Zentralbl Bakteriol A, 1981 Aug, 249(3), 302 - 9 Ultrastructural study of interaction of group A streptococci with tissue culture cells; Ryc M et al.; Submicroscopic aspects of the adherence of Group A streptococci to HEp-2 cells and the time sequence of their further interaction with these cells were studied . The M+ variant of streptococci, characterized by the presence of filamentous protrusions on the cell wall, displayed a high capacity for adherence, in contrast to the M- variant of the same strain, where adherence was low . The first stage of the interaction between M+ variant of Group A streptococci and HEp-2 cells was adherence of the filamentous protrusions of the bacterial cell wall to host cell cytoplasmic membrane; this was followed by closer contact of the streptococcus cell wall with HEp-2 cell surface . Continuing incubation led to the development of invaginations in the cytoplasmic membranes of HEp-2 cells, into which streptococci gradually penetrated . Ingestion of streptococci into the forming pseudovacuoles of the host cell was accompanied by bacterial cell division, culminating in total disintegration of the host cell and release of the streptococci into the medium . At all stages of the interaction there was a pronounced tendency to form multiple contacts between the surface structures of the streptococcus cell and the membrane structures of the animal cell being attacked. Obstet Gynecol, 1981 Aug, 58(2), 222 - 6 Intraamniotic infection due to group G streptococcus: treatment and antibody response; Larsen JW Jr et al.; Penicillin treatment and antibody response were studied using a rhesus monkey model for intraamniotic infection with type III group B streptococci (T3GBS) . Acute and convalescent phase sera from mothers and their offspring were tested with a radioactive antigen-binding assay to determine the concentration of antibody to the capsular T3GBS antigen . The frequency of placentitis was significantly lower in penicillin-treated animals (3 of 8) than in controls (10 of 10; P less than .01) . The penicillin group also had a significantly lower neonatal mortality (1 of 9) than controls (6 of 10; P less than .05) . Both groups of rhesus mothers developed a significant increase in concentration of antibody to T3GBS, but the antibody response was of lesser magnitude in the penicillin-treated group . This experimental model appears to be useful for studying both therapy for intraamniotic infection and the humoral immune response to infection with T3GBS. J Hyg (Lond), 1981 Aug, 87(1), 109 - 29 Streptococcus pyogenes in the throat: a study in a small population, 1962-1975; Hope-Simpson RE; A general practice population of around 6700 was kept under clinical and laboratory surveillance from 1962 to 1975 . Illnesses totalled 18703 in three morbidity classes: sore throat (Throats) 4451, acute febrile respiratory diseases (FRD) 4934, acute non-febrile respiratory diseases (Non-FRD) 9318 . Specimens were examined for beta-haemolytic streptococci (BHS) from 37.1% of these illnesses: from Throats 33.3%, from FRD 67.8%, from Non-FRD 22.6%, and 515 specimens were collected from a miscellaneous ("Other') class consisting of healthy persons and ailments that could not have had a streptococcal component . Strains of BHS were isolated from 7448 specimens as follows: group A (Streptococcus pyogenes) 353, group C 36, group G 15, other groups 274 . Group A strains were isolated from specimens at the following rates: Throats 16.7%, FRD 2.4%, Non-FRD 0.9% . Other 1.4% . The last two classes reflect the carrier rate in the general community, which must be deducted to obtain the streptococcal morbidity in the other classes . Carriers thus accounted for 6% of the strains isolated from the Throats class and for 42% of those from FRD illnesses . No consistent seasonal trend of prevalence was detected . Long-term fluctuations in prevalence over several years affected all groups and most group A serotypes . Serotyping was performed on 304 strains from 1963 to 1975 . The commonest types found were T-types 4 and 12 and M-type 12 . Immunity against re-infection by identical strains appeared to be fairly strong and also against heterotypic strains that shared a T-antigen, but little protection was conferred against re-infection by group A strains with no shared M- or T- antigen . R-28 antigen is considered here as a marker epidemiologically equivalent to an M-antigen . Epidemicity, as measured by a simple estimate of aggregation, appeared to be low and there were differences between and within serotypes . The infecting organism appeared to linger in the pharynx, sometimes for several months, after a streptococcal illness. J Clin Periodontol, 1981 Aug, 8(4), 349 - 58 Studies of a periodontal tissue lesion in the rat, untreated or treated with chlorhexidine digluconate; Kenworthy R et al.; The studies currently reported formed part of an enquiry whose overall objective was to identify a suitable animal model upon which initial screening of compounds and formulations with prophylactic and/or therapeutic potential in periodontitis could be carried out . An earlier study (Rovin et al . 1966) reported that periodontal inflammation could be produced in the conventional laboratory rat by application of a ligature to the molar teeth . The present paper describes the pathological and histo-pathological changes in the periodontium following application of ligatures to the molar teeth of young rats, and the tissue responses observed after topical application of chlorhexidine digluconate . Plaque formed rapidly and an acute periodontitis was induced; application of increasing concentrations of chlorhexidine digluconate gave a progressive diminution in the severity of the lesions . The major bacterial components of the plaque were actinomycetes and streptococci. Aust Dent J, 1981 Aug, 26(4), 209 - 13 The changing nature of pyogenic dental infections; Woods R; During the years 1978 and 1979 there has been a marked change in the proportion of bacteria isolated from dental infections compared with the ten year period to 1978 . There has been a reduction in the proportion of streptococci found and an increase in the proportion of the Gram negative species encountered . There has been a steady decline in the effectiveness of penicillin although this has to some extent been offset by the introduction and widespread use of amoxycillin . The greatest change in antibiotic sensitivity has been the reduction in sensitivity to the tetracyclines. Oral Surg Oral Med Oral Pathol, 1981 Aug, 52(2), 187 - 96 Acute pulpal-alveolar cellulitis syndrome . II . Clinical assessment of antibiotic effectiveness against microbes isolates from intact teeth; Matusow RJ; Ten antibiotics were comprehensively screened for effectiveness against 105 microbes, specifically isolated from seventy-eight teeth involved with acute pulpal-alveolar cellulitis . On the basis of effectiveness and compatibility, erythromycin was regarded as the drug of choice for initial therapy . Streptococci were the predominant class of microbes isolated; enterococci were the most resistant . No resistance was noted wit erythromycin; 52 percent resistance was obtained with clindamycin . Tetracycline was the most effective of the common drugs for aerobic gram-negative rods . Polyantibiotic resistance was noted among microbes of all types . A clinical perspective in drug therapy for acute oral infection is discussed. J Invest Dermatol, 1981 Aug, 77(2), 246 - 9 Purification and characterization of streptococcal proliferative factor; Rasmussen EO et al.; Group A streptococcal infections are often associated with scarlet fever and flares of guttate psoriasis . Previous investigation has demonstrated the presence of a factor in streptococcal culture filtrates capable of stimulating proliferation of rabbit keratinocytes in vivo and human lymphocytes in vitro . This report outlines an in vivo method for the production of streptococcal proliferation factor, its purification, and characterization of its physical properties . We cultured Group A streptococci (Type 12, Strain NY5) in synthetic media by in vivo incubation within dialysis casing surgically implanted in rabbit peritoneum . Streptococcal exoproteins were isolated by centrifugation of the bacteria and millipore filtration . Purification of streptococcal proliferative factor was accomplished by differential solubility and molecular sieve was discovered in the resulting product . The relative by SDS gels and molecular sieve chromatography . The sedimentation coefficient determined by sucrose gradient ultracentrifugation is 2.7S . Isoelectric focusing showed minimal microheterogeneity with the pI of the major band being 5.0 . Thus, streptococcal proliferative factor can be produced by in vivo incubation of streptococci in synthetic media . Purification entails a rapid 2-step process . The relative molecular weight, sedimentation coefficient and isoelectric points have been established. Science, 1981 Jul 24, 213(4506), 474 - 5 Ureaplasma urealyticum incriminated in perinatal morbidity and mortality; Kundsin RB et al.; Perinatal morbidity and mortality are associated with colonization of the chorionic surface of the placenta by Ureaplasma urealyticum or Mycoplasma hominis or both . These organisms are more strongly associated with unfavourable gestational outcome than group B streptococci . Chlamydia trachomatis does not appear to be important in the etiology of reproductive casualties . The mechanisms linking the mycoplasmas to perinatal disorders and death are not clear but merit investigation. G Batteriol Virol Immunol, 1981 Jul-Dec, 74(7-12), 283 - 96 {Inhibitory and fatal activity of amoxicillin, erythromycin and josamycin against Streptococci}; Savoia D et al.; 23 Streptococcus sp . of different serological groups were assayed to evaluate the susceptibility to amoxycillin, erythromycin and josamycin . Inhibitory (CMI) and bactericidal (CMB) activity were compared to minimal lethal concentration (CML) observed at different times from the beginning of incubation to study the kinetic of lethal effect of the three antibiotics . Erythromycin shows an earlier bactericidal efficacy against most of the strains assayed . CMB and CML evaluated after 18 hours of incubation are generally similar, while CML against Streptococci group G, Streptococci group D assayed with macrolides and CML against alpha-haemolytic Streptococci assayed with amoxycillin are higher. Br J Surg, 1981 Jul, 68(7), 498 - 500 Aerobic and anaerobic bacteriology of subcutaneous abscesses; Ghoneim AT et al.; Pus from 84 patients with subcutaneous abscesses was examined for aerobic and anaerobic bacteria: organisms were recovered from 70 (83.3 per cent) . In 13 no organisms were seen in the Gram-stained smears and the cultures showed no bacterial growth . Staphylococcus aureus was the most prevalent organism (n = 44), isolated in 43 in pure culture, in marked contrast to the anaerobic organisms which almost invariably were associated with mixed cultures . All patients were treated by the primary suture method . Half of them were not given preoperative antibiotics and 3 developed bacteraemia and 1 septicaemia . Blood isolates were of S . aureus of the same phage type as pus isolates . The other patients received one infection of 300 mg of clindamycin phosphate 30 min to 1 h before surgery . From this group only one patient, with a perianal abscess, developed Escherichia coli bacteraemia . The levels of clindamycin in the abscess aspirate were inhibitory for S . aureus, bacteroides, streptococci and other Gram-positive bacteria but not for E . coli. Antimicrob Agents Chemother, 1981 Jul, 20(1), 128 - 35 pH-dependent penicillin tolerance of group B streptococci; Horne D et al.; Group B streptococci lose viability without apparent lysis during treatment with beta-lactam antibiotics and vancomycin . Rapid loss of viability was observed in early-exponential-phase cultures . Cultures in the mid-exponential growth phase exhibited various degrees of resistance to the bactericidal effect of the antibiotics, whereas their susceptibilities to the growth-inhibitory effect remained unchanged . This growth-phase-dependent tolerance was caused by the gradual increase in acidity of the cultures as the cell concentration increased . Retitration of the pH to neutrality made the formerly tolerant bacteria again fully susceptible to the killing effect of penicillin . Conversely, lowering the pH value of the medium resulted in antibiotic tolerance throughout culture growth . The penicillin-binding proteins of whole bacteria and their labeling pattern were found to be independent of culture pH . It is suggested that the mechanism of Ph-dependent tolerance is indirect and may be mediated by an autolysin . The tolerance of group B streptococci for penicillin could be clinically relevant in view of the relatively low pH values known to prevail in the natural host environments colonized by these bacteria. Zh Mikrobiol Epidemiol Immunobiol, 1981 Jul, (7), 42 - 6 {Detection of an antigen of the L-forms of group A hemolytic streptococci in the sera of rheumatic patients following immune complex separation}; Gorina LG et