Inflammation, 1982 Dec, 6(4), 343 - 64 Bacteria and zymosan opsonized with histone, dextran sulfate, and polyanetholesulfonate trigger intense chemiluminescence in human blood leukocytes and platelets and in mouse macrophages: modulation by metabolic inhibitors in relation to leukocyte-bacteria interactions in inflammatory sites; Ginsburg I et al.; Human blood leukocytes and platelets and mouse peritoneal macrophages emit very rapid and very intense Luminol-dependent chemiluminescence (CL) signals when treated with streptococci, staphylococci, or with zymosan, which have been preopsonized with arginine-rich histone, dextran sulfate or polyanetholesulfonate (liquoid) . Liquoid alone at 10-30 micrograms/2 X 10(5) leukocytes also triggers intense CL responses in the absence of a carrier . Strong CL can also be triggered, and at the same levels, when the various polyelectrolytes are simply mixed with the bacteria or zymosan and added to the leukocyte suspensions . The CL responses induced by the polyelectrolyte-bacteria complexes greatly exceed those triggered in leukocytes by antibody-complement-coated particles . Liquoid also shows a unique property of markedly augmenting CL signals which have already been induced by other ligand-coated bacteria or zymosan particles . Streptococci and staphylococci were found to be much superior to zymosan, Gram-positive bacilli, or E . coli as carriers for the various polyelectrolytes in the CL reaction . Neither protamine sulfate, lysozyme, myeloperoxidase, crystalline ribonuclease (all cationic in nature), chondroitin sulfate, heparin, nor alginate sulfate acted as ligands for triggering CL, when used to opsonize bacteria or zymosan . The induction of CL in blood leukocytes by the various ligand-coated bacteria is markedly inhibited by azide, KCN catalase, aminotriazole, and EDTA, agents known to inhibit the production of oxygen radicals following stimulation of leukocytes by opsonized bacteria . Two children diagnosed for chronic granulomatous diseases (CGD) of childhood and an apparently healthy sister of one of the male patients completely failed to respond with CL either to the polyelectrolyte-bacteria complexes, liquoid or antibody-coated bacteria and zymosan . It is proposed that liquoid be employed for the rapid screening of defects in certain oxygen-dependent metabolic processes in both PMNs and macrophages . It is also suggested that polyelectrolytes like the ones described in this study may markedly enhance the bactericidal properties of leukocytes and macrophages towards both extracellular and intracellular microorganisms and may perhaps also augment the tumoricidal effects of activated macrophages. Infect Immun, 1982 Dec, 38(3), 925 - 31 Antigenic determinant of the Lancefield group H antigen of Streptococcus sanguis; Rosan B et al.; Previous studies indicated that the teichoic acid isolated from strains of Streptococcus sanguis was group specific and defined the Lancefield group H streptococci . To determine the specific antigenic determinants, the antigen was extracted from a group H streptococcus (ATCC 903) by the phenol-water method and purified by column chromatography . The isolated antigen had a glycerol/phosphate/glucose molar ratio of 1:0.9:0.3; the lipid concentration was 7.6% of its dry weight . No nucleic acids were detected, and amino acids constituted approximately 2% of the dry weight . The minimum concentration of antigen required to sensitize erythrocytes for hemagglutination with a 1:1,000 dilution of either group H antiserum or antiteichoic acid serum was 0.02 microgram/ml . Hemagglutination inhibition studies suggested that the major antigenic determinant consisted of an alpha-glucose linked to the glycerol phosphate backbone. FEBS Lett, 1982 Nov 29, 149(2), 233 - 9 Transmembrane potential variations accompanying the PMA-triggered O-2 and H2O2 release by mouse peritoneal macrophages; Lepoivre M et al.; Stimulation by PMA of Streptococci-elicited macrophages induced a transient membrane depolarization preceding the onset of detectable O-2 production . Mice-resident peritoneal macrophages were unresponsive to PMA for both activities . The PMA-triggered membrane depolarization seemed to be independent from O-2 production because inhibition of membrane depolarization by EGTA had no effect on rates of O-2 or H2O2 release and rate of antimycin A insensitive O2 uptake by Streptococci-elicited macrophages . The portion of O2 uptake recovered as O-2 was found to be 1/3 . The rate of O-2 release was twice the rate of H2O2 production (1.1 nmol H2O2.min-1 X 10(6) macrophages-1). Nouv Presse Med, 1982 Nov 18, 11(46), 3385 - 90 {In vitro antibacterial activity of dibekacin on staphylococci, streptococci and aerobic Gram negative bacilli}; Deforges L et al.; Dibekacin is a new aminoglycoside derived semi-synthetically from kanamycin B . Its in vitro antibacterial activity, evaluated by the study of 43 reference strains and 1,177 clinical isolates, was found to be very similar to that of gentamicin, tobramycin, sisomicin and netilmicin on strains sensitive to these aminoglycosides; in the case of strains carrying plasmidic resistance factors, dibekacin behaves like tobramycin; it is inactivated by the same bacterial enzymes. Schweiz Rundsch Med Prax, 1982 Nov 16, 71(46), 1812 - 5 {Useful and superfluous measures in the treatment of respiratory infections}; Mombelli G; A safe and inexpensive approach to respiratory infections requires: 1 . an accurate diagnosis, 2 . a critical attitude towards drugs whose clinical efficacy is unproven, 3 . to avoid antibiotics where they are not strictly indicated, 4 . to use penicillin instead of more expensive (and often less active) antibiotics in the treatment of infections due to streptococci or pneumococci. Schweiz Med Wochenschr, 1982 Nov 6, 112(45), 1592 - 6 {Etiology and clinical course of bacterial endocarditis, 1971-1980}; Hammel T et al.; Etiology and clinical course of infective endocarditis were analyzed in 31 patients seen at this institution between 1971 and 1980 . The follow-up period averaged 60 (1-180) months . The infection relapsed 9 times (relapse rate 31-38%) . The etiologic agent isolated from blood cultures in 26/42 infective episodes . Penicillin-sensitive streptococci were by far the most frequent cause of infective endocarditis (46%), followed by Staphylococcus aureus in 23% . A predisposing cardiac lesion existed in 26/31 patients (84%), aortic valve disease and a prolapsing mitral valve being the most frequent . In the 31 patients there were 5 deaths, 2 of which occurred acutely within a few days following the onset of endocarditis (mortality rate 6%), 2 suddenly after completion of antimicrobial therapy and 1 from another cause during the observation period . Surgery was necessary in 18 patients, emergency valve replacement being required in 3 cases (10%) . In 15 patients (52%) cardiac surgery was performed electively after healing of the endocarditis . The indication for surgery was onset of heart failure due to valvular incompetence in 16 patients and recurrent systemic embolization in 2 patients . All patients survived surgery . At restudy no difference was observed in overall cardiac function, physical working capacity and employment activities among the surviving patients whether operated upon or not. Antimicrob Agents Chemother, 1982 Nov, 22(5), 930 - 2 Activity of nine antimicrobial agents against Lancefield group C and group G streptococci; Rolston KV et al.; The activity of nine antimicrobial agents against 44 strains of group C and group G streptococci was studied using a microtiter broth dilution technique . Several antimicrobial agents, including third-generation cephalosporins, the newer semisynthetic penicillins, and erythromycin, exhibited good activity against the organisms . Occasional tolerance to various agents was observed . No cross-tolerance was observed in this study. J Dairy Sci, 1982 Nov, 65(11), 2119 - 24 Nonantibiotic approach in control of bovine mastitis during dry period; Oliver SP et al.; Twenty cows were used to determine effectiveness of a nonantibiotic method for control of intramammary infection during the dry period . Right mammary quarters of cows were infused with colchicine, endotoxin, or both at 1 day prior to or at the end of lactation . Left quarters were uninfused controls within group . Samples (n = 1105) of foremilk were obtained aseptically from quarters for bacteriological analysis . Quarters were sampled during the last week of lactation, early nonlactating period, prepartum, at parturition, and 1 and 2 wk postpartum . Primary pathogens isolated were esculin + streptococci, coagulase + staphylococci, and coliform bacteria . Isolation of primary pathogens was reduced 50% in right infused quarters during the 1st wk of involution as compared to left uninfused quarters . Thirteen of 80 quarters were infected at the end of lactation (6 right and 7 left), and 20 of 80 quarters (9 right and 11 left) were infected at calving . Sixteen of the 20 infections at calving were new during the dry period . Treatment reduced infection during early involution but failed to prevent new infection during the remainder of the dry period. Am J Med Sci, 1982 Nov-Dec, 284(3), 36 - 9 Scarlet fever, Toxic-shock syndrome and the Staphylococcus; Rahman AN et al.; A case of scarlet fever studied in 1959 and caused by Staphylococcus aureus, phage type 52/52a/80 infection of a surgical burn is reported . The literature is reviewed and data are presented which indicate the distinct antigenicity of the erythrogenic toxins of staphylococci and group A streptococci . The patient developed neutralizing antibodies to staphylococcal toxin which disappeared ten months after infection . The similarity of the rashes and desquamation of the skin of several diseases caused by staphylococci indicate at least one common toxin. South Med J . 1982 Nov;75(11):1427. Bacteremic group G streptococcal pneumonia; Vracin W et al.; Bacteremic group G streptococcal pneumonia occurred in a patient with premyelogenous leukemia and porphyria cutanea tarda . Group G streptococci have been recognized as a cause of endocarditis, septic arthritis, puerperal sepsis, and cellulitis . The organism has not previously been implicated as a pneumonic pathogen in adults . Group G streptococcal infection may be more common than previously reported, and is likely to cause infection in patients with underlying malignancy. Arch Dermatol, 1982 Nov, 118(11), 934 - 6 Atypical erysipelas caused by group G streptococci in a patient with cured Hodgkin's disease; Shama S et al.; Erysipelas developed in a young woman whose condition had been in remission for ten years after treatment of stage IIIA Hodgkin's disease . The erysipelas was atypical both in its clinical manifestation and its causative organism . The patient had an erythematous, macular eruption on both buttocks and thighs . Group G streptococci, a rare cause of erysipelas, were isolated from both blood cultures and a skin biopsy specimen . The unusual clinical manifestation of the disease when the patient was initially seen may have been the result of a group G streptococcal bacteremia, coupled with impairment of the lymphatic drainage of the involved area from a partial thoracic duct obstruction and a restrictive cardiomyopathy, both secondary to previous irradiation treatment. J Med Microbiol, 1982 Nov, 15(4), 451 - 64 The opacity factor of group-A streptococci; Hallas G et al.; Cell-bound opacity factor (OF) was extracted with sodium dodecyl sulphate (SDS) to yield stable extracts with titres of greater than 20 000 . The mol.