Streptococcal

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 (second to twentieth week) are associated with a 50 percent and 20 percent mortality, respectively . The acute syndrome is usually a result of infection from a maternal source whereas the late syndrome is more often associated with nosocomial or community acquisition of GBS . Antibiotic prophylaxis by treating infants at risk or colonized mothers has not proven efficacious; however, maternal antibodies have been shown to afford protection to neonates . Further evaluation of antibiotic prophylaxis and therapy, clarification of the mechanism of acquired immunity versus susceptibility and further characterization of the antigens of GBS with a possibility of a vaccine as a measure of prophylaxis are currently in progress.

J Dent Res, 1982 May, 61(5), 636 - 9
Phagocytic and killing activity of human blood, gingival crevicular, and salivary polymorphonuclear leukocytes for oral streptococci; Scully C; The phagocytosis and killing of oral streptococci by blood, crevicular, and salivary polymorphonuclear leukocytes (PMNL) were examined using a visual assay based on differential staining of viable and non-viable microorganisms by acridine orange . Crevicular PMNL were 83% viable, 19% contained bacteria on collection, and phagocytosis occurred in vitro in 66% of glass-adherent leukocytes . Salivary PMNL were 56% viable, 11% contained bacteria on collection, and 44% phagocytosed streptococci in vitro . Crevicular and salivary PMNL were capable of phagocytosis and killing of oral streptococci, but both were impaired . Crevicular fluid was not significantly leukotoxic; mixed saliva caused a significant reduction in PMNL viability and in phagocytic and killing activity for oral streptococci . Crevicular PMNL may be actively functional phagocytes, but salivary PMNL are unlikely to be significant in oral defenses.

Infect Immun, 1982 May, 36(2), 745 - 50
Phage influence on the synthesis of extracellular toxins in group A streptococci; Nida SK et al.; Phage conversion of group A streptococci to produce streptococcal exotoxins was shown to occur more widely than has been previously reported . Toxigenic conversion was found in 19 newly constructed lysogenic and pseudolysogenic strains resulting in synthesis of exotoxin types A and B . Conversion was accomplished by a positive conversion effector, which was a phage characteristic expressed by the prophage and vegetatively reproducing phage . Exotoxin production was determined by the rabbit skin test and by countercurrent immunoelectrophoresis with type-specific antisera . New lysogens and pseudolysogens were constructed with strains which failed to produce at least one exotoxin type . Phages were obtained from toxigenic strains isolated from cases of scarlet fever . Conversions were consistent and repeatable; loss of the recently introduced phage was accompanied by loss of the newly acquired toxin productivity . Conversion resulted in production of additional exotoxin type or types and never affected existing toxin synthesis . Converting phages were characterized by electron microscopy and negatively stained preparations and were all found to be of morphological class B1 . All phage nucleic acid was double-stranded DNA . Though similar in structure, each converting phage had a different host range, and the nine new converting phages identified here did not react with antiserum prepared against the originally reported converting phage.

Am J Med Sci, 1982 May-Jun, 283(3), 129 - 40
Bacteremia following dental extractions in patients with and without penicillin prophylaxis; Baltch AL et al.; This study describes the type, rate and magnitude of bacteremia in 128 patients undergoing dental extractions with and without penicillin prophylaxis . The most prolonged and highest rates of bacteremia occurred in patients undergoing extractions and alveoplasty while under general anesthesia following nasotracheal intubation . The most common aerobes in patients receiving no penicillin were streptococci . Bacteroides sp . were detected most often in patients receiving penicillin prophylaxis . The overall bacteremia, streptococcal and polymicrobial bacteremia rates were lowest for the patients receiving penicillin . Only two of 66 patients given penicillin prophylaxis had recoverable streptococci in blood cultures . Our study indicates that both intravenous and oral penicillin G prophylaxis for dental extractions decreased bacteremia rates significantly, including the recovery of streptococci.

Am J Clin Pathol, 1982 May, 77(5), 608 - 10
Comparison of slide agglutination test (Phadebact) with counterimmunoelectrophoresis for detection of streptococcal group antigens; Fung JC et al.; Sera from mice infected with group B streptococci and culture supernatants of group B, A, and C streptococci were examined for the presence of group-specific antigens by the Phadebact slide agglutination (PSA) test and counterimmunoelectrophoresis (CIE) . The results were correlated with the number of organisms present in the blood or in vitro cultures . The PSA test was slightly more sensitive than CIE.

J Clin Microbiol, 1982 May, 15(5), 920 - 5
Identification of viridans streptococci isolated from clinical specimens; Ruoff KL et al.; Of 532 strains of viridans streptococci isolated from clinical specimens, 517 were identified by using a scheme based on the work of Facklam (R . R . Facklam, J . Clin . Microbiol . 5:184-201, 1977) . The strains were distributed among nine of the species described by Facklam and an additional group of physiologically homogeneous streptococci not recognized in Facklam's scheme . The method for identification involves a battery of 10 tests that employ both conventional media and commercially prepared disks . The identification of most of the isolates was accomplished within 48 h.

J Clin Microbiol, 1982 May, 15(5), 860 - 4
Comparison of recovery of organisms from blood cultures diluted 10% (volume/volume) and 20% (volume/volume); Auckenthaler R et al.; We compared blood cultures that were diluted 1:5 (20%, vol/vol) and 1:10 (10%, vol/vol) and contained specimens from patients with suspected septicemia . Streptococcus pneumoniae was recovered significantly more frequently from blood cultures diluted 20%, whereas gram-negative bacilli, group D streptococci, Staphylococcus aureus, and Candida spp . were recovered significantly sooner and more frequently from blood cultures diluted 10% . Statistically significant differences in isolation rates, however, represented only a small number of patients for whom the positive cultures affected therapy . We conclude that as long as at least two separate sets of blood cultures are obtained per septic episode from each patient, a 1:5 to 1:10 blood/vented (aerobic) medium ratio provides acceptable results . Nevertheless, the results also demonstrate that blood cultures diluted 10% provided greater and faster yields than those provided by blood cultures diluted 20%.

Yale J Biol Med, 1982 May-Aug, 55(3-4), 265 - 70
Epidemiology of group A streptococcal infections--their changing frequency and severity; Quinn RW; The frequency and severity of streptococcal infections and their sequelae have declined dramatically in the past century, yet the prevalence of streptococcal infections is still high . The reasons for this decline must be intimately related to host resistance, virulence of the agent, and environmental factors, especially crowding . Close examination of these fundamental influences does not reveal any evidence that humans have become less resistant to streptococcal infections, but they react less violently . There is some evidence that the agent may have lost a degree of its virulence . The decline in morbidity and mortality due to streptococcal infections began long before antibiotics, especially penicillin, were available . However, penicillin has proved to be an important factor in prevention of streptococcal infections, especially in rheumatic fever prophylaxis . There are certain indications that repeated streptococcal infections due to similar M types, occurring in young children over the past several decades, have resulted in some degree of immunity as well as the possible evolution of less virulent, but not less infectious, strains of group A streptococci . Also, a decrease in crowding would be expected to result in fewer streptococcal infections . Although there are more people in the world than at any other time in the history of man, urban population density in the western world, at least, is less than in the late 1800s and early 1900s.

J Med Microbiol, 1982 May, 15(2), 153 - 62
Preparation of specific antisera to the opacity factors of group-A streptococci; Fraser CA; Type-specific antibody to the opacity factor (OF) of group-A streptococci can be demonstrated in human sera but the multiplicity of antibodies to different serotypes limits their usefulness in anti-OF typing . The antibody response in rabbits is inconsistent; only 61 of 138 (44%) of rabbit anti-M sera tested contained OF antibody . Of these only about half had titres of greater than 16, and usable sera to only 11 of 23 OF-positive serotypes were obtained . On the other hand good anti-OF sera (titres greater than 16) to 27 of 28 serotypes resulted from the interperitoneal and subcutaneous inoculation of heat-killed whole-cell vaccines in guinea-pigs and the frequency of response in groups of animals given injection of the same vaccine was 100% for all but three serotypes . Antibody response was not obtained with M-type 13 . A comparison of routes of inoculation for M-type 25 showed that the subcutaneous route alone could probably be used in the routine production of anti-OF typing sera . Use of the set of 27 sera in OF-inhibition tests confirmed the remarkable specificity of OF antigens and their parallelism with M-antigen specificity, with the exception fo a reciprocal cross reaction between M-type 61 and provisional type PT3875.

Antimicrob Agents Chemother, 1982 May, 21(5), 698 - 705
Conjugative R plasmids in Streptococcus faecium (group D); Le Bouguenec C et al.; Ten isolates of Streptococcus faecium were found to be resistant to penicillin, tetracycline, macrolides and related drugs, streptomycin, and kanamycin, and four strains were resistant to chloramphenicol . Six of these 10 strains transferred all their resistance markers (except penicillin) by conjugation at a low frequency (10(-7) to 10(-9)) . Several plasmids of different molecular weights were found in each of the wild-type strains . In 5 of 11 transconjugant strains, R plasmids were detected which had molecular weights identical to those of the plasmids found in the corresponding donor strain . Each of the six other transconjugants harbored one plasmid with a size different from those found in the corresponding donor strain, suggesting the occurrence of molecular events during or after conjugative transfer . None of the five tetracycline-resistant transconjugants contained detectable satellite DNA, HindIII restriction enzyme fingerprints of S . faecium resistance plasmids were different from the HindIII patterns of macrolide, aminoglycoside, and tetracycline resistance plasmids from other strains of streptococci.

Infect Immun, 1982 May, 36(2), 469 - 75
Receptor in group C and G streptococci detects albumin structures present in mammalian species; Wideback K et al.; The presence of albumin structures with the capacity to bind to a surface receptor in group C and G streptococci was studied in serum samples from 45 mammalian species representing 15 different orders, using an inhibition assay . The ability of animal sera to inhibit the uptake of radiolabeled human serum albumin by the streptococci indicated the presence of such albumin structures . Positive reactions were found in species of most orders tested, with Marsupialia as a notable exception . All Carnivora sera tested were strongly positive . In some orders such as Artiodactyla both positive and negative species were identified . Serum samples from 62 bird species representing 15 orders and from 5 fish species were also tested in the inhibition assay . None of these serum samples was capable of inhibiting the uptake of human serum albumin by streptococci . Some differences were also noted in the results obtained with group C and G streptococci from human and bovine sources, respectively, indicating the presence of two types of receptors . The present studies suggest a phylogenetic origin of albumin structures with affinity for the streptococcal receptor to a period after the divergence of Marsupialia from the other mammalian orders.

J Dent Res, 1982 May, 61(5), 632 - 5
Effect of gramicidin D on the acidogenic properties of oral streptococci and human dental plaque; Vadeboncoeur C et al.; The effect of gramicidin D, Gramicidin S, and carbonylcyanide p-trifluoromethoxyphenyl hydrazone on the glycolysis of various oral streptococci was investigated . Gramicidin D was the most effective and inhibited the glycolysis of all the streptococci studied in the presence of the most common sugars found in man's diet (sucrose, lactose, glucose, and fructose) . A concentration of 2.5 X 10(-6) M gramicidin D was sufficient to decrease significantly the rate of glycolysis of human dental plaque in the presence of sucrose . The use of this ionophore as a caries preventive agent is discussed.

J Gen Microbiol, 1982 Apr, 128 (Pt 4), 713 - 20
Construction of matrices for computer-assisted identification of aerobic Gram-positive cocci; Feltham RK et al.; Two identification matrices for use with computerized probabilistic identification were constructed, based on 327 reference strains and 212 field isolates of Gram-positive, aerobic coccoid bacteria . The first, MICR1, was constructed for catalase-positive strains (Micrococcaceae); the second, STPC1, for catalase-negative strains (streptococci) . The quality of the resultant data was assessed using statistical analysis, and the value of the identification statistic used was considered in the light of possible alternatives.

Infect Immun, 1982 Apr, 36(1), 325 - 32
Role of granulocytes in experimental Streptococcus sanguis endocarditis; Meddens MJ et al.; We investigated the role of granulocytes during the induction and course of experimental Streptococcus sanguis endocarditis in rabbits by depleting blood granulocytes with nitrogen mustard . The induction of the endocarditis was not influenced by granulocytopenia: the 50% infectious dose was 5.4 X 10(4) colony-forming units in normal and granulocytopenic rabbits . However, granulocytopenia influenced the curse of the endocarditis, as shown by a significant increase in the number of colony-forming units per gram of vegetation (P less than 0.02) from 24 to 72 h after the injection of 10(5) colony-forming units of S . sanguis . This rise did not occur in the control rabbits . Furthermore, bacteremia was significantly higher in the granulocytopenic rabbits (P less than 0.05) during the first 48 h compared with the control rabbits . This was not because of altered clearance of the streptococcus inoculum or seeding of streptococci from extracardiac bacterial foci . We concluded that granulocytes have no measurable effect on the induction of S . sanguis endocarditis, but during the course of the endocarditis, granulocytes keep the endocardial infection in check.

Arch Intern Med, 1982 Apr, 142(4), 789 - 92
Infective endocarditis in a community hospital; Venezio FR et al.; Recent reviews from major university centers of infective endocarditis have stressed an increase in unusual infections owing to virulent pathogens . This article compares the 40 episodes of infective endocarditis at a community hospital complex with the recent literature . It was observed that the majority of infecting microorganisms were penicillin-susceptible streptococci similar to those seen in the early antibiotic era . An older patient population was encountered, but overall mortality was low . Streptococcus bovis was a frequent cause of both natural and prosthetic valve infections . Symptoms lasting longer than two months were associated with vegetations demonstrated by echocardiography and high morbidity . Clinical features in this series that significantly correlated with a poor prognosis were height of fever at admission, the failure of fever to resolve within one week of appropriate therapy, the degree of peripheral leukocytosis, gross hematuria, and CNS signs . Conservative parenteral treatment closely monitored by serum bactericidal levels was employed . No relapses occurred among patients surviving initial therapy.

J Clin Microbiol, 1982 Apr, 15(4), 725 - 7
Clinical significance of viridans streptococci isolated from blood cultures; Swenson FJ et al.; The clinical significance of viridans streptococci isolated from the blood cultures of 86 patients was determined . Isolates that were significant or suggestive of infection represented only 21% of the cases . Among 54 isolates for which the species was known, Streptococcus sanguis II was the most common . However, a significant association between species and clinical significance was not found.

J Immunogenet, 1982 Apr, 9(2), 143 - 7
Association between maternal Gm allotype and neonatal septicaemia with group B streptococci; Grubb R et al.; Thirty-four mothers to infants seriously infected with group B streptococci (GBS) were investigated for G1m (1) and G3m(5) allotype markers . The frequency of Gm (1, -5) was 14.7%, of Gm(1,5) 20.6% and Gm (-1, 5) 64.7% . There was a marked deficit Gm (1) individuals and the distribution significantly differed from that in the normal Swedish populations.

J Clin Immunol, 1982 Apr, 2(2 Suppl), 31S - 35S
Functional characteristics of a modified immunoglobulin preparation for intravenous administration: summary of studies of opsonic and protective activity against group B streptococci; Fischer GW et al.; Group B streptococci (GBS) remains a major cause of morbidity and mortality in newborn babies, despite antibiotic therapy, Recent studies suggest that phagocytosis and killing of GBS is ineffective due to a deficiency in anti-GBS antibody . Using an opsonophagocytic bacterial assay and a suckling rat model of GBS sepsis, we analyzed a modified human immunoglobulin for opsonic and protective antibody . Immune globulin (IGIV) prepared for intravenous use (Gamimune, Cutter Laboratories, Inc.) was highly protective in this experimental GBS model . Using the opsonophagocytic assay, antibody activity to several strains of types Ia, II, and III GBS were also demonstrated with IGIV . To ensure that the IGIV activity was in fact antibody, globulin from IGIV was isolated and analyzed . Purified IgG retained opsonic activity in vitro and also provided protection in experimental GBS disease . Variation in the quantity of IgG necessary for protection was observed in different GBS strains . Since IGIV has opsonic and protective activity against several strains and serotypes of GBS, its intravenous administration may provide a valuable adjunct to standard antibiotic therapy for neonatal GBS infections.

Acta Pathol Microbiol Immunol Scand {B}, 1982 Apr, 90(2), 161 - 8
Cationic polyelectrolytes, liquoid and leukocyte extract modulate the binding of IgG to group A streptococcal Fc-receptors; Ginsburg I et al.; Various polyelectrolytes were investigated regarding their capacity to inhibit the binding of human IgG to Fc-receptors on group A streptococci, type M1 . Of cationic substances, protamine and arginine-rich histone inhibited significantly, while lysine-rich histone, concanavalin A, lysozyme, polymyxin B, ribonuclease and tuftsin did not . Of anionic materials, liquoid was inhibitory, in contrast to chondroitin sulphate, dextran sulphate, DNA and heparin . Washing experiments showed that the inhibition was caused by binding of the polyelectrolytes to the streptococci . The finding that heated IgG inhibited the binding of histone to the streptococci also indicated a close relation between the binding sites for these compounds . Diffusion-in-gel experiments with alkaline extract of M1 demonstrated that the substances blocking the IgG Fc-receptor were bound to polyglycerophosphate, suggesting that the inhibition of the IgG uptake was due to interaction with lipoteichoic acid . Leukocyte and platelet extracts could modify the binding of IgG, probably by an enzymatic digestion of the receptors . The arginine-rich histone was also capable of inhibiting the binding of IgG to type M15 group A streptococci and to one group G strain . However, the polyelectrolytes had no effect on the binding of IgG to Staphylococcus aureus or of IgA to type 4 group A streptococci.

J Clin Invest, 1982 Apr, 69(4), 1042 - 5
Antiopsonic activity of fibrinogen bound to M protein on the surface of group A streptococci; Whitnack E et al.; When virulent group A streptococci of M type 24 were incubated in fresh heparinized whole blood or in blood reconstituted from cellular elements and plasma, little uptake by neutrophils occurred as determined by light microscopy . When fresh human serum (with or without added heparin) was substituted for plasma, uptake occurred promptly . Uptake in serum could be prevented by adding either plasma or purified human fibrinogen to the incubation mixtures, or by pretreating the organisms with plasma or fibrinogen . Fibrinogen solutions absorbed with purified homologous M protein and centrifuged to remove precipitates lost their inhibitory activity . Uptake in serum depended on heat-labile factors . Immunofluorescent staining of bacteria using fluorescein-labeled antibody to the third component of complement showed that streptococci incubated in fresh serum bound complement evenly over the entire cell surface, whereas streptococci incubated in fresh plasma or in serum plus fibrinogen fluoresced only at some of the cross-walls between adjacent daughter cocci and at occasional terminal cocci . In electron micrographs, the surface fibrillar layer of streptococci treated with plasma or fibrinogen lost its hairlike appearance and became a dark band that stained heavily with ferritin-labeled antifibrinogen . We conclude that the known antiopsonic effect of M protein derives in part from binding of fibrinogen.