al.; Tests were carried out to confirm the presence of the antigens of group A hemolytic streptococci in the L-form as a part of immune antigen-antibody complexes in the blood of rheumatic patients . The preliminary dissociation of antigen-antibody complexes with the subsequent gel filtration of the samples resulted in a significant increase in the number of serum samples giving the positive result in the aggregate hemagglutination test . The total number of serum samples yielding the antigen was more than 69.4%, whereas the commonly used aggregate hemolysis test allowed detection of the L-form antigen in 18-24% of serum samples obtained from rheumatic patients, as well as from patients with infectious myocarditis. Placenta, 1981 Jul-Sep, 2(3), 187 - 91 The multiplication of three different isolates of group B streptococci in pregnant mice; Coid CR et al.; The ability of three streptococcal isolates of different pathogenicity to multiply in the tissues of pregnant mice was investigated following intravenous injection . The highly pathogenic isolate multiplied most rapidly whilst the isolate of low pathogenicity showed the least rapid growth within the observation period of 24 hours . The greatest concentration of streptococci per gram of tissue was found in the placentae of mice injected with the highly pathogenic and moderately pathogenic isolates when compared with the concentration of livers and spleen . Fetal infection did not occur within 24 hours of intravenous injection of the isolates but retarded fetal growth and infection was demonstrable five days after the injection . The isolate of moderate pathogenicity infected a greater proportion of the fetuses than the isolates of low pathogenicity . It is suggested that the outcome of streptococcal infections by the ability of isolates to multiply in host tissues. Mol Biol (Mosk), 1981 Jul-Aug, 15(4), 894 - 900 {Comparative characters of the transducing virulent streptococcal phages A25 and CA1}; Totolian AA et al.; The properties of two virulent streptococcal bacteriophages and their DNAs have been studied . Both phage A25 and phage CA1 generated the generalized transduction of chromosomal and plasmid markers among group A streptococci . Phage CA1 differs from the morphologically and serologically related and well-known transducing phage A25 by the efficiency of transduction, the duration of the latent period of reproduction, buoyant density in CsCl and by the lytic spectrum . Phage CA1 also was active against the lysogens resistant to phage A25 . Phage genomes are presented as the linear permutated DNA molecules with molecular mass of 23 megadaltons having terminal repetitions of different size . These data have been obtained as a result of homoduplex analysis of the DNAs . A non-homologous fragment 29% of the molecular length of the phage genomes has been revealed by heteroduplex analysis of phage DNAs . This fragment seems to be responsible for the differences in biological properties of the phages . Phage A25 is heterogenous in buoyant density and molecular length of its DNA. Infect Immun, 1981 Jul, 33(1), 326 - 8 Streptolysin S activation by lipoteichoic acid; Theodore TS et al.; Lipoteichoic acid from streptococci and Staphylococcus aureus both activated membrane-bound precursor streptolysin S and induced the formation of extracellular streptolysin S . Lipoteichoic acid could replace other substances, such as yeast ribonucleic acid core, that act as carriers for hemolysin but which are not components of the streptococcus or the host . Lipoteichoic acid may play a role as the physiological carrier of streptolysin S to host tissues. Infect Immun, 1981 Jul, 33(1), 267 - 74 Role of neutrophil degranulation in streptococcal leukotoxicity; Sullivan GW et al.; Cinemicrography and electron microscopy suggested that leukotoxic Streptococcus pyogenes killed polymorphonuclear neutrophils (PMN) by inducing intracytoplasmic rupture of the PMN granules . To further study the relationship between granule rupture and the mode of action of the streptococcal leukotoxin, PMN degranulation was experimentally altered . Exocytosis of PMN granule contents was blocked with 80 mM tetraethylammonium chloride, 2 mM dibutyryl cyclic adenosine monophosphate, or 2 mM magnesium ethylene glycol-bis(beta-aminoethyl ether)-N,N-tetraacetate in calcium-free medium . This treatment did not prevent the granules from firing into the cytoplasm of the PMN, nor did it significantly diminish leukotoxicity . Degranulating the PMN before exposure to the leukotoxic streptococci did partially block leukotoxicity if both the specific and the primary granules were released with either 5 microM calcium ionophore A23187 or 10% zymosan-activated serum plus 5 micrograms of cytochalasin B per ml . Leukotoxic streptococci stimulated intracytoplasmic rupture of granules, and this granule lysis contributed significantly to the ability of these streptococci to kill PMN. Am J Obstet Gynecol, 1981 Jul 1, 140(5), 515 - 20 A prospective study of group B streptococcal bacteriuria in pregnancy; Wood EG et al.; Bacteriuria in pregnancy was prospectively studied in 569 women, with specific reference to group B streptococcal infection . Forty-six patients (8%) had bacteriuria, including 14 with group B streptococcal infection; group B streptococci (GBS) were exceeded in frequency only by Escherichia coli . Two thirds of the bacteriuric patients remained asymptomatic . The outcome of pregnancy was studied in 41/46 bacteriuric patients, including all those with group B streptococcal infection . Two pregnancies ended in intrauterine fetal death, and one neonate developed group B streptococcal sepsis; all three complications occurred in the 14 women with group B streptococcal bacteriuria . Diabetes mellitus appeared to increase the risk of group B streptococcal bacteriuria . This study revealed that group B streptococcal bacteriuria is more common in pregnancy than was previously suspected and suggests that culture methods to detect GBS should be used in bacteriuria screening programs done in pregnancy . In terms of perinatal infection risk, screening for group B streptococcal bacteriuria at or near the time of delivery may be more meaningful than other group B streptococcal surveillance culture studies. Antimicrob Agents Chemother, 1981 Jul, 20(1), 88 - 97 Clinical evaluation of moxalactam; Livingston WK et al.; We investigated the clinical efficacy of moxalactam for treatment of a variety of infectious disorders in 50 patients (38 males and 12 females) . Patient ages ranged from 8 days to 98 years, with a median of 66 years . Infectious disorders were confirmed by isolation of etiological bacteria in all patients . Thirty-eight patients had gram-negative bacillary disease, nine had pneumococcal infection, and three had disorders caused by staphylococci or streptococci . Twenty-three patients had pneumonia, 17 had bacteremic diseases other than pneumonia, and 10 had miscellaneous infectious diseases . The overall efficacy of moxalactam was excellent . Forty-eight patients were cured by clinical criteria, and 45 were cured by bacteriological criteria . A total of 19 adverse reactions were associated with the use of moxalactam in 18 patients, but none were severe and only one necessitated discontinuation of treatment . Moxalactam promises to be an important addition to our therapeutic armamentarium, especially for therapy of gram-negative bacillary infections. Dtsch Med Wochenschr, 1981 Jun 26, 106(26), 837 - 9 {Listeria monocytogenes meningitis (author's transl)}; Dierich MP et al.; Listeria monocytogenes meningitis was observed in a 24-year-old obese patient . Morphology and serology of CSF bacterial isolates indicated beta-haemolytic streptococci group B first . However, further differentiation permitted certain classification as Listeria monocytogenes serovar 4b . Treatment with erythromycin (2 g/d) and gentamicin (40 mg t.i.d.) led to rapid improvement of clinical symptoms. Am J Obstet Gynecol, 1981 Jun 15, 140(4), 381 - 6 Cyclic variation in the adherence of group B streptococci to human vaginal epithelial cells; Zawaneh SM et al.; Studies conducted on three normally menstruating women demonstrated a distinct cyclic variation in adherence of group B streptococcus type III to vaginal epithelial cells . This cyclic variation consisted of a gradual rise in adherence during the first half of the menstrual cycle, reaching a maximum on day 14, followed by a sharp decline to low levels of adherence that persisted through the second half of the cycle . These changes in adherence correlated directly with the variation in the pyknotic index of the vaginal epithelial cells, suggesting that hormonal factors played a role in adherence of group B streptococci to vaginal epithelium. Am J Obstet Gynecol, 1981 Jun 15, 140(4), 405 - 11 Streptococcal infections in pregnancy . A study of 48 bacteremias; Gibbs RS et al.; During a 4-year period, 48 obstetric patients with aerobic streptococcal bacteremia were identified . The isolates were group B (31); group D, enterococci (5); group A (4); group D, not enterococci (3); Streptococcus pneumoniae (3); and viridans streptococci (2) . The most common diagnoses were endometritis (36) and chorioamnionitis (8) . For all streptococcal genital infections, the clinical presentation included early-onset fever, often with few localizing signs . Only one patient had a chronic debilitating disease . There was an excellent correlation between genital and bloodstream isolates (36 of 42) . Maternal response to therapy was good, with no deaths nor episodes of septic shock . Possible infectious complications developed in two fetuses and four neonates . The microbiologic and clinical features of aerobic streptococci were reviewed, and the outcome in obstetric patients and that in other adults were compared. Schweiz Med Wochenschr, 1981 Jun 13, 111(24), 892 - 7 {Simple and reliable detection of beta-hemolytic streptococci in throat swabs with the streptococcus-isocult}; Schaad UB et al.; Culture of throats specimens is essential in the diagnosis of streptococcal tonsillo-pharyngitis . Selective sheep's blood agar media for beta-hemolytic streptococci have been developed to simplify throat streptococcal bacteriology . In this prospective study the reliability and practical performance of a selective medium of this kind, the Isocult culture test for throat streptococci, were evaluated in 226 pediatric patients with the clinical diagnosis of acute tonsillo-pharyngitis . At the time of diagnosis two throat specimens were obtained from each patient; one swab was cultured for group A beta-hemolytic streptococci on standard laboratory media, and the other on the Isocult media . Procedure and interpretation of the two culture methods were carried out independently . In 209 (92.5%) of the 226 patients the two culture results were in agreement, i.e . either positive (19 patients) or negative (190 patients) for group A beta-hemolytic streptococci . In comparison to routine bacteriology the Isocult results showed sensitivity, specificity, and predictive value of 86%, 93% and 91% . Neither the performance nor the interpretation of the Isocult method require special bacteriological training or equipment . It is concluded that the Isocult culture test for throat streptococci is a simple and reliable diagnostic tool in the management of patients with sore throat. Acta Pathol Microbiol Scand {B}, 1981 Jun, 89(3), 161 - 5 Infection with RS streptococci in pigs; Pedersen KB et al.; RS streptococci were isolated from pigs that died in an outbreak of septicemia and meningitis in a Danish herd of swine . Most of the affected pigs were 7-9 weeks old . Experimental inoculation of SPF pigs with a culture of the streptococci isolated from the brain of a pig that had died during the outbreak showed that the bacterium was pathogenic for pigs . Out of 35 8-15-week-old pigs inoculated, nine developed arthritis and one died in septicemia . At necropsy, four of the pigs were found to have endocarditis . Blood cultures from pigs with endocarditis were constantly positive throughout the experiment, i.e., until the pigs died 5-7 weeks after inoculation . In vivo loss of capsular antigen was observed . A human strain of R streptococci isolated from a case of septicemia was also shown to be pathogenic for pigs. Onderstepoort J Vet Res, 1981 Jun, 48(2), 69 - 75 Levels of glucose, serum albumin and somatic cells before and during early stages of acute clinical mastitis artificially induced in cows by means of human strains of group-B streptococci (GBS) administered intracisternally; Giesecke WH et al.; The investigation was performed on 3 cows, sampled repeatedly before and during the initial 48 h of artificially induced, acute, clinical mastitis . The results of the investigation both augment and support those of earlier work on the levels and significant correlations of glucose, serum albumin and somatic cells in normal and abnormal secretions monitored before and after the usual milking of healthy lactating cows had been suspended . During acute mastitis, udder secretions from artificially infected quarters showed highly significant escalations of somatic