-wt distributions of extracellular and SDS-extracted OF, determined by ultrafiltration or chromatography on Sepharose 4B, suggested that the high mol . wt (1 x 10(6)) of extracellular OF is due to aggregation, because cell-bound and extracellular OF in the presence of SDS had an average mol . wt of only 2 x 10(5) . At least four apparent multiple-molecular forms (mol . wt 7.4-12.0 x 10(4)) of OF were detected by SDS polyacrylamide-gel electrophoresis . It seemed more probable that these were due to aggregation rather than the existence of different stable conformations . To explain the molecular-size distribution, the subunit would have to be as small as 1 x 10(4) but this was supported by the finding that OF can be detected after passing through a dialysis membrane provided that its "substrate", alpha 1-lipoprotein, is present on the other side . This raises the possibility that OF is associated with a carrier molecule . The isoelectric-focusing profiles of OF were complex and differed markedly with the method used to prepare OF . Extracellular OF had a simple profile with an isoelectric point of 4.0, whereas Triton-extracted OF was the most complex and formed three peaks, the position of which varied depending on whether the detergent was present or absent during focusing runs. Res Vet Sci, 1982 Nov, 33(3), 333 - 7 Electron microscopic visualisation of the in vitro phagocytosis of group B streptococci by bovine polymorphonuclear leucocytes; Mackie DP et al.; The phagocytosis of group B streptococci by bovine blood polymorphonuclear leucocytes, after 30 minutes at 37 degrees C, was visualised using scanning and transmission electron microscopy . Several polymorphonuclear leucocytes were seen to have phagocytosed more than one bacterium, despite the initial ratio of bacteria to cells being unity . All bacteria within the cells appeared to be viable and some were undergoing multiplication. Antimicrob Agents Chemother, 1982 Nov, 22(5), 897 - 900 Susceptibility of group B streptococci to 16 beta-lactam antibiotics, including new penicillin and cephalosporin derivatives; Jacobs MR et al.; The susceptibility of 100 group B streptococci to 16 beta-lactam antibiotics was tested by agar dilution . Penicillin G and N-formimidoyl thienamycin were the most active agents tested, both having a 90% minimal inhibitory concentration (MIC90) of 0.06 microgram/ml . Ceftriaxone, cefotaxime, cefamandole, and SCH 29482 were almost as active, all having an MIC90 of 0.12 microgram/ml, and ampicillin, cephalothin, and mezlocillin all had an MIC90 of 0.25 microgram/ml . The MIC90 for piperacillin, cefoperazone, and ceftazidime was 0.5 microgram/ml . Least active were carbenicillin, ticarcillin, cefoxitin, and moxalactam, with MIC90s of 1, 2, 4, and 8 micrograms/ml, respectively . No penicillin-tolerant strains were detected. Infect Immun, 1982 Nov, 38(2), 791 - 4 Influenza type A virus-mediated adherence of type 1a group B streptococci to mouse tracheal tissue in vivo; Jones WT et al.; Influenza type A virus-mediated adherence of pathogenic bacteria to the mucosal surface of the respiratory tract may be one of several mechanisms whereby influenza predisposes to bacterial pneumonia . In the present study, we quantified the adherence of intranasally administered type 1a group B streptococci to the tracheal tissue of influenza type A/PR8/34 (HONI) virus-infected and mock-infected mice . Influenza type A/PR8/34 virus infection effected a 120-fold increase in the adherence of type 1a group B streptococci to tracheal tissue relative to that observed in mock-infected mice . Adherence of type 1a group B streptococci to the trachea of influenza type A/PR8/34 virus-infected mice was reduced by more than 90% by prior intranasal instillation of chicken antiserum to influenza type A/PR8/34 virus, whereas virtually no reduction in adherence was noted with normal chicken serum or rabbit antiserum to herpes simplex virus type 2 . These findings suggest that adherence of type 1a group B streptococci to the tracheal tissue of influenza type A/PR8/34 virus-infected mice is effected by a viral component(s). Infect Immun, 1982 Nov, 38(2), 573 - 9 Type-specific antibodies to structurally defined fragments of streptococcal M proteins in patients with acute rheumatic fever; Bisno AL et al.; Group A streptococci of M protein type 5 have been epidemiologically related to acute rheumatic fever in a number of reported outbreaks . Preliminary bacteriological evidence suggests that M5 may be an important "rheumatogenic" type in Santiago, Chile . To assess further the relationship of this streptococcal serotype to rheumatic fever in Chile, sera of 34 patients with rheumatic fever and an equal number of age-, sex-, and race-matched controls were assayed for antibodies to types 5, 6, and 24 in an enzyme-linked immunosorbent assay with purified pepsin extracts of the respective M proteins as solid-phase antigens . Sera of 11 rheumatic fever patients (32%) were positive (titer greater than 1:800) for type 5 antibodies, but only 1 (3%) of the matched controls was positive (P less than 0.01) . Neither the patients nor the controls had antibodies to type 24 . Although 38% of the patient sera contained antibodies to type 6, 29% of the control sera also had such antibodies (P greater than 0.20) . The enzyme-linked immunosorbent assay served as an accurate predictor of which sera contained type 5 opsonic antibodies as measured by the opsonophagocytic test . Although antigenic cross-reactivity exists between M protein type 5 and type 6 group A streptococci, this phenomenon is unlikely to have accounted for the preferential occurrence of type 5 antibodies in rheumatic fever sera . The enzyme-linked immunosorbent assay and opsonic antibody results suggest that M5 is an important rheumatogenic type in Chile. Infect Immun, 1982 Nov, 38(2), 513 - 20 Fibrinogen-mediated adherence of group A Streptococcus to influenza A virus-infected cell cultures; Sanford BA et al.; A quantitative radioassay was used to study the adherence of group A Streptococcus to Madin-Darby canine kidney cells infected with influenza A virus (strains FM1, Jap 305, and NWS) and reacted with fibrinogen . Treatment of virus-infected cell cultures with human fibrinogen significantly enhanced streptococcal adherence (P less than 0.0005) compared with adherence to untreated, virus-infected cells and uninfected control cells . Enhanced adherence was not seen with NWS virus-infected cell cultures or with virus-infected cells treated with human fibronectin, canine fibrinogen, or porcine fibrinogen . Human fibrinogen was shown to bind directly to surface membranes of virus-infected cells . Virus-infected cell cultures were incubated in the presence of tunicamycin, an antibiotic that inhibits glycosylation of virus-specific surface membrane glycoproteins . We found that with increasing antibiotic concentration there was a progressive decrease in fibrinogen-mediated streptococcal adherence . Adherence of 3H-labeled streptococci to fibrinogen-treated, virus-infected cell cultures showed saturation kinetics and could be blocked with monospecific antibodies against fibrinogen . These results suggest that human fibrinogen binds to a glycoprotein moiety on the surface of influenza A virus-infected cells, and that once bound the fibrinogen molecule acts as an "acquired" receptor for the attachment of group A Streptococcus . We postulate that this mechanism, it if occurs in vivo, might help explain the observed association between influenza A virus infection and subsequent bacterial superinfection with group A Streptococcus. Jpn Circ J, 1982 Nov, 46(11), 1180 - 3 Significance of anti-deoxyribonuclease-B (ADN-B) determination in clinical practice; Fujikawa S et al.; The determination of anti-deoxyribonuclease-B (ADN-B) is very important for the diagnosis of antecedent streptococcal infection because almost all of group A streptococci have this antigen and a strong elevation of the antibody is observed in patients with acute rheumatic fever, acute glomerulonephritis and other streptococcal infections . Moreover, ADN-B titers are elevated in cases with streptococcal skin infection, whereas anti-streptolysin O (ASO) titers are rarely elevated in these cases . So the determination of ADN-B is recommended as the second streptococcal antibody test to ASO detection (manual of WHO) . In our study, the upper limits of ADN-B in normal subjects were 1:60 in preschool age, 1:480 in school age and 1:340 in adult age groups . In acute rheumatic fever, ADN-B titers were elevated in 87% of the cases and also 87% of the patients with acute glomerulonephritis had high ADN-B titers . In inactive rheumatic fever, 72% of the patients had high ADN-B titers, while, ASO titers were elevated in only 22% of the cases . In streptococcal carrier states, 39% of the children had high ADN-B titers but ADN-B was positive only 8% in non-carrier children. J Infect Dis, 1982 Nov, 146(5), 683 - 90 Enocin: an antibiotic produced by Streptococcus salivarius that may contribute to protection against infections due to group A streptococci; Sanders CC et al.; Clinical studies have indicated that certain constituents of the normal throat flora may play a role in resistance to group A streptococcal infections . Strains of Streptococcus salivarius were among the most active components of this protective flora . The present studies were designed to determine the mechanism responsible for the antagonism of group A streptococci by S . Salivarius . Cell-free filtrates made at the end of the logarithmic growth phase of S . salivarius inhibited the growth of group A streptococci . The only other organisms susceptible to inhibition by these filtrates were those that require exogenous pantothenate, as group A streptococci do . The activity of filtrates was primarily bacteriostatic and could be specifically reversed by pantothenate . Activity was not due to a simple depletion of the vitamin but rather to the presence of a substance that interfered with the utilization of pantothenate . This substance, given the name enocin, was heat labile but was unaffected by proteolytic enzymes . Thus, strains of S . salivarius that appear to enhance the resistance of certain individuals to streptococcal infection may exert their protective effect through in situ production of the antibiotic enocin. J Infect Dis, 1982 Nov, 146(5), 665 - 72 Antibody-independent activation of C1 by type Ia group B streptococci; Eads ME et al.; A prototype fresh clinical isolate of type Ia group B streptococci (strain 515) can be opsonized by serum containing low levels of antibody . This opsonizing process can also occur in hypogammaglobulinemic serum, confirming its antibody independence, but it does require Ca++ ions and the second component of complement (C2) . When formalin-fixed organisms are reacted with whole serum, C4 and C3 are cleaved . These data are strong evidence that this organism can directly activate C1 in the absence of antibody and that this activation leads to the formation of a classical C3 convertase (C4b2a), which cleaves C3 . The observation that opsonization can occur in hypogammaglobulinemic serum suggests that complement alone, presumably the fixation of C3b, is sufficient for phagocytes to ingest this pathogen. S Afr Med J, 1982 Oct 9, 62(16), 569 - 70 {Group A beta-hemolytic streptococci in a traditional black community}; van Staden DA et al.; Throat swabs taken from a group of traditionally living people in a remote area of Venda, with no symptoms of sore throat, revealed the presence of Group A beta-haemolytic streptococci in 1,62% of subjects in the 5 - 25-year age group . This is significantly different from the picture in an urban population in Pretoria where the carrier rate was found to be 16,8% . The incidence is apparently not influenced by the low economic level in the rural area . The organisms in the rural area were found to be less sensitive to sulphafurazole than those in the urban area. J Clin Microbiol, 1982 Oct, 16(4), 744 - 6 Screening for penicillin tolerance in viridans streptococci by a simple disk method; Dankert J et al.; A disk method was developed for demonstrating penicillin tolerance in viridans streptococci . This was achieved by the substitution of the penicillin disk used for susceptibility testing by a disk containing penicillinase . After reincubation, penicillin-tolerant strains exhibited new growth in the area adjacent to this disk, providing a rapid screening test. J Am Vet Med Assoc, 1982 Oct 1, 181(7), 690 - 3 Diagnosis and treatment of acute mastitis in a large dairy herd; Anderson KL et al.; In a 270-cow dairy herd, milk samples from all cows with acute mastitis were cultured during a 12-month period . Of 119 isolates (from 166 quarters), 49% were gram-positive organisms, 39% were gram-negative organisms, and 12% were yeasts . Of all samples from cows with acute mastitis, 40% failed to produce colonies on culture media . Recovery of the common gram-positive pathogens, Staphylococcus aureus (11% of isolations) and Streptococcus agalactiae (1% of isolations), was rather low . However, S epidermidis (14% of isolations) and streptococci other than Str agalactiae (9% of isolations) were recovered more frequently than expected, particularly in recently calved cows . Coliform organisms accounted for 35% of the total isolates and were the single most important cause of acute mastitis . Of 42 cows with coliform mastitis, 6 died despite intensive antibiotic and electrolyte therapy . There was no death loss among cows with mastitis caused by gram-positive organisms . Antimicrobial susceptibilities of 95 isolates to 11 antimicrobials was determined by standardized methods . Organisms were most often susceptible to chloramphenicol, cephalothin, and gentamicin . A treatment regimen consisting primarily of oxytetracycline and/or sulfonamides systemically in conjunction with intramammary infusions of cephapirin was evaluated . Treatment response in 37 quarters was determined by culturing before treatment and at 4 or more days after treatment . Of 23 quarters initially culture-positive, 22 were negative on reculture . Treatment response appeared to agree with the results of the susceptibility testing. Am J Epidemiol, 1982 Oct, 116(4), 709 - 21 Hemolytic streptococci and streptococcal antibodies in normal schoolchildren in Kuwait; Karoui R et al.; A total of 1041 asymptomatic "normal" schoolchildren in Kuwait, aged 6-16 years, were investigated over six months from November 1978 through April 1979 for hemolytic streptococcal throat carriage and for streptococcal immune response . A high carrier rate of beta-hemolytic streptococci (47%) with an unusually