Infect Immun, 1982 Apr, 36(1), 227 - 34
Isoelectric points and surface hydrophobicity of Gram-positive cocci as determined by cross-partition and hydrophobic affinity partition in aqueous two-phase systems; Miorner H et al.; Thirty-nine streptococcal strains belonging to groups A, C, and G and 12 staphylococcal strains were investigated with respect to surface charge and hydrophobicity . Isoelectric points of the bacteria were determined by cross-partition experiments in dextran-polyethylene glycol two-phase systems containing charged polymers . The results obtained indicate that group A, C, and G streptococci have isoelectric points of pH 3.75 +/- 0.15 standard deviation . Staphylococci show an isoelectric point of around pH 2 and thereby differ markedly from the streptococci . Pretreatment of bacteria with human serum resulted in a significant change in the isoelectric points of streptococci . In a second series of experiments, an aqueous dextran-polyethylene glycol two-phase system containing polyethylene glycol palmitate or stearate was used to study the hydrophobic surface properties of the bacterial cells . The partition of the staphylococci was not influenced by the addition of up to 1% (wt/wt) polyethylene glycol palmitate or stearate, whereas the streptococci showed a large variation in affinity for polyethylene glycol-bound hydrophobic groups . The bacterial strains included in the study were also tested for uptake of human serum proteins . A positive correlation was found between the hydrophobic affinity of group A streptococci and the density of receptors for aggregated beta-2-microglobulin.

J Immunol, 1982 Apr, 128(4), 1897 - 902
Restricted deposition of C3 on M+ group A streptococci: correlation with resistance to phagocytosis; Jacks-Weis J et al.; In this report, the mechanism of resistance to phagocytosis by group A streptococci and the participation of M protein in this process were studied . A quantitative fluorometric immunoassay was used to determine the amount of the opsonic third component of complement, C3, fixed by group A streptococci in the presence and absence of M protein . In the absence of M protein, phagocytosis was found to be dependent on the amount of C3 fixed . However, when M protein was present, the streptococci still bound sufficient C3 to have promoted phagocytosis, yet none was observed . Further investigation using immunofluorescent microscopy demonstrated that the C3 fixed to M+ chains was confined to dense patches, interspaced by areas devoid of detectable C3 . This uneven distribution of C3 was dependent on the presence of a trypsin-sensitive structure; most likely the M protein . The significance of this restricted C3 deposition with respect to resistance to phagocytosis by group A streptococci is discussed.

J Immunol, 1982 Apr, 128(4), 1514 - 21
Immune recognition in the streptococcal carditis of mice: the role of macrophages in the generation of heart-reactive lymphocytes; Dos Reis GA et al.; The role of immune T cells and of streptococcus-pulsed M phi in the production of cardiac lesions, as well as the ability of M phi to present streptococcal antigens to mouse lymphocytes, was investigated . Cells of mice infected with extracts of group A streptococcus were able to induce the appearance of heart lesions when transferred to syngeneic receptors as well as to transfer DTH reactions to syngeneic heart extracts . Streptococcus-pulsed M phi were also able to induce heart lesions and an increase in the serum CPK activity when injected into syngeneic receptors . This last phenomenon was only observed in mice aged 5 mo or more . Furthermore, it was shown in an in vitro model of T cell proliferation that peritoneal M phi pulsed with group A streptococci are able to induce a specific response to syngeneic cardiac extracts . M phi pulsed with group G streptococcus failed to induce such a response . Those findings are discussed as part of a model for the induction of rheumatic cardiac lesions in which M phi display a central role by selecting antigenic determinants from the pathogenic organism for presentation to immunocompetent cells.

Jpn Circ J, 1982 Apr, 46(4), 352 - 61
Spectrum of the infective endocarditis in the past five years; Nakamura K et al.; One hundred and thirty patients at our Heart Institute with infectious endocarditis during the past 5 years were reviewed to provide an overview of the spectrum of infective endocarditis and to assess the accuracy of echocardiography in detecting the infective valvular and endocardial lesions . Of the 130 patients, 36 (28%) had the previous cardiovascular surgery . The mean age of the patients was 34 years, and only 11% of the patients were over 50 years of age . Of the 94 patients who had no cardiovascular surgery before developing infective endocarditis, 6 underwent urgent surgery, 49 had elective surgery and the remaining 39 were followed up with medical treatment . The mortality rate of the 55 patients who were operated on was 5.5% as against 18.0% in 39 without surgery . Half of the 36 patients who had been operated on before developing endocarditis had prosthetic valves inserted . Of the 5 patients with bioprosthetic valve endocarditis, only one survived as a result of prompt medical and surgical treatment . Streptococci were still commonly found, about 75% in the group without surgery and 50% in the group with surgery . Gram-negative bacilli and fungi were found in patients with prosthetic valve endocarditis . In 61 patients, morphologic abnormalities confirmed at surgery or necropsy were compared with the preoperative echocardiograms . Vegetations were identified preoperatively in 50 (95%) of the 53 valves involved, and valve destruction was correctly predicted in all 23 cases . Mycotic aneurysm was detected preoperatively in only 3 of the 12 patients in whom it occurred . Thirteen patients, in whom vegetation was recorded, were treated successfully with antibiotics alone and they needed no surgical intervention during the 2-year follow up period . The presence of a vegetation in an echocardiography does not necessarily require surgical intervention in itself or predict the ultimate course.

Obstet Gynecol, 1982 Apr, 59(4), 499 - 508
Infection as a predominant cause of perinatal mortality; Christensen KK; During a 15-month period, all 34 infants delivered at the department of obstetrics and gynecology at University Hospital in Lund, Sweden, who died perinatally or neonatally were included in a prospective study of causes of death . Autopsies--including extensive culturing of specimens for bacteria, chlamydia, fungi, mycoplasmas, and viruses--were performed for all infants . Maternal sera obtained during pregnancy and after delivery were examined regarding titers against a number of microorganisms . During the study period, the perinatal mortality rate was 0.60% and the neonatal mortality rate 0.56% . It was found that 37% of the deaths were caused by lethal malformations, 17% by idiopathic respiratory distress syndrome, and 9% by ablatio placentae . However, no less than 21% occurred as a direct consequence of infections, including 2 deaths caused by group B streptococci, 2 by Coxsackie B virus, and 3 deaths each by Hemophilus influenzae, Pseudomonas pyocyanea, and Candida albicans . A 6-month study of late abortions revealed another case of intrauterine group B streptococcal infection . The study has demonstrated that autopsy, including microbial examination, is recommended in all cases of perinatal and neonatal deaths.

J Exp Med, 1982 Apr 1, 155(4), 1010 - 8
Hybridoma antibodies against protective and nonprotective antigenic determinants of a structurally defined polypeptide fragment of streptococcal M protein; Hasty DL et al.; Hybridoma technology was used to produce a set of monoclonal antibodies against a purified polypeptide fragment of type 24 streptococcal M protein to delineate the protective determinants of M protein exposed on the surface of the virulent streptococci . Several hybridoma antibodies were found to be opsonic against the homologous type streptococci . At least two of these antibodies (IIC3.7 and IIC4.6) protected mice against challenge infections with the homologous, but not a heterologous, serotype of bacteria . One of the hybridoma antibodies that reacted in high dilution (1:204,800) with the isolated M protein failed to react with the M protein on the surface of type 24 streptococci, and thus did not opsonize the homologous organisms or protect mice against challenge infections . Because hybridoma antibodies are directed against a single distinct immunodeterminant, these results indicate that protective immunity may be directed at any one of several distinct antigenic determinants of M protein exposed on the surface of virulent group A streptococci.

Can J Biochem, 1982 Apr, 60(4), 452 - 62
Inorganic pyrophosphatase activity in oral streptococci: purification and properties of the enzyme from Streptococcus salivarius; Khandelwal RL et al.; Inorganic pyrophosphatase has been purified from the soluble fraction of Streptococcus salivarius by protamine sulfate treatment, ammonium sulfate fractionation, and chromatography on Sephadex G-200 and DEAE-cellulose . The enzyme was purified approximately 500-fold with a 33% yield . The purified enzyme was homogeneous since it showed a single band when examined by nondenaturing polyacrylamide gel electrophoresis . It was rich in acidic (glutamic and aspartic) amino acids, as well as serine and glycine . The enzyme was devoid of sulfur-containing amino acids . The purified enzyme was specific for the hydrolysis of inorganic pyrophosphate and did not hydrolyze any other phosphate-ester compound examined . Inorganic pyrophosphatase activity was completely dependent on a divalent cation . Activity was maximum in the presence of Mg2+ while activity in the presence of Mn2+ and Co2+ was significantly lower . In the presence of Mg2+, a number of divalent cations, however, inhibited the enzyme activity . The true substrates for S . salivarius inorganic pyrophosphatase were magnesium-pyrophosphate complexes, i.e., MgPPi and Mg2PPi, while free Mg2+ had no effect on the enzyme activity and free PPi inhibited the hydrolysis of inorganic pyrophosphate . Km value for magnesium-pyrophosphate complexes was 16.4 microM . Km value for total Mg2+ was similar ranging between 14.4 and 20 microM . Analysis of data by Hill plots indicated one binding site for Mg2+ and two for PPi . Among various nucleotides and glycolytic intermediates examined, GDP, GMP, and fructose-1, 6-P2 showed significant inhibitory effect on enzyme activity.

Vet Microbiol, 1982 Mar, 7(1), 19 - 33
Recovery of microorganisms from synovial and pleural fluids of animals using hyperosmolar media; Buchanan AM et al.; L-phase (CWD) broth and plate media were used in parallel with conventional microbiological media during a 3-year period for culturing synovial and pleural fluids of animals . Two kinds of recoveries were obtained where parallel conventional methods were negative: (1) parent or normal bacteria, in very low numbers; and (2) Type B CWD variants in equally low numbers . Organisms in group 1 were: Streptococcus zooepidemicus from horses (2x); beta-hemolytic streptococci, Lancefield Gp . G (2x); Staphylococcus aureus; Actinobacillus, and Actinomyces viscosus . Group 2 consisted of Bacteroides sp., Propionibacterium acnes, and three "Nocardia-like" sp . Catalase + Actinomyces was not recovered equally well on CWD plates as on conventional media with fluids obtained during ampicillin treatment . This occurred in spite of the fact that the CWD media was shown to support growth and reversion of laboratory induced L-phase variants of Nocardia caviae and N . asteroides, and had facilitated recovery of a Bacteroides L-phase variant from a pleural fluid . The nature of this fault in the media is under investigation in this laboratory.

Arch Intern Med, 1982 Mar, 142(3), 634 - 5
Necrotizing fasciitis complicating intravenous drug abuse; Jacobson JM et al.; Two cases of necrotizing fasciitis in intravenous cocaine abusers are presented to alert the medical community to the possibility of these severe infections in such addicts . Antimicrobial therapy should include agents effective against Bacteroides species, streptococci, and Gram-negative aerobes; therapy directed only against staphylococci and Gram-negative aerobes is not sufficient.

Mayo Clin Proc, 1982 Mar, 57(3), 155 - 61
Prosthetic valve endocarditis; Wilson WR et al.; Prosthetic valve endocarditis is an infrequent but serious complication of cardiac valve replacement . The overall frequency of prosthetic valve endocarditis is approximately 2% . The frequency of early-onset and late-onset infections is 0.78% and 1.1%, respectively . Staphylococci are the most common isolate from patients with early-onset infection, accounting for 47.5% of the total number of isolates . Staphylococcus epidermidis causes 27% of these staphylococcal infections . Among patients with late-onset infection, streptococci are the predominant microorganism, constituting 42% of the total number of isolates from patients in this group . The overall mortality among patients with prosthetic valve endocarditis is high--59%; the mortality among patients with early- or late-onset infections is 77% and 46%, respectively . Most patients with staphylococcal prosthetic valve endocarditis should undergo cardiac valve replacement in addition to antimicrobial therapy . Closely monitored anticoagulant therapy should be cautiously continued in patients with prosthetic valve endocarditis.

Eur J Pediatr, 1982 Mar, 138(2), 166 - 7
Prevalence of group B streptococci in parturient mothers and their infants; Naor N et al.; Eighty pregnant women and their newborn infants were studied for the presence of group B Beta hemolytic streptococci (G.B.S.) . G.B.S . were recovered from endocervical cultures in 5 (6.5%) women and 2 (2.5%) had positive throat cultures . Six (7.5%) infants had umbilical and external ear cultures positive for G.B.S . Four infants presented with clinical signs of respiratory distress . All infected infants were treated with penicillin and gentamycin . One case developed fulminant sepsis and died in spite of early diagnosis and treatment . This study shows a high incidence of G.B.S . infection and sepsis with a high mortality rate.

Monatsschr Kinderheilkd, 1982 Mar, 130(3), 153 - 6
{Long-term sequelae of neonatal group B streptococcal septicemia/meningitis (author's transl)}; Schroder H et al.; In recent years group B streptococci accounted for nearly 40% of all cases of neonatal septicemia in our intensive-care-unit . Nineteen of 38 babies did not survive the acute illness (mortality 50%) . Six of 18 surviving children showed abnormalities related to the septicemia/meningitis (morbidity 33%) . The severity of chronic complications ranged from minor neurological problems to marked retardation, deafness, blindness, and epilepsy . In our series there seemed to be a relation between the severity of complications during the acute illness (meningitis, convulsions), and later neurological sequelae . Early detection and early treatment were found to be most important for the final outcome.

Pediatr Res, 1982 Mar, 16(3), 209 - 12
Group B streptococcal lung infection in neonatal rabbits; Sherman M et al.; The interaction of alveolar macrophages (AMs) and group B streptococci (GBS) was investigated in 1 and 2-day-old rabbits following infection in an exposure chamber containing 10(7) streptococci per cubic foot of air . The % of streptococci within AMs was similar at 0 and 4 h (36 and 65%) after infection for the two groups of rabbits . Twenty-four h after infection, the 2-day-old rabbits had a significantly higher % of ingested GBS (86 versus 68%) . Sixty % of inspired GBS were inactivated by the older rabbits within 4 h after infection . This clearance persisted in the younger rabbits until 48 h (mean negative clearance of -17, -276, and -79% at 4, 24, and 48 h) before their numbers were reduced by inflammation . Sixty of 78 1-day-old rabbits had inflammatory responses between 24 and 72 h versus only 5 of 50 older rabbits . At 24 h after infection, AMs of 1-day-old rabbits contained significantly increased numbers of intracellular GBS microcolonies (17/20) than did AMs from 2-day-old rabbits (5/19) . These observations suggest that the enhanced susceptibility to GBS infection in the immediate postnatal period is caused at least in part by ineffective intracellular killing by AMs.

J Bacteriol, 1982 Mar, 149(3), 995 - 1004
Heterogeneity of tetracycline resistance determinants in Streptococcus; Burdett V et al.; We found that naturally occurring tetracycline resistance in streptococci is encoded by more than one genetic determinant . Two of these distinct determinants were cloned, and the regions that are necessary and sufficient for expression of tetracycline resistance were defined by deletion analysis . These cloned determinants were further characterized by DNA-DNA hybridization experiments which also identified a third genetically unrelated tetracycline resistance determinant . Some of these genetic differences appear to represent mechanistic differences . The tetL determinant was associated with small nonconjugative plasmids and mediated resistance to tetracycline . The tetM determinant was most often "nonplasmid" associated and mediated resistance to minocycline as well as tetracycline . The tetN determinant was represented on a large conjugative plasmid and was genetically distinct from tetL and tetM, although phenotypically it resembled tetM.

J Med Microbiol, 1982 Feb, 15(1), 123 - 5
Serotypes among Lancefield-group G streptococci isolated in Nigeria; Lawal SF et al.; Six serotypes were found among haemolytic streptococci of Lancefield-group G . Members of these types accounted for about one-third of the strains isolated from human infections and carriers in Nigeria . The type antigens were similar to the M-protein antigens of group-A streptococci in that they were associated with the ability of the streptococci to survive and multiply in fresh human blood unless specific antibody was present . It was also possible to demonstrate in these group-G streptococci and non-type-specific M-associated protein similar to that formed by M-positive strains of group-A streptococci.

J Clin Microbiol, 1982 Feb, 15(2), 226 - 30
Evaluation of Phadebact and Streptex Kits for rapid grouping of streptococci directly from blood cultures; Wellstood S; The Phadebact Streptococcus Test and the Streptex Test kits were evaluated for grouping streptococci directly from blood cultures . Pellets of bacteria obtained from centrifuged samples of positive blood cultures were inoculated into Todd-Hewitt broth for 2- and 4-h Phadebact tests and into pronase for Streptex tests . Hemolysis was determined after pipetting a portion of each pellet into cuts made in blood agar plates incubated anaerobically for 2 to 6 h . Serological groups were also determined from colonies of the 137 strains of streptococci used in the study by the Lancefield precipitin method . Of the 126 strains tested by the 4-h Phadebact method, 120 (95.2%) agreed with Lancefield groupings, and 133 (97.1%) of the 137 strains tested by Streptex were in agreement . In contrast, only 31 of 55 strains (56.4%) were correctly identified by the 2-h Phadebact method . Misidentifications were related to multiple agglutinations and weak agglutinations in homologous antisera . Group A isolates were most frequently misidentified by all of the test methods . Hemolysis was determined within 4 h for 92.7% of the isolates and within 6 h for the remaining strains . Although the 4-h Phadebact procedure and the Streptex procedure were comparable in overall accuracy, cost, and technologist time, Streptex was the method of choice for direct groups . Results were available within 75 min for the Streptex procedure compared with 4 h for the Phadebact method . Because few cross-reactions occurred, agglutination responses were clearer and easier to interpret . Results from 2-h Phadebact tests were not satisfactory, and this method is not recommended.

Mayo Clin Proc, 1982 Feb, 57(2), 95 - 100
Treatment of penicillin-sensitive streptococcal infective endocarditis; Wilson WR et al.; Patients with infective endocarditis caused by penicillin-sensitive streptococci (minimal inhibitory concentration less than or equal to 0.1 microgram/ml of penicillin) may be treated successfully with one of the following three regimens: (1) aqueous penicillin G administered intravenously for 4 weeks, (2) aqueous penicillin G administered intravenously for 4 weeks in combination with streptomycin for the first 2 weeks of therapy, or (3) parenterally administered penicillin plus streptomycin for 2 weeks . No substantial difference in the relapse rate exists among the three regimens, and a cure rate of at least 98% may be anticipated with each of the three forms of therapy . The major advantage of the 2-week regimen is that it is more cost-effective than 4 weeks of hospitalization and therapy . The major disadvantage of the 2-week regimen and the 4-week regimen that uses streptomycin is the relatively low risk of streptomycin-associated vestibular toxicity . Patients unable to tolerate penicillin may be treated with vancomycin or a cephalosporin administered parenterally for 4 weeks.