cell counts which coincided with equally significant increases of a high and intermediate level of serum albumin values in both the infected and non-infected quarters . Corresponding glucose values fluctuated from 0,07-0, 22 and 0,18-0, 32 mM in the former and latter quarters respectively . The selective and elevated transfer of serum albumin in otherwise unaffected quarters of acutely mastitic udders suggests rather specific collateral vascular and epithelial changes of unknown nature and magnitude . The data indicate that marked fluctuations of glucose may occur within and between quarters of individual and different cows respectively . Such variations could significantly affect phagocytosis and killing of bacteria challenging the intramammary leucocytic udder barrier before and particularly during manifestation of mastitis . Hence, udder health, although dependent on specific natural defence mechanisms such as the leucocytes and related systems in milk, may depend even more significantly on the supplies of glucose to and within the bovine mammary gland. Zh Mikrobiol Epidemiol Immunobiol, 1981 Jun, (6), 74 - 6 {Erythrocyte and lymphocyte interaction with streptococcal L-forms}; Eshmantaite NA et al.; The adsorption of human, sheep and human red blood cells and human lymphocytes on the colonies of streptococci in the L-form has been studied . Th electron-microscopic study of the interaction between human lymphocytes and streptococcal L-forms is suspensions has also been carried out . The red blood cells of all species under study, as well as human lymphocytes, have been found capable of being adsorbed on the colonies of streptococci in the L-form, this adsorption occurring only on the periphery of the colony . The study of electron-microscopic preparations has revealed that streptococcal L-forms adhere to the surface (on 1 or 2 sites) and to the processes of human lymphocytes. Antimicrob Agents Chemother, 1981 Jun, 19(6), 1075 - 7 Importance of bacterial growth phase in determining minimal bactericidal concentrations of penicillin and methicillin; Kim KS et al.; The minimal inhibitory concentrations of penicillin against 96 strains of group B streptococci and of methicillin against 10 strains of Staphylococcus aureus were unrelated to the growth phase of test bacteria . However, the minimal bactericidal concentrations were significantly higher in the stationary phase than the logarithmic phase for both organisms (P less than 0.001 and less than 0.05, respectively). Z Ernahrungswiss, 1981 Jun, 20(2), 96 - 106 {Sweetening agent, Palatinit under specific consideration as to microbiological and caries-prophylactic aspects}; Gehring F et al.; Several cariogenic bacterial species, a mixed streptococci flora composed of nine species, as well as the plaque- and saliva-mixed flora from human beings were tested for acid production from the sugar substitute palatinit, which was compared to sorbitol, mannitol, xylitol and the low molecular carbohydrates sucrose, glucose and fructose . Complementary experiments with gnotobiotic and conventionally fed rats were performed in order to test the cariogenic properties of palatinit and palatinit-chocolate in comparison to xylitol, sorbitol and sucrose and the corresponding chocolate substances . Palatinit and palatinit-chocolate show highly significant lower cariogenic properties than sucrose and sucrose-chocolate . On the basis of these microbiological and animal experiments, the use of palatinit as sugar substitute for caries prophylaxis can be recommended. J Clin Microbiol, 1981 Jun, 13(6), 1017 - 22 Follow-up study of pharyngeal carriers of beta-hemolytic streptococci among school children in Sapporo City during a period of 2 years and 5 months; Maekawa S et al.; A total of 124 normal school children in three classes (aged 8 to 9) were examined for beta-hemolytic streptococci for 29 months from August 1977 to December 1979 be means of serial monthly throat cultures . No significant difference between the carrier rate of boys and that of girls was observed . Although no monthly variation of carrier rates appeared in class II, marked temporal increases of carrier rates appeared from June 1978 (in Class I) and from August 1978 (in class III) in August 1979 . These periodical variations of carrier rates observed in this investigation do not coincide with the low-in summer and high-in winter seasonal variations which has generally been observed by many other investigators . The average values of carrier rates throughout the period of this investigation were 30.9, 29.7, and 24.5% in classes I, II, and III, respectively . The carrier rate of group A streptococci by month and by class showed some positive correlation with the carrier rate of total beta-hemolytic streptococci . T-type 4 and T-untypable strains were not identified up to a certain period; then each strain appeared at a given time during the course of our investigation in one class, spread to all three classes, and continued to be isolated until the end of this investigation . The origin of these type of strains could not be identified in this study . Of the children, 36 (29.0%) never became streptococcal carriers during the period of examination and 88 (71.0%) became streptococcal carriers at least one time during the 29 examinations; among these positive carriers, 29 children (23.0%) showed positive results in more than 50% of the examinations. Clin Nephrol, 1981 Jun, 15(6), 279 - 85 Depression of endostreptosin, streptolysin O and streptozyme antibodies in patients with idiopathic nephrosis with and without a nephrotic syndrome; Lange K et al.; We determined antibody titers to Endostreptosin (ESS), a recently described protein antigen in the cytoplasm and the plasma membrane of Group A streptococci in 286 normals of different age groups and in 34 children and 19 adults who had or had had at one time a nephrotic syndrome due to idiopathic nephrosis . Antistreptolysin O titers were also determined in 33 of the idiopathic nephrotics . Similarly, antibody titers to Streptozyme were determined in 21 patients with idiopathic nephrosis and 61 normals with a similar age distribution . Severe depression of these antibody titers was found in almost all patients with this disease not only during the presence of a nephrotic syndrome but for long periods up to 20 years following an episode of a nephrotic syndrome when the patients were in complete remission . Patients with a nephrotic syndrome due to chronic glomerulonephritis (5), S.L.E . (4), membranous nephropathy (5), diabetes mellitus (1) or amyloidosis (1) did not show abnormally low values for antibodies to Endostreptosin, Streptolysin O or Streptozyme . High-dose steroid medication as such for prolonged periods of time does not depress Endostreptosin or Streptolysin O antibody titers below the expected mean, as demonstrated in 15 patients with S.L.E. Tijdschr Diergeneeskd, 1981 Jun 1, 106(11), 560 - 6 {Organizing mastitis control (author's transl)}; Jaartsveld FH; In view of the considerable losses caused by clinical, though particularly subclinical, mastitis, organized mastitis control is justified . Cell counts of herd milk samples are the most effective method so far available in detecting herds in which mastitis is a problem . Cell counts are primarily made to determine the quality of the milk delivered; secondly, cell counts are used in mastitis control . Using the same cell count in determining the quality and in detecting herds affected with mastitis is a difficult matter . Herds in which mastitis is a problem, are systematically detected in a limited number of provinces in the Netherlands . In mastitis control on a farm, particular attention is paid to: (1) hygiene on the farm (2) the house climate (3) special arrangements for maintenance of the milking plant (4) the procedure adopted in milking (5) teat dipping (6) dry cow therapy (7) culling chronically infected cattle . Because of mastitis in the cows, there may be an increase in bacterial counts due to streptococci causing mastitis in addition to cell counts in herd samples . These streptococci are perceptible in the form of small punctate colonies, so-called pin-points, in bacterial counts . Bacteria other than streptococci causing mastitis may also produce these pin-points . In recent years, the cell counts of herd milk samples showed a marked decrease in the southern Netherlands . This decrease was due in part to the large number of improvements in the milking apparatus . Moreover, intensive education by lectures, excursions and counselling of factories has also stimulated this favourable development . However, these effects are hard to measure . The continued reduction of the cell count in herd samples imparts confidence in the results of this mastitis control. J Bacteriol, 1981 Jun, 146(3), 1075 - 82 Nutritionally variant streptococci from patients with endocarditis: growth parameters in a semisynthetic medium and demonstration of a chromophore; Bouvet A et al.; Nutritionally variant streptococci have been characterized in the past by their growth as satellite colonies and by their nutrient requirements of cysteine or vitamin B6 for growth in complex media . To further understand the growth characteristics of these strains, we studied fresh isolates from patients with endocarditis by using chemically defined medium enriched with 2% Todd-Hewitt dialysate . Under anaerobic conditions, growth yields of the strains in this medium were comparable to those obtained from a complex medium supplemented with vitamin B6, whereas under aerobic conditions, most of the strains had higher growth yields in the semisynthetic medium . Furthermore, the requirement for cysteine and vitamin B6 in the semisynthetic medium was no greater than that of other Streptococcus species . Electron microscopic studies demonstrated normal cell wall structures in organisms grown in the semisynthetic medium as compared with abnormal and irregular cell wall thickening in organisms grown in supplemented complex medium . Finally, these strains appeared to contain a common component when grown in the semisynthetic medium as demonstrated by the appearance of a chromophore after boiling the bacteria at pH 2 . Therefore, the demonstration of a medium which permits adequate growth with a normal ultrastructure of nutritionally variant streptococci will permit the further study of this group of important streptococci. Am J Vet Res, 1981 Jun, 42(6), 949 - 55 Bacteriologic study of sow agalactia; Ross RF et al.; Necropsy of 13 agalactic and 11 normally lactating sows at 1 to 2 days after parturition revealed that 7 of the agalactic and 4 of the clinically normal sows had lesions of mastitis . Escherichia coli, Streptococcus equisimilis, and Staphylococcus epidermidis were the predominant organisms isolated . The organisms were isolated as pure and as mixed cultures and all 3 were isolated from normal appearing, as well as mastitic, glands . Pure culture isolation of E . coli (44 gland segments) was significantly associated with microscopic lesions of mastitis, regardless of the number of colonies isolated, whereas pure culture isolation of Streptococcus equisimilis or S epidermidis in low to moderate numbers was not . Isolation of large numbers of beta-hemolytic streptococci (2 gland segments) or of S epidermidis (6 gland segments) was associated with microscopic evidence of mastitis . Cultural examination of uterus and cervix revealed 5 isolates of strict anaerobic bacteria, all different species, from 4 of the 24 sows . Culture of 2 mammary glands from each sow revealed no strict anaerobes . Phase-contrast microscopic examination of specimens from mammary glands, uterus, and cervix of each sow revealed no spirochetes . Attempts to isolate mycoplasmas and chlamydiae from mammary gland, uterine tube (fallopian tube), uterus, cervix, and urethra of the 24 sows were negative . The evidence confirms previous reports that coliforms are the most significant bacteria in mastitis of the sow. J Infect Dis, 1981 Jun, 143(6), 761 - 6 Genital and intestinal carriage of group B streptococci during pregnancy; Anthony BF et al.; To evaluate the relative importance of genital and gastrointestinal carriage of group B streptococci, repeated semiquantitative and qualitative cultures were obtained from 64 patients during pregnancy . Carriage was documented in 20% of the women at the first visit, in 41% of the women cumulatively, and at 24% of 295 visits . Group B streptococci were isolated from 20% of genital, 17% of rectal, and 17% of stool cultures . Concordance of carriage among these body sites was high (87%-93%) for cultures collected simultaneously . Counts of streptococci ranged between 10(2) and 10(7) colony-forming units per gram of dry stool (geometric mean, 2.3 x 10(5)) and varied widely among repeated samples from chronic carriers . The group B streptococci tended to appear, persist, and disappear simultaneously in genital, rectal, and stool cultures of individuals, although some women appeared to harbor the organism in the birth canal or lower bowel alone. J Hyg (Lond), 1981 Jun, 86(3), 265 - 73 Streptococcal antibodies in patients with burn injuries; Widdowson JP et