bind to and are aggregated by Fn . The presence of Fn in artificial tooth pellicles suggests that this macromolecule may play a role in the attachment of potentially cariogenic and other oral streptococci to dental tissues. Am J Clin Pathol, 1983 Jul, 80(1), 107 - 10 Vitamin B6-dependent Streptococcus mimicking fungi in a patient with endocarditis; Dykstra MA et al.; A patient was referred to our hospital with a tentative diagnosis of fungal endocarditis based upon clinical symptoms, suggestive travel history, and microscopic visualization in blood cultures of gram-negative bulbous filaments that appeared to be fungal elements . Subcultures of the blood culture bottles were unsuccessful on all media with the exception of blood agar plates, which had been cross-streaked with Staphylococcus aureus . These plates grew vitamin B6-dependent streptococci . This nutritionally variant organism was determined by biochemical tests to be Streptococcus mitis (mitior) . It had a penicillin MIC and MBC of 0.015 micrograms/mL and 0.03 micrograms/mL, respectively and streptomycin MIC and MBC of 0.78 micrograms/mL and 1.56 micrograms/mL, respectively . The patient was treated with these two agents and recovered . We stress the importance of suspecting vitamin B6-dependent streptococci, even when gram stains may suggest presence of other microorganisms. Biomaterials, 1983 Jul, 4(3), 225 - 7 Copper-inhibition of the growth of oral streptococci and actinomyces; Duguid R; Copper ions were found to inhibit the rate of growth in broth culture of Streptococcus mitis, Streptococcus mutans, Streptococcus salivarious, Streptococcus sanguis, Actinomyces viscosus and Actinomyces naeslundii . In all cases, 10(-3) M copper inhibited the rate of growth, whereas 10(-4) M and lower concentrations had little or no effect . At the concentrations used in mouthwashes one mode of action of copper ions is to reduce the rate of growth of oral bacteria in vitro. Am J Med Sci, 1983 Jul-Aug, 286(1), 31 - 6 Penicillin sensitive nutritionally variant streptococcal endocarditis: relapse after penicillin therapy; Levine JF et al.; Studies to date have indicated that nutritionally-variant streptococci (NVS) causing bacterial endocarditis are frequently inhibited but not killed by low concentrations of penicillin . We report a patient with endocarditis due to a NVS strain which was killed in vitro by penicillin at a concentration of 0.09 microgram/ml . Despite therapy with intravenous penicillin for four weeks, the infection relapsed and was then cured by combined penicillin-gentamicin in therapy . In vitro studies demonstrated a synergistic effect of these two antibiotics . This experience suggests that combination therapy with penicillin and an aminoglycoside may be required for cure of all cases of nutritionally-variant streptococcal endocarditis regardless of in vitro susceptibility to penicillin. J Clin Microbiol, 1983 Jul, 18(1), 29 - 32 Rapid biochemical tests for the identification of groups A, B, C, F, and G streptococci from throat cultures; Slifkin M et al.; A test employing three fluorogenic 4-methylumbelliferyl substrates and the lectin of Dolichos biflorus was developed for the identification of beta-hemolytic streptococcal colonies associated with throat cultures . This non-serological method is unique in that it permits the accurate identification of groups C, F, and G streptococci, as well as groups A and B streptococci . The method is rapid, simple, and specific and appears to be a useful means to identify groups A, B, C, F, and G streptococci. Infect Immun, 1983 Jul, 41(1), 28 - 32 Effects of cell wall inhibitors on cell division in Streptococcus mutans; Kral TA et al.; The addition of inhibitors of cell wall biosynthesis to exponential-phase cultures of Streptococcus mutans may do one of three things, depending on the concentrations used: (i) prevent cell division at a time coincident with the onset of chromosome replication, (ii) prevent cell division later in the cell cycle coincident with or near completion of septation, or (iii) lead to limited cell lysis . The relative tolerance of S . mutans to inhibitors of cell wall biosynthesis may be due to the fact that S . mutans cultures treated with low levels of cell wall antibiotics seem to be blocked at a stage before initiation of autolytic activity, whereas cultures treated with high levels of these antibiotics seem to be blocked after termination of the autolytic phase . Thus, the cells escape