Mayo Clin Proc, 1982 Feb, 57(2), 86 - 94
Pediatric endocarditis; Johnson CM et al.; Infective endocarditis is a rare disease in the general pediatric population . Nonetheless, children with congenital heart disease have a substantial lifetime risk for development of endocarditis, and recent advances in the management of these children should increase the number of patients who survive infancy and early childhood . During the 30-year period from 1950 through 1979, 50 cases of endocarditis in children were diagnosed at the Mayo Clinic . Of these 50 patients, 37 had congenital heart disease, and 8 were diagnosed as having endocarditis within 3 months after having undergone a cardiac surgical procedure . Nineteen patients died of the disease or its complications . The most common organism isolated at Staphylococcus aureus (19 patients), followed by viridans streptococci (14 patients) . Children younger than 10 years of age experienced a particularly high mortality, as did patients of all ages with S . aureus infection . Any unexplained fever in a child with congenital heart disease deserves close investigation; if endocarditis is suspected, early empiric antibiotic therapy is indicated after appropriate culture specimens have been obtained . Moreover, localized bacterial infections in children at risk must be treated aggressively to prevent metastatic spread to the heart.

J Infect Dis, 1982 Feb, 145(2), 234 - 41
Prediction of tracheobronchial colonization in current cigarette smokers with chronic obstructive bronchitis; Irwin RS et al.; To help in clarifying the conflicting data on the role of tracheobronchial microflora in chronic bronchitis, the tracheobronchial microflora of a homogeneous group of clinically stable patients with chronic obstructive bronchitis was characterized by transtracheal aspiration . Their mean percentage ratio of forced expiratory volume in 1 sec to the forced vital capacity was 45% . The results were that (1) a bacterial tracheobronchial microflora was present in only 50% of the patients, (2) viridans streptococci were the bacteria most frequently isolated, and (3) the presence or absence of a tracheobronchial microflora was significantly associated with the amount of present cigarette smoking . The fact that patients who smoke less than one pack per day were most likely to have a sterile tracheobronchial tree (P=0.015) implied that there was a critical amount of cigarette smoke that impaired the clearance and/or detoxification of bacteria from the tracheobronchial tree and that it must have been persistently present.

Am J Obstet Gynecol, 1982 Feb 1, 142(3), 282 - 7
Functional bacterial opsonic activity of human amniotic fluid; Cone MJ et al.; There are some data to suggest that amniotic fluid protects the fetus from invasion by pathogenic bacteria . To examine methods by which amniotic fluid may offer such protection, quantitative antibody, complement activity, and functional opsonic capacity were measured . Immunoglobulins were measured by laser nephelometry and total hemolytic complement was determined by radial diffusion; results suggested activity adequate for bactericidal capacity . The chemiluminescence assay was used to quantitate the functional interaction between polymorphonuclear leukocytes and E . coli, group B streptococci (GBS), or zymosan particles preopsonized with amniotic fluid obtained at different stages of gestation . Results were compared to those for normal serum . Data were analyzed by evaluation of the initial slope, area under the curve, and peak chemiluminescence response . Opsonic activity of amniotic fluid for E . coli and GBS was demonstrated, with E . coli showing greater reactivity (maximum = 15,000 to 25,000 cpm) than GBS (10,000 to 20,000 cpm) . Specific, as well as nonspecific, opsonic activity was demonstrated by absorption of amniotic fluid with killed bacteria . Concentration of amniotic fluid did not result in an increase in chemiluminescent activity, which demonstrates that optimal opsonic activity already exists . The classical and alternate pathways of complement were assessed for E . coli and GBS . Preterm amniotic fluid did not differ in response from that of amniotic fluid obtained from term pregnancies . This study demonstrates that amniotic fluid can provide the fetus with protection from bacterial pathogens and delineates mechanisms for such protection.

Mayo Clin Proc, 1982 Feb, 57(2), 101 - 5
Enterococcal endocarditis; Wilkowske CJ; Ten to twenty percent of all cases of bacterial endocarditis are caused by enterococci . The enterococci are penicillin-resistant group D streptococci that can be distinguished from other streptococci by certain biochemical reactions, including growing the bile or 6.5% sodium chloride . In patients with enterococcal endocarditis, the portal of entry often is the genitourinary tract . Therapy is difficult; combination chemotherapy with penicillin G or ampicillin and an aminoglycoside is required . Although specimen streptomycin is preferred, occasional strains of enterococci are resistant to this agent, and gentamicin must be substituted . The minimal duration of therapy is 4 weeks.

Antimicrob Agents Chemother, 1982 Feb, 21(2), 344 - 6
Comparative in vitro bactericidal activity of cefonicid, ceftizoxime, and penicillin against group B streptococci; Bayer AS et al.; The minimal inhibitory and bactericidal concentrations for 108 group B streptococcal strains were determined for two new cephalosporins, cefonicid and ceftizoxime, and compared to those of penicillin G . Penicillin G was the most active inhibitory and bactericidal agent . Ceftizoxime was a significantly more active inhibitory and bactericidal agent than cefonicid (P less than 0.0005, P less than 0.025, respectively.

Infect Immun, 1982 Feb, 35(2), 476 - 82
Physiology of "mutans-like" Streptococcus ferus from wild rats; Freedman ML et al.; Strains of Streptococcus ferus isolated from the oral cavities of wild rodents inhabiting sucrose-rich and sucrose-poor environments have many traits in common with the "mutans" streptococci . Thus, S . ferus HD3 and 8S1, like cariogenic S . sobrinus 6715-13, from adherent, alpha (1 leads to 3) glucopyranosyl-glucose linkage-rich, plaquelike deposits in vitro and in vivo through the action of constitutive glucosyltransferase(s) enzymes on sucrose, produce and degrade intracellular polysaccharide, produce short-chain fatty acids from the catabolism of mono- and disaccharides, carry the c antigen of S . mutans, and penetrate, persist, and proliferate in a sucrose-augmented fashion in the oral cavities of specific-pathogen-free rodent caries models . However, unlike infection with common S . mutans, infection with tested S . ferus strains does not cause caries . This avirulence appeared to result more from the reduced aciduricity of S . ferus than from differences in glucosyltransferase complements . Studies showed that despite generally similar growth rates and extracellular glucan syntheses, the acidogenic metabolism of S . ferus was more inhibited by declining environmental pH than was cariogenic S . sobrinus 6715-13 and that, in vitro, less hydroxyapatite was solubilized by S . ferus metabolic end products . The physiology of these S . ferus strains demonstrated that, in addition to plaque formation and acid production, acid tolerance was crucial to the carious process.

J Dent Res, 1982 Feb, 61(2), 435 - 8
Bacterial invasion of pulpal dentin wall in vitro; Akpata ES et al.; Instrumented root canals of extracted human teeth were inoculated with known pulpal bacterial isolates . The inoculated teeth were immersed in the appropriate culture media and incubated at 37 degrees C for varying periods . Streptococci multiplied in the root canals and invaded the radicular dentinal tubules . The extent of bacterial invasion was time-dependent . This experimental model of bacterial invasion was time-dependent . This experimental model may be useful in investigating the effect of intra-canal medicaments on microorganisms lodged in the pulpal dentin wall.

Arch Dermatol Res, 1982, 274(1-2), 39 - 45
Experimental necrotic dermatosis induced by group G streptococci in mice; Reitmeyer JC et al.; Self healing necrotic lesions were produced on the backs of laboratory mice by injecting group G streptococci into the skin . The incidence and severity of necrotic dermatosis was dose related . When 1 x 10(1) colony forming units (cfu) were injected subcutaneously, lesions developed on three of 16 mice 4 days post inoculation . Injection of 1 x 10(3) cfu produced lesions on five of 16 mice and 1 x 10(5) cfu produced lesions on seven of 15 mice 3 days post inoculation . An inoculation of 1 x 10(7) cfu produced lesions on all of 16 mice 2 days post inoculation . Lesions produced by the 1 x 10(1) inoculum were smaller and had healed by the 15th day post inoculation, whereas lesions produced by the 1 x 10(7) inoculum persisted until the 24th day post inoculation . No mortality could be attributed to experimental design and all lesions healed without the use of medication or antibiotics.

Scand J Infect Dis, 1982, 14(4), 277 - 82
The prevalence of antibodies to hemolytic Streptococci and Yersinia enterocolitica in Danish school children and among hospitalized patients; Ibsen KK et al.; Serological investigations in infections caused by hemolytic streptococci and by Yersinia enterocolitica (Y . ent.) can be diagnostically decisive . Here are presented the results of 2 extensive serologic investigations of a population of school children (n = 929) and of hospitalized patients (n = 2121) . It is shown that only very high titers of streptococcal antibodies were of diagnostic value in single samples as most other titers had the same distribution and frequency in the healthy population . Titers of antibodies to Y . ent . were elevated 5 times more often in the hospital patients than in the healthy population . Antibodies to Y . ent . were approximately at the same level in all age groups in contrast to the streptococcal antibodies, which decreased with age . In about 4% of the 2121 patients investigated elevated antibody titers to both bacteria were found simultaneously . The differential diagnosis may be difficult in such cases especially if they exhibit symptoms of rheumatic fever.

Microbios, 1982, 35(141-142), 139 - 50
Comparison of computer methods for taxonomy of some streptococci using gas chromatographic chemotaxonomic data; Drucker DB et al.; Gas chromatographic fingerprints of eighty-three strains of Streptococcus were analysed by computer . Seven measures of association were compared for their ability to identify strains . The most effective measure was the Stack coefficient which correctly identified 68% of strains, mostly of oral origin . Clustering of strains was carried out by median, average, single-linkage, furthest neighbour, and centroid linkage, Andrew's plots, and Minimum Spanning Trees . Of the clustering methods, centroid linkage produced the most inclusive and compact clusters . Clusters of strains of S . mitis, S . mutans, S . salivarius and S . sanguis showed varying degrees of heterogeneity; while, S . milleri was comprised of three chemotypes corresponding to oral isolates, biochemically atypical vaginal isolates, and biochemically typical strains from other sources.

Arch Gynecol, 1982, 231(4), 299 - 306
Endometrial bacteriology in patients with endometrial cancer before and after primary intracavitary irradiation using IR-192 and an afterloading technique; Gerstner GJ et al.; In a prospective clinical and bacteriological study the endocervical and endometrial flora of 38 patients with biopsy proven cancer of the endometrium was studied before and after intrauterine irradiation with 10 Gy (Ir-192, afterloading device, Buchler, Braunschweig) . Bacteriological swabs were taken transcervically . Anaerobic transport media were used and cultures were done aerobically and anaerobically . The mean number of aerobic organisms per patient increased from 2.13 to 2.49 (not significant (n.s.)), and of anerobic organisms from 1.42 to 2.00 (n.s) . Neither the recovery rate of aerobic and anaerobic bacteria nor the composition of endometrial flora was altered significantly by intracavitary irradiation . Only aerobic sporeformers increased from 5.3% to 21% (2 p less than 0.05) . The most prevalent aerobic species were S . epidermidis, streptococci and E . coli, the predominant anaerobic species Pepto- and Peptostreptococcus and Bacteroides . Our results clearly show that the intrauterine administration of 10 Gy by a Ir-192-afterloading device does not sterilize the endocervix or endometrium and infections may occur after intracavitary radiotherapy.

J Hyg Epidemiol Microbiol Immunol, 1982, 26(3), 308 - 14
A bacteriological and/or immunological study of anaerobic streptococcal infection in chronic tonsillitis, paratonsillitis and periodontitis patients; Povolotskii YL et al.; Anaerobic streptococci were isolated from 100% of tonsil tissue samples obtained from 36 chronic tonsillitis patients . The strains displayed antigenic and other differences . Sera of chronic tonsillitis, paratonsillitis and periodontitis patients exhibited significantly more often, and in significantly higher titres, antibodies to the anaerobic streptococci isolated from tonsils than did sera of normal persons.

Infection, 1982, 10(3), 196 - 8
The role of bacterial adherence in the pathogenesis of infective endocarditis; Thompson J et al.; Bacterial adherence as a result of specific surface properties may be a contributory factor in the pathogenesis of bacterial endocarditis giving certain types of bacteria a selective advantage to cause this disease . Adherence could interact with other pathogenetic mechanisms, and this interaction could promote or hamper the development of endocarditis . Dextran production by streptococci, the activation of the clotting system by monocyte tissue thromboplastin, and phagocytic removal of bacteria from the vegetational surface by granulocytes and monocytes are examples of interacting mechanisms that could contribute to the pathogenesis of bacterial endocarditis.

Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Bacteriol Virusol Parazitol Epidemiol, 1982 Jan-Mar, 27(1), 17 - 22
{Evolutive peculiarities of streptococcal infections in the year 1980, in the city of Bucharest}; Magureanu E et al.; In further investigations on the evolutive trends of the epidemiologic streptococcal process, an extensive epidemiological survey was carried out in prescholar and school communities in the town of Bucharest with a view to applying efficient antiepidemic measures able to limit primary streptococcal infections and prevent late, redoubtable complications . In 1980, in Bucharest, morbidity from scarlet fever was at its lowest level (92.7 per 100,000) during the last 31 years; it was in general benign, affecting especially in the month of March the 5-9 years age group (623.9 per 100,000) and the 1-4 years age group (529.4 per 100,000) . The trailing evolution of a scarlet fever focus in a prescholar community suggested the hypothesis of the potentiation of the induction of streptococcal toxigenesis under the influence of intercurrent vital infections, especially measles . There were no deaths from scarlet fever . Laboratory investigations for the active detection and treatment of anginas, of carriers at risk, totalled 52101 tests; of these 4478 (8.59%) were positive for group "A" streptococci . In the prescholar communities surveyed no poststreptococcal complications were reported (acute articular rheumatism and glomerulonephritis) . In 1980, there were 63 cases of acute articular rheumatism (code 250) in the 0-18 year-old group . The results suggest the need of continued epidemiological survey of streptococcal infections in children with a view to improving the health status of the population.

Antimicrob Agents Chemother, 1982 Jan, 21(1), 176 - 9
High-level aminoglycoside resistance in group A, B, G, D (Streptococcus bovis), and viridans streptococci; Horodniceanu T et al.; Of 20 clinical isolates of group A, B, G, D (Streptococcus bovis), and viridans streptococci, 5 transferred their antibiotic resistance markers into streptococcal recipients at a low frequency (10(-4) to 10(-8)) in the apparent absence of extrachromosomal elements . All strains carried genetic markers for high-level resistance to streptomycin, kanamycin, neomycin, lividomycin A, and ribostamycin, as well as resistance to macrolides and related drugs, tetracycline, and chloramphenicol.

Mol Immunol, 1982 Jan, 19(1), 119 - 26
Fractionation of rat IgG subclasses and screening for IgG Fc-binding to bacteria; Nilsson R et al.; The four IgG subclasses of the rat, IgGl, IgG2a, IgG2b and IgG2c, were purified from normal serum by a combination of protein A-affinity chromatography and DEAE-cellulose chromatography . Purified, radiolabelled preparations of IgG were tested for binding to Gram-positive bacteria representing five different Fc-receptor (FcR) types . Distinct rat subclass-specific Fc-binding was noted to bacterial species belonging to different Fc-receptor types . Staphylococcus aureus (FcR I) strains bind IgGl and IgG2c as shown by others . Group C and G Streptococci (FcR III) bind all four subclasses of rat IgG . Streptococcus zooepidemicus strains (FcR V) also bind all four subclases but only to a lower degree . Human group A Streptococci (FcR II) and bovine group G Streptococci (FcR IV) do not bind any of the rat IgG subclasses . Elution studies on two strains . Staphylococcus aureus, Cowan I, and human group G Streptococcus, G 148, showed that both thiocyanate and pH-elution might be useful for the fractionation of IgG subclasses bound to bacterial cells . The present work indicates the possible use of bacterial cells as solid-phase absorbents in immunological studies of rat IgG.

Ann Acad Med Singapore, 1982 Jan, 11(1), 101 - 9
A three-year streptococcal survey among Singapore school children: Part II . Streptococcal infections; Leng T et al.; The cumulative streptococcal pyoderma and pharyngitis rates of 491 children followed over a period of three years were 19.8 and 15.7% respectively . Streptococcal infections occurred more commonly in Malays, in children from families with monthly household incomes of less than $500/- and in those living in attap/zinc-roofed houses . During the three years, streptococcal pyoderma and pharyngitis rates varied from 1.6-5.3 and 0.4-4.3% respectively . Skin sores occurred most frequently on lower limbs . About one in six acquisitions of streptococci in throats was accompanied by clinical manifestations of respiratory infections . 90.9% of pyoderma cases responded to penicillin therapy . Penicillin was effective in eradicating group A streptococci from the throats of 84.6% of 136 children with previous positive cultures . The treatment schedule implemented for School C did not seem to reduce the streptococcal infection and carrier rates in that school to a great extent.

Ann Otol Rhinol Laryngol, 1982 Jan-Feb, 91(1 Pt 1), 41 - 3
Intracranial complications of sinusitis in children . A sequela of periapical abscess; Brook I et al.; The cases of two children with periapical abscess in the upper incisors, sinusitis, and intracranial abscess are described . The ethmoid and maxillary sinuses were involved in both patients . Subdural empyema occurred in both, and one of the children had also cerebritis and brain abscess . Anaerobic bacteria were isolated from the infected subdural empyemas . Peptostreptococcus intermedius and microaerophilic streptococci were recovered in one patient and Fusobacterium sp in the other . Surgical drainage and appropriate antimicrobial therapy resulted in complete eradication of the infection in both patients . The role of anaerobic bacteria and the therapy directed against them in periapical abscess and the sinusitis and intracranial abscess which follow are discussed.

Scand J Thorac Cardiovasc Surg, 1982, 16(1), 65 - 70
Septicaemia and endocarditis--uncommon but serious complications in connection with permanent cardiac pacing; Bluhm G et al.; Between 1971 and 1978 septicaemia was observed in 14 patients undergoing permanent pacemaker treatment . The causative microorganisms were: S . aureus (9), S . epidermidis (3), alfa-haemolytic streptococci + P . morganii (1), enterococci (1) . In 4 patients, a mural endocarditis of the right atrial wall surrounding the electrode was found at operation or autopsy . The interval between the preceding pacemaker operation and onset of septicaemia varied between 2 days and 23 months (median 2 months) . In 5 patients, the last operation before septicaemia was performed because of local infection in the pacemaker pocket or along the electrode . A probable portal of entry was found in 11 patients . The electrode was the origin in 8, the pacemaker pocket in one, and a focus outside the pacemaker system in 2 . Of the 6 patients treated with antibiotics alone, 3 were cured, 2 died and one is still on treatment . Eight patients underwent various surgical procedures in addition to the antibiotic treatment . In 4 the electrode was completely removed . In 2 of them cardiotomy during extracorporeal circulation had to be used . All of these patients were cured . In 3 the pacemaker system was partially extracted . Only one of them was cured, one developed osteomyelitis and one died . Based on our experience, we now recommend that all foreign material should be removed, if possible, in the presence of septicaemia and/or endocarditis, and that parenteral antibiotic treatment should be given for at least 6 weeks.