al.; Serum samples from 14 patients whose burns had become infected with streptococci of groups A (11 patients), C (one patient) or G (two patients), and from 19 burned patients without bacteriological evidence of streptococcal infection were examined for anti-streptococcal antibodies . Tests were made for anti-streptolysin O (ASO), anti-hyaluronidase (AH), anti-deoxyribonuclease B (anti-DNAase B) and antibody against M-associated protein (MAP) . Sera from the patients with streptococcal infections were also examined, when this was practicable, for 'bactericidal' (anti-M) antibody and for antibody against the opacity factor (OF) of the infecting serotype . In patients infected with group A streptococci, the ASO response was generally poor, except in patients infected with strains of type T12/M12, and the AH response was rather similar, but most of the patients gave a rapid and vigorous anti-DNAase B response, except when the burn was small or colonization occurred very late . Antibody to the M and MAP antigens, and to OF (when the infecting strain formed this), was weak and transient, or absent, except in three of four patients infected with streptococci of type T12/M12. Biull Eksp Biol Med, 1981 Jun, 91(6), 704 - 6 {Cross-reacting antigens of human thymus myoid cells and stable L-forms of group A streptococci}; Beletskaia LV et al.; Indirect immunofluorescence has shown a similarity between the antigen components of group A streptococcus L-forms and human thymus myoid cells . An analogous antigen (or antigens) is present in the cytoplasmic membrane of human myocardial cell fibers . The depletion of antiserum to the streptococcal L-forms both by the culture of L-forms grown in meat or casein media and by the homogenate of the cardiac muscle leads to the inhibition of immunofluorescence . The depletion of serum by the homogenate of other tissues (liver) or by L-form culture does not virtually affect the immunofluorescence intensity . According to the authors' opinion, the similarity of antigens of group A streptococcus L-forms to the antigenic components of organ tissues is likely to be responsible for long-term persistence of the microorganisms under consideration and to favour, in some cases, the occurrence of autoantibodies . The latter circumstance might lead to pathological changes in organs containing cross-reacting antigens. S Afr Med J, 1981 May 23, 59(22), 783 - 4 {Beta-hemolytic streptococci as a cause of sore throat in the Pretoria area}; van Zyl ML et al.; A study was performed in Pretoria on 232 unselected patients who presented with the complaint of sore throat . A throat swab was positive for Lancefield group A beta-haemolytic streptococci in 33,2% of these patients . The incidence was significantly higher in Black patients (45,5%) than in White patients (23,2%) and 12,1% of healthy controls showed a positive culture . No seasonal variation was detected . Throat swabs kept overnight at room temperature were falsely negative for beta-haemolytic streptococci in 43,2% of cases . A correlation was found with certain clinical signs. Infect Immun, 1981 May, 32(2), 583 - 91 Adherence of Streptococcus mutans and Streptococcus sanguis to salivary components bound to glass; Stinson MW et al.; Adherence of radiolabeled Streptococcus mutans and Streptococcus sanguis to saliva-treated glass surfaces was studied under conditions which minimized bacteria-glass interactions . Treatment of glass with an alkylsilane solution decreased nonspecific bacterial adherence and enhanced adsorption of radiolabeled salivary components to these surfaces . Addition of Triton X-100 to the bacterial suspensions also reduced nonspecific adherence to siliconized glass, but did not affect adherence to salivary components attached to siliconized glass . Calcium stimulated S . mutans adherence to saliva-free glass, but inhibited adherence to saliva-treated glass . S . sanguis adherence to either saliva-free or saliva-treated glass was inhibited slightly at high calcium ion concentrations . Adherence of streptococci to saliva-treated glass exhibited saturation kinetics, and the numbers of binding sites on the experimental salivary pellicle and the affinity constants for bacteria-saliva attachment were determined . Preincubation of the streptococci with whole saliva decreased their capacity to adhere to saliva-treated glass, but not to saliva-free glass . Bacteria adherent to saliva-treated glass surfaces were readily desorbed by washing with saliva . The addition of homologous antisera, ammonium sulfate-precipitated immunoglobulins, or Fab fragments to the bacterial suspensions inhibited cell adherence to saliva-treated glass. Arch Environ Health, 1981 May-Jun, 36(3), 130 - 5 Effect of ferrous sulfate aerosols and nitrogen dioxide on murine pulmonary defense; Sherwood RL et al.; A murine infectivity model was used to test the effect of exposure to atmospheres containing 290 +/- 50 microgram/m3 of respirable sized ferrous sulfate (FeSO4) particles (0.4 micron mass median aerodynamic diameter) and 1.0 ppm nitrogen dioxide (NO2) prior to infection with aerosols of Staphylococcus aureus or group C streptococci . Exposure to these combined pollutants for 24 or 48 hr did not impair pulmonary inactivation of S . aureus . Exposure to FeSO4 or NO2 for 48 hr, or to both pollutants for 24 or 48 hr, resulted in significant decreases in inactivation of inhaled group C streptococci . Mortality studies following pollutant exposure demonstrated earlier, but not an increased number of deaths . These studies demonstrate the importance of the test organism in assessing air quality standards with the infectivity model and enhanced toxicity and prolongation of exposure to relatively low levels of submicron-size particles of FeSO4 and NO2. Medicine (Baltimore), 1981 May, 60(3), 197 - 207 Infections due to Lancefield group F and related Streptococci (S . milleri, S . anginosus); Shlaes DM et al.; We can no longer accept classification of streptococci solely on the basis of hemolytic reactions or Lancefield agglutinations . While the "viridans" streptococci cannot be serologically differentiated, physiological separation of the species offers a satisfactory method of classifying human isolates . We review the microbiology of Lancefield group F and related streptococci (S . milleri, S . anginosus), emphasizing microbial ecology and current taxonomic considerations . A series of 28 patients infected with these organisms is presented . There was a striking male predominance in the series (6:1) as well as an obvious association with underlying diseases and/or antecedent trauma . The most remarkable feature of these pathogens is their predilection for abscess formation, confirming their overdue recognition as the most common "viridans" streptococcus recovered from abscesses within internal organs . We observed purulent disease of the nervous and skeletal systems, oral cavity, lung and pleural space, abdomen and subcutaneous tissues . Microbial synergy (i.e . polymicrobic infection) was not a requisite for abscess formation . Four of the five deaths in this series occurred in patients 60 years of age of older . Some degree of variability in antimicrobial susceptibility was noted, so speciation alone may not always provide sufficient information on which to base a therapeutic decision. Antimicrob Agents Chemother, 1981 May, 19(5), 872 - 80 Physiological properties of penicillin-binding proteins in group A streptococci; Gutmann L et al.; We detected five major penicillin-binding proteins (PBPs) in group A streptococci by labeling either cell membrane preparations or live bacteria with tritiated penicillin . All PBPs appeared to be equally accessible to penicillin in vitro and in vivo . Individual PBPs differed in their rates of deacylation, and four of the five PBPs underwent rapid inactivation both in vivo and in vitro . At least two processes seemed to contribute to in vivo inactivation; these were (i) a penicillin-induced release of all five PBPs into the growth medium and (ii) degradation, as evidenced by the appearance of penicillin-labeled protein band of lower molecular weight and also by a gradual increase in material migrating with the same electrophoretic mobility as PBP 3 . Inactivation of the PBPs was stimulated greatly by pretreatment of bacteria with gentamicin, cerulenin, or Triton X-100, whereas chloramphenicol, tetracycline, and lincomycin treatments had no such effect. Antimicrob Agents Chemother, 1981 May, 19(5), 745 - 53 Hypersusceptibility of penicillin-treated group B streptococci to bactericidal activity of human polymorphonuclear leukocytes; Horne D et al.; Pretreatment of serotype Ib group B streptococci with benzylpenicillin, other beta-lactam antibiotics, or vancomycin increased the susceptibility of these bacteria to the bactericidal activity of a mixture of human polymorphonuclear leukocytes and normal human serum . Increased susceptibility of the bacteria to killing by phagocytes was elicited even by exposure to subinhibitory levels of the beta-lactam antibiotics . Inhibitors of protein synthesis did not induce such susceptibility . We investigated the possible biochemical basis of penicillin-induced susceptibility to phagocytosis . Penicillin treatment induced the release of substantial quantities of group B streptococcal surface components into the growth medium (lipoteichoic acid, lipid, and capsular polysaccharide) . Labeling of the live streptococci with 3H-labeled penicillin was used to evaluate the effect of exposure to subinhibitory concentrations of this antibiotic on the penicillin-binding proteins . Our results suggested that beta-lactam antibiotics and components of the immune system may act in concert to eliminate invading bacteria. Antimicrob Agents Chemother, 1981 May, 19(5), 716 - 25 Synergism, killing kinetics, and antimicrobial susceptibility of group A and B streptococci; Baker CN et al.; The susceptibility of 110 group A and 179 group B streptococci to 25 antimicrobics was tested by broth microdilution and agar disk diffusion tests . Representative strains were used in killing kinetics, penicillin-gentamicin synergy, and minimal bactericidal concentration tests . Group A streptococci were more susceptible than group B streptococci to 17 of the 25 antimicrobics tested . Group A and B streptococci were killed at the same rate if the amount of penicillin used was equivalent to their respective penicillin minimal inhibitory concentrations . Synergism was demonstrated for both group A and B streptococci when penicillin was used at concentrations equal to each respective minimal inhibitory concentration and subinhibitory concentration of gentamicin . This synergy could be demonstrated best using minimal bactericidal concentrations obtained by culturing 3- and 6-h cultures from the microdilution checkerboard tests rather than from 24-h subcultures . A greater synergistic effect was achieved by adding penicillin first and then adding gentamicin rather than in the reverse order, or simultaneously. J Clin Pathol, 1981 May, 34(5), 556 - 8 Comparison of five selective media for beta-haemolytic streptococci; Milatovic D; Five selective media for beta-haemolytic streptococci were tested and compared with the conventional blood agar plate using 200 throat swabs from children with possible streptococcal pharyngitis . The medium described by Liebermeister and Braveny, which is based on the reduction of nutrients and enhancement of the haemolytic activity of beta-streptococci, was markedly superior to the other selective media containing inhibiting agents. Infect Immun, 1981 May, 32(2), 625 - 31 Characterization of lipoteichoic acid binding to polymorphonuclear leukocytes of human blood; Courtney H et al.; Human polymorphonuclear leukocytes (PMN) were shown to possess specific binding sites for lipoteichoic acid (LTA) . LTA binding was reversible and time and temperature dependent . Scatchard plot analysis revealed an apparently single population of 6.6 X 10(6) LTA binding sites per PMN with a dissociation constant of 5.6 microM . Attachment of an avirulent, unencapsulated, M-negative strain of group A streptococci to PMN was inhibited by LTA, but not by other bacterial somatic antigens tested . Occupation of 30% of the LTA binding sites resulted in greater than 70% inhibition of streptococcal attachment to PMN . In contrast, LTA failed to block attachment of Escherichia coli or antibody-coated streptococci, indicating that binding sites for E . coli and the Fc portion of immunoglobulin G are distinct from those for LTA . Immunofluorescent studies demonstrated that LTA remained uniformly bound to PMN membranes for as long as 2 h at 37 degrees C . Cross-linking of PMN-bound LTA with anti-LTA resulted in rapid capping of LTA receptor sites . The results suggest that LTA is a monovalent ligand interacting with mobile receptors in the plasma membrane of PMN. J Clin Microbiol, 1981 May, 13(5), 891 - 4 Evaluation of techniques for isolation of group A streptococci from throat cultures; Kurzynski TA et al.; In the first study, selective sulfamethoxazole-trimethoprim blood agar (SXT-BA) and conventional blood agar (BA) plates incubated under CO2 and