high prevalence of group C (32%) was found . Group A was isolated in 10%, group B in 2%, and group G in 3% of the children . Comparison of the prevalence of the different serogroups of beta-hemolytic streptococci in our study with that of similar studies reported from temperate, subtropical, and tropical zones showed a high prevalence of groups C and G and a lower prevalence of group A in subtropical and tropical countries in contrast to a high prevalence of group A and lower prevalence of groups C and G in countries with temperate climate . The geometric mean titer of antistreptolysin O in group A carriers in our study was 270 Todd units and significantly higher than that in group C carriers (p less than 0.001), while the geometric mean titer of antihyaluronidase in group A carriers was 240 units and significantly higher than that in groups B, C, and G carriers (p less than 0.0005) . The high magnitude of the streptococcal immune response probably reflects a high frequency of streptococcal infections in schoolchildren in Kuwait and possibly indicates a high attack rate of rheumatic fever in the country. Postgrad Med, 1982 Oct, 72(4), 166 - 8, 171-3, 176-8 passim Bacterial skin infections: management of common streptococcal and stapylococcal lesions; Witkowski JA et al.; Skin infection occurs in any age-group, sex, and race but is particularly common in children . It is usually minor, but may indicate underlying systemic disease or may lead to systemic infection . Streptococci and staphylococci are common causes . Group A beta-hemolytic streptococci account for the majority of streptococcal infections in man . Infection most often involves the lower extremities and produces spreading erythema and necrosis but little purulence . Staphylococcal infections most commonly involve the face, the hair follicles and eccrine sweat ducts being the initial sites . Lesions appear as bullae and pustules with a narrow rim of erythema . Intense cellulitis surrounding the lesions usually points to a virulent, penicillin-resistant strain of Staphylococcus . Treatment of both types of infection consists of cleansing with antibacterial agents, removal of crusts, application of warm compresses, and use of topical or systemic antibiotics, depending on the severity of the infection and the type of pyoderma involved. Arch Otolaryngol, 1982 Oct, 108(10), 655 - 8 Microorganisms isolated from peritonsillar abscess and indicated chemotherapy; Sugita R et al.; A bacteriologic study was made of 30 patients with peritonsillar abscesses with the use of both aerobic and anaerobic culture procedures . The abscess was punctured and the pus was aspirated by a syringe with an 18-gauge needle . Aerobes and anaerobes were detected in a frequency rate of approximately 1:2 . Peptostreptococcus (30.2%), group a streptococci (27.9%), Peptococcus (16.3%), and Fusobacterium (9.3%) were preponderant pathogens . Anaerobic organisms were isolated in 75% of 30 cases . Aside from group A streptococci, anaerobes play a major etiologic role in peritonsillar abscess . Penicillins or cephalosporins will provide maximum chemotherapeutic benefit. Int J Oral Surg, 1982 Oct, 11(5), 310 - 5 Life threatening complications from a lower wisdom tooth; Thijs LG et al.; The case history of a 25-year-old student who developed a number of very serious complications after a simple extraction of a lower wisdom tooth is presented . A submandibular abscess was followed by septic shock with severe thrombocytopenia and transient renal insufficiency, adult respiratory distress syndrome, pneumothorax and pericarditis . From the blood, alpha-hemolytic Streptococci were cultured, while cultures from the abscess grew Bacteroides fragilis . With intensive treatment, including artificial ventilation with PEEP, the patient survived this life-threatening episode. J Clin Lab Immunol, 1982 Oct, 9(1), 27 - 31 Rheumatic fever and smooth muscle antibodies; Somerfield SD et al.; Rheumatic fever is a nonsuppurative sequelae to Group A streptococcal pharyngitis . Valvulitis resulting from cardiac involvement in this disease, is the main cause of morbidity in rheumatic fever . The study of rheumatic fever sera on cryostat sections of a variety of tissues using indirect immunofluorescence is described . A 95% incidence of smooth muscle antibody was found in 236 rheumatic fever sera, from 55 patients . Sera from hospital patients with a variety of diseases had an overall incidence of 12% for smooth muscle antibodies . The pattern and distribution of tissue staining strongly suggests that the smooth muscle antibodies described in rheumatic fever sera have antiactin specificity . This finding raises many questions concerning the immunopathogenesis and immunogenetics of rheumatic fever, and the pathogenesis of a number of diseases in which streptococci have not previously been considered. Acta Pathol Microbiol Immunol Scand {B}, 1982 Oct, 90(5), 347 - 51 Differential susceptibility of cell-bound streptococcal immunoglobulin Fc-receptors to autolytic degradation; Schalen C et al.; The susceptibility of IgA and IgG Fc-receptors of different streptococci to autolytic degradation was tested by incubating washed bacteria in phosphate-buffered saline at 37 degrees C for 24-72 h . Before incubation, strain M1 bound 74 per cent of 2.5 micrograms radio-labelled IgG added to 200 microliter of the suspension, and strain M4 bound 85 per cent of 2.5 micrograms radio-labelled IgA; both types of binding decreased to less than 15 per cent . Evidence was obtained that the decrease in binding was caused by digestion of the respective receptors, and not by degradation of the immunoglobulins or through inhibition by solubilized Fc-receptors . The autolytic process was inhibited by EDTA, iodoacetic acid, benzamidinium chloride, phenylmethylsulfonyl fluoride and diisopropylfluorophosphate . The IgG Fc-receptors in other types of group A streptococci (including type M4) and a group C and a group G strain were not affected by such prolonged incubation, also when strains were mixed with M-type 1 streptococci from the start of incubation . These findings, which thus revealed certain differences in stability between streptococcal Fc-receptors, are discussed in relation to the intracellular degradation of streptococci. Infect Immun, 1982 Oct, 38(1), 392 - 5 Binding of human C-reactive protein to bacteria; Mold C et al.; The binding of C-reactive protein to a variety of species of bacteria with potential clinical significance was studied to assess the potential function of C-reactive protein in nonimmune defense against infection . Purified, radioiodinated human C-reactive protein bound to all Streptococcus pneumoniae tested and to some viridans streptococci, but not to group A or group B streptococci or to any of eight different gram-negative rods and cocci. J Infect Dis, 1982 Oct, 146(4), 536 - 9 Antimicrobial susceptibilities of nutritionally variant streptococci; Gephart JF et al.; Seventeen strains of nutritionally variant streptococci were examined for susceptibility to 15 antimicrobial agents . All strains grew in blood culture medium containing blood and blood products or, in the absence of blood or blood products, in broth containing glucose and pyridoxal hydrochloride . Growth was enhanced by incubation in an atmosphere containing 5%-10% CO2 or, in some cases, was CO2-dependent . Rifampin, penicillin, clindamycin, and erythromycin were the most active antibiotics tested with minimal bactericidal concentrations of 2, 1, 2, and 2 microgram/ml, respectively, for 90% of the strains; the corresponding values for vancomycin and streptomycin were 32 and 16 microgram/ml, respectively. Pathol Biol (Paris), 1982 Oct, 30(8), 707 - 10 {Bacteriologic study of 125 cases of streptococcal infectious endocarditis}; Etienne J et al.; Streptococci remain the bacterial group the most frequently associated with microbial endocarditis . This paper points out the ability of the different species to cause endocarditis . 128 streptococci are isolated from patients with microbial endocarditis (127 from blood cultures, 1 from a valve) . Isolates are speciated by biochemical tests and the determination of their group antigen . The viridans streptococci most frequently isolated are S . sanguis I (27 p . cent), S . mitis (16.5 p . cent) and S . sanguis II (9.6 p cent) . A comparative survey of the results is rather difficult due to the methodological and taxonomical divergences. Early Hum Dev, 1982 Oct, 7(1), 71 - 80 Short-time low-temperature pasteurisation of human milk; Wills ME et al.; Using the Oxford Human Milk Pasteuriser human milk was exposed to lower temperature and shorter time periods than employed in classical holder pasteurisation . Heating human milk at 62.5 degrees C for 5 min completely destroyed Escherichia coli, Staphylococcus aureus, and group B beta-haemolytic streptococci inoculated into the samples . Heating at 56.0 degrees C for 15 min destroyed over 99% of the inoculated organisms . The mean percentage remaining activity of certain antimicrobial proteins after heat treatment at 62.5 degrees C for 30 min, 62.5 degrees C for 5 min and 56 degrees C for 15 min were as follows: IgA 67, and 90%; lactoferrin 27, 59 and 91%; and lysozyme 67, 96 and 106%, respectively . These results suggest that human milk can be effectively pasteurised using less heat treatment than in classical holder pasteurisation . Lower temperature and shorter heat treatment also preserves substantially more of the activity of the antimicrobial proteins present in human milk. Pediatr Res, 1982 Oct, 16(10), 816 - 9 Prevention of group B streptococcal colonization with topically applied lipoteichoic acid in a maternal-newborn mouse model; Cox F; An animal model of maternal-newborn transmission of group B streptococci (GBS) was developed . Pregnant Swiss-Webster mice were colonized by applying 10(8) GBS to the oral cavity, vagina, and nipples daily for 3 days before delivery . Lipoteichoic acid (LTA) from type III GBS or phosphate buffered saline was applied topically to the oral cavity, perineum or nape of newborn mice . Cultures of newborn mice at 3 days of age revealed 35 of 75 (47%) controls and 0 of 79 animals given 2 doses of LTA (2 mg/ml) were positive for GBS at one or more sites . One to two% of control and LTA-treated mice remained culture positive at 7 days of age . None developed GBS disease and no obvious toxicity was noted . This is the first in vivo evidence that colonization with GBS can be prevented by interfering with their adherence to epithelial surfaces . LTA also prevented colonization by 60,000 GBS in the oral cavity of 1-day-old newborn mice . A minimum concentration of 0.5 mg LTA/ml was required and similar dose response curves were obtained in preventing maternal-newborn transmission or oral newborn colonization . LTA from type III GBS also protected against types Ia and II . Only 6 of 15 (40%) vaginally colonized, nonpregnant mice became noncolonized 3 days after LTA treatment . Topically applied lipoteichoic acid from group B streptococci may be a useful method of preventing GBS colonization and/or disease in human infants at birth if it is nontoxic . The method avoids the problems associated with antibiotic prophylaxis and vaccine development. Infect Immun, 1982 Oct, 38(1), 183 - 8 Transduction of the genetic determinant for streptolysin S in group A streptococci; Skjold SA et al.; The genetic determinant for streptolysin S production (SLS+) was successfully transduced to two naturally occurring nonhemolytic strains of group A streptococci (Streptococcus pyogenes), an M-type 18 strain associated with an outbreak of rheumatic fever and an M-negative variant of a type 49 strain isolated from a skin lesion . Attempts to transduce this determinant to a nonhemolytic M-type 68 strain and a nonhemolytic T-type 12 strain were not successful . Transduction was accomplished with a double temperature-sensitive mutant bacteriophage . Cellular antigenic characters and the phage sensitivity of the transductants remained unaltered . The donor strain also transduced streptomycin resistance well when the nonhemolytic type 49 strain was used as a recipient . There was no evidence of cotransduction of the determinants for streptolysin S and streptomycin resistance. Am J Epidemiol, 1982 Oct, 116(4), 704 - 8 Comparison of carriage rates of group B streptococcus in diabetic and nondiabetic persons; Casey JI et al.; In several published studies, diabetic persons appeared to be at increased risk for Group B streptococcal disease . Since colonization with pathogens frequently antedates disease, the authors studied the carriage rate of Group B streptococcus in 38 diabetic and in 39 nondiabetic age- and sex-matched subjects . Fifty-four per cent of the controls and 34% of the diabetics carried Group B streptococci in at least one of five sites cultured (p less than 0.05) . The data indicate that an increased carriage rate of Group B streptococci cannot be invoked as a reason for the increased numbers of diabetic persons among patients with Group B streptococcal infections. Br J Vener Dis, 1982 Oct, 58(5), 334 - 7 Carriage and transmission of group B streptococci among STD clinic patients; Jackson DH et al.; High rates of carriage of group B streptococci were found among men (38%) and women (42.3%) attending a clinic for sexually transmitted diseases . Swabs from the perineal/anorectal area gave the highest isolation rate and those from the urethra the lowest . The subpreputial sac was an important site for carriage of the organism, and there was a strong association between streptococcal isolation and balanitis . Of 92 couples studied, neither partner was colonised with group B streptococci in 36 . In a further 36 one or other was colonised and in 20 both were colonised . Serotyping and phage typing showed that only three of these 20 couples were colonised with similar strains of the organism. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1982 Oct, 253(1), 81 - 7 {Release of extracellular metabolic products by Streptococci groups C and G}; Tiesler E et al.; 24 group C and 31 group G streptococcal strains were studied examining the production of extracellular nucleases, NADase, hyaluronidase and streptolysin O . 5 mucous strains were characterized by diminished growth and lack of hyaluronidase and NADase-production . Regarding the other strains of group C, one half produced nuclease-activity whereas only one out of ten group G streptococci did . Group G streptococci were more active in the production of NADase and hyaluronidase than group C streptococci . The levels of streptolysin O in groups C and G are comparable. J Bacteriol, 1982 Oct, 152(1), 215 - 22 Helper plasmid cloning in Streptococcus sanguis: cloning of a tetracycline resistance determinant from the Streptococcus mutans chromosome; Tobian JA et al.; A model system for testing the helper plasmid cloning system of Gryczan et al . (Mol . Gen . Genet . 177:459-467, 1980) was devised for the Streptococcus sanguis (Challis) host-vector system . In this system, linearized pVA736 plasmid efficiently transformed an S . sanguis (Challis) host containing a homologous plasmid, pVA380-1, but did not transform a plasmidless host or a host containing a nonhomologous plasmid, pVA380 . In addition, whereas monomeric circular pVA736 transformed a plasmidless host with two-hit kinetics, it transformed a pVA380-1-containing host with one-hit kinetics . This helper plasmid cloning system was used to isolate two HindIII fragments (5.0 megadaltons {Mdal} and 1.9 Mdal in size) from the chromosome of Streptococcus mutans V825 which conferred high-level tetracycline resistance . One tetracycline-resistant clone was examined and found to contain three plasmids which were sized and designated pVA868 (9.0 Mdal), pVA869 (9.5 Mdal), and pVA870 (9.8 Mdal) . Results of Southern blot hybridization and restriction endonuclease digestion confirmed that all three chimeras were composed of two HindIII fragments of the S . mutans V825 chromosome, as well as a large portion, varying in size for each chimera, of the 2.8 Mdal cloning vector, pVA380-1 . Incompatibility observed between pVA380-1 and each of the chimeras indicated that replication of the chimeras was governed by the pVA380-1 replicative origin . Southern blotting experiments revealed that the chimeras hybridized to Tn916, providing the first evidence that transposon-related genes of enteric streptococcal origin are disseminated among oral streptococci. J Exp Med, 1982 Oct 1, 156(4), 1165 - 76 Protective antigenic determinant of streptococcal M protein shared with sarcolemmal membrane protein of human heart; Dale JB et al.; We present definitive evidence that at least one protective antigenic determinant on type 5 M protein of group A streptococci evokes antibody that is cross-reactive with human heart tissue . One of nine rabbits immunized with a peptide fragment of type 5 M protein (pep M5) produced antibody that cross-reacted by immunofluorescence with sarcolemmal membranes of human heart . The cross-reactive antibody could be removed by absorbing the antiserum with sarcolemmal membranes, types 5 and 19 streptococci, or their pepsin-extracted M proteins, but with no other serotypes tested . Although each of the pep M5 immune sera was opsonic for type 5 streptococci, only the heart-reactive antiserum opsonized type 19 streptococci . The opsonization of type 19 streptococci was abolished by absorbing the antiserum with sarcolemmal membranes isolated from human heart tissue . Purified heart-reactive antibodies eluted from sarcolemmal membranes opsonized both types 5 and 19 streptococci, indicating that the heart cross-reactive determinant of type 5 M protein is cross-protective . The cross-reactive antigen was purified by affinity chromatography from detergent extracts of sarcolemmal membranes and determined to be a complex protein composed of four subunits apparently linked by disulfide bonds. Ann Microbiol (Paris), 1982 Sep-Oct, 133(2), 255 - 69 {Viridans streptococci in human infections: identification and susceptibility to antibiotics}; Horodniceanu T et al.; A method for the speciation of viridans streptococci (devoided of group antigens) is described . The major identification criteria are based on the reaction of a series of biochemical tests such as acid production in lactose, inuline, raffinose, mannitol and sorbitol, hydrolysis of arginine, esculin and Na hippurate, and production of polysaccharides in 5% sucrose media . A total of 460 strains were isolated from human specimens and identified as follows: 118 Streptococcus mitis, 102 S . sanguis II, 75 S . Sanguis I, 87 S . milleri (Streptococcus MG-intermedius), 28 S . mutans, 25 S . salivarius, 14 S . morbillorium, 2 S . uberis and 9 unspeciated . Susceptibility to antibiotics was studied for 318 strains: 63% of them were susceptible to all drugs tested; 37% of the strains were resistant to one or several antibiotics as follows: 34% to tetracycline, 8.5% to macrolides and related drugs, 5.3% to streptomycin and/or kanamycin (MIC greater than 2,000 micrograms/ml), 5% to penicillin (MIC = 1-4 micrograms/ml) and 4% to chloramphenicol. Infect Immun, 1982 Sep, 37(3), 1200 - 8 Isolation and characterization of coaggregation-defective mutants of Actinomyces viscosus, Actinomyces naeslundii, and Streptococcus sanguis; Kolenbrander PE; Spontaneously occurring coaggregation-defective (COG-) mutants of oral actinomycetes and streptococci were isolated and used to study interactions between cells of these two kinds of bacteria . COG- mutants of each kind of bacteria were isolated by a simple enrichment scheme . Parent strains were mixed with a coaggregating partner strain, coaggregated cells were removed by low-speed centrifugation, and non-coaggregated cells were recycled by the addition of more partner strain cells . COG- mutants constituted up to 10% of the parent strain cell type in the final enriched cell suspension . Unlike their respective parent strains, COG- mutants of Actinomyces viscosus T14V and Actinomyces naeslundii ATCC 12104, and A . naeslundii I exhibited no lactose-reversible coaggregation with certain oral Streptococcus sanguis strains . However, these COG- mutants were not altered in their coaggregations with another S . sanguis strain, H1, a member of a streptococcal coaggregation group that exhibits only lactose-nonreversible coaggregations with oral actinomycetes . Although all coaggregations between S . sanguis H1 and these actinomycetes appear to be alike, examination of a COG- mutant of S . sanguis H1 revealed that, like its parent, it coaggregated with A . viscosus T14V and its COG- mutants, but unlike its parent, it did not coaggregate with the two A . naeslundii strains or their COG- mutants . Thus, it was concluded that at least two types of surface components are important in mediating coaggregation between S . sanguis H1 and actinomycetes . The COG- mutant of S . sanguis allowed detection of these components, which were indistinguishable in previous studies. Am J Epidemiol, 1982 Sep, 116(3), 533 - 40 Foodborne outbreak of group G streptococcal pharyngitis; Stryker WS et al.; An outbreak of pharyngitis associated with beta-hemolytic streptococci of Lancefield group G occurred among persons who had attended a convention that was held June 21-24, 1979, in a Florida hotel . Seventy-two (31 per cent) of 231 interviewed conventioneers were ill . Group G streptococci were isolated from the throats of 10 (63 per cent) of 16 persons with pharyngitis and 1 (2 per cent) of 41 persons without pharyngitis (p less than 10(-5)) . Antistreptolysin O titers in convalescent-phase serum samples from persons with pharyngitis were significantly higher than those from age-matched controls . Fifty-seven (51 per cent) of 111 conventioneers who had attended a convention luncheon developed pharyngitis compared with 12 (10 per cent) of 117 persons who did not (p less than 10(-9)) . All persons who had attended the luncheon and had become ill had eaten a chicken salad served at the luncheon . Their median incubation period was two days . The cook who had prepared this chicken salad developed pharyngitis after the luncheon and had a throat culture positive for group G streptococci . No instances of rheumatic fever were identified and secondary illness in household contracts was rare . This outbreak indicates that group G streptococci can cause outbreaks of pharyngitis similar to those caused by group A streptococci and suggests that penicillin therapy and prophylaxis may not be needed. Br J Dermatol, 1982 Sep, 107(3), 333 - 7 Microbial eczema of the feet; Weismann K et al.; Twenty-seven patients were investigated for eczema of the feet which mainly affected the medial interdigital spaces and the dorsal areas of the medial toes . The lesions tended to spread to the dorsum of the foot, rather than the plantar surface as seen in tinea pedis, which typically affects the lateral interdigital spaces . In all patients S . aureus and/or haemolytic streptococci were cultured, whereas scrapings for fungi were negative . All responded well to treatment aimed at eradicating bacteria and dermatitis, but relapses occurred in 33% of the cases . We believe this clinical entity is due to infective dermatitis in which the presence of bacteria provokes an eczematous response in the host, probably due to pre-existing sensitization rather than direct infection. Arch Intern Med . 1982 Sep;142(9):1739. Osteomyelitis caused by viridans streptococci; Ribner BS et al.; A 34-year-old man without known underlying disease was seen with osteomyelitis of the proximal shaft of the left femur . At operation, only viridans streptococci were isolated . The patient responded to a combination of intravenous penicillin G potassium and gentamicin sulfate therapy . To our knowledge, this is the first reported case of osteomyelitis of a long bone produced by hematogenous seeding by viridans streptococci. J Bacteriol, 1982 Sep, 151(3), 1543 - 52 Isolation and analysis of sacculi from Streptococcus sanguis; Reusch VM Jr; Sacculi were prepared from Streptococcus sanguis 34 by exhaustive extraction of bacteria with hot 1% sodium dodecyl sulfate-0.5% 2-mercaptoethanol . Lyophilized residue was dissociated by brief sonication to single bodies closely resembling streptococci in phase-contrast microscopic density, staining properties, and morphology . Electron micrographs revealed bodies that contained variable amounts of cellular contents and were bounded by intact cell walls . Chemical analyses of sacculi demonstrated the presence of peptidoglycan, carbohydrate, protein, and phosphate . The hexose content of sacculi varied 10-fold depending upon the composition of the growth medium . When sacculi were subjected to treatment with 5 M LiCl, 8 M urea, 40% phenol (25 degrees C), or dimethyl sulfoxide most of the nitrogen and carbohydrate present was recovered in the insoluble fraction . These data suggest that sacculi contain the cell wall fraction of the extracted bacteria and that most of the carbohydrates and proteins of sacculi are firmly bound to the insoluble fraction, which contains the peptidoglycan matrix. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1982 Sep, 252(4), 456 - 62 Group and type distribution of beta-haemolytic streptococcus strains in Belgrade, Yugoslavia, 1973-1980; Vlajinac H et al.; Group and type differentiation by Griffith' method of agglutination was performed on 7514 haemolytic streptococcal strains isolated from patients with acute streptococcal infections . Thirteen different groups were found--the most frequent were groups A (63.0%), B (12.5%), C (8.1%) and G(2.5%) . The group A was predominant among strains isolated from upper respiratory tract, but in later years the frequency of group A strains among streptococci causing respiratory infections was significantly lower . In every year of the study period the most prevalent group A types were T1, T2, T4, T12 and T28--only their relative distribution was changing in the course of time. J Rheumatol, 1982 Sep-Oct, 9(5), 719 - 22 Possible involvement of group A streptococci in the pathogenesis of psoriatic arthritis; Vasey FB et al.; Bacteria have been implicated in the form of Reiter's syndrome, known as reactive arthritis . If bacteria are important in the related spondyloarthropathy psoriatic arthritis, they may be those comprising skin flora . We found elevated levels of antibody to the streptococcal exotoxin antideoxyribonuclease-B in psoriatic arthritis patients in comparison to patients with psoriasis without arthritis, rheumatoid arthritis, other forms of dermatitis, and normal controls . Patients with peripheral arthritis were more likely than psoriatic spondylitis patients to be antideoxyribonuclease-B positive . Streptococci or streptococcal products may be involved in the pathogenesis of psoriatic arthritis in some patients. Immun Infekt, 1982 Sep, 10(5), 187 - 92 {Streptococcal A-induced polyclonal T-cell activation leads to a secondary functional activation of human B-cells}; Gross WL et al.; Human lymphocytes are activated by cell walls or cytoplasma membranes of A-streptococci . Even in health human volunteers lymphocyte proliferation, lymphokine production and immunoglobulin synthesis is induced by high concentrations of streptococcal cell components following a pattern of polyclonal lymphocyte activation . We were interested in the special cellular requirements in this particular model . In cell separation and restitution experiments the observed B-cell activation was identified as the consequence of a primary monocyte-dependent polyclonal T-cell activation . Furthermore, lymphocyte proliferation and lymphokine production proved to be a monocyte- and T-cell-dependent process as well . Thus, lymphocyte activation induced by somatic streptococcal structures in humans depends upon a pattern of cell cooperation of mononuclear subpopulations well-known in a series of classical mitogen-induced lymphocyte activation. Antimicrob Agents Chemother, 1982 Sep, 22(3), 522 - 4 Effect of rifampin on ampicillin killing of group B streptococci; Smith SM et al.; The activity of rifampin against group B streptococci as a single agent and in combination with ampicillin was examined . The minimum concentration of rifampin required to inhibit 90% of the isolates of group B streptococci (18 of 20 isolates) was 0.6 microgram/ml . The checkerboard double-dilution studies of these two antibiotics and the time-killing studies both indicate that rifampin inhibits the bactericidal activity of ampicillin for group B streptococci. J Hosp Infect, 1982 Sep, 3(3), 275 - 84 Analysis of bacterial infections in a neonatal intensive care unit; Hoogkamp-Korstanje JA et al.; An analysis was made of all cases of infection among 181 neonates admitted to the neonatal intensive care unit (NICU) during one year . Twenty-four per cent had an infection on admission; their infections correlated with prolonged ruptured membranes and the degree and site of colonization . The predominant organisms found in perinatal infections were Staphylococcus aureus, Group B streptococci and Escherichia coli . Thirty per cent acquired a hospital infection . This correlated with the length of the period of instrumentation . The majority of the hospital-acquired infections was caused by Gram-positive cocci (micrococci, Staph . saprophyticus, Staph . aureus, forming 65 per cent of the total), E . coli and Pseudomonas aeruginosa . Most hospital infections were nosocomial and not auto-infection . The outcome of the neonates with hospital infection was good, except for those with pseudomonas infection . Acquisition of hospital infection prolonged the period of hospitalization up to twice that required for neonates without infection. Zh Mikrobiol Epidemiol Immunobiol, 1982 Aug, (8), 45 - 50 {Isolation and evaluation of properties of muramidase causing the lysis of group A streptococci}; Shmakova ZF et al.; Muramidase which actively lyses the cell walls of group A hemolytic streptococci has been isolated from the culture fluid of Actinomyces levoris by precipitation on ammonium sulfate, gel filtration on Sephadex G-25, ion exchange chromatography on DEAE cellulose and double electrofocusing . The enzyme thus obtained has shown its maximum activity at 40-50 degrees C . At 60 degrees C muramidase was completely inactivated . The enzyme has a wide range of optimum pH values: 5.0-9.5 . The highest percentage of lysis of streptococcal cell walls has been observed in plycine-NaOH and potassium phosphate buffers at pH 8.0 . Muramidase completely lysed Streptococcus pyogenes cells of different serological groups except enterococci (group D) and staphylococci . This sign allows to differentiate group D streptococcus from streptococci of other groups. Infect Immun, 1982 Aug, 37(2), 513 - 8 Growth inhibition of oral streptococci in saliva by anionic proteins from two caries-free individuals; Cowman RA et al.; Mixed saliva from two caries-free individuals possessed antimicrobial activity toward Streptococcus mutans and S . sanguis . This inhibitory activity was attributed to the presence of a group of four anionic proteins each of which strongly inhibited the growth of the oral streptococci in a saliva protein-based medium but not in a medium containing amino acids as a nitrogen source . These proteins, with isoelectric points of 4.70, 4.90, 4.98, and 5.05, respectively, neither reacted with antisera to immunoglobulin A, G, or M nor appeared to be functionally related to a number of salivary peroxidases, lactoferrin, or lysozyme . On this basis, they may represent a previously unreported group of growth-inhibitory antimicrobial factors occurring in the saliva of some individuals. J Hyg (Lond), 1982 Aug, 89(1), 9 - 21 A large outbreak of streptococcal pyoderma in a military training establishment; Cruickshank JG et al.; An outbreak of streptococcal pyoderma in a military institution into which fresh susceptible recruits were regularly introduced involved more than 1300 persons over an eighteen-month period . Two M types were responsible for the great majority of the cases and an attack by one conferred immunity to that strain but not to the other . Lesions varied from trivial to disabling . Epidemiological studies indicated that contact -- direct or indirect -- through such things as gymnasium equipment and room dust was the means of transmission . The outbreak was eventually controlled by vigorous case finding, thorough treatment of cases and the strict application of hygienic principles to prevent spread . There were no late complications and throat streptococci were not involved . It is possible to control such an outbreak without isolation or the making of any significant concessions in the training programme even when large numbers of persons are living and working at close quarters. Clin Pediatr (Phila), 1982 Aug, 21(8), 463 - 5 Gram stain interpretation of blood cultures; Wald ER; Bacteremia without an obvious focus of infection occurs relatively frequently in highly febrile children between the ages of six and 24 months . Management depends on the clinical situation and probable identity of the bacteria . A year-long study to determine the accuracy of differentiating gram-positive cocci morphologically on the Gram-stained smear of a blood culture demonstrated that streptococci and staphylococci can be distinguished when Gram staining is the procedure used by the laboratory . From such a preliminary report, the bacteremia can be evaluated in the context of the clinical situation and appropriate action can be taken. Br J Exp Pathol, 1982 Aug, 63(4), 452 - 7 An alternative role for specific antibody in neutrophil bactericidal activity against highly pathogenic group B streptococci; Cleat PH et al.; An investigation was undertaken into the role of antibody and complement in neutrophil phagocytosis and killing of group B streptococci of low and high pathogenicity . Phagocytosis of both types of organism appears to be a nonspecific event requiring only nonspecific antibody or complement . However, neutrophil bactericidal activity is mediated by the pathogenicity of the infecting organism . Neutrophils alone can kill some streptococci of low pathogenicity, but their killing ability is considerably increased in the presence of specific antibody or complement . An active role for the alternative pathway of complement in the killing process was demonstrated for organisms of low pathogenicity . Neutrophils did not kill the highly pathogenic organisms in the absence of antibody and complement, and required specific antibody, but not complement, to kill these bacteria . The alternative complement pathway is not involved in killing of highly pathogenic organisms . Addition of specific antibody to neutrophils containing ingested bacteria stimulated the neutrophils to kill the intracellular bacteria, suggesting an alternative role for specific antibody in the killing process other than as an opsonin . It is suggested that activation of Fc receptors on the neutrophil surface initiates the bactericidal action of the neutrophils. Eur J Clin Microbiol, 1982 Aug, 1(4), 212 - 6 Anaerobic radiometric detection of facultative Gram-positive cocci in blood; Beckwith DG et al.; Radiometric detection of facultative gram-positive cocci, particularly streptococci, has been reported to be suboptimal . A recently marketed anaerobic Bactec bottle (7C) with purportedly improved capability to detect facultative gram-positive cocci in blood was compared with the previously available bottle in a study of simulated bacteremia . The Bactec system detected all beta-hemolytic streptococci and enterococci tested . Detection of alpha-hemolytic streptococci was improved in general . However, detection of Streptococcus mutans, Streptococcus bovis and Streptococcus pneumoniae remained suboptimal under anaerobic conditions . A metabolic index unit threshold for positivity of 15 is recommended when employing the anaerobic Bactec bottle. J Bacteriol, 1982 Aug, 151(2), 600 - 8 D-tagatose 1,6-diphosphate aldolase from lactic streptococci: purification, properties, and use in measuring intracellular tagatose 1,6-diphosphate; Crow VL et al.; Two D-ketohexose 1,6-diphosphate aldolases are present in Streptococcus cremoris E8 and S . lactis C10 . One aldolase, which was induced by growth on either lactose or galactose, was active with both tagatose 1,6-diphosphate (TDP) and fructose 1,6-diphosphate (FDP), having a lower Km and a higher Vmax with TDP as the substrate . This enzyme, named TDP aldolase, had properties typical of a class I aldolase, being insensitive to EDTA and showing substrate-dependent inactivation by sodium borohydride . Sodium dodecyl sulfate-gel electrophoresis indicated a subunit molecular weight of 34,500 . The amino acid composition of TDP aldolase is reported . When the enzyme was incubated with either triose phosphates or FDP, the equilibrium mixture contained an FDP/TDP ratio of 6.9:1 . The other aldolase, which had properties typical of a class II aldolase, showed activity with FDP but not with TDP . The intracellular TDP concentration, measured with the purified TDP aldolase, was 0.4 to 4.0 mM in cells growing on lactose or galactose and was lower (0 to 1.0 mM) in cells growing on glucose . The intracellular concentration of FDP was always higher than that of TDP . The role of ketohexose diphosphates in the regulation of end product fermentation by lactic streptococci is discussed. J Reticuloendothel Soc, 1982 Aug, 32(2), 87 - 99 Stimulation of several functional properties of macrophages after injection of a suspension of killed Streptococci; Lemaire G et al.; Mouse peritoneal macrophages elicited by injecting i.p . killed group C Streptococci were shown to exhibit several characteristics commonly found in inflammatory macrophages: they secreted high levels of plasminogen activator but had to be stimulated in vitro by LPS to elaborate significant amounts of lymphocyte activating factor (LAF); they contained increased acid hydrolase activities as compared to resident macrophages whereas ecto 5'-nucleotidase was diminished; and they released less arachidonic acid oxygenation products than resident macrophages . However, they also expressed biochemical and functional properties attributed to classically activated macrophages, harvested from immune animals: they displayed reduced levels of alkaline phosphodiesterase; when suitably triggered, they released large quantities of H2O2; and they were strongly cytostatic to syngeneic tumor cells. Infect Immun, 1982 Aug, 37(2), 805 - 10 Fibronectin-mediated binding of group A streptococci to human polymorphonuclear leukocytes; Simpson WA et al.; Human plasma was shown to promote the attachment of an avirulent strain of Streptococcus pyogenes to human polymorphonuclear leukocytes . Removal of the fibronectin by absorption of the plasma with agarose-immobilized gelatin abolished the attachment-promoting activity . The activity of the absorbed plasma was restored with purified human serum fibronectin . The fibronectin was found to promote the attachment of three M protein-negative, but not of three M protein-positive, strains of streptococci . Radiolabeled fibronectin was shown to bind in various degrees to all strains of S . pyogenes tested . Thus, in the absence of streptococci surface M protein, fibronectin promotes the association of group A streptococci with human