Can J Microbiol, 1982 Jan, 28(1), 106 - 10
Growth of group E streptococci and production of antigens in a chemically defined medium; Wessman GE; Group E streptococci were grown in a modification of a chemically defined medium (CDM) originally formulated for streptococci of group A . Ten of 12 strains studied produced greater or equal cultural densities and growth rates in CDM than in the complex medium (Todd-Hewitt broth) . All strains produced similar amounts of group antigen in both media . Eight strains of demonstrable serotype produced comparable amounts of type antigen in both media . cells grown in CDM were less resistant to phagocytosis than those grown in the complex medium, but all strains produced antiphagocytic factor when cultured in either medium to which 10% porcine serum had been added.

Am J Dis Child, 1982 Jan, 136(1), 42 - 5
Penicillin-resistant Streptococcus constellatus as a cause of endocarditis; Levin RM et al.; Endocarditis in a 2-year-old child was caused by a penicillin-resistant Streptococcus constellatus . Viridans streptococci in general and those associated with endocarditis in particular are usually believed to be penicillin sensitive . Although the patient did not receive prophylactic antibiotics, the child had recently been treated with an oral penicillin . Penicillin-resistant viridans streptococci are usually sensitive to the synergistic effects of penicillin and an aminoglycoside, but this organism was not . Clindamycin was ultimately shown to demonstrate admirable bactericidal activity against this patient's S constellatus.

Scand J Infect Dis Suppl, 1982, 31, 105 - 11
Septicaemia in newborns and infants; Pettay O; In the lifespan of a human being the two extremes, the early childhood and old age are prone to septicaemia because of poorly functioning anti-infectious defensive mechanisms . In a newborn full term baby these mechanisms are all present but still unexperienced . The importance of both specific and nonspecific factors will be discussed . The etiologic agents, causing septicaemia in nurseries undergo continuous change . In Helsinki we have during the last 20 years experienced staphylococci to start with, changing then to Gram-negative rods, to streptococci group B and now we have increasing difficulties with hospital infections . In the treatment of these children antibiotics alone are not sufficient but repeated exchange transfusions and granulocyte transfusions are needed . In infants after the first month of life, septicaemias produce a clinical picture different from that in newborns but still different also from that in adults . Also in this age group a shift in etiology has been observed . Increasing resistance to antimicrobial agents in the bacteria encountered makes a reconsideration of therapeutic schemes necessary.

Infection, 1982, 10(2), 107 - 11
The adherence of group A streptococci to oropharyngeal cells: the lipoteichoic acid adhesin and fibronectin receptor; Beachey EH et al.; The attachment of group A streptococci to oropharyngeal epithelial cells is mediated by adhesive molecules (adhesins) on the surfaces of the micro-organisms that interact with receptor molecules on the epithelial cells . The evidence that the adhesin is composed of lipoteichoic acid (LTA) complexed with bacterial cell surface proteins is as follows: (a) Among the purified cell wall substances tested, only LTA was able to inhibit attachment; (b) treatment of streptococci with anti LTA but not with antibody against other surface substances blocks attachment; (c) LTa forms complexes with purified M protein, the most abundant protein on the surface of virulent streptococci; (d) the lipid moieties of LTA, which mediate attachment, remain free in the M protein-LTA complexes to interact with receptor analogues, such as serum albumin . The evidence that the receptor for the LTA mediated binding of streptococci resides in fibronectin molecules on oropharyngeal cells is as follows: (a) the addition ot adhesion test mixtures of fibronection inhibits binding; (b) the number of streptococci capable of attaching is directly proportional to the amount of fibronectin present on epithelial cells; (c) purified fibronectin immobilized on latex beads agglutinates suspensions of streptococci; (d) radiolabeled fibronectin binds to group A streptococci; (e) both the agglutination of fibronectin-beads and the binding of fibronectin to streptococci is blocked by LTA, the streptococcal adhesin.

Arch Oral Biol, 1982, 27(4), 331 - 5
The streptococcal flora of the tongue of the monkey Macaca fascicularis; Beighton D et al.; The major streptococcal biotypes in the 8 monkeys investigated resembled Streptococcus sanguis and Streptococcus mitior with Streptococcus salivarius forming only 5 to 6 per cent of the total colony count and being isolated from only 4 monkeys . The predominant tongue streptococci were not isolated from the dental plaque . Similarly, Streptococcus mutans, present in large numbers in the plaque of monkeys fed sucrose-rich diets, was isolated from the tongue of only 2 animals and formed only 2.4 per cent of the total colony count . Changing from a starch-based maintenance diet to sucrose-rich diets did not significantly alter the tongue flora except that the proportion of typical Strep . sanguis was significantly reduced . The oral streptococcal flora of monkeys is similar in distribution to that found in the human mouth.

Zentralbl Gynakol, 1982, 104(5), 302 - 8
{Coincidence of lethal B-streptococcal disease of newborn with acute puerperal polyarthritis of mother due to infectious allergy (author's transl)}; Friedrich W et al.; Reported in this paper is a lethal B-streptococcal disease of a newborns which grew manifest as meningitis . It had been caused by Type Ic B-streptococci . The same pathogen was isolated from the mother's vaginal secretion . The mother fell sick with acute allergico-infectious polyarthritis, ten days after birth . This coincidence between infection of the newborn and the mother's puerperal disease is discussed.

Int Arch Allergy Appl Immunol, 1982, 68(3), 193 - 5
Low levels of antibodies to surface antigens of group B streptococci in commercial IgG preparations; Linden V et al.; 53 different batches of commercial IgG were tested for antibodies to group B streptococci (GBS) types Ia, Ib, II and III . The levels of antibodies varied widely . Comparison of the anti-GBS antibody levels in these preparations with those found in normal blood donor sera showed that the commercial IgG contained approximately 2.6 times less type-specific antibodies . We conclude that the commercial IgG now available is not optimal for passive immunization against GBS infections in neonates.

Am J Med Technol, 1982 Jan, 48(1), 37 - 42
Group G streptococci: a review of the literature; Cudney NJ et al.; A review of the occurrence, general characteristics, and identification procedures for Group G streptococci is presented . Group G streptococci cause the same types of infection and have similar morphological characteristics as the other beta-hemolytic streptococci . If serological methods are used for identification, cross reactions may be seen between Group G and B streptococci, as they share a common antigenic determinant . Group G may also be misidentified as Group A streptococci with biochemical testing because at least 7% of Group G are sensitive to bacitracin . are sensitive to bacitracin . are sensitive to bacitracin.

J Immunol Methods, 1982, 48(3), 349 - 58
An indirect immunofluorescence staining procedure for detection of human Fc gamma receptors on streptococci; Lebrun L et al.; Fc gamma receptors on streptococci are usually revealed by hemagglutinating techniques (IgG coated red blood cells) or uptake of radiolabeled IgG . The results obtained with these methods are not always satisfactory . For this reason, we developed a technique involving indirect immunofluorescence staining . Bacterial smears were treated with human Fc gamma fragment and their binding to streptococcal Fc gamma receptors was revealed by a fluorescent F(ab')2 fragment of anti-human Fc gamma sheep antibodies purified on an IgG immunosorbent . These purified sheep F(ab')2 fragments did not contain any IgG nor Fc gamma as shown by SDS polyacrylamide gel electrophoresis . Under these conditions indirect immunofluorescence staining was a highly specific and sensitive method of detecting Fc gamma receptors on streptococci . Distribution of Fc gamma receptors was studied in 237 streptococcal strains of human origin belonging to groups A, B, C, D and G; these receptors were also looked for in 21 strains of alpha-hemolytic streptococci which did not possess the group carbohydrate and 12 strains of pneumococci . Fc gamma receptors were found only in group A, C and G streptococci, but all strains of these groups did not possess Fc gamma receptors.

Chemotherapy, 1982, 28(1), 40 - 5
Biophotometric comparison of cephalexin and cephradine against gram-positive bacteria; Brumfitt W et al.; We have compared the antibacterial activities of cephalexin and cephradine against Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus (Micrococcus spp . type III), and group B streptococci (35 strains in total), using the Biophotometer . Analysis of growth curves obtained in the presence of various concentrations of the antibiotics revealed little difference between the activities of the two cephalosporins . However, both antibiotics showed maximal activity at 8-16 microgram/ml, and increasing the concentration past this point resulted in a reduced antibacterial effect . Unlike the other species tested, streptococci were not lysed by cephalexin or cephradine.

Infect Immun, 1982 Jan, 35(1), 335 - 42
Isolation of heart- and kidney-binding protein from group A streptococci; Stinson MW et al.; Tritium-labeled, water-soluble components of Streptococcus pyogenes type M6 absorbed to cardiac tissue in vitro . Tissue binding was time dependent, saturable, and reversible . Chromatography of the crude bacterial extract on Bio-Gel P-300 indicated a molecular weight greater than 300,000 for the heart-binding component . Sodium dodecyl sulfate (SDS) dissociated this aggregate into a protein of 18,000 to 20,000 daltons as determined by Sephacryl S-200 chromatography and SDS-polyacrylamide disc gel electrophoresis . The tissue-binding protein was also purified from streptococcal extracts by absorption to immobilized heart components . SDS-polyacrylamide gel electrophoresis of the protein desorbed from tissue revealed a radioactive band of 19,000 daltons . Indirect immunofluorescence tests on cardiac tissue treated with streptococcal extract showed an accumulation of a bacterial antigen on the sarcolemmal sheaths . Streptococcal components also adsorbed to basement membranes of kidney . Antisera prepared to isolated cytoplasmic membranes and water-soluble extracts of S . pyogenes type M6 were the most sensitive reagents for the detection of bacterial components bound to tissue . Antisera prepared to isolated cell walls and to intact bacteria were weakly reactive in these assays.

Infection, 1982, 10(2), 58 - 62
Identification of attached bacteria in the nasopharynx of the child; Lundberg C et al.; Bacteria attached to epithelial cells in mucus and cell scrapings obtained from the nasopharynx in children undergoing adenoidectomy appear rather monomorphic under the microscope, and for this reason it is not possible to identify different species . To overcome this difficulty, a micromanipulation method has been devised which allows the isolation of single squamous epithelial cells seen to carry bacteria . The cells are transferred to culture media for bacteriological analysis . Ciliated epithelial cells were never seen to carry bacteria, and cultures or these cells gave no growth . Bacterial growth was found in 36 of 47 cultures of single epithelial cells seen to carry 10 to 50 bacteria . Two species were isolated from 11 cultures and three species from one culture . Viridans streptococci dominated; the most frequently isolated species was Streptococcus mitior, followed by Streptococcus group K . In all, 15 different species were found to adhere to squamous epithelial cells in the nasopharynx.

J Reprod Fertil Suppl, 1982, 32, 151 - 9
Factors affecting phagocytosis of bacteria by neutrophils in the mare's uterus; Asbury AC et al.; Ten mares, 5 resistant and 5 susceptible to bacterial endometritis, were examined for differences pertaining to the efficiency of phagocytosis of bacteria by neutrophils in the uterus . An assay for chemiluminescence was used to evaluate various schemes of opsonization and relate them to phagocytic rate . 123I-labelled albumin was used to measure protein migration to the inoculated uterus . Neutrophil numbers moving to the uterine lumen were determined . Before inoculation resistant mares were found to have substances in their uterine secretions that opsonized bacteria, resulting in effective phagocytosis . In contrast, uterine contents of susceptible mares were not effective in opsonization . The addition of serum to uterine washings significantly enhanced opsonization of bacteria in both groups . In response to intrauterine challenge with pathogenic streptococci, no differences were observed between resistant and susceptible mares in the migration of serum protein or neutrophil numbers to the site of contamination . Following inoculation, the ability of the uterine contents to opsonize bacteria was similar between groups . Clinical observations after inoculation confirmed that mares were resistant or susceptible to endometritis.

Arch Oral Biol, 1982, 27(1), 65 - 8
The effect of extracts from human dental plaque, oral streptococci and actinomyces bacteria on HELA cell growth, {3H}-thymidine uptake and 51Cr release; Duguid R et al.; Dialysed extracts from dental plaque and a number of species of oral streptococci and actinomycetes have been investigated for their effects on cell growth, {3H}-thymidine uptake and 51Cr release from HeLa cell cultures . Eight of the 15 extracts inhibited cell growth and all but one inhibited {3H}-thymidine incorporation . None of the extracts stimulated 51Cr release from prelabelled cells . These results suggest that many of the species of streptococci and actinomyces found in the mouth and in dental plaque are capable of producing high mol . wt substances that interfere with HeLa cell cultures by inhibiting {3H}-thymidine uptake and DNA synthesis but do not affect the degree of intactness of the external cell membrane.

Swed Dent J, 1982, 6(1), 29 - 36
The effect of fluoride on the acid production of Streptococcus mutans and other oral streptococci; Okuda K et al.; The influence of fluoride on the acid production of streptococcal strains was examined using an established method for the determination of acid production by microorganisms . The inhibitory effects of fluoride on acid production increased when the pH dropped from 5.5 to 4.0 . A concentration of 5 ppm fluoride inhibited the acid production activity of Streptococcus mutants at pH 5 and below . Susceptibility to fluoride varied among streptococcal strains . These results suggest that fluoride in dental plaque may affect acid production below pH 5.5.

J Dent Res, 1982 Jan, 61(1), 60 - 5
A comparative study of enzymes involved in glucose phosphorylation in oral streptococci; Vadeboncoeur C et al.; The properties of two enzymes involved in the phosphorylation of glucose were studied in three oral streptococci species . The glucokinase of Streptococcus mutans had a lower affinity for glucose and ATP than did those from S . salivarius and S . sanguis . The enzyme had an identical pH optimum (pH 8.0) in all three bacteria . However, the result from the phosphoenolpyruvate phosphotransferase system showed a different pattern when its activity was measured using 2-deoxyglucose with toluenized cells . Uptake studies of 2-deoxyglucose also revealed that the three microorganisms had different affinities for this compound . This glucose analogue strongly inhibited the acid production of S . salivarius, but did not affect the glycolysis of the other two bacteria.

Acta Histochem, 1982, 71(1), 35 - 9
Agglutination of bacteria by a sialic acid-specific lectin of the snail Cepaea hortensis; Wagner M; Aqueous extracts from lyophilized albumen glands of the garden snail (Cepaea hortensis) exhibit, after separation from a second lectin, a specificity against sialic acid-containing polymers . In agglutination studies with bacteria, the lectin interacts with all strains of group B streptococci (Streptococcus agalactiae) containing type-specific polysaccharides . In contrast, group B streptococci containing only protein type antigens as well as all strains of other Lancefield streptococcal groups and several other bacterial strains did not react.

Immunobiology, 1982, 162(2), 128 - 40
Tissue cages for study of experimental streptococcal infection in rabbits . I . Production of erythrogenic toxins in vivo; Knoll H et al.; Tissue cages implanted subcutaneously were used to infect rabbits with erythrogenic toxin (ET) producing streptococci . The in-vivo production of ET was followed during the infection by immunoprecipitation analyses of the tissue cage fluid (TCF) . ET types A and C were mainly detected during the first week of infection, but, as late as 4 weeks after the inoculation, ET was occasionally found in TCF . The nonspecific mitogenic activity of ET on human lymphocytes was also used as a biological marker to recognize ET in TCF . Mitogenic activity was detected in 90% of samples during the first week . In order to characterize the mitogenic material released by growing streptococci, TCF was electrofocused in polyacrylamide gel . The eluates of sliced gels were checked for mitogenic activity and compared with a purified ET preparation containing ET types A and C . It could be verified that ET type A was produced under in-vivo conditions by strains NY-5 and SF130, while ET type C was produced by strain T18 . Differences between production of toxins in vitro and in vivo might be of significance for the understanding of the pathogenetic mechanisms in streptococcal infection.

Int Arch Allergy Appl Immunol, 1982, 67(3), 267 - 74
Detection of antibodies to streptococcal mucopeptide in patients with rheumatic disorders and normal controls; Pope RM et al.; Bacterial mucopeptide is an integral part of bacterial cell walls and is therefore ubiquitous in our environment . An enhanced degree of humoral immunity has ben detected not only in patients with acute rheumatic fever (ARF), with a known recent response to streptococci, but also in patients with adult and juvenile rheumatoid arthritis (RA and JRA) . Our studies confirmed this association with ARF and JRA using a precipitin system as well as a radioimmunoassay to detect IgG anti-mucopeptide antibodies . In those with adult RA, either IgM or IgA rheumatoid factors or IgM or IgA antibodies specific for mucopeptide were responsible for the increased incidence of precipitins to mucopeptide in the RA patients detected in this and other studies . No differences in the specificities of the anti-mucopeptide antibodies were noted between the various patient populations as there were no lines of partial identity or nonidentity when examined by Ouchterlony double diffusion analyses . Additionally, no differences of anti-mucopeptide antibody were observed when the sera from these same patient populations were examined employing inhibition studies utilizing N-acetylglucosamine and rhamnose.

Public Health Rep, 1982 Jan-Feb, 97(1), 73 - 7
Cost-benefit of a streptococcal surveillance program among Navajo Indians; Coulehan JL et al.; A school-based streptococcal surveillance program has been in effect among Navajo Indians for more than 4 years . Throat cultures of symptomatic children are obtained when indicated, and routine throat cultures are performed monthly . Children whose cultures are positive for group A beta-hemolytic streptococci are treated . During 4 academic years, between 48 percent and 56 percent of elementary school children attended the schools that had 4 or more monthly surveys in each year, but only 24 percent (7 of 29) of the acute rheumatic fever (ARF) cases occurred in children at those schools . Six of seven children attending covered schools were not cultured before their ARF episodes . Five cases occurred in children attending previously covered schools, during years in which participation lapse . Three or four ARF cases per year appeared to have been prevented, but the program's costs were five times the estimated costs of the prevented cases, even excluding risks of allergic reactions to penicillin . There is little evidence that most asymptomatic carriers are at risk to develop ARF . The authors recommend that streptococcal surveillance efforts be confined largely to culturing throat swabs of children with pharyngitis.

J Clin Microbiol, 1982 Jan, 15(1), 187 - 9
Serogrouping of beta-hemolytic streptococci from throat swabs with nitrous acid extraction and the Phadebact streptococcus test; Slifkin M et al.; A direct extraction of the antigen of group A beta-hemolytic streptococci from 373 throat swabs was done with a microtechnique of the nitrous acid extraction-Phadebact coagglutination method . The technique yielded a 96% agreement with the results obtained by a standard throat culture method in which the Phadebact grouping procedure with overnight broth supernatants was employed.