anaerobically were compared for their ability to recover group A streptococci from throat cultures . Recovery rates were: SXT-BA (anaerobic), 100%; SXT-BA (CO2), 98%; BA (anaerobic), 89.2%; and BA (CO2), 76.5% . Primary plate bacitracin test results could be read on significantly more of the SXT-BA plates . Readability rates were: SXT-BA (anaerobic), 97%; SXT-BA (CO2), 96%; BA (anaerobic), 70.6%; and BA (CO2), 32.4% . A second study compared with the SXT-BA method versus a BA-double-disk (BA-DD) method which utilizes conventional media with addition of a bacitracin differentiation and a sulfamethoxazole-trimethoprim susceptibility disk placed adjacent to one another in the heavy area of inoculation . Isolation rates were: SXT-BA, 100% and BA-DD, 88% . Readability rates for direct bacitracin tests were: SXT-BA, 92% and BA-DD, 76.2% . In our hands, the SXT-BA method was superior for yielding highest isolation rates and for yielding highest readability rates of direct bacitracin test results. Antimicrob Agents Chemother, 1981 May, 19(5), 794 - 7 Activity of moxalactam and cefotaxime alone and in combination with ampicillin or penicillin against group B streptococci; Landesman SH et al.; The activities of moxalactam and cefotaxime, alone and combined with ampicillin or penicillin, against 40 isolates of group B streptococci were assessed by using the microtiter broth dilution, checkerboard, and time-kill techniques . Penicillin and cefotaxime were bactericidal for all isolates at concentrations of 0.06 micrograms/ml or less . Ampicillin was slightly less active . Moxalactam was bactericidal for all strains at concentrations of 4 to 8 micrograms/ml . The ampicillin- moxalactam combination was partially synergistic for 60% of the isolates tested; the ampicillin-cefotaxime combination was partially synergistic for 35% of these isolates . No instances of antagonism were observed . In time-kill evaluations, ampicillin (3.0 micrograms/ml) and penicillin (0.75 micrograms/ml) effected 2.5 to 3.5 log10 reductions in numbers of colony-forming units . The addition of 4 micrograms of cefotaxime per ml or 8 to 16 micrograms of moxalactam per ml to penicillin or ampicillin did not alter killing kinetics . Moxalactam and cefotaxime neither enhanced nor decreased the activity of ampicillin or penicillin against group B streptococci. Arkh Anat Gistol Embriol, 1981 May, 80(5), 98 - 103 {Changes in the blood-testis barrier as a result of streptococcal sensitization}; Ogurtsov RP et al.; Permeability of the histo-hematic barrier in the guinea pig and mouse testes immunized with streptococci has been studied radiometrically and luminescent microscopically with application of labelled bovine serum albumin, human gamma-globulin and blue dye preparations . The permeability of the hemato-testicular barrier increases on the 7th--30th day after immunization . Test-preparations penetrate from the vessels of the intercanalicular connective tissue layers through the membrane of the convoluted tubules . The testicular autoantigen is revealed in blood . The disturbance in permeability of the hemato-testicular barrier precedes or coincides in time with the developing destruction of the testicular spermatogenic elements. JAMA, 1981 Apr 17, 245(15), 1545 - 7 Simultaneous Streptococcus and picornavirus infection . Muscle involvement in acute rhabdomyolysis; Porter CB et al.; Streptococci seldom invade muscle in healthy people with intact integument . However, infection with another agent simultaneously may change this general observation . In a two-week period we encountered dual infections with group A, beta-hemolytic streptococci and a picornavirus in each of two hospitalized patients . Both were acutely ill; one died . Renal failure developed in the patient who survived and rhabdomyolysis was demonstrated in the patient who died . Picornavirus titer increases were demonstrated in the patient who survived, and viral inclusions in muscle cells were demonstrated by light microscopy in necropsy specimens and confirmed by electron microscopy in the second patient . We believe that streptococcal invasion of muscle may be facilitated during an outbreak of certain picornavirus infections. Z Hautkr, 1981 Apr 1, 56(7), 452 - 8 {Necrotizing fasciitis--a frequently mistaken disease (author's transl)}; Richter S et al.; A case of Fasciitis necroticans on the leg is reported in a female patient, age 28 . The disease began with symptoms of an erysipelas, but it was resistant to penicillin . Within a few days necrotic decay of circumscribed skin areas occurred and the adjacent skin was widely undermined by the necrotizing process . Beta-hemolytic streptococci and Staphylococcus aureus haemolyticus were isolated . However, the disease could not be managed by adequate antibiotic therapy . Finally, the process was brought under control by extended incisions and removal of the necrotic masses . Defects were covered by plastic surgery. Am J Clin Pathol, 1981 Apr, 75(4), 634 - 6 Media-dependent subculture of nutritionally variant streptococci; Peterson CE et al.; A case of infective endocarditis due to a strain of Streptococcus that demonstrated unusual nutritional requirements is reported . This strain was recognized as a nutritional variant because it could not be subcultured on certain routine primary plating and subculture media . The media-dependent recovery of this nutritionally variant Streptococcus is stressed, since media used routinely in some laboratories would result in this organism's being missed . Variability of routine media in supporting the growth of this isolate is also demonstrated. South Med J, 1981 Apr, 74(4), 511 - 2 Facial abscess due to group L streptococcal infection; Smalley DL et al.; A Lancefield group L streptococcal infection was found in a previously healthy male adult during a survey of beta-hemolytic streptococci . The infection was apparently acquired subsequent to a mild injury to the face and contact with soil . Treatment with cephalothin and cephalexin was successful after surgical drainage of the wound abscess. J Trauma, 1981 Apr, 21(4), 313 - 8 Aerobic and anaerobic bacterial flora of burns in children; Brook I et al.; Aerobic and anaerobic bacterial flora of burn sites in 180 children were monitored . Specimens were obtained twice a week; each patient had between one and 21 cultures taken (mean 2.4) . A total of 392 specimens were collected over 2 years, of which 319 were positive . Aerobic bacteria alone were present in 225 specimens (71%) and anaerobic bacteria alone were present in 26 (8%) . Mixed aerobic and anaerobic bacteria were present in 68 burn specimens (21%) . A total of 580 isolates (448 aerobes and 132 anaerobes) were recovered, accounting for 1.8 isolates per specimen (1.4 aerobes and 0.4 anaerobes) . The predominant aerobic isolates were S . epidermidis, S . aureus, alpha hemolytic streptococcus, Pseudomonas sp., and Group D streptococcus . The predominant anaerobic isolates were: P . acnes, anaerobic Gram-positive cocci, and Bacteroides sp . Blood cultures were drawn from 45 children: four showed bacterial growth of one of each of the following isolates: S . aureus, E . coli, Peptococcus asaccharolyticus, and B . fragilis . The numbers of isolates per specimen were higher in the oral and anal area (3.2 and 2.8) than in the extremities and trunk (1.8 and 0.9) . Gram-negative enteric rods and Group D streptococci were more frequently recovered from the anal area . S . aureus, S . epidermidis, and P . acnes were more frequently recovered from extremities . Bacteroides sp . and Fusobacterium nucleatum were more frequently recovered from the anal and oral areas . All children were treated with local application of silver sulfadiazine, and antimicrobial therapy was used in 128 children . Statistical analysis showed no correlation between the bacteria isolated and use of antimicrobial agents . These data suggest a role for anaerobic bacteria in the colonization of burns in children, especially in burns of the anal and oral areas. Infect Immun, 1981 Apr, 32(1), 80 - 5 Colonization and cariogenicity of Streptococcus ferus in rats; Coykendall AL et al.; Streptococcus ferus, which is indigenous to wild rats, is a member of the mutans group of streptococci . We tested its ability to colonize and to cause caries in laboratory rats by comparing two strains of S . ferus with the very cariogenic Streptococcus sobrinus strain 6715 . Groups of rats were fed either finely ground mouse chow or a 56% sucrose diet, or they were switched from chow to the sucrose diet . All three strains colonized the mouths of rats regardless of diet . However, the infectants reached higher proportions of the total flora more quickly in the rats consuming sucrose . Similarly, the percentage of the oral flora represented by an infecting organism increased numerically when rats originally fed chow were switched to the sucrose diet . S . ferus formed plaques on the teeth of the rats, but these plaques did not proliferate over smooth tooth surfaces as extensively as did those of S . sobrinus . Although S . ferus colonized and accumulated, it was non-cariogenic in rats fed sucrose compared both with rats fed similarly but infected with S . sobrinus 6715 and with uninfected controls . In vitro measurements suggested the S . ferus produced acid less rapidly than S . sobrinus . Thus, the lack of cariogenicity in S . ferus may result from an inability to form copious plaques on smooth tooth surfaces and from low acid production and, therefore, may represent a natural absence of the pathogenic potential usually inherent in the mutans streptococci. Jpn J Pharmacol, 1981 Apr, 31(2), 201 - 9 Effect of streptococcal lipids on Ehrlich ascite tumor cells; Kigoshi S et al.; The lipids extracted from group A hemolytic streptococci (strain Su, Blackmore and C203U) were examined for their antitumor effect against Ehrlich ascites carcinoma in mice . Total lipids were extracted from streptococcal cells according to the method of Folch et al, and separated into 9 lipid fractions by thin-layer chromatography, using various solvent systems . Three fractions were compound lipids (diphosphatidyl glycerols, monoglucosyl diglycerides and diglucosyl diglycerides), and the remaining 6 fractions were neutral lipids such as free fatty acids, glycerides, sterols and sterol esters . For biological testing, the lipid fractions suspended in physiological saline containing Tween 20 (0.02%) were incubated with Ehrlich tumor cells at 37 degrees C for 90 min, and the cell mixture was given intraperitoneally into mice thereafter . Among 9 lipid fractions, free fatty acids and monoglycerides from the streptococci examined were highly active in suppressing the depressing the development of ascites carcinoma in mice . Diphosphatidyl glycerols from two strains of streptococci (BLackmore and C203U) were also effective in suppressing the tumor growth in mice . However, the other lipid fractions had little effect on the tumor growth. Acta Pathol Microbiol Scand {B}, 1981 Apr, 89(2), 87 - 91 Binding of aggregated IgG in the presence of fresh serum: strong association with type 12 group A streptococci; Christensen P et al.; Highly selected group A streptococci, 108 strains isolated from different groups of individuals, were tested for binding of aggregated human IgG which had been pre-incubated in fresh human serum . All strains displayed resistance to phagocytosis typical of M-producing strains . Among 73 strains isolated from sporadic cases of acute glomerulo-nephritis (AGN), 34 (47 per cent) bound the aggregates . All of 26 type 12 group A streptococci but none of 15 type 49 strains proved positive in the test system . Furthermore, one type 1 and one type 18 strain were positive . All 9 type 49 strains isolated in a minor epidemic of AGN proved negative . Twenty-six strains of type 12 group A streptococci were isolated during three different prospective studies in which no cases of AGN had occurred; all these strains bound aggregates in the presence of fresh serum . Thus, it was found that the capacity to bind aggregates in the presence of fresh serum was strongly associated with--though not limited to--group A streptococci carrying the type 12 antigen . However, this characteristic is not common to all nephritogenic strains, since all type 49 group A streptococci were negative in the test system. Acta Pathol Microbiol Scand {B}, 1981 Apr, 89(2), 49 - 55 Binding of fibrinogen degradation products to S . aureus and to beta-hemolytic streptococci group A, C and G; Runehagen A et al.; Binding of fibrinogen degradation products was measured to Gram-positive cocci known to carry receptors for human fibrinogen . Forty-one strains of S . aureus and group A, C and G streptococci were studied . The largest plasmin produced fragment (X-fragment, HMWDP) showed higher binding levels to the bacterial receptors in all four species as compared to intact fibrinogens . The enzymatically produced C-terminal fragment D was strongly reactive, whereas the N-terminal fragment E was non-reactive . Inhibition experiments showed that reactive fragments were bound to the same receptors as fibrinogen . Three chemically-produced and