polymorphonuclear leukocytes. J Med Microbiol, 1982 Aug, 15(3), 363 - 72 Binding of type-III group-B streptococci to buccal epithelial cells; Bagg J et al.; A binding assay was used to study the attachment of type-III group-B streptococci (GBS) to buccal epithelial cells . Results indicate that an adhesin, with the characteristics of a protein, is the molecule at the streptococcal cell surface responsible for attachment to the buccal cells . The bacterial adhesin probably recognises a sugar on the surface of the mucosal cell, because periodate oxidation of the buccal cells caused a significant reduction in subsequent adherence of GBS . A sonicate to type-III GBS blocked the binding of the organism to buccal cells . The effects of physical and chemical modifications of the sonicate on its ability to prevent bacterial attachment are described; these corroborate the evidence gained from heat and periodate treatments of the buccal cells and GBS . Results suggest a lectin type of attachment mechanism for type-III BGS which can be blocked by N-acetyl-D-glucosamine, rather than attachment by means of a lipoteichoic acid as described for group-A streptococci. Microbiologica, 1982 Jul, 5(3), 281 - 4 R factors in group D streptococci: classification by compatibility; Messi P et al.; Antibiotic transferable resistance determined by R-factors is largely distributed among the enterococci . Over a two year period, 106 strains of D streptococci have been tested . Transferable resistance has been detected in 45 strain (57.7% of the resistant strains) . The compatibility group of 24 plasmids has been determined: 12 belong to the group I; 4 belong to the group II; only one to the group III; one belongs to compatibility group IV; k R-factors have attributed to a new group V and the other two are not classifiable in any of the described groups. J Dairy Sci, 1982 Jul, 65(7), 1258 - 68 Environmental and physiological factors affecting mastitis at drying off and postcalving; Funk DA et al.; Duplicate milk samples from udder quarters were collected from 3987 cows when the cows were dried off and again postcalving . Samples were cultured for staphylococcal, Streptococci agalactiae, other streptococci species, and coliform organisms . Cows were treated with one of five dry cow therapy drugs or left as untreated controls after collection of samples at dry off . Cows treated with dry cow therapy drugs had more quarters cured during the dry period than did untreated control cows for all organisms considered . A program of dry cow treatment plus teat dipping was superior to dry cow treatment only, teat dipping only, or neither . Cows were more vulnerable to mastitis infections with increasing age . Month of year of drying off affected mastitis infection, although trends were erratic and varied by organism . Mastitis infections at dry off under different herd management systems of type of milking equipment, type of milking facility, and type of housing were dependent on the organism . Management systems had little influence on mastitis infections postcalving . Higher producing cows had fewer mastitis infections when dried off, but milk production the previous lactation had little influence on mastitis infections postcalving. Am J Clin Pathol, 1982 Jul, 78(1), 78 - 80 Speciation of the "viridans" streptococci; Sands M et al.; A simple scheme for the speciation of clinical isolates of "viridans" streptococci based on nine physiological characteristics is presented . Use of this scheme will enable successful speciation of most "viridans" strep isolates in any laboratory and allow for the accumulation of data necessary for the definition of clinical syndromes or unique clinical problems associated with particular species. J Clin Pathol, 1982 Jul, 35(7), 719 - 22 Evaluation of an improved Streptex kit for the grouping of beta-haemolytic streptococci by agglutination; Castle D et al.; A modified Streptex kit in which the extraction procedure had been simplified was used to group 200 streptococcal strains . Positive reactions could be obtained with live colonies and over 90% of isolates were correctly grouped from primary isolation plates . Some minor cross-reactions were seen with Streptex, but these were not strong enough to cause any confusion and no isolates were incorrectly grouped . The extraction enzyme in the Streptex kit was relatively poor at extracting the group-specific teichoic acid of group D strains but worked well with groups A, B, C, F and G. J Clin Microbiol, 1982 Jul, 16(1), 92 - 5 Comparison of the API 20S Streptococcus identification system with an immunorheophoresis procedure and two commercial latex agglutination tests for identifying beta-hemolytic streptococci; Keville MW et al.; The API 20S Streptococcus identification system and a new immunorheophoresis procedure were evaluated as means for determining the Lancefield serogroup of beta-hemolytic streptococci recovered from human clinical specimens . The serogroup of 96 strains was determined by these methods and by two commercially available latex agglutination tests . Streptex and SeroSTAT . The results of all four procedures were compared with the results of a classical precipitin test . The API 20S system correctly categorized 92.7% of the isolates; 94.8% were correctly identified by the immunorheophoresis procedure . The latex agglutination procedures were of comparable accuracy, yielding correct identifications with approximately 92% of the strains tested. J Clin Microbiol, 1982 Jul, 16(1), 111 - 4 In vitro lymphocyte proliferation in response to type III group B streptococci; Lillie MA et al.; The in vitro cell-mediated responses to group B streptococci (GBS) and the relationship of cell-mediated immunity to specific humoral immunity to type III GBS were investigated . Blood was obtained from 20 adult volunteers, and lymphocytes were isolated and cultured in microtiter plates . Each well contained 2 x 10(5) lymphocytes, 15% autologous serum, and either GBS (cell-to-organism ratio of 1:10, 1:1, or 1:0.1), phytohemagglutinin, streptokinase-streptodornase, or RPMI 1640 . Cells were harvested at 5, 6, or 7 days, and DNA synthesis was quantitated . Serum antibody titers were determined with an enzyme-linked immunosorbent assay . Maximal lymphocyte responses occurred at 6 days of culture and at a cell-to-organism ratio of 1:1 . Individuals with significant antibody titers to type III GBS, as well as those with undetectable antibody, responded to GBS (stimulation index greater than 10) . There was a significant difference (P less than 0.001) between mean antibody concentrations in responders (stimulation index greater than 10) and nonresponders (stimulation index less than 10) . Thus, the in vitro responses to GBS may be both to a specific antigen and to a nonspecific mitogen and may be important in host immunity to GBS. Infect Immun, 1982 Jul, 37(1), 209 - 15 Immunochemical analysis of streptococcal group A, B, and C carbohydrates, with emphasis on group A; Fung JC et al.; Streptococcal group A, B, and C carbohydrates were analyzed by counterimmunoelectrophoresis, immunoelectrophoresis, and inhibition of immunoprecipitation . Extracts of streptococci group A or C were shown by counterimmunoelectrophoresis to contain both anodic and cathodic migrating components . In immunoelectrophoresis, group A and C substances formed a continuous precipitation line stretching from the anode to the cathode, suggesting a heterogeneous population of molecules with immunochemical identity . This identity was confirmed by inhibition of immunoprecipitation, in which both anodic and cathodic immunoprecipitates were inhibited by the same constituent sugars: group A-anti-A was inhibited by N-acetylglucosamine, and group C-anti-C was inhibited by N-acetylgalactosamine . Extracts of group B showed only anodic migration in counterimmunoelectrophoresis and a narrow, anodic arc in immunoelectrophoresis . The group B-anti-B reaction was inhibited by rhamnose . Carbohydrates of variant strains of group A streptococci were also analyzed by the same methods . The results suggest that the heterogeneity of group A carbohydrate may have resulted from attachment of various amounts of N-acetylglucosamine to the polyrhamnose backbone. Zh Mikrobiol Epidemiol Immunobiol, 1982 Jul, (7), 41 - 6 {Sequential isolation of the structural components of the cell wall of Streptococcus group A}; Blinnikova EI et al.; The scheme of the consecutive isolation of cell-wall components from group A streptococci, type 29, has been developed . Extraction by means of 1 M hydroxylamine buffer with pH 6.0 (stage 1) and 10.0 (stage II) has yielded proteins showing different behavior in the double immunodiffusion test in agar . The protein obtained at pH 6.0 has given cross reaction with antiserum to type 1, while the protein obtained at pH 10.0 has been found to react only with homologous serum to type 29 . Extraction with 10% trichloroacetic acid at 4 degrees C (stage III) and 5% trichloroacetic acid (stage IV) has resulted in obtaining, respectively, polysaccharide forming one line with group-specific antiserum to group A in the double immunodiffusion test and polysaccharide having no such activity . At the last stages the HCl extract of the cell-wall residue (stage V) and peptidoglycan (stage VI) have been obtained. Pediatr Infect Dis, 1982 Jul-Aug, 1(4), 236 - 8 Erythromycin resistance in group A beta-hemolytic streptococci; Haddy RI et al.; Recent reports have indicated a high incidence of erythromycin resistance in Group A streptococci isolated from children in Japan . The present study investigated antibiotic susceptibility patterns of 280 pharyngeal isolates from ambulatory patients using the plate dilution technique . The incidences of resistance to erythromycin and tetracycline were 4.3 and 7.8%, respectively . No resistance to penicillin, ampicillin, methicillin, oxacillin, cefaclor or moxalactam was found, and there was no evidence of penicillin tolerance using the standard tube dilution technique . The erythromycin-resistant isolates were of T-pattern 12, M-type 12, and two erythromycin-resistant isolates were also resistant to tetracycline . Data on the source of the isolates suggest that a localized outbreak of erythromycin-resistant streptococcal infection occurred. Can J Microbiol, 1982 Jul, 28(7), 726 - 32 Cross protection in mice with the Smith diffuse stain of Staphylococcus aureus versus a type Ia strain of group B streptococci; Ichiman Y et al.; Active immunization of mice with whole cell vaccine or cell surface polysaccharide from either the Smith diffuse strain of Staphylococcus aureus or SS-615 (type Ia of group G streptococci) protected against challenge by either the homologous or heterologous strains . In the peritoneal cavity of mice immunized with either of these organisms rapid phagocytosis and reduction of the viable cells was observed at 6 h after the challenge . Cell surface polysaccharides extracted from strains Smith diffuse and SS-615, both prepared by the same procedure as that of the Smith surface antigen, were capable of absorbing the protective antibody in rabbit hyperimmune sera prepared with homologous or heterologous strains. Acta Paediatr Scand, 1982 Jul, 71(4), 639 - 44 Modified human immune serum globulin for intravenous administration: in vitro opsonic activity and in vivo protection against group B streptococcal disease in suckling rats; Fischer GW et al.; Human immune serum globulin (ISG) preparations were tested in an in vivo suckling rat protection assay and an in vitro opsonophagocytic assay against various types and strains of Group B streptococci (GBS) . Standard ISG provided minimal protection in suckling rats against type III GBS sepsis, whereas preparations of ISG modified for intravenous administration (MISG) provided significant protection against all strains of type III, type II and type Ia GBS tested . Although less protection was obtained against type Ia strains, the survival in suckling rats challenged with all types of GBS varied from 73% to 91% with MISG therapy, as compared with 5% to 12% survival in untreated animals . In this in vivo model, MISG was protective even when administered after bacterial challenge, but had to be administered within 5 h of infection . MISG also had high in vitro opsonic activity against GBS types III and II, but was less effective with some type Ia strains . Just as MISG was more protective than ISG in vivo, it also was more opsonic in vitro . A detailed comparison of one lot of MISG with its parent ISG revealed that the modified preparation actually contained less IgG . When equivalent concentrations of affinity-purified IgG from both preparations were tested, the IgG from MISG was significantly more opsonic . Since the affinity purification procedure eliminated the possibility that IgM or substances introduced in the modification process were actually responsible for the enhanced bactericidal activity, it appears that the individual IgG molecules in MISG may be more effective . These studies suggest that MISG which has been modified by reduction and alkylation for intravenous administration may provide a valuable adjunct to chemotherapy in the treatment of GBS disease in the neonate. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1982 Jul, 252(3), 299 - 309 Characterization of partially purified group B streptococcal clumping factor; Usui Y et al.; Using a strain of group B Streptococci, characteristics of the streptococcal clumping factor was investigated . In contrast to that of Staphylococcus, the streptococcal clumping factor reacted with plasmas from guinea-pig and sheep although staphylococcal clumping factor did not react with them . In addition, streptococcal clumping factor was resistant to heat, sonication, and chemical reagents; it was also degradable by proteolytic enzyme and galactose oxidase . Hydrochloric acid extract of the whole cell was subjected to Sephadex column chromatography and fraction containing streptococcal clumping factor was obtained . This fraction reacted selectively with fibrinogen in human plasma, caused paracoagulation, and the factor was presumed to be an acidic proteinaceous substance. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1982 Jul, 252(3), 287 - 98 Growth of group B streptococci and development of surface antigens in tissue cages implanted in rabbits; Wagner M et al.; Using tissue cages implanted in rabbits the growth of some strains of group B streptococci and the development of cell surface antigens were analyzed and compared to those under in vitro conditions . Two encapsulated strains grew well in the tissue cage fluid . Their capsules could be heavily labelled by ferritin-conjugated antibody against the type-specific polysaccharide . However, the thickness of the capsule was different to that following cultivation in vitro . In both strains the labelling of the group polysaccharide in the cell wall was sterically hindered by the large capsule . Two strains lacking a capsule did not grow in the tissue cage fluid but were mostly phagocytized . This again demonstrates the importance of the type-specific polysaccharides as significant virulence factors of group B streptococci. Immun Infekt, 1982 Jul, 10(4), 136 - 41 {Haptoglobins, streptococcus agglutination and streptococcal infections}; Kohler W et al.; The haptoglobins in man and in mammals react with streptococci bearing the T4-antigen . Hp 2-2 and Hp 2-1 react with high titres like complete agglutinins while Hp 1-1 acts like a blocking antibody . It is surprising to observe the similarity of the behaviour of the haptoglobins and of IgG and IgM . Streptococci carrying Hp 1-1 yield a positive Coombs-test . The Coombs-serum however, is an anti-human-haptoglobin-body from sheep . By means of supplements it has been possible to increase partly considerably the titres of Hp 2-1 and Hp 2-2 against the streptococci. Zh Mikrobiol Epidemiol Immunobiol, 1982 Jul, (7), 50 - 2 {Carbamoyl phosphate biosynthesis in Streptococci}; Khramov VA et al.; Nine streptococcal strains belonging to different serological groups (A, B, C, D) were shown to synthesize carbamoyl phosphate from ammonium hydrocarbonate and ATP . The reaction was catalyzed by carbamate kinase (EC 2.7.2.2) . The speed of the reaction was evaluated according to the increase of the content of citrullin (the combination of carbamate kinase and ornithine transcarbamoylase) . The representatives of different serological groups were found to have quantitative differences in carbamate kinase activity: the highest specific activity (13 nmol of citrullin per minute in 1 mg of dried microbial biomass) was detected in group A streptococci, while group D streptococci showed the lowest specific activity (0.5 nmol). J Clin Microbiol, 1982 Jul, 16(1), 200 - 1 Detection of human Fc (gamma) receptors on streptococci by indirect immunofluorescence staining: a survey of streptococci freshly isolated from patients; Lebrun L et al.; With immunofluorescence staining, Fc (gamma) receptors were found on groups A, C, and G streptococci and never on pneumococci or on groups B, D, H, or K streptococci. Antimicrob Agents Chemother, 1982 Jul, 22(1), 128 - 36 Penicillin-resistant and penicillin-tolerant mutants of group A Streptococci; Gutmann L et al.; Penicillin-resistant and penicillin-tolerant mutants have been isolated from group A streptococci mutagenized by ethyl methane sulfonate . The resistant mutants had an elevated minimal growth inhibitory concentration for benzylpenicillin (minimal inhibitory concentration, 0.2 microgram/ml, as compared with the minimal inhibitory concentration of 0.006 microgram/ml in the penicillin-susceptible parent strain); they also had an abnormal cellular morphology and showed altered penicillin-binding proteins . Penicillin-tolerant mutants were killed more slowly than were the parental cells during treatment with penicillin; they had virtually unchanged minimal inhibitory concentration values for penicillin and normal cellular morphology and penicillin-binding proteins. Scand J Dent Res, 1982 Jun, 90(3), 200 - 6 Influence of combinations of oral bacteria on periapical tissues of monkeys; Fabricius L et al.; The present study deals with the ability of 11 bacterial strains, in various combinations, to induce periapical reactions . The indigenous oral bacteria were originally isolated from an experimental apical periodontitis in monkey . Eight of the strains were complete collection isolated from one root canal . These strains were inoculated together, in equal proportions, into 12 root canals . In addition, 63 canals were inoculated with other combination or separate strains . At the end of the experimental period it was found that in the mixed infections the Bacteroides oralis strain predominated in most root canals . In contrast, this Bacteroides strain was not reisolated in any of nine root canals when inoculated in a pure culture . Enterococci, however, survived as pure cultures in all canals . The mixed infections showed the greatest capacity of inducing apical periodontitis, as revealed by radiography, and most pronounced was the "eight-strain collection" . The facultatively anaerobic streptococci induced only weak periapical reactions. Pathol Biol (Paris), 1982 Jun, 30(6), 376 - 9 {Antibacterial activity of netilmicin in combination with other antibiotics . Comparison with other aminoglycosides (author's transl)}; Cluzel M et al.; We studied in vitro bactericidal effects of netilmicin combined with other antibiotics, comparing with that obtained with other aminoglycosides combinations . We used strains of Streptococci and Gram negative rods tested versus 11 antibiotics : penicillin (P), ampicillin (Am), carbenicillin (Cb), cefalotin (Cth), cefazolin (Cfz), cefradin (Cfa), cefoxitin (Cxt), cefotaxime (CTX), erythromycin (E), pristinamycin (Pr), vancomycin (V) . These were combined with streptomycin (Sm), tobramycin (To), amikacin (Ak), gentamicin (G) and netilmicin (Nl) . First of all, we noted the high bactericidal power of Nl, whatever the strains tested . Against Streptococci, the activity of P + Nl and Am + Nl were equivalent or superior to that of P + G and Am + G . Among cephalosporins, we noted a synergistic effect of Ctx + Nl which did not exist with Ctx + G . In the same way, E + Nl showed synergism whereas E + G didn't . V + Nl combinations, as active upon Streptococci as V + G, are more active than V + G upon Enterococci . Against Gram negative bacilli, we observed good effects with Cb + Nl . Cephalosporins combinations were also interesting : Cfz + Nl were as active Cfz + G but Czt + Nl showed higher synergistic effect than Cxt + G . Ctx + Nl combinations were effective upon E . coli. J Clin Microbiol, 1982 Jun, 15(6), 991 - 3 Enzyme-linked immunosorbent assay for measurement of antibody to type III group B streptococci; Polin RA et al.; Neonates at risk for fulminant type III, group B streptococcal (III GBS) infection are those who lack antibody to the capsular polysaccharide . A newly developed enzyme-linked immunosorbent assay (ELISA) was compared with a standard radioactive antigen-binding assay (RABA) for quantitation of III GBS antibody in human sera . Although there was a significant correlation between the ELISA and RABA (r = 0.81; P less than 0.001) in general, the ELISA detected antibody both to core and native antigens of III GBS, whereas the RABA detected antibody to native polysaccharide exclusively . The results of the two assays were discordant when sera which had only high native or core antibody (not both) were assessed . Although the ELISA was reproducible and required less than 1 microliter of serum, interpretation of data obtained by the assay should be viewed with caution since only antibody to native III GBS has been correlated with human immunity. J Clin Microbiol, 1982 Jun, 15(6), 987 - 90 Presumptive identification of streptococci with a new test system; Facklam RR et al.; A test is described that could replace bacitracin susceptibility for presumptive identification of group A streptococci as well as 6.5% NaCl agar tolerance for presumptive identification of enterococcal streptococci . The L-pyrrolidonyl-beta-naphthylamide test, based on hydrolysis of pyrrolidonyl-beta-naphthylamide, was used in conjunction with the CAMP and bile-esculin tests to presumptively identify the streptococci . Among the beta-hemolytic streptococci; 98% of 50 group A, 98% of 46 group B, and 100% of 70 strains that were not group A, B, or D were correctly identified by the new presumptive test scheme . Among the non-beta-hemolytic streptococci; 96% of 74 group D enterococcal, 100% of 30 group D nonenterococcal, and 82% of 112 viridans strains were correctly identified by the new presumptive test scheme. J Clin Microbiol, 1982 Jun, 15(6), 981 - 3 Preliminary identification of beta-hemolytic streptococci in throat swab cultures with a commercial blood agar slide (streptocult); Christensen P et al.; A commercial blood agar slide (Streptocult, Orion Diagnostica) was used for preliminary identification of beta-hemolytic streptococci of groups A, C, and G in throat swab specimens . The sensitivity of the test was 93.6% and the specificity was 94.7%, as judged from 580 specimens . A model is suggested for routine processing of throat swab specimens, involving inoculation and reading of the slide in general practice and transport of positive or inconclusive slides to a bacteriology laboratory for isolation and serological grouping of beta-hemolytic streptococci . The model combines preliminary detection of beta-hemolytic streptococci within 24 h with the reliability of serological groupings, and should reduce the volume of specimens sent to the laboratory considerably. J Infect Dis, 1982 Jun, 145(6), 800 - 3 Maternal carriage and neonatal acquisition of group B streptococci; Hoogkamp-Korstanje JA et al.; Vaginal, cervical, and rectal swabs were obtained from 762 women early in pregnancy to culture group B streptococci (GBS) . The overall carrier rate was 13.9% and the rectal, vaginal, and cervical carrier rates were 10.6%, 7.9%, and 6.3%, respectively, GBS were isolated only from the rectum in 33%, so the rectum is an important reservoir . Seventy-five percent of the culture-positive women were permanent or intermittent carriers . Ninety percent of all women positive at labor were positive before the 20th week; acquisition of GBS late in pregnancy was rare . The frequency of transmission to the neonates was 63.4% among permanent carriers . Other determinants for transmission were the number of positive sites, the heaviness of colonization, and the (cervical) localization of GBS at labor . The serotypes of GBS isolated from the mothers and neonates were the same . Serotype distribution fluctuated during pregnancy . Types III (29%) and Ib (27%) were predominant, followed by types II (12%) and Ic (10%). J Infect Dis, 1982 Jun, 145(6), 794 - 9 Anorectal and vaginal carriage of group B streptococci during pregnancy; Dillon HC Jr et al.; A longitudinal prospective study of carriage of group B streptococci during pregnancy was conducted in 2,540 women over a three-year period . Carriage was documented in 18% of the women by anorectal culture, in 4% by vaginal culture, and in 13% by simultaneously obtained anorectal and vaginal cultures (overall carriage rate, 35%) . The rate and pattern of carriage were nearly identical from year to year . In sequential cultures in the second and third trimesters of 754 women, carriage rates were 31% and 28%, respectively; only 17% of the women were carriers in both trimesters . (1) Persistence of carriage was most common when the initial anorectal swabs were positive, (2) spread from the intestinal tract to the vagina occurred, and (3) the intestinal tract was commonly the primary site of acquisition in patients with previously negative cultures . The intestinal tract appears to be a primary reservoir for group B streptococci and the likely source of vaginal or urogenital colonization in pregnant women. J Hyg (Lond), 1982 Jun, 88(3), 439 - 52 Why type streptococci? The epidemiology of group A streptococci in Oxfordshire 1976-1980; Mayon-White RT et al.; The results of typing all group A streptococci isolated in one laboratory in 5 years were reviewed to see if the collected information