J Clin Microbiol, 1982 Jan, 15(1), 184 - 6
Mutanolysin enhancement of serogrouping of single colonies of streptococci; Calandra GB et al.; Single colonies of beta-hemolytic streptococci could be grouped by antibody-coated latex bead agglutination or coagglutination with staphylococci coated with antibody after incubation of the colonies with mutanolysin . This simple and quick procedure provided an enzymatic means of enhancing the sensitivity of tests such as Phadebact and SeroSTAT.

Vet Med Nauki, 1982, 19(10), 91 - 7
{Culture medium for the isolation of group B Streptococcus}; Popovski B; Comparative studies were carried out on a new medium--a soybean agar of the Difco type with the addition of beta-staphylococcus toxin, washed sheep erythrocytes, esculin, and Congo red to isolate and differentiate the streptococci of the serologic B group . Congo red was used in dilution of 1:10000 to suppress the beta-hemolysis of the streptococci belonging to other serologic groups . The higher objectivity of the final results required the use of a blood agar and a medium with thallium sulfate and crystal violet--nutrient media for the bacteriologic diagnostics of mastitis . It was established with all three lines of research of selected cultures (control strains) through sampling milk of the four quarters of the udder and pooled milk by groups and farms that soybean agar proved superior to the remaining nutrient media, more specifically in the diagnosis of mastitis caused by streptococci of the serologic group.

Scand J Infect Dis, 1982, 14(4), 261 - 6
Relation between neonatal pneumonia and maternal carriage of group B streptococci; Christensen KK et al.; Obstetrical and neonatal complications were studied among 143 urogenital carriers of group B streptococci (GBS) and their 144 infants and compared with complications occurring in a control group of 157 pregnant non-carriers and their 158 infants . All parturients had experienced uncomplicated pregnancies until week 36 . 26 infants, 13 from each group, were transferred to the neonatal intensive care unit for treatment and observation within the first 7 days of life . Among these infants, 11/13 infants of GBS carriers contracted pneumonia and pulmonary adaptation syndrome, in contrast to 3/13 infants of non-carriers (p less than 0.05) . The GBS carrier infants transferred to the neonatal intensive care unit had higher birth weights and higher gestational ages . Within the group of infants born to GBS carriers, those with pulmonary diseases evidenced abnormal fetal heart rate changes during labour in a higher rate than in the controls . Puerperal endometritis occurred with a significantly higher frequency among the GBS carriers (7/143) than among the non-carriers (0/157) . Maternal carriage of GBS is a high risk factor for both the mother and her newborn, also after an otherwise uncomplicated pregnancy.

J Hyg Epidemiol Microbiol Immunol, 1982, 26(4), 396 - 404
Complex surveillance of Streptococcus pyogenes V . Protective features complex surveillance of streptococcus of cell-mediated immunity against group a streptococci; Kahlich R et al.; Exoproducts of incubated white blood elements from persons hypersensitive to zymosan were found to promote the phagocytic activity of human microphages (and guinea pig macrophages) under conditions of a combined model of "MIF-opsonophagocytic test" . The stimulation resulted in a bacteriostatic effect, was non-type-specific and improved microphage potential to inactivate streptococci opsonized with anti-M antibodies in low titre . The microphages pre-exposed to anti-M sera remained unaffected, the effect was non-species-specific and nontype-specific and the stimulation resulted from the action of albumin fraction exoproducts . This seems to suggest that human mediators (lymphokines) may promote the activity of phagocytes . The cell-mediated immunity appears thus to have protective features even in the case of streptococci which are the typical extracellular parasites . The drawbacks of the model used, which make it difficult to quantify the found mechanism under in vivo conditions, are discussed in detail.

Microbios, 1982, 34(135), 7 - 15
Electron microscopic study of the location of the Fc-reacting factor on group A streptococci; Ryc M et al.; The presence of the Fc-reacting factor was demonstrated on four out of five different group A Streptococcus strains using ferritin-labelled immunoglobulin G . A comparison of the results obtained by this electron microscopic technique with Fc-reacting factor detection results obtained with hydrochloric acid extracts of cells in passive haemagglutination on sensitized red cells, showed that not only hydrochloric acid extractable but also non-extractable Fc-reacting factor can be present on the group A Streptococcus cell . Out of several IgGs tested, only rabbit and swine IgGs bound to Fc receptors of group A Streptococcus walls . The Fc-reacting factor is ultrastructurally localized on the tips of the filamentous protrusions forming the outermost layer of the Streptococcus wall . The involvement of the Fc portion of IgG in the reaction was demonstrated by a positively reacting sandwich arrangement in which Streptococcus cells were incubated with rabbit antiferritin before being treated with ferritin.

Med Microbiol Immunol (Berl), 1982, 171(1), 23 - 32
Serological grouping of streptococci: a collective evaluation in six laboratories of three rapid methods; Guinet R et al.; Three serological methods for streptococci grouping: latex agglutination after pronase extraction (LAP), latex agglutination after nitrous acid extraction (LAN) and counterimmunoelectrophoresis after nitrous acid extraction (CIEN) were evaluated in six laboratories with 310 strains of streptococci . To reduce the possible influence of a particular laboratory, each serological procedure was performed in two different laboratories with identical protocols and strains . Between the three procedures, a total agreement of 81.3% with six identical results was obtained . Since only one discordant result was obtained in 12.2% (CIEN 4.8%-LAN 5.8%-LAP 1.6%) and two discordant results with two different serological methods in 2.6%, it could be concluded that agreement between the three procedures was 96% . For B (99 strains tested) and D(100 strains tested) groups, total agreements of respectively 95% and 92% were achieved . In conclusion, LAP, LAN, and CIEN gave equivalent results for streptococci grouping, but LAN was the most simple needing no heating, centrifugation, or electrophoresis equipment and lacking cross-reactivity of group C antibody.

Int Arch Allergy Appl Immunol, 1982, 67(4), 369 - 76
Isolation and some properties of an IgG Fc-binding protein from group A streptococci type 15; Grubb A et al.; An IgG Fc-binding protein was isolated from alkaline extracts of group A streptococci type 15 by ion-exchange chromatography and immunosorption on an IgG column . Ample use of protease inhibitors was necessary to achieve successful isolation . 600 micrograms protein was obtained from 60 g bacteria (wet weight) . The protein appeared homogeneous on agarose gel and sodium dodecyl sulfate polyacrylamide gel electrophoresis and had an apparent molecular weight of 29,500 . It contained appreciable amounts of the amino acids glutamic acid, alanine, leucine, aspartic acid and lysine, but little or no tyrosine, phenylalanine, proline, glucosamine or galactosamine . It precipitated human monoclonal IgG of all four sub-classes in agarose gels as well as polyclonal IgG, IgG Fc and normal human serum . It did not precipitate IgG Fab, IgA, IgM, IgD or free kappa or lambda chains.

Mol Gen Genet, 1982, 188(1), 161 - 3
Marker rescue allows direct selection for recombinant plasmids in streptococci; Behnke D; Resident deletion derivatives (Ems or Cms) of the streptococcal plasmid vector pGB301 rescue antibiotic resistance genes from linearized pGB301 (Emr, Cmr) DNA with high frequency . Insertion of passenger DNA next to an antibiotic resistance determinant of pGB301, which is missing on the resident plasmid, forces corescue of these two plasmid domains, thus allowing direct selection for recombinant plasmids.

Infect Immun, 1982 Jan, 35(1), 86 - 90
Characteristic differences between saliva-dependent aggregation and adhesion of streptococci; Rosan B et al.; Comparison of saliva-mediated aggregation of Streptococcus sanguis, Streptococcus mitis, and Streptococcus mutans and adhesion of these organisms to saliva-coated hydroxyapatite showed that there was no relationship between these two activities . Adsorption of salivary aggregating activity to bacteria appears to have little effect on the ability of the residual saliva to support adherence; conversely, adsorption of salivary adherence factors to hydroxyapatite does not affect aggregation . Although heating saliva significantly reduces bacterial aggregation, it has little or no effect on adherence . A comparison of aggregation and adhesion with serial dilutions of saliva demonstrated that adhesion could still be detected at 100 to 500-fold-lower concentrations of salivary protein that bacterial aggregation . These findings support the concept that aggregation and adherence involve two distinct mechanisms of microbial clearance in the oral cavity.

Ann Immunol (Paris), 1982 Jan-Feb, 133C(1), 45 - 56
Significance of anti-IgG antibodies obtained by immunization of rabbits with some streptococcal strains; Lebrun L et al.; Anti-human IgG antibodies have been found in a number of rabbit sera immunized with freshly isolated streptococci . The significance of these anti-IgG antibodies was investigated . An IgM rheumatoid factor was excluded because the antibodies to human IgG present in rabbit sera belonged to the IgG class and reacted with the different isotypes of the human 7 S IgG . No cross-reaction between streptococci and human IgG was found . The anti-IgG production could be attributed to the in vivo non-immunological binding of host IgG to the infecting streptococci, via their Fc(gamma) receptors . A strong adjuvant effect of streptococci for IgG was found, and it explained the noticeable induction of anti-IgG antibodies by trace amounts of immunogen bound to streptococci . The possible induction of anti-human IgG antibodies by streptococcal cells could be an alternative explanation of the numerous cross-reactions described between streptococci and different human tissues.

Schweiz Med Wochenschr, 1981 Dec 26, 111(52), 2030 - 5
{Changes in infectious endocarditis in 3 decades}; Schwytzer F et al.; The course, clinical picture and outcome were compared in 101 patients with infective endocarditis (1975-79, phase III) with our earlier investigations 1947-57 (phase I) and 1961-74 (phase II) . An impressive change in this disease was found: - The average age of the patients is higher . - Acute cases and postoperative courses (after valve replacement) are more common and the outcome in these cases is better . Subacute courses are on the decrease . The clinical picture often is oligosymptomatic: - Fever is absent in a quarter, cardiac murmur in nearly a fifth and splenomegaly in four fifths of the patients . - For the first time 5 patients with right-heart endocarditis were observed in phase III . Three of these patients were intravenous drug abusers . The initial clinical picture was misinterpreted as pneumonia or pulmonary embolism . - The most common infective agents were streptococci, followed by staphylococci . The portion of negative blood cultures was strikingly high (35%) . - Despite the higher frequency of acute courses, mortality has decreased . Urgent cardiac valve replacement, which has been performed in a fifth of our patients, can prevent irreversible congestive heart failure.

Tijdschr Diergeneeskd, 1981 Dec 15, 106(24), 1284 - 7
{Lesions in slaughtered animals . IV . Decubital lesions in pigs (author's transl)}; Nouws JF et al.; Bacteriological studies (bacteriological examination in conformity with Meat Inspection Regulations) were done in 315 pigs . Examination was positive for bacteria in 58.4 per cent of these slaughtered pigs . The likelihood of bacteriological examination being positive increased with the diameter of the decubital lesion, 39.8 per cent being positive when the diameter was less than 5 cm and 69.2 per cent being positive when the diameter was greater than or equal to 5 cm . In 95.1 per cent of the animals in which examination was positive for bacteria, C . pyogenes or haemolytic streptococci were isolated from the splenic tissues . The presence of a decubital lesion was usually associated with disturbances of locomotion in the slaughtered animal . Inflammatory lesions such as (poly)arthritis of the extremities and vertebral abscesses were frequently observed . Of twenty-six pigs showing a decubital lesion unaccompanied by other pathological findings, ten animals (38.5 per cent) were found to be positive on bacteriological examination . It is concluded that the presence of a decubital lesion in a slaughtered pig should be regarded as an objective criterion for bacteriological examination of the animal in question.

Br Med J (Clin Res Ed), 1981 Dec 5, 283(6305), 1503 - 5
Colonisation of babies and their families by group B streptococci; Weindling AM et al.; A high incidence of group B streptococcal disease of the newborn in West Berkshire led to a prospective study of the condition . Cultures taken from 1090 babies shortly after birth showed that 65 (6%) were colonised with the streptococcus . Thirty of these babies were assigned to group 1 . Bacteriological samples were taken from babies and mothers at birth and at four, eight, and 12 weeks, and also from fathers and siblings . Fifty uncolonised babies and their families were similarly studied and served as controls (group 2) . In group 1,28 of the 30 mothers and 14 of the 28 fathers examined were colonised by group B streptococci . In group 2 the streptococci were isolated from three babies, 12 mothers, and 11 out of 45 fathers during follow-up . These findings suggest that group B streptococci are carried predominantly in the lower gastrointestinal and genitourinary tracts . Most families are lightly colonised, but in others maternal colonisation is stable and heavy and the incidence of paternal colonisation high . Results of serotyping suggest that sexual transmission occurs, which may explain the difficulty in eradicating the organism during pregnancy.

Infect Immun, 1981 Dec, 34(3), 856 - 63
Enolases from fluoride-sensitive and fluoride-resistant streptococci; Bunick FJ et al.; The enolase from a highly fluoride-sensitive strain of Streptococcus salivarius and its fluoride-resistant mutant, as well as those from strains of Streptococcus sanguis and Streptococcus mutans with intermediate and low sensitivities to fluoride have been shown to be inhibited by fluoride . Comparisons of the purified, strain-specific enzymes showed a high degree of similarity for all preparations . The Michaelis constants for the substrate 2-phosphoglycerate were 1.3 x 10(-4) to 2.4 x 10(-4) M, pH optima were 7.3 to 7.7, and Mg2+ optima were 2 mEq/liter for all . Inhibition by fluoride required the presence of inorganic phosphate and was competitive in nature, and the calculated modified inhibition indices were found to be in the range from 3.3 x 10(-14) to 5.8 x 10(-14) M4 . Percent inhibitions were determined under standardized conditions (0.16 mM NaF, 2 mM MgSO4, 0.5 mM Pi, and 0.5 mM 2-phosphoglycerate) and were found to range from 53.3 to 65.9% for all of the purified enzymes . The differences do not appear to be meaningful metabolically . Inhibition was reduced to about 14% at pH 6.0 . From the similarities in the behavior of the strain-specific enzymes it is concluded that the differences in the glycolytic sensitivities of the different strains of streptococci to fluoride are not the consequence of any kinetic differences between the respective enolases.

Can Med Assoc J, 1981 Dec 1, 125(11), 1246 - 9
Bacteremia caused by viridans streptococci in 71 children; Gaudreau C et al.; A review of the hospital records of 71 patients from whose blood viridans streptococci were isolated showed that in 13 cases the patient's illness was definitely related to the bacteremia: 4 patients had endocarditis, 3 had pneumonia, 2 had peritonitis and 1 each had meningitis, a scalp wound infection, sinusitis and otitis media . The bacteremia may have contributed to the two deaths among these 13 patients . In 45 cases the viridans streptococci may have contributed to the patient's illness: 15 patients had an infection of the lower respiratory tract and 7 an infection of the upper respiratory tract, 8 were neonates with suspected septicemia, 3 had soft tissue infections, 3 had leukemia and sepsis, and 9 had miscellaneous infections; the bacteremia was unrelated to the two deaths in this group . In another 13 cases the viridans streptococci could not be related to the patient's illness . The species most frequently isolated were Streptococcus mitis, S . sanguis II and S . MG-intermedius . The outcome of the bacteremia was generally good, even among the 11 patients not treated with antibiotics . When viridans streptococci are cultured from a single blood sample, further samples of blood and, if feasible, specimens from the associated focus of infection should be obtained for culture; further blood cultures are especially important in cases of suspected endocarditis.

J Am Vet Med Assoc, 1981 Dec 1, 179(11), 1208 - 10
Pathogenesis of contagious streptococcal lymphadenitis in cats; Swindle MM et al.; Transmission and pathogenesis studies were undertaken in cats inoculated orally with Lancefield group G beta-hemolytic streptococci . These bacteria, which had been isolated from cats during a natural episode of lymphadenitis, rapidly colonized the tonsils of inoculated cats and disseminated along lymphatic channels . Acute purulent inflammation of lymph nodes on the head and neck was followed by toxemia, which coincided with pyrexia and other signs of clinical illness.

Am J Clin Pathol, 1981 Dec, 76(6), 819 - 22
Group identification of streptococci . Evaluation of three rapid agglutination methods; Burdash NM et al.; The clinical need to rapidly and correctly differentiate beta-hemolytic streptococci into Lancefield groups has prompted the commercialization of rapid agglutination methods . Three serogrouping kits, Phadebact, Sero STAT, and Streptex, were compared with the classic precipitin technic . One hundred and fifty beta-hemolytic streptococci and 75 alpha-hemolytic streptococci isolated from clinical specimens were used . Phadebact grouped all beta-hemolytic strains correctly while Sero STAT and Streptex were 96.7% and 99.3% accurate, respectively . Phadebact and Streptex correctly identified all group D streptococci . Commercial agglutination reagents represent a simple and reliable method for grouping streptococci.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1981 Dec, 251(2), 152 - 6
Effect of subminimal inhibitory concentrations of penicillin on hyaluronidase production by group A streptococci; Benchetrit LC et al.; A sensitive dye-binding assay was employed to study the extracellular hyaluronidase produced by three penicillin-sensitive strains of group A streptococci belonging to M types 4, 24 and 28 . Enzyme was produced by all strains at appreciable levels . Subminimal inhibitory concentrations of penicillin in growing cultures increased enzyme production by M types 4 and 24 strains . Growth of the M type 28 R strain with added antibiotic was accompanied by a reduced production of hyaluronidase.

Acta Pathol Microbiol Scand {B}, 1981 Dec, 89(6), 433 - 5
IgG-Fc-receptors in T-type 12 group A streptococci from clinical specimens: absence from M-type 12 and presence in M-type 22; Burova LA et al.; Eighty-eight T-type 12 group A streptococcal strains were randomly selected from routine specimens in two epidemiologically unrelated districts . All of 26 M-type 12 strains lacked IgA and IgG Fc-receptors, whereas all 32 M-type 22 strains had IgG Fc-receptors and 20 of them also receptors for IgA Fc . The remaining strains were not further M-typed but 18 of these 30 strains exhibited receptors for IgG and 13 for IgA.

NIPH Ann, 1981 Dec, 4(2), 69 - 73
Hyaluronidase production, lactose and salicin fermentation and phage-typability in bovine group B Streptococci; Haug RH et al.; Hyaluronidase, also called the spreading factor, may be an important pathogenic factor for the streptococci . Production of hyaluronidase is found in 75% of human clinical isolates of group B streptococci, and we have in our investigation found the same frequency (74%) in 195 bovine isolates . Of the same 195 isolates 17% turned out to be lactose negative, a characteristic usually regarded as being typical of group B streptococci of human origin . These same strains were also mostly hyaluronidase positive . The parameters investigated: hyaluronidase production, lactose and salicin fermentation and phage-typability, can be useful in tracing the origin of the group B . However, bovine and human streptococcal populations do not seem to be completely distinguishable because overlapping exists between the characteristics.