well-characterized fragments from the terminal and the middle portions of the fibrinogen molecule were all negative in binding assays . The binding patterns for fibrinogen and the fragments tested were identical in the four bacterial species tested, S . aureus and group A, C and G streptococci . The results confirm and extend earlier data on similarities between fibrinogen receptors on these Gram-positive bacterial species. J Infect Dis, 1981 Apr, 143(4), 570 - 7 Enhanced phagocytosis of group A streptococci M type 6 by oleic acid; Speert DP et al.; M protein, located on the surface fimbriae of group A streptococci, is antiphagocytic by unknown means . It is known that oleic acid kills group A streptococci and distorts the fimbriae . The effect of oleic acid on phagocytosis of group A streptococci was examined . Phagocytosis of a strain possessing M protein (M+) and its M- variant was assessed by uptake of radiolabeled bacteria and by chemiluminescence . The M- but not the M+ streptococci were well phagocytized and induced chemiluminescence . Oleic acid-killed and heat-killed streptococci (both M+ and M-) were readily phagocytized and induced sustained chemiluminescence . M+ streptococci killed by ultraviolet irradiation were inefficiently phagocytized and did not induce chemiluminescence . Oleic acid-killed M+ streptococci absorbed type-specific antibody . An extract of M protein reduced the bactericidal capacity of oleic acid . It is proposed that oleic acid may bind to and alter the M protein of group A streptococci and thereby enhance phagocytosis. J Laryngol Otol, 1981 Apr, 95(4), 377 - 84 Optimal methods for the isolation of groups A, B, C and G streptococci; Cumming CG et al.; The recovery of beta-haemolytic streptococci on laboratory media over a 48-hour period was studied from a variety of swabs held in plastic containers only, and from those held in transport media, stored either at room temperature or at 4 degrees C . The best results were obtained from swabs not held in transport medium and of these plain cotton-wool swabs consistently produced optimal results . The percentage recovery over 48 hours was maintained satisfactorily only when the swabs were kept at 4 degrees C. Am J Dis Child, 1981 Apr, 135(4), 355 - 8 Transmission of group B streptococci . Traced by use of multiple epidemiologic markers; Band JD et al.; During a three-week period, septicemia caused by group B Streptococcus, serotype III, developed in four infants born at a community hospital . The first infant had early-onset disease; late-onset disease that appeared, from epidemiologic data, to be nosocomial developed in the other three infants . Bacteriophage typing and antimicrobial susceptibility testing confirmed the relatedness of the isolates . A prospective study designed to differentiate between vertical and nosocomial transmission of group B Streptococcus showed that of 82 infants, 21 (26%) were culture-positive during their hospitalization, and nine of these infants (43%) had been culture-negative at birth . Although serotype III strains were recovered from four of nine infants with apparently nosocomial acquisition, none of the isolates displayed an antibiogram or bacteriophage type similar to that of the isolates involved in the recent cluster . Bacteriophage typing and antimicrobial susceptibility testing in addition to the use of serotyping may be helpful in epidemiologic studies of group B Streptococcus. Infect Immun, 1981 Apr, 32(1), 86 - 91 Immunochemical analysis of intact M protein secreted from cell wall-less streptococci; van de Rijn I et al.; M protein is a major virulence factor of group A streptococci, which provides these organisms with protection against phagocytosis in the absence of specific antibody . To gain insight into the nature of the native M-protein molecule, type 12 M protein was isolated and purified from the extracellular supernatants of a group A streptococcal L form and stabilized protoplasts . The intact purified M protein from both sources had a molecular weight of 58,000, as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis . This is in contrast to the 32,0000-dalton molecule isolated from the parent type 12 organism by using a nonionic detergent . The purified secretory M protein removed opsonic antibodies from type 12 rabbit immune serum, as demonstrated by a bactericidal assay . Therefore, it appears that either previous nondestructive methods of M-protein isolation have not removed intact M protein from cell walls or part of the molecule is fragmented during its association with cell walls. Am J Obstet Gynecol, 1981 Mar 15, 139(6), 686 - 9 Group B beta-hemolytic streptococci and puerperal infections; Faro S; Group B beta-hemolytic streptococci as a major cause of puerperal infection in 40 patients is described . Unique features of this bacterial infection are the development of an average peak oral temperature within 12 hours of delivery, tachycardia, distended abdomen, and endomyometritis or endomyoparametritis . Bacteremia occurred in 35% of these patients. Laryngoscope, 1981 Mar, 91(3), 377 - 82 Aerobic and anaerobic bacteriology of adenoids in children: a comparison between patients with chronic adenotonsillitis and adenoid hypertrophy; Brook I; Adenoids were obtained from 18 children with chronic adenotonsillitis (Group A) and from 12 others with adenoid hypertrophy (Group B) . Patients' ages ranged from 20 months to 15 years (mean 6 years); 18 were males and 12 females . The adenoids were sectioned in half after heat searing of the surface, and the core material was cultured for aerobic and anaerobic microorganisms . Mixed aerobic and anaerobic flora were obtained from all patients, yielding an average of 7.8 isolates (4.6 anaerobes and 3.2 aerobes) per specimen . There were 97 anaerobes isolated . The predominant isolates in both groups were: Bacteroides sp . (including B . melaninogenicus and B . oralis), Fusobacterium sp., gram-positive anaerobic cocci, and Veillonella sp . There were 138 aerobic isolates . The predominant isolates in both groups were: alpha and gamma hemolytic streptococci, beta hemolytic streptococci (Group A, B, C, and F), S . aureus, S . pneumoniae, and Hemophilus sp . Hemophilus influenzae type B, and S . aureus were more frequently isolated in Group A . B . fragilis was only recovered in Group A . Beta lactamase production was noted in 27 isolates obtained from 18 patients . Fifteen of these patients belonged to Group A (83% of Group A), while 3 were members of Group B (25% of Group B) . These bacteria were all isolates of S . aureus (11) and B . fragilis (2), 8 of 22 B . melaninogenicus group, 4 of 11 B . oralis, and two of 8 H . influenza type B . Our findings indicate the polymicrobial nature of deep adenoid flora and demonstrate the presence of many beta lactamase-producing organisms in children with recurrent adenotonsillitis. Laryngoscope, 1981 Mar, 91(3), 372 - 6 Aerobic and anaerobic bacterial flora of normal maxillary sinuses; Brook I; The bacterial flora of non-inflamed maxillary sinuses were studied in 12 adults . Patients' median age was 35 years (range 25 to 53 years): 8 were females and 4 were males . Aseptic aspiration of the sinus was made when the patients were under general anaesthesia for corrective plastic surgery of the nasal septum . All aspirates were cultured for aerobes and anaerobes . Anaerobes were isolated in all 12 specimen patients; in 5 patients (42%), they were the only organisms isolated, and in 7 (58%), they were recovered mixed with aerobes . There were 33 anaerobic isolates (2.75 pr specimen) and the predominant ones were: 11 Bacteroides sp . (including 6 B . melaninogenicus), 10 anaerobic gram-positive cocci and 5 Fusobacterium sp . There were 16 aerobic isolates (1.3 per specimen) and the predominant ones were: 5 beta hemolytic streptococci, 3 alpha hemolytic streptococci, and 2 each of S . pneumoniae and hemophilus parainfluenzae . Beta lactamase production was noted in 4 isolates recovered from 3 patients . These included all isolates of S . aureus (2) and 2 of 6 isolates of B . melaninogenicus . The presence of aerobic and anaerobic organisms in the non-inflamed sinus demonstrates the non-sterility of the sinus cavity . In the events that follow closure of the sinus ostium, these bacteria may become pathogenic. Infect Immun, 1981 Mar, 31(3), 935 - 41 Effect of bacterial aggregation on the adherence of oral streptococci to hydroxyapatite; Liljemark WF et al.; Several in vitro assay systems to measure the adherence of human dental plaque bacteria to solid surfaces such as teeth, glass, and hydroxyapatite have been published . In many studies a variety of macromolecular solutes have been used to study the adherence process . Often these solutes are able to aggregate the test bacterial and thus may alter the outcome of adherence experiments . In this study, the effects of the aggregation of Streptococcus sanguis on adherence to spheroidal hydroxyapatite is described . Adherence of preformed aggregates and of bacteria which were aggregating during the adherence reaction was examined . Bacteria were aggregated with whole saliva, concanavalin A, and wheat germ lectin . Further effects of the coaggregation of S . mitis and Actinomyces viscosus to saliva-coated spheroidal hydroxyapatite are presented . These studies suggest that formation of large aggregates resulted in a decrease in the numbers of organisms which adhered . In contrast, the formation of small aggregates actually increased the numbers of bacteria that adhered . All increases in adherent bacteria occurred at low concentrations of aggregating substance in which visible bacterial aggregation was not evident . The data indicate that adequate dose-response experiments must be performed to ensure that solutes used as probes to study adherence mechanisms do not affect the adherence simply as a result of aggregation of the test microorganisms. South Med J, 1981 Mar, 74(3), 377 - 8 Constrictive pericarditis due to Streptococcus sanguis; Callanan DL et al.; We have described the third case of pericarditis caused by anaerobic streptococci in children . Despite operative drainage and high-dose penicillin therapy, there was rapid progression to constrictive pericarditis . Complete pericardiectomy was life-saving. South Med J, 1981 Mar, 74(3), 325 - 6 Streptococcal pharyngitis in infants: a reappraisal of its prevalence; Schwartz RH et al.; The prevalence of group A streptococcal pharyngitis in children under 3 years of age was determined by retrospective review of the results of throat cultures taken from children seen in a middle-class, suburban, private pediatric practice . Of 2,200 throat cultures obtained, 7% (149) were from children in this age group, and 15% (23) of these were positive for group A streptococci . All children had pharyngeal injection and the majority were symptomatic, with fever, rash, or rhinitis . Exudative pharyngitis was rare . This study suggests that pharyngeal infection with this organism in infants and young children is not uncommon, and justifies the need for throat cultures in this population. Infect Immun, 1981 Mar, 31(3), 985 - 91 Hyaluronate capsule prevents attachment of group A streptococci to mouse peritoneal macrophages; Whitnack E et al.; The antiphagocytic properties of the streptococcal hyaluronic acid capsule were explored in a system in which binding of the organism to the phagocyte, but not ingestion, could occur . The capsule was found to be highly effective in preventing attachment of two strains of group A streptococci to mouse peritoneal macrophages . Variation in attachment with phase of growth in broth culture (low in early log phase, high in late-log phase and thereafter) could be accounted for by production and subsequent loss of capsule . Hyaluronidase treatment removed the capsule and increased adherence; treatment with proteolytic enzymes removed M protein and decreased resistance to phagocytosis in whole human blood but did not remove the capsule or increase adherence to the mouse peritoneal macrophages. Infect Immun, 1981 Mar, 31(3), 868 - 73 Ecology and nature of immunoglobulin A1 protease-producing streptococci in the human oral cavity and pharynx; Kilian M et al.; The identity and proportional distribution of immunoglobulin A1 (IgA1) protease-producing streptococci in the oral and pharyngeal microflora were studied . A collection of 459 streptococcal strains, including reference strains of Streptococcus species, and fresh isolates from human dental plaque and buccal and pharyngeal mucosa were identified by biochemical means and were examined for IgA1 protease production . IgA1 protease production was demonstrated in some, but not all, strains of Streptococcus sanguis and Streptococcus mitior and in a group of strains of uncertain taxonomic affiliation . The property was not associated with particular biotypes within the two species . Strains of S . sanguis and S . mitior isolated from Macaca fascicularis also cleaved human IgA1 . A significantly different proportion of streptococcal populations in different ecosystems produced IgA1 protease . The enzyme was released by 62.7% of streptococcal isolates from buccal mucosa in contrast