showed epidemiological patterns . The great majority of the 5858 streptococci typed came from patients seen in general practice: 72% from throat swabs and 11% from skin lesions . Eight types, M types 1, 2, 3, 4, 6, 12, 22 and type 28 R accounted for 65% of strains . These eight types had different patterns: types 2 and 6 caused small circumscribed outbreaks and were uncommon between epidemics; types 3, 4 and 12 caused larger, wider epidemics, whereas types 1, 22 and 28 R had a more stable pattern . Type 4 was more commonly resistant to tetracycline than most other types, a finding which affected the apparent incidence of tetracycline resistance in group A streptococci . Streptococci from superficial sites were more likely to have serum opacity factor and to lack a detectable M-antigen than strains isolated from the throat . Routine typing of streptococci helped to detect outbreaks of infection in special groups . It is concluded that regular streptococcal typing should be continued in some places. J Immunol, 1982 Jun, 128(6), 2731 - 3 The presence of sialic acid on two related bacterial polysaccharides determines the site of the primary immune response and the effect of complement depletion on the response in mice; Markham RB et al.; We have examined the antibody responses in mice to two structurally similar antigens: the capsular polysaccharide of type 3 group B streptococci (sssGBS 3) and the capsular polysaccharide of type 14 pneumococci (sssPn 14), which differ only in the presence of a terminal sialic acid on the side chain of the former . The cells that produce antibody to the nonsialated antigen (sssPn 14) reside in the spleen, whereas the cells that produce antibody to the sialated antigen (sssGBS 3) do not . Cobra venom factor treatment of the mice before immunization abrogates the antibody response to the nonsialated antigen, but does not affect the response to the sialated antigen. Arch Inst Pasteur Tunis, 1982 Jun-Sep, 59(2-3), 243 - 50 {Beta-hemolytic streptococci in the schoolchildren of the Tunis governorship}; Khemiri F et al.; An investigation based on 1008 pharyngeal samples effected on school children aged six to twelve years of Tunis area has shown 71 carriers of beta-hemolytic streptococci (percentage 7%) whose 42 Lancefield's group A . The strains isolated had been tested by agar diffusion technic about seven antimicrobial agents . The most active ones Ampicillin are . Tetracyclin, Oxytetracycline and Oxacillin are the less active ones. Jpn J Antibiot, 1982 Jun, 35(6), 1493 - 510 {Clinical evaluation of cefmetazole in the dermatologic field}; Asada Y et al.; The therapeutic efficacy and safety of cefmetazole, a cephamycin-derived antibiotic in an injectable form were evaluated in patients with pyogenic infection in the dermatological field . Especially, it was found to be extremely effective for the skin diseases due to staphylococci or streptococci . The results obtained were the following; marked improvement in 18 cases and moderate improvement in 34 cases out of 61 cases, attaining efficacy of 86.7% . Side effects were noted as the rise of GOT and GPT in 3 cases, which were normalized by ceasing its further administration . The MIC of cefmetazole against Staphylococcus aureus isolated out of foci was 0.39-6.25 microgram/ml, while those of CEZ, CXM and ABPC used as the controls exceeded 50 microgram/ml in some cases . It is considered thus, that cefmetazole, is superior to these other antibiotics also in terms of MIC. J Gen Microbiol, 1982 Jun, 128(Pt 6), 1381 - 4 Polysaccharase activity in Streptococcus agalactiae (group B streptococci); Davis GH et al.; Of 300 recently isolated strains of Streptococcus agalactiae from human sources, 97% degraded starch . Representative strains also degraded glycogen, pullulan, amylopectin and amylose . The polysaccharase activity is easily detected by clearing around growth on Columbia agar base medium . The activity is weaker than that of some S . pyogenes strains, and it does not appear to produce fermentable products but is inhibited by the presence of easily used sugars. J Bacteriol, 1982 Jun, 150(3), 1024 - 32 Arginine metabolism in lactic streptococci; Crow VL et al.; Streptococcus lactis metabolizes arginine via the arginine deiminase pathway producing ornithine, ammonia, carbon dioxide, and ATP . In the four strains of S . lactis examined, the specific activities of arginine deiminase and ornithine transcarbamylase were 5- to 10-fold higher in galactose-grown cells compared with glucose- or lactose-grown cells . The addition of arginine increased the specific activities of these two enzymes with all growth sugars . The specific activity of the third enzyme involved in arginine metabolism (carbamate kinase) was not altered by the composition of the growth medium . In continuous cultures arginine deiminase was not induced, and arginine was not metabolized, until glucose limitation occurred . In batch cultures the metabolism of glucose and arginine was sequential, whereas galactose and arginine were metabolized concurrently, and the energy derived from arginine metabolism was efficiently coupled to growth . No arginine deiminase activity was detected in the nine Streptococcus cremoris strains examined, thus accounting for their inability to metabolize arginine . All nine strains of S . cremoris had specific activities of carbamate kinase similar to those found in S . lactis, but only five S . cremoris strains had ornithine transcarbamylase activity. Med J Aust, 1982 May 29, 1(11), 459 - 61 Antibiotic susceptibility of Staphylococcus aureus community acquired strains; Mutton KJ et al.; Over 250 strains of Staphylococcus aureus isolated from patients who presented with infections acquired outside the hospital were tested for susceptibility to penicillin G, minocycline and erythromycin . Only 15.5% of strains could be regarded as sensitive to penicillin, whereas 99.2% and 90.2% were sensitive to minocycline and erythromycin respectively . Beta-haemolytic streptococci were found in association with Staph . aureus in 17.5% of the lesions cultured in this survey . The susceptibility of a further 100 strains of methicillin-sensitive Staph . aureus to a wider range of antimicrobial agents was also examined. Fortschr Med, 1982 May 20, 100(19), 886 - 7 {Gram negative infection of the axilla}; Hubner HM et al.; Report on a 58-year-old woman with eczema-like lesions in both axillae . The lesions had been treated as a mycotic infection, but no fungi grew in the cultures . There was massive growth of pseudomonas aeruginosa, and some few colonies of B-streptococci were found . The lesions disappeared two weeks after treatment with gentamycin and water dressings . The disease is reported as "gram-negative infection of the axillae" because its clinical and anamnestic features are similar to those of the so-called "gram negative infection of the feet". J Rheumatol, 1982 May-Jun, 9(3), 424 - 7 Group G streptococcal arthritis; Lin AN et al.; Four cases of infectious arthritis due to beta hemolytic streptococci, Lancefield Group G are described . Three patients presented with acute polyarthritis involving unusual sites while the 4th patient had acute monoarthritis . All 4 cases had underlying diseases which predisposed them to infection: alcoholism (2 cases), malignant disease (1 case) and diabetes mellitus (1 case) . Three patients had coexistent Group G streptococcal infection: endocarditis in 2 and skin infection in 1 . With adequate parenteral antibiotic therapy and frequent joint aspiration, the prognosis for return of normal joint function following infection with Group G streptococcus appears to be excellent . These cases demonstrate the need for routine serogrouping of streptococcal isolates in patients with septic arthritis . The importance of recognizing this uncommon type of infectious arthritis is emphasized in view of its prognostic and therapeutic implications. J Clin Microbiol, 1982 May, 15(5), 855 - 9 Effect of diving and diving hoods on the bacterial flora of the external ear canal and skin; Brook I et al.; The bacterial flora of the external ear canals and posterior auricular skin surfaces were investigated in a group of 26 divers after 25 dry-suit dives in harbor water and 20 dry-suit dives in clear test tank test . A control group of 16 divers wore rubber hoods 19 times for a similar period (25 to 30 min) but did not dive . The protective effect of 2% acetic acid was tested by instilling it in the left ear of 14 divers and 8 nondivers . Staphylococcus epidermidis, Propionibacterium acnes, alpha-hemolytic streptococci, and enteric gram-negative rods were the predominant isolates from skin and ear samples . After the divers dove or after they wore hoods without going in the water, there was a substantial increase in the number of these organisms on the skin (46.9%) or in the external ears (43.8%) of the divers . However, an increase in the bacterial counts in the external ear canals occurred in only 13.6% of the individuals treated prophylactically with acetic acid drops . Although no gram-negative rods were recovered from the skin or external ear canals of divers in clear tank water, 23 strains were isolated after the dives in harbor water . Identical gram-negative isolates also were recovered from the harbor water . Gram-negative organisms also were recovered from three newly acquired skin lacerations, where they persisted for at least 24 h . Our data show the acquisition of gram-negative rods when dives were made in polluted water . The data also demonstrate the increase in bacterial counts that occurs when rubber diving rods are worn (in or out of water) and that this increase can be controlled by pretreatment of ears with acetic acid. South Med J, 1982 May, 75(5), 608 - 10 Streptococcus anginosus-constellatus infections of the nervous system; Plotkin GR; Two patients are presented with central nervous system infections due to an uncommon type of viridans streptococci, S anginosus-constellatus . Of the various streptococci, S pneumoniae is the most common etiologic agent in meningitis, but many species, including those which are facultative anaerobes or microaerophiles, have been isolated from cerebrospinal fluid, subdural empyema, and abscesses involving the brain and epidural space. Z Gesamte Inn Med, 1982 May 1, 37(9), 253 - 9 {The value of fosfomycin}; Tauchnitz C et al.; After description of the most important properties of fosfomycin including pharmacokinetics, antibacterial activity and hitherto got clinical experiences the determinations of the resistance on frequent clinical pathogenic agents are reported . They were performed in the diffusion test in a platelet content of 20 micrograms with admixture of glucose-6-phosphate . High sensitivity rates showed E . coli, P . mirabilis, hemophiliacs and above all Staph . aureus, but also a large part of the Klebsiella and the Pseudomonas strains could be classified as sensitive . Streptococci, pneumococci and enterococci mostly proved as resistant . Thus, in an oral therapy the spectre is smaller than in a highly dosed parenteral supply . Nevertheless, fosfomycin in the two forms of application is to be regarded as an enrichment of the therapeutic possibilities and further should be tested clinically. J Clin Lab Immunol, 1982 May, 8(1), 55 - 8 Interaction between human neutrophils and group B streptococci (GBS) and group antigens, monitored by Luminol-dependent chemiluminescence; Kowolik MJ et al.; Interaction between the five serotypes of GBS and human neutrophils was investigated using Luminol-dependent chemiluminescence . A considerable variation in response, and a variable dependence pre-opsonisation was demonstrated both for while bacteria and HCl-extracts . These preliminary results may have relevance to clinical infection with GBS and demonstrate hitherto unrecognised differences in the nature of "group-specific" antigen extracts from GBS serotypes. J Clin Microbiol, 1982 May, 15(5), 787 - 90 Carriage of Streptococcus agalactiae in women and neonates and distribution of serological types: a study in Brazil; Benchetrit LC et al.; The prevalence of group B streptococcal carriage was evaluated in nonpregnant women and in mothers and their offsprings . The overall carriage rate of group B streptococci at one site was 18.2% . Streptococci were recovered from one or more of the sites sampled in 25.6% of mothers and 15.4% of newborn infants . The maternal genital carriage rate was 18.6%, and acquisition of the organism from the mother was assessed by serological typing of group B streptococcal isolates in the mother-infant pairs . A cervical carriage rate of 16.3% was seen in nonpregnant women. Ann Clin Lab Sci, 1982 May-Jun, 12(3), 239 - 43 Group B streptococcal infection in the neonate; Manos JP; The incidence of disease caused by the Group B streptococci (GBS) has risen significantly in the past two to three decades and the GBS are now a leading cause of meningitis in the neonate . The GBS are sub-classified into five groups (Ia, Ib, Ic, II, and III) with type III being the most common, especially in meningitis . The two syndromes, early (first week) and the late (s