Infect Immun, 1981 Dec, 34(3), 915 - 9
Phage-host interactions and the production of type A streptococcal exotoxin in group A streptococci; McKane L et al.; The infection of Streptococcus pyogenes nontoxigenic strain T 253 with bacteriophage T12 to form lysogen T 253 (T12) resulted in the production of type A streptococcal exotoxin (erythrogenic toxin or streptococcal pyrogenic exotoxin) . Two lines of evidence indicated that lysogeny per se was not sufficient to promote toxigenic conversion of strain T 253 . First, a virulent mutant of phage T12, unable to form stable lysogens, was able to affect type A exotoxin production by strain T 253 . An unrelated virulent phage A25 did not affect type A exotoxin production after infection of strain T 253 . Second, the temperate phage H4489A, which established stable lysogens with strain T 253 did not promote type A exotoxin production . These results suggest that there is a strain specificity to the phage-host interaction which affects type A exotoxin synthesis . Additional evidence is presented which indicates that type A streptococcal exotoxin was not a structural component of phage T12.

Pediatr Res, 1981 Dec, 15(12), 1525 - 9
Type III group B streptococcal strain differences in susceptibility to opsonization with human serum; Fischer GW et al.; Human serum opsonins to type III Group B streptococci (GBS) were studied in an in vitro opsonophagocytic assay . Two type III GBS test strains were susceptible (893 and IIINor) and two resistant (891 and 892) to opsonization by the majority of sera from 15 healthy adults . Four individuals with undetectable or low opsonic titers to the test strains were immunized with pneumococcal vaccine; immunization with pneumococcal vaccine induced a titer rise in all but one instance when susceptible GBS strains were tested . In contrast, only a single titer rise was detected when resistant GBS strains were employed in the test . These results indicate that immunization with a cross-reacting antigen (identical to core antigen of type III GBS) fails to induce opsonic antibody to all strains of type III GBS . A resistant strain was made highly susceptible to neutrophil killing in vitro by exposure to neuramindase prior to incubation with opsonic serum . Using a fluorescent lectin-binding assay, this enzyme appeared to remove surface sialic acid, suggesting that sialic acid is an antiphagocytic factor . However, the possibility that other surface moieties may act as antiphagocytic factors cannot be ruled out . Both opsonic susceptible and resistant strains absorbed opsonic antibody from serum, which suggests that the GBS antiphagocytic factors do not prevent binding of antibody to resistant bacteria . These findings indicate that demonstration of serum opsonic activity to one strain of type III GBS may not accurately depict opsonic activity to other strains . In addition, immunization with core antigen did not enhance opsonic activity against all GBS strains . These data also point out the need to use assays which measure functional antibody, since demonstration of antibody binding may not reflect its ability to facilitate bacterial phagocytosis and killing.

Jpn Circ J, 1981 Dec, 45(12), 1384 - 90
Infection of group A streptococcus and antibody response to extracellular antigens; Kawakita S et al.; A study demonstrating the relationship between pharyngeal infection of group A streptococci and the antibody response was performed . Group A streptococci were recovered from 44 (9.4%) of 466 children, of which 41 strains were typable by T-protein . Fifty-five percent of 41 children from whom group A streptococci were recovered showed a significant rise in anti-streptolysin O (ASO) titers in sera . In children from whom group A streptococci were recovered and with elevated ASO titers, titers of antideoxyribonuclease B (ADNase B) were significantly higher than those who were negative for group A streptococci and also showed elevated or normal titers for ASO . Patients with acute rheumatic fever demonstrated elevated titers of both ASO and ADNase B . These findings suggest that a combination of ASO and ADNase B titers should be applied to diagnose the streptococcal infections . Antinicotinamideadenine dinucleotidase showed a low level of titers in children who had group A streptococci in their throat and exhibited elevated titers in streptococcal antibodies, and also in patients with acute rheumatic fever.

J Pediatr, 1981 Dec, 99(6), 944 - 7
Group G streptococcal colonization and sepsis in neonates; Dyson AE et al.; Group G streptococci were isolated from the blood of seven neonates over a five-year period at the New York Hospital . All but two were born near term . All presented clinically with signs and symptoms of neonatal sepsis . Only one case was associated with a major complication--epidermolysis bullosa; this patient died . Two presented as late-onset sepsis at 11 and 12 days of age . Six of the seven responded promptly to antibiotic therapy . A one-year survey was carried out of colonization with groups B and G streptococci at the time of discharge (day 3) . Colonization with group G streptococci varied between 41 and 76% of babies each month . Group B streptococcal colonization ranged between 1 and 11% . Statistical analysis suggested that colonization with these organisms may be a mutually exclusive phenomenon.

J Pediatr, 1981 Dec, 99(6), 873 - 9
Protective efficacy of a modified immune serum globulin in experimental group B streptococcal infection; Santos JI et al.; In spite of aggressive antimicrobial therapy and extensive support measures, the mortality rate in early-onset group B streptococcal infection continues to be exceedingly high . In previous studies, we have demonstrated that passive immunotherapy with fresh whole blood containing opsonic antibody-improved survival in human neonates with group B disease . Transfusion of whole blood, plasma, or other blood products has a number of drawbacks, however . In the present study, we have evaluated immune serum globulin and a preparation of ISG modified for intravenous use for levels of type-specific antibody, opsonic activity, and protective efficacy against type Ia, II, and III group B streptococci . Type-specific antibody was detected in most of the preparations tested . In general, the level in MISG was less than that in the comparison ISG lot . Opsonic activity was also detected in these preparations against the more antibody-sensitive group B strains but was not present for opsonin resistant strains of type Ia, II, and III . Both ISG and MISG provided protection in neonatal rats infected with group B streptococci; in most cases MISG was more efficacious than the ISG from which it was made . These studies suggest that passive immunotherapy with MISG may be a valuable adjunct to current regimens used in the management of early-onset group B disease . This would be especially so if donors could be selected whose serum or plasma contained high levels of opsonic and protective activity against both antibody-sensitive and antibody-resistant group B strains.

J Hyg (Lond), 1981 Dec, 87(3), 465 - 76
Skin sepsis in meat handlers: observations on the causes of injury with special reference to bone; Barnham M et al.; Outbreaks of wound infection with Streptococcus pyogenes and Staphylococcus aureus occurred in a abattoir and a pork-processing factory in Autumn 1980 . Investigations showed that staff handling the meat before de-boning were particularly affected and that bone was the cause of 48% of the wounds which became clinicially infected . Of the total isolates of Strep . pyogenes and Staph . aureus from wounds of known cause 75% were from lesions caused by bone . In one outbreak streptococcal infection was seen principally in newly-employed staff . Group L streptococci were found in several sites in the pork factory and were isolated from infected lesions in two workers . Strep . pyogenes and Staph . aureus were cultured from tap handles in the lavatories . Sixty-six workers were examined in a non-epidemic period and 59% were found to have current wounds on the hand or wrists; 13% of wounds were infected but Strep . pyogenes was not isolated . Bone was the commonest of the many causes of injury, accounting for 31% of all wounds . Butchers had the highest rates of wounding and most bone-inflicted injury was seen in this group . Packers were the only group to wear protective gloves regularly . Damaged fingernails were found in 50% of workers, including a high proportion of nail-biters (33% of all workers) . The epidemic strain of Staph . aureus was cultured from bitten fingernails . Three of four infected workers carrying epidemic organisms in the throat were examined and all were nail-biters . Sharp-edged bone was produced by rotary saws early in the production line and bone dust contaminated the carcasses and adjacent surfaces . It is suggested that bone fragments could contaminate wounds and that this might have implications for the initiation of infection and the development of outbreaks.

Scand J Dent Res, 1981 Dec, 89(6), 475 - 84
Influence on periapical tissues of indigenous oral bacteria and necrotic pulp tissue in monkeys; Moller AJ et al.; In nine monkeys (Macaca fascicularis) the pulps of 78 teeth were aseptically necrotized . Twenty-six of the pulp chambers were kept bacteria-free by sealing, while 52 were infected by the indigenous oral flora . The results were recorded clinically, radiographically and microbiologically at the beginning of the experiment and after 6-7 months . The final examination also included histologic recordings . The initially noninfected root canals were all sterile at the final samplings, indicating that the risk of contamination (including hematogenous) of root canals of this animal is very slight . It was shown that noninfected necrotic pulp tissue did not induce inflammatory reactions in the apical tissues . By contrast, teeth with infected pulp tissue showed inflammatory reactions clinically (12/52 teeth) and radiographically (47/52 teeth) . Facultatively anaerobic streptococci, coliform rods and obligately anaerobic bacterial strains were most frequently found . In the final samples the number of obligately anaerobic strains increased . Some microorganisms which were isolated in the initial samples were not detected in the final samples . All infected teeth histologically examined showed strong inflammatory reactions in the periapical region.

Prim Care, 1981 Dec, 8(4), 583 - 91
Prevention of streptococcal neurosis; Boxerbaum B; Despite the decrease in the incidence and severity of rheumatic fever and rheumatic heart disease in the United States, overzealous emphasis on proper diagnosis and treatment of group A streptococcal pharyngitis in order to prevent these illnesses may often result in a frustrating, anxiety-provoking condition known as "streptococcal neurosis." Physicians, parents, and patients may all suffer from this condition, which often occurs even after all possible and appropriate treatment has been used to eradicate the group A streptococci . "Streptococcal neurosis" and the perplexing problem of treatment failure can be avoided or alleviated by utilizing knowledge of the interrelationship of the human host, the group A streptococcus, and nonsuppurative sequelae.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1981 Dec, 251(2), 157 - 64
Reactivity of antistreptococcus hyperimmune sera with human myocardial tissue; Bicova R et al.; Antimyocardial antibodies were determined in hyperimmune rabbit sera against group A streptococci . The detection method was indirect immunofluorescence in human myocardial tissue sections . Positively reacting sera were absorbed with group A streptococcus cell walls and cytoplasmic membranes, the objective being to locate the cross-reacting antigen in the streptococcus cell under the given experimental conditions . Cell walls gave the better absorption results . Whether or not the streptococci possessed the Fc-reacting factor was without influence on the absorption result.

Rev Infect Dis, 1981 Nov-Dec, 3 suppl, S250 - 8
Vancomycin therapy for infective endocarditis; Geraci JE et al.; The use of vancomycin is increasing for the treatment of serious life-threatening staphylococcal and other bacterial infections, including infective endocarditis, in patients who are allergic to the penicillins . The literature through 1978 reveals approximately 55 cases of infective endocarditis treated with vancomycin alone or with combined antibiotic therapy . Many of these 55 patients were treated by different clinicians, were given variable regimens of therapy, received other therapy before vancomycin, had associated valve replacement; various amounts of data were provided for the reported cases . A summary of these reports indicates a cure in 48 (87%) of the 55 patients . Recent in vitro and in vivo animal and patient data indicate that vancomycin alone or as part of combined therapy is bactericidal and curative in patients allergic to penicillin for infective endocarditis caused by staphylococci and streptococci-both enterococcal and nonenterococcal (Streptococcus bovis and viridans group streptococci) infections . In this study, 10 patients with infective endocarditis were treated with vancomycin or combined therapy; seven were cured . Five of the 10 patients with infective endocarditis caused by viridans streptococci were cured with combined vancomycin-streptomycin given in short-term therapy for two weeks.

Ann Microbiol (Paris), 1981 Nov-Dec, 132 B(3), 441 - 54
Classification of macrolide-lincosamide-streptogramin-B-type antibiotic resistance determinants; Ounissi H et al.; We have examined the relationship between the genes specifying resistance towards macrolid-lincosamide-streptogramin-B-type (MLS) antibiotics from group D and H streptococci, Staphylococcus aureus, Bacillus licheniformis, and Bacteroides fragilis by DNA annealing . We detected homology between the MLS resistance determinants from the Gram-positive cocci (streptococci and staphylococci) but not between these and the genes from B . licheniformis and B . fragilis . Based on these DNA-DNA hybridizations and on data obtained from the literature, at least four distinct classes of MLS R determinants could be defined: classes A and B for the Gram-positive cocci, class C for B . licheniformis and class D and B . fragilis . These genetic classes did not correlate with differences in phenotypic expression or in regulation (inducibility or constitutivity) of resistance towards MLS antibiotics . These findings are in favor of a recent common origin of R determinants in streptococci and staphylococci but do not suggest that gene transfer may occur between Gram-positive cocci and anaerobes (B . fragilis) despite the fact that these pathogenic bacterial genera share common human eco-systems.

J Clin Microbiol, 1981 Nov, 14(5), 530 - 3
Extraction of group A streptococcal M protein with nitrous acid; Hafez K et al.; Specific precipitating and opsonic neutralizing antigens were identified in dilute-nitrous acid extracts of group A streptococci . This was done by decreasing the temperature and time of exposure of the streptococcal cells to the nitrous acid . Ninety percent of 31 strains of group A streptococcal dilute-nitrous acid extracts formed precipitin lines of identity with conventional Lancefield extracts of the same group A streptococci.

Zh Mikrobiol Epidemiol Immunobiol, 1981 Nov, (11), 44 - 7
{Role of hyaluronic acid in the virulence of group A streptococci}; Burova LA et al.; The effect of hyaluronic acid and hyaluronidase on the virulent properties of group A streptococci in mice were studied . The passage of streptococci belonging to different serotypes in mice was accompanied by a considerable increase of their virulence and the accumulation of hyaluronic acid . The electron microscopy of the initial and passaged strains allowed one to reveal the presence of considerable differences in their cell wall structure . The passaged strains had a pronounced filamentous and sharply thickened medium layer containing hyaluronic acid . The treatment of passaged streptococci of the infected mice with hyaluronidase did not induce decrease of virulence in the passaged cultures . The data obtained indicate that hyaluronic acid is not a virulence factor for mice . Such virulence may be determined by some component, not yet identified, of the filamentous layer of the cell wall in group A streptococci.

J Infect Dis, 1981 Nov, 144(5), 411 - 9
Penicillin tolerance in group B streptococci isolated from infected neonates; Kim KS et al.; Four (4%) of 100 isolates of group B streptococci from the blood or cerebrospinal fluid of infected neonates were shown to be tolerant to penicillin by significantly slower rates of killing at penicillin levels that were 16 times greater than the minimal inhibitory concentrations . Different killing rates between nontolerant and tolerant streptococci were observed with penicillin only in the logarithmic phase of growth . Nontolerant strains in the stationary phase and tolerant strains in both the logarithmic and stationary phases were killed at similar rates, which were slower than the rates for nontolerant streptococci in the logarithmic phase . When incubated with {14C}lysine-labeled preparations of cell wall, freeze-thaw extracts of tolerant strains released less radioactivity than did those of nontolerant strains . This activity of nontolerant streptococci was maximal during logarithmic growth and was heat-labile, a result which presumably reflected the activity of autolytic enzyme(s).

J Clin Microbiol, 1981 Nov, 14(5), 550 - 6
Rapid identification of material colonization with group B streptococci by use of fluorescent antibody; Boyer KM et al.; To identify women colonized with group B streptococci during parturition, we used pooled type-specific fluorescent antibody to examine vaginal swabs enriched by preincubation in selective broth medium . In preliminary experiments, group B streptococcus strain III-Bell was reliably detectable with fluorescent antibody at concentrations of greater than 10(5) colony-forming units per ml, achieved after 6 h of incubation of small inocula (18 to 26 colony-forming units) . Of the vaginal swabs from 924 parturient women examined prospectively by both fluorescent antibody and selective bacteriology techniques, group B streptococci were isolated in 154 . The sensitivity of the fluorescent antibody technique increased with increasing incubation time and ranged from 49% (3 to 6 h) to 81% (7 to 12 h) to 83% (13 to 18 h) to 93% (greater than 18 h) . Colonized mothers identified within 6 h by the fluorescent antibody technique had higher rates of vertical transmission to their newborn infants (61%) than colonized mothers whose fluorescent antibody examinations were negative within this time interval (32%; P = 0.027) . However, because of the timing of their admissions, none of the colonized mothers of the four infants who developed early-onset group B streptococcal sepsis were identified with fluorescent antibody until after delivery . Although its sensitivity approaches selective culture methods after 6 h of incubation, fluorescent antibody examination of vaginal swabs does not appear to offer a practical approach to identifying colonized parturient women for intrapartum antibiotic prophylaxis of group B streptococcal infection.

Infect Immun, 1981 Nov, 34(2), 535 - 9
Bactericidal capacity of newborn phagocytes against group B beta-hemolytic streptococci; Becker ID et al.; The bactericidal capacity of mononuclear and polymorphonuclear phagocytes obtained from normal newborn infants and from healthy adults was evaluated in vitro, using two group B beta-hemolytic streptococci (GBBHS) serotypes (GBBHS-Ia-SS-615/28 and GBBHS-III-SS-620/50) and uniform opsonic conditions . No intertype differences in bacteriolysis of these two serotypes were observed among leukocytes from newborns or adults . As group, only polymorphonuclear phagocytes from newborns disclosed a significantly lower mean bactericidal capacity than their adult cellular counterpart, and only with respect to GBBHS-III-SS-620/50 . On the other hand, 4 or 16 polymorphonuclear samples from newborns tested revealed significantly low bactericidal capacities against both GBBHS serotypes, and an additional sample revealed a bactericidal capacity against GBBHS-III-SS-620/50 alone . Interstrain variations in the intrinsic bactericidal capacity of polymorphonuclear phagocytes from newborns against GBBHS-III may exist, as suggested by a single observation made by using four clinical isolates of GBBHS-III . Such deviant phagocytic capacities of polymorphonuclear phagocytes from newborns may constitute an additional selective risk factor in the genesis of GBBHS sepsis of the newborn.

Infect Immun, 1981 Nov, 34(2), 448 - 54
Correlation between the production of extracellular substances by type III group B streptococcal strains and virulence in a mouse model; Durham DL et al.; Twelve strains of serotype III group B streptococci (8 isolated from cases of neonatal disease, 3 isolated from asymptomatically colonized infants, and 1 laboratory reference strain) were examined for the vitro production of three potential extracellular virulence products: type-specific antigen, neuraminidase, and protease . In addition, virulence in a mouse model, expressed as 50% lethal dose, was determined for the 12 strains to determine whether a relationship existed between the production of any of the three extracellular products and virulence . Only production of extracellular type-specific antigen showed a correlation with virulence in the mouse model . The high producers of extracellular type-specific antigen were an average of 166-fold more virulent for mice than low producers of the same component . There was no correlation between virulence and either neuraminidase or protease production, nor was there a correlation between either of these two extracellular products and the levels of extracellular type-specific antigen . When levels of group B streptococci of each type (a high and low producer of extracellular type-specific antigen) in organs of infected mice were examined, comparable levels of organisms were found in the brain, spleen, and lungs of mice near death regardless of the initial inoculum . However, the high producer of extracellular type-specific antigen caused death in mice with a 2 to 3 log lower inoculum than the low producer, suggesting that these strains may be more invasive.