to only 7.8% from pharyngeal mucosa . In samples from initial and mature dental plaque 38 to 40% of streptococcal isolates produced IgA1 protease . This difference was largely a result of the frequency by which IgA1 protease activity was present in S . mitior, the predominant streptococcal species in all samples . Among otherwise identical isolates of S . mitior, 67.8% from buccal mucosa in contrast to only 5.9% from pharyngeal mucosa produced IgA1 protease . The results indicate that IgA1 protease may confer an ecological advantage to streptococci colonizing surfaces exposed to a secretory IgA-mediated selection pressure. South Med J, 1981 Mar, 74(3), 332 - 4 Comparative costs of diagnosis and treatment in acute pharyngitis; Smith DL et al.; Throat cultures from 86 consecutive patients with a clinical diagnosis of pharyngitis yielded 23 (27%) that were positive for beta-hemolytic streptococci . The cost of using oral antibiotics and of obtaining and processing throat cultures was determined . Using these data the following two theoretic strategies were cost accounted: Strategy A: Empiric Treatment . Obtain no cultures but treat all patients with oral antibiotics for ten days . Total cost = the cost of antibiotics for 86 patients . Strategy B? Selective Treatment . Obtain throat cultures on all patients . Treat patients have cultures positive for beta-hemolytic streptococci with a ten-day course of oral antibiotics . Costs were similar for the two strategies . Culture costs are itemized, and methods for cost reduction are suggested . This study presents economic justification for selective treatment as the appropriate approach in the majority of cases of acute pharyngitis of undetermined cause. Obstet Gynecol, 1981 Mar, 57(3), 330 - 4 Penicillin treatment for group B streptococcal meningitis in the rhesus monkey; Larsen JW Jr et al.; Penicillin therapy for experimentally produced neonatal meningitis due to intracerebral inoculation of group B streptococci (GBS) was studied in 25 rhesus monkeys . Penicillin was administered either therapeutically to the newborns 3 hours after GBS inoculation or prophylactically as a bolus to the pregnant females 2 hours before delivery . The neonatal mortality in the newborn treatment groups was 40% (6 of 15) compared to 100% (5 of 5) in the maternal prophylaxis group, and 0% (0 of 5) among uninfected and untreated controls . It was concluded that although penicillin can be used successfully to treat neonates with meningitis after intracerebral inoculation of GBS, penicillin given antepartum as bolus prophylaxis to the mother monkey was ineffective. Bull Tokyo Med Dent Univ, 1981 Mar, 28(1), 23 - 5 Immunosuppressive action of oral Streptococci; Saito Y et al.; The study on the immunosuppressive activity of the cytoplasmic component (SF) from Streptococcus mitis on the immune response of mice to the sheep red blood cells (SRBC) was carried out . The bacterial cell suspension was disrupted in a Braun shaker . The disrupted cell suspension was diluted and centrifuged at 10,000 x g for 30 minutes to remove the cell walls . The supernatant was centrifuged at 31,000 x g for 45 minutes and the final supernatant was dialyzed against distilled water, frozen and lyophilized . These products were employed as the cytoplasmic component (SF) . The SF in the extracts of Streptococcus mitis suppresses the antibody formation in mice against SRBC . It is effective to inject it just one day before the inoculation with SRBC. Infect Immun, 1981 Mar, 31(3), 856 - 61 Receptors for fibrinogen and aggregated beta 2-microglobulin detected in strains of group B streptococci; Schonbeck C et al.; Binding of radiolabeled human fibrinogen and aggregated beta-microglobulin was measured in 60 strains of beta-hemolytic group B streptococci . Positive fibrinogen binding was detected in seven of the strains . Six of the group B strains showed an uptake of aggregated beta 2-microglobulin . Four individual strains carried both receptors, indicating a positive correlation between their occurrence . Inhibition studies showed that fibrinogen competed sterically with beta 2-microglobulin binding . Receptors for both proteins were trypsin sensitive . The presence of receptors did not correlate with the serological type of the 49 group B strains tested . However, all seven type II strains were negative . No uptake of fibrinogen was noted in any of 40 group D strains tested . Binding structures for fibrinogen and aggregated beta 2-microglobulin detected in group B streptococci were similar to receptors for the same proteins in group A, C, and G streptococci in terms of mutual correlation and steric interference of binding . The occasional occurrence of these receptors also in group B strains might reflect a common origin of some types of surface proteins in gram-positive cocci. Antimicrob Agents Chemother, 1981 Feb, 19(2), 256 - 9 Evaluation of ceforanide as treatment for staphylococcal and streptococcal endocarditis; Cooper RH et al.; Ceforanide administered parenterally twice daily was used as the sole agent to treat 17 patients with right-sided endocarditis due to Staphylococcus aureus or nonenterococcal streptococci . Fifteen patients were cured of their original infection . Two patients were withdrawn from the study . One patient was transferred to another hospital 4 days after ceforanide therapy was initiated, and the other was changed to a different antibiotic regimen when his viridans streptococcus proved tolerant to ceforanide . The intramuscular form of ceforanide was well tolerated . It was stopped in two patients after week 3 of therapy because of adverse effects, possibly related to the study drug . These findings resolved with discontinuation of the ceforanide, and no additional antimicrobial therapy was necessary . Two patients who continued to abuse drugs intravenously during the study developed bacteremia with new organisms and required additional antimicrobial therapy . Ceforanide proved to be a useful agent in the treatment of right-sided endocarditis due to susceptible S . aureus and nonenterococcal streptococci. Acta Pathol Microbiol Scand {B}, 1981 Feb, 89(1), 1 - 6 Analysis of bacterial cell wall proteins and human serum proteins bound to bacterial cell surfaces; Bjorck L et al.; A method was developed for the characterization of proteins non-covalently bound to the cell wall of Gram-positive cocci . The method employs radioactive labelling of cell wall proteins followed by solubilisation and analysis on polyacrylamide gel electrophoresis in sodium dodecyl sulphate . Using this experimental procedure, protein patterns obtained from group A, C and G streptococcal strains showed marked similarities within each group . Protein peaks were also found to be shared between group C and G strains . Two major peaks with molecular weights of about 30 000 and 70 000 characterized group A strains, whereas group C and G strains showed one consistent peak of about 45 000, thus reflecting the closer relationship between these two groups as compared to group A streptococci . By incubating bacteria with human serum proteins before labelling, solubilisation and electrophoretic analysis, it was also possible to study external proteins specifically bound to the bacterial surface . A group G streptococcus, strain G 148, showed protein peaks corresponding to its known specific binding of human albumin and immunoglobulin G, but also additional protein peaks . When Staphylococcus aureus, strain Cowan I, was pre-incubated with human serum in excess, protein peaks corresponding to heavy and light chains of immunoglobulins were seen . Three more protein peaks of serum origin were also detected, indicating binding of proteins other than Ig to S . aureus . Experiments with protein A-coated Sepharose beads resulted in the same protein pattern, suggesting that binding of these different polypeptides is indeed mediated by protein A. Zentralbl Bakteriol A, 1981 Feb, 248(4), 446 - 54 {Studies of the heterogeneity of streptokinases; IV . Evidence for isostreptokinases in Streptococcus pyogenes type 1 (author's transl)}; Gerlach D et al.; Two strains of Streptococcus pyogenes, originating from the same Griffith strain SF 130/13 but different in M protein synthesis, produce two isostreptokinases . The molecular weights of both isostreptokinases are the same (about 50 000 daltons) as well as the specific activities (38 000 and 43 000 U/mg, resp.) . The activity values are influenced by an incomplete removal of ampholytes . The isoelectric points were determined as pI 6.3, and 6.5, resp . The presence of isostreptokinases was concluded by (1) the absence of proteolytic activities in the culture filtrate, (2) the same molecular weights, (3) the same specific activities, (4) the constant quantitative relation of about 1:2.5 between both isostreptokinases after refocusing, (5) a lack of cystein- or cystin residues in the molecule, (6) the appearance of both isostreptokinases in untreated culture filtrates, (7) the separability by disc electrophoresis, and (8) the lack of such double bands in streptokinases of other streptococci . Isoelectric focusing of streptokinase produced by a type 3 strain of S . pyogenes was followed by the appearance of four bands with streptokinase activity . It is unlikely that these four bands represent isostreptokinases . Both streptokinases (type 1 and type 3 streptococci) differ from streptokinases of other types by their relatively high content of tryptophane (table 1) and the high isoelectric points (6.5 to 6.0; streptokinases of other types and groups show pI's between 5.05 to 5.65 (6). Zentralbl Bakteriol A, 1981 Feb, 248(4), 437 - 45 {Comparative study of five different methods for grouping beta-haemolytic streptococci (author's transl)}; Logering HJ; 161 strains of beta-haemolytic streptococci, that had been isolated from patients' material, and 7 reference strains were group}ed with the techniques of precipitation, direct immunofluorescence, co-agglutination (Phadebact Streptococcus Test), latex agglutination (Streptex), and biochemical tests (Api-Strep) . From the reference strains one group G strain was incorrectly identified with the Api-Strep . The direct immunofluorescence test yielded a result in agreement with the precipitation method in 94% of the freshly isolated strains . Co-agglutination and latex agglutination gave corresponding results with the precipitation method in 99%, taking into consideration that the first method doesn't apply to groups D and F . The biochemical determination with Api-Strep gave correct results with all strains of groups A and B, but did not do so with some group G and most of the group C streptococcal strains . Therefore especially co-agglutination and latex agglutination can be recommended for routine diagnostic purposes as reliable, rapid, and simple methods. Infect Immun, 1981 Feb, 31(2), 615 - 23 Factors influencing release of type III antigens by group B streptococci; Doran TI et al.; The release of serotype III group B streptococcal polysaccharides into the supernatant fluid was examined under a variety of physiological conditions . Release of both high- and low-molecular-weight type III antigens was fairly constant throughout exponential growth, but increased markedly upon entering the stationary phase of growth . Increased glucose and decreased phosphate concentrations both caused a large increase in release of antigens . Inhibition of protein synthesis in exponentially growing cells by chloramphenicol (10 micrograms/ml) caused a condition of unbalanced growth in which antigen release was increased greatly over control values . Strain variability in antigen release was also observed . Strains which are known to be high neuraminidase producers released elevated levels of both low- and high-molecular-weight type III antigens . Non-neuraminidase-producing strains released considerably less high-molecular-weight antigen, but similar levels of the low-molecular-weight antigen compared with the high neuraminidase producers . Strain D136C, a type III non-neuraminidase producer, released negligible quantities of the high-molecular-weight antigen in the supernatant fluid . These results indicate that both the physiological environment and the type III strain are important in determining the quantity of type-specific antigen released into the culture fluid. J Clin Microbiol, 1981 Feb, 13(2), 279 - 82 Rapid method for identification of group B streptococci in neonatal blood cultures; Holmes RL et al.; A rapid technique used for the identification of Streptococcus agalactiae, Lancefield group B, from the blood cultures of two neonatal infants is reported . The method utilized the Phadebact Streptococcus Test System (Pharmacia Diagnostics, Piscataway, N.J.) and the supernatant from 13- and 14-h blood cultures . Additional studies with simulated neonatal blood cultures revealed that this method was reproducible . Additional studies also revealed that some non-specific agglutination did occur, which could not be eliminated with dithiothreitol, but was visibly reduced by treatment with soluble staphylococcal protein A. Am J Med, 1981 Feb, 70(2), 417 - 22 Bacterial colonization and infection in the neonate; Goldmanln DA; The vast majority of healthy term neonates tolerate their abrupt introduction to the bacterial world with little risk of infection . However, infants who require a longer hospital stay are at greater risk of having an infection, particularly when intensive care is needed . In one study, 15.3 percent of the infants in an intensive care unit acquired a nosocomial infection . Gram-negative bacilli have emerged as the principle cause of nosocomial infection . Nosocomial infection due to gram-negative bacilli usually occurs in neonates already colonized with gram-negative bacilli in the pharynx or intestine, and the risk of colonization with hospital strains of gram-negative bacilli (which are often resistant to multiple antibiotics) increases dramatically the longer a baby stays in intensive care . The factors which predispose individual neonates to colonization and infection with gram-negative bacilli require further study, but gram-negative bacilli are most often transmitted among neonates on the hands of personnel . Neonates in whom intestinal colonization with gram-negative bacilli develops are a particularly important reservoir of gram-negative bacilli in the nursery; once colonized, infants may harbour antibiotic-resistant hospital strains of gram-negative bacilli in their stool for more than a year . Pharyngeal colonization with alpha streptococci appears to protect neonates from pharyngeal colonization with gram-negative bacilli, and bacterial interference may play an important role in regulating intestinal colonization as well . Investigation of the mechanisms of bacterial interference may lead to better understanding of the colonization process and development of alternatives to classic infection control methods. J Bacteriol, 1981 Feb, 145(2), 696 - 703 Identification of a lysin associated with a bacteriophage (A25) virulent for group A streptococci; Hill JE et al.; A phage-associated lysin was found in culture lysates resulting from the propagation of virulent bacteriophage A25 on the group A streptococcal strain designated K56 . In contrast to the previously described group C streptococcal phage-associated lysins, A25 phage-associated lysin was more active on chloroform-treated cells, was not phage bound, and was active on some group G and H strains, as well as on group A and C strains . A25 phage-associated lysin had an optimum pH of 6.7 and was inactivated by 10(-3) M p-hydroxymercuribenzoate . Group A cells exposed to penicillin were more susceptible to A25 phage-associated lysin, whereas chloramphenicol-treated cells became resistant to lysis . Release of lipoteichoic acid appeared to precede lysis, and cardiolipin treatment of cells reversed the effects of chloroform and penicillin treatments . These results suggest the possibility that A25 phage-associated lysin may have a mechanism similar to the mechanism of an autolysin or that cell lysis may be due to the activation of an autolysin. J Clin Microbiol, 1981 Feb, 13(2), 293 - 300 Technical aspects of the Staphylococcus aureus teichoic acid antibody assay: gel diffusion and counterimmunoelecrophoretic assays, antigen preparation, antigen selection, concentration effects, and cross-reactions with other organisms; Sheagren JN et al.; Because variable results are being reported from laboratories performing the teichoic acid antibody assay in patients with serious infections due to Staphylococcus aureus, we have thoroughly reviewed all technical aspects of the test . This paper reports on the importance of agar and antigen preparation in standardizing results of the assay and reducing the prevalence of false-negative and -positive tests . Once standardized, the counterimmunoelectrophoretic method is as accurate as the gel diffusion method for both initial screening and generating titers; practically, however, unless numerous tests are to be performed, the gel diffusion technique will suffice for most purposes . The cell wall of the Lafferty strain of S . aureus was used as the standard antigen in assays for serum antibodies . We studied whether it is an appropriate antigen and found that antibody titers obtained with the Lafferty strain antigen were, in three patients with endocarditis, the same as those obtained with antigens from the individual blood stream isolates . We have also confirmed that pooled human gamma globulin can be used, by back titration against newly prepared lots of antigen, to select optimal antigen concentration and is as good as more specific, higher titer serum specimens for that purpose . Finally, cell wall antigens from Staphylococcus epidermidis and a variety of streptococci may react with normal human sera, but such antigens are distinct by immunoprecipitation from those from S . aureus. J Bacteriol, 1981 Feb, 145(2), 1102 - 5 Conjugative R plasmids in group C and G streptococci; Bougueleret L et al.; Two streptococcal isolates of groups C and G harbored conjugative R plasmids with molecular weights of 17 X 10(6) (pIP646) and 20 X 10(6) (pIP920) . These plasmids carried genetic markers for resistance to macrolides and related drugs, as well as to chloramphenicol (pIP920), and have very similar HindIII restriction enzyme patterns. JAMA, 1981 Jan 23-30, 245(4), 360 - 3 Short-term therapy for streptococcal infective endocarditis . Combined intramuscular administration of penicillin and streptomycin; Wilson WR et al.; In a prospective study, 91 patients with penicillin-sensitive infective endocarditis (IE) were treated for two weeks with intramuscular (IM) penicillin G procaine, 1.2 million units every six hours, plus streptomycin sulfate, 500 mg IM every 12 hours . Viridans streptococci were isolated from 70 patients (77%); 21 patients (23%) had Streptococcus bovis infections . Eighteen patients (20%) had had symptoms of IE for three months or longer . Follow-up ranged from two months to 6.6 years . There were no relapses; mild vestibular toxic reactions occurred in two patients (2%) . Two patients (2%) died--one of sudden-onset severe heart failure and one of cardiac arrest after aortic valve replacement . Twenty-six patients (19%) required cardiac valve replacement after completion of antimicrobial therapy . This therapy seems as efficacious as four weeks of parenteral antimicrobial therapy and is more cost-effective. Z Hautkr, 1981 Jan 15, 56(2), 118 - 25 {Etiology and diagnosis of necrotizing fasciitis (author's transl)}; Galosi A et al.; This is the report of three cases of necrotizing fasciitis, an acute and progressive disease involving the connective tissue, which may appear after infection with beta-hemolytic streptococci of group A (S . pyogenes) . Painless ulcerations and necrosis along the fascial tissue are pathognomonic . Treatment consists in immediate and wide incisions to terminate the toxic effects due to the cell wall constituents of the streptococci together with an adequate chemotherapy . The laboratory diagnosis and the pathogenic mechanisms are discussed. Microbios, 1981, 31(125-126), 183 - 8 Comparison of fatty acid fingerprints of streptococci of Lancefield groups A, D, E, F, G, H, K, O, P and Q; Drucker DB; Twenty-two strains of Lancefield-groupable streptococci were examined by gas chromatographic analysis of their methyl carboxylic esters . In all cases, their major cellular fatty acids had the retention characteristics of myristic, palmitic and octadecenoic acids . Other peaks present in most strains were due to peaks having the retention characteristics of hexadecenoic, stearic, and octadecenoic acids . The quantitative data sets were compared using the coefficient of linear correlation as a measure of association . It was possible to differentiate between certain serotypes, solely on the basis of fatty acid fingerprint . Members of groups E, F, G, H, K, O, P and Q were more similar to reference strains of groups E, F and Q than to A. Arkh Patol, 1981, 43(5), 10 - 5 {Palatal tonsil changes and interstitial microbial foci in chronic tonsillitis}; Vartazarian ND; Bacteriological, histological, immunomorphological, and bacterioscopic methods were used to study faucial tonsils removed in 85 patients with chronic tonsillitis and 100 cadavers of apparently normal subjects dying of trauma . The main feature of chronic tonsillitis was interstitial streptococcal infection . The size of interstitial microbial foci with broken integrity of the histohematic barrier and typical morphological signs defining the chronic tonsillitis as a whole are important . Three main morphological signs determining the presence of chronic tonsillitis should be distinguished: (1) microbial (large interstitial streptococcal foci and colonies of the microbes), (2) immunomorphological (hyperplasia of lymphoid follicles and plasmatization of the lymphoid tissue, cryptal epithelium and the surrounding tissue with accumulation of the cells containing IgM and IgG, and in adults also increase content of IgA producers); (3) pathological (foci of perivascular sclerosis, granulation tissue, wide cryptae filled with necrotic masses and microbes) . These lesions indicate transformation of faucial tonsils into a focus of infection with an appropriate complex of tissue changes in which streptococci frequently break the integrity of barriers and penetrate into the blood and lymph vessels. Antimicrob Agents Chemother, 1981 Jan, 19(1), 122 - 9 Antibacterial activity of fortimicin A compared with those of five other aminoglycosides, and factors affecting susceptibility tests; Thornsberry C et al.; Fortimicin A, a pseudodisaccharide aminoglycoside, was found to have broad-spectrum activity against most clinically important aerobic and facultatively anaerobic bacteria, except Pseudomonas aeruginosa, some other Pseudomonas species, and streptococci . It was comparable to amikacin in its level of activity (minimum inhibitory concentrations) and spectrum of activity (except for the lack of activity on P . aeruginosa) . Fortimicin A was bactericidal and was affected by cations when tested against P . aeruginosa . Minimum inhibitory concentrations were affected by the inoculum used in the susceptibility test . The drug was resistant to most aminoglycoside-inactivating enzymes, but probably is not active against permeability mutants. Z Rheumatol, 1981 Jan-Feb, 40(1), 30 - 6 {Antidesoxyribonuclease B-titer in persons of different ages and sex and comparative studies of antistreptolysin titers}; Otto R et al.; The antidesoxyribonuclease B reaction shows in persons of all classes of age examined a similar distribution of titres as the antistreptolysin reaction . The anti DNase B titres however are mostly lower than the titres of the antistreptolysin reaction, except in the group of children, 6 to 17 years of age, suffering frequently from latent infections of streptococci . Women in childbed showed lower anti DNase B titres than other persons of corresponding age . Among persons with anti DNase B titres higher than antistreptolysin titres predominate men. Rev Rhum Mal Osteoartic, 1981 Jan, 48(1), 83 - 91 {Infectious sacroiliitis . Multicenter study of 214 cases}; Feldmann JL et al.; Out of 214 cases of infective sacro-ileitis observed on Rheumatology Units, 65% were due to common bacteria, 25% were tuberculous and 10% due to brucellosis . Post-partum infections were early, severe and often due to streptococci . Sacrocoxalgia was accompanied in 50% of cases by another focus of active tuberculosis . Two clinical presentations are possible, either that of acute sacro-ileitis with a sudden onset, severe pain, frank infection and major impotence which is common in infections due to current bacteria; or the presentation may be that of subacute sacro-ileitis with progressive onset with little or no fever, pain and moderate impotence which may be due to any bacteria . Identification of the responsible organism depends on blood culture, bacterial sampling at the point of entry of the infection but, above all, direct swab or preferably needle biopsy . Bone scan may demonstrate early hyperfixation in the absence of any radiological signs . Prolonged antibiotic treatment is sufficient in most cases. Int Urol Nephrol, 1981, 13(3), 299 - 307 Use of radioimmunoassay for the detection of circulating antistreptococcal antibody in patients with glomerulonephritis; Krzymanski M et al.; A method of radioimmunologic quantitation of antibodies to streptococcal antigen separated from the cell wall extract of group A type T12 strain has been developed . The highest values of radioactive antigen binding were observed in acute glomerulonephritis (75%), as compared to chronic glomerulonephritis in which values of 25% to 56% were found depending on the morphology of renal changes . It was shown that none of the patients with pyelonephritis, Alport's syndrome, lupoid nephritis and polycystic renal disease had elevated antistreptococcal antibody levels . In contrast to this, all patients with tonsillitis and proteinuria exhibited increased titre of this antibody . It was shown that the antigen is related neither to M-protein nor to group A polysaccharide and that it is not type-specific because the binding of antigen T12 may be inhibited by the antigen produced