J Am Dent Assoc, 1981 Nov, 103(5), 719 - 22
In vitro effect of tobacco on the growth of oral cariogenic streptococci; Lindemeyer RG et al.; Most pouch and plug chewing tobaccos with high sugar contents are able to support the growth of S mutans and S sanguis in vitro . Snuff and unprocessed tobacco, although not able to stimulate growth of these organisms, do not inhibit growth . Inhibitory agents present in tobacco leaves do not preclude use of tobacco sugars by the organisms tested . Because factors other than bacterial populations play an important role in caries initiation, clinical studies are needed to identify the effects of commercial tobacco on the human dentition.

JAMA, 1981 Oct 16, 246(16), 1790 - 5
Penicillin V for group A streptococcal pharyngotonsillitis . A randomized trial of seven vs ten days' therapy; Schwartz RH et al.; The effect of duration of orally administered penicillin V potassium on the bacteriologic and clinical cure of group A streptococcal pharyngitis was evaluated . One hundred ninety-one middle-class patients received either seven days (96 patients) or ten days (95 patients) of therapy . Compliance with taking penicillin was assessed by multiple methods, including penicillinuria . Throat cultures were obtained during therapy and three times in the three weeks after therapy . M-precipitin and T-agglutinin typing were done on paired isolates of group A streptococci from patients who had recurrences . Patients treated for seven days had a significantly greater failure rate (30/96 {31%}) compared with patients receiving ten days of penicillin (17/95 {18%}) . Compliance rates were high; 66% to 81% of patients showed penicillinuria throughout the study period . Treatment failure was not a function of poor compliance in either treatment group . The data support the current recommendation for ten full days of penicillin therapy and suggest that persistence of streptococci in the throat after adequate therapy may be common.

Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Bacteriol Virusol Parazitol Epidemiol, 1981 Oct-Dec, 26(4), 229 - 33
{Variability of the serogroups of beta-hemolytic streptococci in groups of adolescents studied in a pilot project}; Rosiu I et al.; The present is the report of a pilot on the distribution per serologic groups of Streptococcus-hemolyticus strains isolated from children in a vocational school and a specialized secondary school . The prevalence of streptococci group C was observed . In the vocational school there was an evident increase in the number of group C strains, especially in the course of the 2nd and 4th terms, whereas in the other school group C strains were present in all terms, especially the 4th . Penicillin in injections, administered preventively and curatively in the vocational school was followed by variation of the serogroups, whereas in the specialized secondary school Streptococcus group C was present in a proportion of 100% in the 4th term, which actually represents the situation in this community before institution of the treatment . Attention is drawn to the fact that group C shows a tendency to prevail over a group A in certain ecologic sites, under the influence of the state of reactivity of the adolescents, survey and treatment of streptococcal infections and environmental conditions.

J Clin Invest, 1981 Oct, 68(4), 1113 - 6
Vancomycin prophylaxis of experimental Streptococcus sanguis . Inhibition of bacterial adherence rather than bacterial killing; Bernard JP et al.; Using a strain of Streptococcus sanguis tolerant to vancomycin to infect aortic vegetations in rats, we found that prophylactic intravenous vancomycin given 30 min before bacterial challenge decreased the incidence of endocarditis from 88 to 8% (P less than 10(-5)) . Because peak vancomycin serum levels were below the minimal bactericidal concentration, mechanisms of protection other than bacterial killing were investigated . S . sanguis were incubated with inhibitory concentration of vancomycin (50 microgram/ml) for 10 h and washed . 85% of rats (73/86) inoculated with control bacteria developed endocarditis, whereas only 42% (33/78) of those inoculated with vancomycin-exposed bacteria did so (P less than 10(-5)) . When rats were killed 30 min after bacterial challenge, S . sanguis were detected by culture of the vegetations in 44% of rats injected with control bacteria, but in only 13% of those challenged with vancomycin-exposed bacteria (P less than 0.03) . Enhanced clearance of vancomycin-exposed streptococci was not responsible for this protection because blood cultures showed no difference in the level and duration of bacteremia after injection of control or vancomycin-exposed S . sanguis . Moreover, this protection was not abolished in neutropenic rats injected with vancomycin-exposed bacteria, despite more prolonged bacteremia . These results suggest that vancomycin exerted its protection by lowering adherence of tolerant S . sanguis to vegetations rather than through bactericidal activity or enhanced clearance of bacteria by phagocytic cells . In the choice of antibiotics for prophylaxis of endocarditis, reduction of bacterial adhesion may be a criterion as important as bacterial killing.

J Dairy Res, 1981 Oct, 48(3), 393 - 403
Relationship of somatic cell count and cell volume analysis of goat's milk to intramammary infection with coagulase-negative staphylococci; Sheldrake RF et al.; The prevalence of intramammary infection in 4 commercial goat herds was studied in conjunction with electronic somatic cell count and volume analysis determined using a Coutler Counter and volume analyser . Neither streptococci nor mycoplasma were isolated from any half and the prevalence of intramammary infection with Staphylococcus aureus ranged from 0 to 3% between herds . For coagulase-negative staphylococci the range from infected halves was 36-71% . There was no significant difference between the mean total microscopic somatic cell count for halves infected with coagulase-negative staphylococci and those free from infection . A similar trend was observed for electronic somatic cell counts although the mean electronic cell count was greater than the mean total microscopic count on the 2 occasions that they were compared . The correlation coefficients between the 2 cell counting methods were 0.86 and 0.94 . Between herds there were significant differences in mean electronic somatic cell count, with herd means ranging from 438 x 103 to 1684 x 103 cells/ml . In 2 of the 4 herds studied, milk samples from halves infected with coagulase-negative staphylococci had a significantly higher prevalence of cell volume distributions with a modal cell volume between 65 mu 3 and 100 mu 3 . This was attributed to a higher proportion of polymorphonuclear neutrophils . Use of electronic somatic cell count and cell volume analysis were considered of little value in predicting infection caused by coagulase-negative staphylococci as there was a high proportion of false negative and false positive predictions.

J Gen Microbiol, 1981 Oct, 126(Pt 2), 477 - 82
Immunochemical studies on the cell-wall antigen of group B streptococcus, type Ib; Cumming CG et al.; A polysaccharide antigen of group B streptococcus type Ib was extracted from sodium dodecyl sulphate-treated cell walls by trichloroacetic acid . In crossed immunoelectrophoresis the polymer reacted with specific antisera to serotypes Ia, Ib and Ic of group B streptococci and with commercial grouping antiserum to give one precipitin line . However, the antigen did not react with antisera to types II and III . The evidence suggests that this polymer confers the group specificity to type Ib of group B streptococci . The polysaccharide, after purification on DEAE-cellulose, was shown to consist of rhamnose, glucosamine, galactose, glucose, sialic acid and a trace of phosphorus.

Clin Exp Immunol, 1981 Oct, 46(1), 225 - 8
Protein A-like activity and streptococcal cross-reactions; Kingston D; Recognition of the protein A-like activity of some strains of group A streptococci has thrown doubt on much previous work suggesting antigenic cross-reactions between these streptococci and mammalian tissues . The strains used in our previous studies have now been examined by the mixed reverse passive antiglobulin reaction (MRPAH) for the 'non-specific' absorption of purified Fc portion of human IgG . They were found to have only traces of activity . The strain of Staphylococcus aureus used to control 'non-specific' absorption by bacterial cell walls was strongly positive . Protein A-like material as detected in this way was not therefore responsible for our earlier results.

Pediatrics, 1981 Oct, 68(4), 544 - 9
Role of antibody to native type III polysaccharide of group B Streptococcus in infant infection; Baker CJ et al.; The role of maternally acquired antibody to native type III polysaccharide of group B Streptococcus as a determinant of susceptibility for infant systemic infection was investigated . Sera from 111 acutely ill infants with type III group B streptococcal bacteremia and/or meningitis and their mothers, and cord sera from 45 healthy neonates and their mothers who had type III group B streptococcal vaginal colonization at delivery were studied . Sera from each of 111 acutely ill infants contained very low levels of antibody (less than 1.7 microgram/ml, median 0.4 microgram/ml), and a significant correlation with maternal levels was tested for early onset infection (median 0.6 microgram/ml; 4 = .76; P less than .01) . Women whose infants remained well had antibody levels greater than 2 microgram/ml in their sera (73%) more often than those whose infants developed symptomatic infection (17%) (P less than .001), and the median level in their sera (12.6 microgram/ml) was considerably higher . Study of sera obtained during convalescence from 86 surviving infants indicated a poor antibody response to infection . In contrast, high levels of antibody were detected in sera from each of five convalescent women with postpartum bacteremia . These data extend earlier observations suggesting the correlation between low levels of type-specific antibody in serum and risk for systemic infection with type III strains of group B streptococci.

Acta Pathol Microbiol Scand {B}, 1981 Oct, 89(5), 323 - 34
Occurrence and specificity of antibodies against group-specific polysaccharides in beta-hemolytic streptococcal infections; Seppala IJ et al.; We studied the possibility of detecting beta-hemolytic streptococcal infections by determining antibodies against the group specific polysaccharides from streptococci of groups A, A-variant, C and G . The methods used were radio-immunoassay with these four polysaccharides and hemagglutination of group A polysaccharide sensitized erythrocytes . Significant increases in these antibodies were rare in tonsillitis patients, whereas high concentrations of antibodies could often be observed in association with severe systemic infections or rheumatic fever . Both strictly immunogen-restricted and crossreactive antibodies could be demonstrated by isoelectric focusing and inhibition of antigen-binding . Although previously considered nonexistent, group specific carbohydrate antibodies of IgM class could also be demonstrated.

Z Geburtshilfe Perinatol, 1981 Oct, 185(5), 276 - 9
{Endometrial bacteriology in puerperal infections (author's transl)}; Gerstner G et al.; From the third to the sixth day postpartum transcervical endometrial swabs were taken from 51 women with the clinical signs of endometritis, like fever over 38 degree C, uterine tenderness and purulent lochia using prereduced anaerobic transport-media . The specimens were cultured aerobically and anaerobically . 27 women had an endometritis following vaginal delivery, 24 following caesarian section . Following vaginal delivery aerobic bacteria were isolated in 85.2% of the cases and anaerobic bacteria in 62.9%, post caesarian section in 75.1% aerobic and in 83.3% anaerobic bacteria . A mixed aerobic/anaerobic infection was found in 48.1% following vaginal delivery and in 58.4% post caesarian section . The aerobes most frequently recovered were Staphylococcus epidermidis, E . coli, Enterocococci and Streptococci, the prevalent anaerobes were the grampositive anaerobic cocci, Peptostreptococcus and Peptococcus, and Bacteroides species . Our results suggest that anaerobic bacterial play an important role in the endometritis post partum and that frequently a polymicrobial aerobic/anaerobic infection is present . Therapeutically, anaerobes should be taken into consideration especially for the treatment of severer infections following caesarian section . In such cases the 5-Nitroimidazoles, such as Metronidazole or antibiotics effective against anaerobes as Clindamycin or Cefoxitin should be administered.

Br J Exp Pathol, 1981 Oct, 62(5), 519 - 25
Variations in the opsonic requirements of group B streptococcus type III; Hastings MJ et al.; The opsonic requirements of strains of Type III Group B streptococci (GBS) were studied using Luminol-dependent chemiluminescence and microscopy . Growth and storage conditions, particularly any reduction in the pH of the medium, affected GBS resistance to opsonization . Opsonization was complement-dependent but there was considerable variation in the requirements of individual strains for the classical and alternative pathways . Antibody was also necessary for opsonization . A few type III GBS strains were resistant to opsonization by pooled serum known to contain type-specific antibody, raising the possibility that protective antibody might in certain circumstances be strain- rather than type-specific . Treatment of these strains with neuraminidase, however, rendered them sensitive to opsonization by the same pool of serum . The resistance of GBS to opsonization in the neonate, where complement activity can be reduced and antibody levels are low, may be a major determinant of virulence.

J Clin Microbiol, 1981 Oct, 14(4), 433 - 6
Improved streptococcal grouping antisera containing polyethylene glycol; George JR et al.; Antisera to streptococcal groups A through G containing 4% polyethylene glycol 6000 were prepared and evaluated . Seventy strains of homologous and heterologous beta- and non-beta-hemolytic streptococci were included in the evaluation . Homologous reactions were determined against extracts prepared by four extraction methods: hot hydrochloric acid (Lancefield) extraction, autoclave extraction, hot formamide extraction, and nitrous acid extraction . Enhancement of the precipitin reaction in the presence of polyethylene glycol 6000 permitted a fourfold dilution of all antisera for use in the capillary precipitin test . At this dilution, the potency of the antisera exceeded requirements established for these reagents.

Int J Oral Surg, 1981 Oct, 10(5), 313 - 22
Anaerobic bacteria in dentoalveolar infections; von Konow L et al.; The bacteriology of 57 dentoalveolar infections was studied using optimal techniques to collect, transport and process specimens . There was an average of 4 bacterial species per specimen, and only 1/3 of the specimens held aerobes . Among the aerobic bacteria, streptococci dominated and among the anaerobes the Gram-negative rods, Bacteroides ruminicola and Fusobacterium nucleatum, were most frequently isolated followed by Gram-positive cocci, in particular Streptococcus intermedius . All aerobic isolates were resistant to penicillins but sensitive to clindamycin and tinidazole . The other anaerobic isolates were sensitive to penicillins but showed varying susceptibility to erythromycin and doxycycline . Tinidazole was effective against all anaerobic Gram-negative rods . The presence of volatile fatty acids in pus from dentoalveolar infections was found to be of presumptive value for the diagnosis of anaerobic infections . Direct gas-liquid chromatographic analysis of pus is recommended as a routine procedure for preliminary diagnosis of anaerobic dentoalveolar infections.

J Infect Dis, 1981 Oct, 144(4), 344 - 8
Role of myeloperoxidase and bacterial metabolism in chemiluminescence of granulocytes from patients with chronic granulomatous disease; Allen RC et al.; Phagocytosis of catalase-positive microbes by normal polymorphonuclear neutrophils results in increased metabolism as required for microbicidal action . Chemiluminescence is a product of the associated oxygenation reactions . Neutrophils from patients with chronic granulomatous disease are capable of phagocytizing catalase-positive microbes, but there is no associated respiratory burst, microbicidal action is greatly decreased, and chemiluminescence is not detected . However, these defective neutrophils can kill catalase-negative, H2O2-generating bacteria . In the present study, chemiluminescence by neutrophils from patients with chronic granulomatous disease after phagocytosis of H2O2-generating streptococci was detected . Acid extracts of myeloperoxidase from either control or patient neutrophils also yielded chemiluminescence in the presence of streptococci, but not in the presence of catalase-positive microbes.

J Dent Res, 1981 Oct, 60(10), 1803 - 8
Utilization of hydroxyapatite adsorbable salivary proteins as growth substrates for plaque-forming oral streptococci; Cowman RA et al.; Following treatment with hydroxyapatite, clarified mixed saliva from one donor source lost much of its growth-supportive activity for S . mutans VA-29R (type c) . Growth of the organism in a basal medium containing proteins desorbed from HA with 0.067 M potassium phosphate buffer, pH 8.0, was accompanied by the disappearance of some of the proteins, including those with isoelectric points of 4.90, 5.72, and 6.00 . These proteins are among those known to be specifically attacked by S . mutans . These findings suggest that some of the proteins selectively adsorbed from saliva with HA may serve as specific growth substrates for the plaque-forming oral streptococci.

Thorac Cardiovasc Surg, 1981 Oct, 29(5), 303 - 5
Aortic valve replacement in active infective endocarditis; Bortolotti U et al.; From 1970 to 1979, 23 patients underwent isolated aortic valve replacement because of active infective endocarditis at our Institution . The main indications for open heart surgery were cardiac failure unresponsive to medical treatment, embolic episodes and septic status . Staphylococci and streptococci were the most frequent offending microorganisms, which could be identified either from blood or valve cultures in 65.2% of the cases . Operative and late mortality was low (4.3 and 4.5% respectively), and postoperative complications rare . The favorable results, probably related to early surgical treatment, and the low incidence of postoperative complication seem to warrant an aggressive approach in the active phases of infective endocarditis involving the aortic valve.

Am J Obstet Gynecol, 1981 Sep 15, 141(2), 184 - 6
Premature rupture of membranes, preterm delivery, and group B streptococcal colonization of mothers; Regan JA et al.; In a prospective study of colonization with group B streptococci (GBS) among 6,706 parturients, we found statistically increased incidences of premature rupture of membranes (PROM) and preterm delivery at less than 32 weeks' gestation among women colonized with GBS . PROM occurred in 8.1% of the total population but in 15.3% of the colonized population (p less than 0.005) . Preterm delivery at less than 32 weeks' gestation occurred in 1.8% of the total population but among 5.4% of women colonized with GBS (p less than 0.005) . The data suggest a causal relationship between GBS colonization and events leading to preterm birth . The possible impact of eradication of colonization with GBS on prematurity is considered.

Can J Microbiol, 1981 Sep, 27(9), 918 - 23
Bacteriocin production by Streptococcus salivarius strain P; Tagg JR et al.; A bacteriocin, streptococcin sal-P, was isolated by freeze-thaw elution from cultures of Streptococcus salivarius strain P grown on tryptic soy agar plus 1% neopeptone . The inhibitor could also be extracted with either 7 M urea of 1 M NaCl from cells grown on this medium, but little activity was recovered from cells grown in liquid media of from the supernatants of these cultures . Streptococcin sal-P was found to be a proteinaceous substance of molecular weight approximately 8000 . It was remarkably stable at extremes of pH or temperature and appeared to adsorb nonspecifically to both sensitive and resistant bacterial cells and also to cellulose membranes . The range of its inhibitory activity was almost entirely against Gram-positive bacteria, particularly streptococci, including strains of S . pyogenes and S . sanguis, but not S . mutans or group D streptococci . Streptococcin sal-P was bactericidal for actively metabolizing susceptible strains.

Pediatr Res, 1981 Sep, 15(9), 1256 - 60
Survival of oral human immune serum globulin in the gastrointestinal tract of low birth weight infants; Blum PM et al.; Six immature infants were given oral feedings of 10% preservative-free human immune serum globulin ranging from 1 to 8 ml/kg/day . A seventh infant served as a control . Undigested and partially digested IgG was detected in the stools in significant quantities in all but the control infant . This coproantibody retained significant opsonic activity for type III group B streptococci as determined by a chemiluminescence assay, but lost most of its tetanus antibody activity . The newborn infants' enzymatic immaturity or rapid transit time permits the passage of intact IgG or partially digested IgG to pass throughout the gastrointestinal tract.

J Clin Microbiol, 1981 Sep, 14(3), 329 - 32
Growth of nutritionally variant streptococci on common laboratory and 10 commercial blood culture media; Reimer LG et al.; Nutritionally variant streptococci fail to grow on routine sheep blood agar plates . Moreover, these strains are a recognized cause of culture-negative endocarditis . We tested the ability of chocolate and brucella blood agars, sheep blood agar with a staphylococcal streak, sheep blood agar with 0.001% pyridoxal, and 10 commercial blood culture media from two manufactures to grow these bacteria . Of the original 25 strains tested, 16 were recovered on chocolate agar, 21 were recovered on brucella blood agar and 21 were recovered on sheep blood agar with a staphylococcal streak . Sheep blood agar with pyridoxal grew all 22 strains tested . Supplemented peptone, thioglycolate, and thiol broths grew all strains, but brain heart infusion and three tryptic soy broths supported five or fewer strains . The addition of 5 ml of human blood improved recovery to 100% in all media except tryptic soy broths . Unless supplemented wih pyridoxal, common laboratory agars were inadequate for recovering all strains of variant streptococci upon subculture of blood culture bottles . As used clinically, the blood culture media that we studied other than tryptic soy broths should reliably grow these bacteria.

J Clin Microbiol, 1981 Sep, 14(3), 266 - 72
Evaluation of blood culture media for isolation of pyridoxal-dependent Streptococcus mitior (mitis); Gross KC et al.; Nutritional variant streptococci identified as pyridoxal-dependent Streptococcus mitior (mitis) account for 5 to 6% of streptococcal endocarditis and may be a cause of "culture-negative" endocarditis . Hence, growth of three variant strains in 11 commercial blood culture broths was compared to that in fresh heart infusion broth . For simulation of clinical specimens, culture bottles were injected with 5 ml of human blood, inoculated with approximately 500 colony-forming units (CFU) per bottle, and monitored for 7 days with Gram stains and viable counts . Only Thiol broth (Difco Laboratories, Detroit, Mich.) supported growth without blood at this low inoculum . In media containing blood, maximal growth of 10(9) CFU/ml was reached within 2 days of incubation, and heavy turbidity was consistently observed in only heart infusion broth, Thiol broth, and media supplemented with pyridoxal hydrochloride . Columbia broth (BBL Microbiology Systems, Cockeysville, Md.) with increased cysteine, thioglycollate broth, and one brain heart infusion broth produced moderate growth (1 x 10(8) to 5 x 10(8) CFU/ml), whereas Columbia broth, another brain heart infusion broth, and two brands of tryptic soy broth showed fair growth (1 x 10(7) to 4 x 10(7) CFU/ml) . The poor growth (1 x 10(6) to 3 x 10(6) CFU/ml) observed in three other brands of tryptic soy broth was often not apparent macroscopically or by Gram stain . Furthermore, on growth occurred in 40% of tryptic soy broth cultures inoculated with 50 CFU . Therefore, to ensure isolation of these variant streptococci from clinical blood cultures, a medium containing thiol compounds or supplemented with pyridoxal should be used . Subcultures should be made within 2 days of incubation to blood agar enriched with pyridoxal or containing a Staphylococcus sp . streak for satellitism.

J Clin Microbiol, 1981 Sep, 14(3), 252 - 5
Simplified coagglutination test for serological grouping of beta-hemolytic streptococci; Engel HW et al.; A new coagglutination kit consisting of a plastic slide with dried antibody-coated staphylococci was evaluated for the grouping of beta-hemolytic streptococci of groups A, B, C, and G . The test was compared with the classical precipitation test, using hot formamide antigen extracts with 224 strains of groups A, B, C, and G streptococci . An agreement of 100% was found between the new coagglutination and the classical precipitation procedures . No false-positive results were obtained with group F and D streptococci; however, group L streptococci reacted with the group A reagent . The test procedure could be shortened by using suspensions of colonies from overnight cultures on blood agar plates in small volumes of Todd-Hewitt broth without further incubation . All 74 strains of groups A, B, C, and G were correctly identified from suspensions in Todd-Hewitt broth; however, suspending the colonies in 0.9% saline or phosphate-buffered saline resulted in lower sensitivities.

Infect Immun, 1981 Sep, 33(3), 697 - 703
Salivary immunoglobulin A antibodies reacting with antigens from oral streptococci: longitudinal study in humans; Gahnberg L et al.; The salivary immunoglobulin A (IgA) activity to antigens from four common oral streptococci was analyzed in samples from five humans . From each individual, parotid and whole saliva were collected 12 times over a period of 4 months . In samples collected at different occasions, the salivary IgA activity varied considerably . The variations showed a covariation with the concentration of total IgA in the saliva samples . A covariation was also found between salivary IgA antibodies of different specificity . It is concluded that reference antigens, in combination with measurement of total IgA concentration, ought to be used when evaluating the salivary IgA response in humans.

Am J Surg, 1981 Sep, 142(3), 377 - 83
Necrotizing fasciitis; Freeman HP et al.; Fourteen patients with necrotizing fasciitis seen over a 5 year period at a public hospital are reviewed . Middleaged men predominated . The disease followed such diverse initiating causes as self-injection with heroin, boil, ischiorectal abscess, perforated occult colonic cancer and trivial abrasions . In a few cases there was no evidence of an initiating lesion . Necrotizing fasciitis affected the arms, legs, trunk and neck . Bacteriologic analysis showed that the disease is usually caused by gram-negative bacilli and hemolytic streptococci, alone or in combination . Morbidity and mortality rates in the present series were influenced by associated clinical conditions such as old age, diabetes mellitus, carcinoma and gram-negative bacteremia.

Tijdschr Diergeneeskd, 1981 Sep 1, 106(17), 868 - 72
{Bacteria and their antibiograms (author's transl)}; Overgoor GH; The antibiograms of the most important pathogenic bacteria isolated from pigs and cattle in the laboratory of the Animal Health Service of the province of Gelderland during the period from 1974 up to and including 1979 are reviewed . The findings are compared with those during a previous period . Adverse developments were not found to be present as regards P . multocida, B . bronchiseptica, H . parahaemolyticus, streptococci and S . typhimurium in pigs . Only pathogenic E . coli as the causative organism of oedema disease (colibacillary) enterotoxaemia) showed reduced sensitivity to co-trimoxazole; an increase in sensitivity to streptomycin, tetracycline and neomycin was observed . The pattern of pathogenic E . coli in breeding calves showed a variable, through on the whole not so favourable picture . There was a negative development as regards S . dublin in veal calves in view of the fact that sensitivity, particularly that to chloramphenicol and tetracycline, but also that to furazolidone and co-trimazole, had diminished . In the case of S . typhimurium, there was a relationship between the sensitivity pattern and a number of phage types . Ever since 1977, P . haemolytica has shown a diminishing and partly variable sensitivity to penicillin, streptomycin, tetracycline and sulphonamide . This was the case to a far less extent with P . multocida.

J Pediatr, 1981 Sep, 99(3), 450 - 4
Non-group D alpha-hemolytic streptococci: new neonatal pathogens; Broughton RA et al.; Review of the bacteriologic records of a large city-county hospital from 1970 through 1980 has indicated a substantial increase in the frequency of isolation of non-group D alpha-hemolytic streptococci from blood and cerebrospinal fluid of neonates since 1978 . These organisms accounted for 23% of all cases of neonatal septicemia and meningitis in 1980, and as a group were exceeded only by group B streptococci (28%) in prevalence . Most neonates (91.2%) had early-onset infection (mean age = 1.4 days); approximately one-third were premature (less than 36 weeks' gestation) . Maternal obstetrical complications were common . Nearly 80% of the infants had signs or symptoms suggesting bacterial sepsis . Findings such as concomitant meningitis, shock, chest roentgenogram abnormalities, leukopenia, abnormal numbers of immature neutrophils, and death were infrequent when compared to those accompanying other invasive neonatal bacterial infections, suggesting that non-group D alpha-hemolytic streptococci may be less virulent for the neonate or that neonatal host defense mechanisms are more effective in containing the infection . Careful surveillance for these potential neonatal pathogens seems warranted.

Jpn Heart J, 1981 Sep, 22(5), 825 - 32
Effects of prednisolone and anti-macrophage serum on the development of carditis and arthritis due to group A hemolytic streptococci in mice; Nishimura T; The effects of prednisolone and anti-macrophage serum (AMS) on the development of cardiac and articular lesions were compared in experimentally infected mice with group A hemolytic streptococci . The predonine-treated mice had a higher mortality rate and greater abscess formation than in the AMS-treated mice . The predonine-treated group had a higher incidence of cardiac lesions due to chronic pericarditis and chronic myocarditis, and the former was particularly frequent . Pathologic findings seen in the AMS-treated mice were those of acute pancarditis . The AMS-treated animals also had lesions of subacute or chronic arthritis, whereas articular lesions encountered in the Predonine-administered group were frequently those of chronic periarthritis and, in no instance, synovitis . These data indicated that treatment with AMS is more effective than that with prednisolone to experimentally induced rheumatic fever in laboratory animals.

Eur J Obstet Gynecol Reprod Biol, 1981 Sep, 12(3), 143 - 50
Obstetrical care in future pregnancies after fetal loss in group B streptococcal septicemia . A prevention program based on bacteriological and immunological follow-up; Christensen KK et al.; Among 22 mothers of infants infected with group B streptococci (GBS), 19 showed markedly low levels of antibodies against the infecting type . Three of the patients with low antibody levels went through a new pregnancy within 1 yr after they had lost an infant (2 patients) or experienced fetal death due to GBS (1 patient) . They were still urogenital carriers of the type of GBS causing the previous infection, and their serum levels of type-specific antibodies remained low . All three went through a successful pregnancy following a prevention program comprising antibiotic treatment from the 28th wk of pregnancy.

J Lab Clin Med, 1981 Sep, 98(3), 326 - 35
The role of the carrier in treatment failures after antibiotic for group A streptococci in the upper respiratory tract; Kaplan EL et al.; During a prospective study of endemic group A streptococcal upper respiratory tract infection and the streptococcal carrier state, we investigated persistence of group A streptococci after treatment with recommended doses of antibiotics . We evaluated clinical findings, culture results, and streptococcal antibody responses at the acute-stage clinic visit and at convalescent-stage visits 3 and 8 weeks later . Data from 280 children ill with pharyngitis and their family contacts were analyzed (mean age 13.3 years); 129 individuals (46%) had group A beta-hemolytic streptococci isolated at the initial visit . Despite antibiotic treatment, group A streptococci were not eradicated from the upper respiratory tract of 34 (26%) of the 129 culture-positive individuals . Thirteen of the 34 (38%) required a second course of antibiotic therapy before the infecting serotype was eradicated, but a majority, the remaining 21 (62%) patients, were not bacteriologically cured despite repeated courses of antibiotics . Streptococcal antibody data suggested that the majority of the treatment failures were streptococcal carriers . Only 5% of asymptomatic individuals with a positive culture for group A streptococci demonstrated an antibody rise . These bacteriologic and serologic data document that it usually is unnecessary to retreat asymptomatic convalescent individuals having throat cultures persistently positive for group A streptococci, since these individuals seldom represent true streptococcal infection.

Proc Natl Acad Sci U S A, 1981 Sep, 78(9), 5303 - 4
Spikes and fimbriae: alpha-helical proteins form surface projections on microorganisms; Cohen C et al.; Two basic alpha-helical plans appear to characterize portions of the proteins projecting from the surface of many microorganisms . Structure A is related to that of the antibody-binding protein A of Staphylococcus aureus, in which a single polypeptide chain doubles back to form an Anti-parallel domain; the other, structure M, is related to the M proteins of group A streptococci, in which Multiple parallel alpha-helical chains interlock in a coiled-coil conformation . A projection about 100 A long may be organized on either plan, but very long projections are likely to be of the M pattern . The alpha-helical motif may account for the length of these spikes, with other functions such as anchoring or antiphagocytic activity located in domains of different structure.

Br Med J (Clin Res Ed), 1981 Aug 15, 283(6289), 459 - 61
Nosocomial transmission of group B streptococci; Easmon CS et al.; The acquisition of group B streptococci by babies in a special-care baby unit and two postnatal wards was investigated over a six-month period using serology and phage typing . Sixty-three culture-positive babies were identified in the postnatal wards, one-third of whom had been born to mothers who were not carrying the organism in the genital tract or anorectal area during labour . A non-maternal source was identified for 14 of these 21 infants: either colonised mothers and babies in the same ward or, on one occasion, a member of the hospital staff . In the special-care baby unit, however, only one instance of nosocomial acquisition of group B streptococci was recorded despite a high prevalence of colonisation in the staff on the unit and the presence of heavily colonised babies . The results of this survey suggest that although sepsis caused by group B streptococci may be the result of nosocomial transmission, this may be prevented by careful attention to hygiene.

Antimicrob Agents Chemother, 1981 Aug, 20(2), 235 - 8
Penicillin tolerance of human isolates of group C streptococci; Portnoy D et al.; Seventeen clinical isolates of group C streptococci were tested for penicillin tolerance . Sixteen of the strains showed penicillin tolerance with a 32-fold or greater difference between the minimal inhibitory concentration and the minimal bactericidal concentration . Synergism was demonstrated with a combination of penicillin and gentamicin for all 17 strains tested . The rate of antibiotic killing was measured for five of the streptococcal strains by using the combination of penicillin and gentamicin . All isolates were killed within 5 h with the combination, but viable organisms were recovered after 48 h when either drug was used alone . Our study suggests that penicillin tolerance with group C streptococci may occur frequently and may account for the poor outcome of serious group C streptococcal infections tested with penicillin alone.

J Med Microbiol, 1981 Aug, 14(3), 233 - 41
Quantitative studies of the flora of the nasal vestibule in relation to nasal carriage of Staphylococcus aureus; Heczko PB et al.; Aerobic and anaerobic bacterial flora and yeast flora of the nasal vestibule were studied quantitatively in eight persons who were persistent, transient or non-carriers of Staphylococcus aureus . The nasal flora of all the subjects consisted of lipophilic and non-lipophilic aerobic diphtheroids, propionibacteria and different staphylococcal species . Other micro-organisms, such as Pityrosporum and Candida, micrococci, streptococci and coliforms were found only occasionally . The presence of S . aureus was related to diminished numbers of other staphylococcal strains and of propionibacteria.

Acta Pathol Microbiol Scand {C}, 1981 Aug, 89(4), 247 - 52
IgG F(ab')2 of rabbit anti-M sera but not the unfractionated sera are bactericidal for some group A streptococci with IgG Fc-receptor activity . Opsonic effect ascribable to anti-IgG; Schalen C et al.; We have earlier reported on a group A streptococcal strain, type M12, which upon serial mouse passage acquired IgG Fc-receptor activity but lost the M-antigen . The passaged strain, 12P, was highly virulent for mice and grew well in normal human blood . The present study particularly concerns the opsonic effect on 12P of rabbit anti-M3, anti-M12 and anti-12P sera, as well as the corresponding IgG F(ab')2 . Indirect bactericidal tests showed that the homologous anti-12P seum and IgG F(ab')2 were opsonic . The anti-M3 and anti-M12 had no effect on 12P; surprisingly, however, IgG F(ab')2 isolated from these sera displayed a clearcut opsonic activity . Data are presented which indicate that these "paradoxical" results can be explained by the binding of IgG F(ab')2 with anti-IgG specificity to human IgG, linked to the streptococcal surface through Fc-receptors . Only anti-12P serum, or IgG F(ab')2, were protective for mice on challenge with strain 12P.

Acta Pathol Microbiol Scand {B}, 1981 Aug, 89(4), 205 - 9
The Ibc protein fraction of group B streptococci: characterization of protein antigens extracted by HCL; Bevanger L et al.; The Ibc protein fraction of group B streptococci was prepared by HCL extraction of the type Ic strains A909 and 335 . The fraction from strain A909 contained two protein antigens (alpha A 909 and beta A909) that could be separated by ion-exchange chromatography and isoelectric focusing . The 335 extract contained the alpha (alpha 335)-but not the beta antigen . The alpha 335 antigen was purified by similar procedures . The beta A909 antigen had a molecular weight of several hundred thousands, was immunogenic in rabbits and dissociated into several polypeptides on SDS-PAGE . Polypeptides with sub-unit molecular weights corresponding to 70,000 daltons showed antigenic activity . The alpha 335 antigen had a molecular weight of approximately 75,000 daltons as judged from gel filtration and SDS-PAGE . The antigen was immunogenic in rabbits . In contrast, the alpha A909 antigen showed neither protein lines on SDS-PAGE, nor immunogenicity in rabbits . However, the two alpha antigens showed serological crossreactivity in tests with the anti-alpha 335 serum.

Br J Exp Pathol, 1981 Aug, 62(4), 393 - 7
Phagocytic and bactericidal activity of human neutrophils against two isolates of Group B streptococci Type Ic of differing pathogenicity; Cleat PH et al.; The phagocytic and bactericidal activities of normal adult human neutrophils against 2 strains of Group B streptococci Type Ic of differing pathogenicity were examined . Both isolates were phagocytosed by the neutrophils in the presence of normal and homologous immune serum . However, the highly pathogenicity streptococci were killed less readily in the presence of immune serum than were the streptococci of low pathogenicity in the presence of immune or normal serum . This difference in killing ability was not due to a defect in phagocytosis by the neutrophils, but to a defect in bactericidal activity . The highly pathogenic streptococci were not killed in the presence of normal serum, but were readily phagocytosed by the neutrophils, in which they accumulated and eventually caused their destruction . The streptococci of low pathogenicity, however, were killed equally as well in the absence of specific antibody as in its presence . It is suggested that an in vitro assessment of neutrophil function against streptococci of differing pathogenicity for mice may provide a useful method by which the pathogenicity of streptococci for man can be compared.

Antimicrob Agents Chemother, 1981 Aug, 20(2), 244 - 6
Susceptibility of group A beta-hemolytic Streptococcus isolates to penicillin and erythromycin; Istre GR et al.; We have reevaluated the antibiotic susceptibilities of group A beta-hemolytic streptococci in view of recent reports of a high prevalence of erythromycin resistance in Japan and of an increase in penicillin treatment failures in the United States . A total of 474 isolates recovered during a 2- to 3-month period in 1980 were tested . All were susceptible by microtiter broth dilution to a penicillin concentration of less than or equal to 0.03 micrograms/ml (minimal inhibitory concentration), and 473 were killed by less than or equal to 0.06 micrograms/ml (minimal inhibitory concentration) . Erythromycin minimal inhibitory concentrations showed a bimodal distribution: 95% were less than or equal to 0.06 micrograms/ml, and 5% were greater than or equal to 1 microgram/ml . Of the minimal bactericidal concentrations, 21% were greater than or equal to 1 microgram/ml and 3% were greater than or equal to 16 micrograms/ml . Group A beta-hemolytic streptococci remain susceptible to the inhibitory and bactericidal actions of penicillin, thus providing no in vitro explanation for the bacteriological relapses reported in some clinical studies . Unlike the Japanese experience, only 5% of our isolates were resistant to erythromycin (minimal inhibitory concentration, greater than or equal to 1 microgram/ml); however, 22% were tolerant (ratio of minimal inhibitory/bactericidal concentrations, greater than or equal to 32).

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