Niger Med J, 1978 Nov, 8(6), 549 - 51 Bacterial flora of the parturient vagina--implications for neonatal sepsis; Noah MA et al.; A bacteriological study of vaginal swabs taken from 78 parturient women at Lagos University Teaching Hospital (L.U.T.H.) is presented . 26.83% of the vaginal cultures were sterile . The most frequently isolated bacteria were Staphylococcus spp . 21.4%, followed by beta hemolytic streptococci 16.65%, of which approximately a half belonged to Lancefield group B . Escherichia coli was isolated in 11.1% of the cases . The implications for neonatal and puerperal sepsis are discussed. Jpn Heart J, 1978 Nov, 19(6), 918 - 25 Change of P-Q intervals of the electrocardiogram in the rat hearts sensitized with the killed group A streptococci; Kamiyama A et al.; Prolongation of P-Q interval in the anesthetized rat was observed by repeated injection of killed group A streptococci . The prolongation was clearly recognized at about the 11th week after the first injection, but afterwards P-Q interval recovered to the normal level in spite of continuous injection of killed streptococci . His bundle electrogram recorded from isolated heart revealed the prolongation of A-H interval in the treated rat . Moreover, the transmembrane action potential in the atrioventricular nodal region of treated rat was slightly deteriorated, but the action potentials in the other cardiac muscles were not changed . It was deduced from the above results that P-Q prolongation was transiently brought about by the injection of killed group A streptocci and that deterioration of muscle in the atrioventricular nodal region might take a main part in the P-Q prolongation. J Clin Microbiol, 1978 Nov, 8(5), 500 - 2 Direct use of counterimmunoelectrophoresis in detection of group B streptococci in specimens containing mixed flora; Fenton LJ et al.; Isolation procedures for the group B streptococci were bypassed by applying counterimmunoelectrophoresis (CIE) directly to the broth containing the initial inoculum . A total of 458 tests were performed on 389 specimens received from 93 mothers and 81 babies . Of all tests, 19.4% were positive group B streptococci by the Lancefield precipitin method . Twenty hours of incubation were required to produce a positive CIE result in 54% of those specimens which were eventually proven a contain group B streptococci by Lancefield technique . There were no false positive CIE results . It is recommended that the initial broth culture be sampled and tested with CIE after an overnight incubation in those cases where another 24 h may be critical in terms of identifying the group B streptococci . A positive result with CIE can be clinically relied upon, but a negative result is indeterminate, and routine isolation procedures would need to be followed in that case. Antibiotiki, 1978 Nov, 23(11), 997 - 1002 {Experimental study of the antimicrobial effect of lysozyme in combination with antibiotics}; Bukharin OV et al.; A synergistic effect of the antibacterial action of the lysozyme combination with various antibiotics against gram-positive and gram-negative microorganisms was found . The intensifying effect of lysozyme on its combination with antibiotics was more evident with respect to gram-positive microbes and less evident with respect to gram-negative organisms . The combinations os lysozyme with methicillin, lincomycin, oleandomycin or erythromycin proved to be most active against staphylococci . A high synergistic effect against streptococci was observed with the use of the lysozyme combination with benzylpenicillin, morphocycline, oleandomycin, ceporin or monomycin . The combination of lysozyme with macrolides had a maximum inhibitory effect on Coli bacteria. Arch Intern Med, 1978 Nov, 138(11), 1645 - 7 Non-group D streptococcal meningitis misidentified as enterococcal meningitis . Diagnostic and therapeutic implications of misdiagnosis by screening microbiology; Bayer AS et al.; Two patients had nonhemolytic Gram-positive coccal meningitis . Both pathogens were initially misidentified as a group D enterococcus by growth in "selective" media, which led to the use of inappropriate and potentially toxic systemic and intrathecal aminoglycosides . Careful evaluation of the antibiotic sensitivity data and additional microbiological studies allowed correct identification of the organism . The important diagnostic and therapeutic considerations in differentiating true enterococcal infections, especially meningitis, from those caused by other alpha-hemolytic or nonhemolytic streptococci are emphasized . A simple laboratory schema for rapid recognition of such pathogens is reviewed. J Med Microbiol, 1978 Nov, 11(4), 419 - 31 Studies on streptococci resembling Streptococcus milleri and on an associated surface-protein antigen; Lutticken R et al.; Ninety-nine strains of streptococci were isolated from 97 cases of pyogenic infections, most of which involved the teeth . Physiological and serological tests were performed on these streptococci and on 37 strains of streptococci from culture collections . The results were used for a numerical classification . Seventy-nine of the strains isolated from patients formed a cluster with Streptococcus milleri and group-F reference strains, and were therefore considered as streptococci resembling S . milleri . By the use of an antiserum prepared against strain Z3, protein antigens were demonstrated in acid extracts of 65% of the strains of S . milleri . These antigens were in only five strains not included in the S . milleri cluster. Am J Med Sci, 1978 Nov-Dec, 276(3), 269 - 77 Beta hemolytic streptococcal endocarditis: predominance of non-group A organisms; Blair DC et al.; Identification of beta hemolytic streptococci (BHS) as group A or non-group A on the basis of bacitracin sensitivity rather than Lancefield serogrouping may lead to misidentification of the pathogen . In four recent cases of endocarditis due to BHS, the pathogens initially were identified as group A; Lancefield serogrouping showed all four to be group G . All four patients presented with a syndrome characteristic of acute bacterial endocarditis . Review of all cases of endocarditis at our institution for the past five years showed none due to group A BHS . In 166 previously reported cases of endocarditis due to BHS, 68 pathogens were serogrouped: 53 belonged to groups B, C, G, or H; only five were group A . Our four cases and review of the literature demonstrate the need for Lancefield serogrouping in serious beta hemolytic streptococcal infections, rather than reliance on bacitracin sensitivity. Ann Intern Med, 1978 Nov, 89(5 Pt 2 Suppl), 746 - 8 Trends in bacterial virulence and antibiotic susceptibility: streptococci, pneumococci, and gonococci; Stollerman GH; Antibiotic usage and improved living conditions may have contributed to a dilution of "rheumatogenic" strains of group A streptococci and to their replacement by attenuated streptococci with less rheumatogenic potential . Whether this is due to decreased virulence or to loss of specific bacterial antigens or toxins in prevalent strains is not yet known . The pneumococcus, which has been moderately resistant to antibiotics only in isolated cases, has appeared in South Africa in strains that are highly resistant to at least five major antibiotics; plasmid transmission of resistance is suspected . The newly available pneumococcal vaccine may become very important if such strains spread . Gonococci isolated from urogenital lesions have developed only moderate drug resistance . Gonococci causing disseminated infection have retained their exquisite sensitivity to penicillin; the most virulent strains are associated with greatest sensitivity . However, the newly discovered penicillinase-plasmid in gonococci is transferable to these virulent strains as readily as to others. Schweiz Med Wochenschr, 1978 Oct 7, 108(40), 1545 - 8 {Transitory bacteremia in rectoscopy}; Reinhart W et al.; A prospective study was undertaken to determine the frequency of transient bacteremia on recto-sigmoidoscopy . Blood specimens were drawn for aerobic and anaerobic bacterial culture immediately before, and 1, 5, 10, 15, 20, 25 and 30 min after the beginning of recto-sigmoidoscopy . 19 blood cultures were supposed to be contaminated . In 3 patients (6%) a positive blood culture was found with the following types of organisms: enterococci, Escherichia coli and nonhemolytic streptococci . The need for antibiotic prophylaxis in patients with valvular heart diseases or prosthetic valves is discussed . In such cases the authors propose prophylaxis with 1 g streptomycin i.m . and 3 g ampicillin by mouth 30 min before recto-sigmoidoscopy. Pediatr Res, 1978 Oct, 12(10), 998 - 1002 Abnormal colonization of neonates in an intensive care unit: means of identifying neonates at risk of infection; Sprunt K et al.; The current investigation was designed to select infants in the neonatal intensive care unit (ICU) at highest risk of infection . The data, derived from a prospective study of 223 neonates, indicate that neonates in an ICU develop their initial aerobic pharyngeal flora according to one of the three patterns shown in Table 1, one of which (low titer or no growth) is dependent on antibiotic therapy . Of particular importance is the finding that infants with normal flora (alpha-streptococci predominating) or cultures showing low titers (less than 10(4) colony-forming units (cfu)/ml) or no growth did not become infected . All infections occurred in the group of infants with abnormal pharyngeal colonization (18 infections in 115 abnormally colonized infants): with a single exception the infecting organism showed the cultural characteristics of the colonizing organism . Consequently one can pinpoint the relatively small number of infants at particular risk of infection and predict what the infecting organism will be if infection occurs. Pediatrics, 1978 Oct, 62(4), 535 - 42 Neonatal osteomyelitis; Fox L et al.; To evaluate current conservative therapy and document the existence of a recent shift in etiologic agents, we reviewed the records of 45 infants who developed osteomyelitis within the first ten weeks of life and who were admitted to Babies Hospital (New York) from 1951 through 1976 . Emphasis was placed on characteristics and course of the disease, etiologic agents, therapy, and outcome . Illness was diagnosed within the first two weeks of life in 34 of the 45 infants (73%) . Only six had been delivered normally after normal pregnancy and led a normal life before development of ostemyelitis . Infected sites were distinctive in frequency of involvement of multiple foci (21), of facial bones (10), and of joints contiguous to infected long bones (22 of 29) . Conservative therapy (nonsurgical) seems reasonable for the majority of patients . Of particular interest is documentation of a shift from Staphylococcus aureus as predominant etiologic agent before 1965 to beta-hemolytic streptococci, commonly group B, from 1965 through 1976 . Data collected from the literature of the 1930s indicate that such shifts have occurred before. Arch Pathol Lab Med, 1978 Oct, 102(10), 518 - 21 Experimental streptococcal endocarditis . The early vegetation; Carrizosa J et al.; Aortic valve vegetation were studied in rabbits before and after intravenous injection of streptococcus mitis . Uninfected vegetation sections revealed compact eosinophilic masses with smooth-appearing edges and scattered polymorphonuclear leukocytes inside and on the surface . Scanning electron microscopic views demonstrated erythrocytes, small leukocytes, and platelets; the surface was markedly irregular . Fifteen minutes after injection of 10(10) streptococci, large mononuclear cells and polymorphonuclear leukocytes lined the vegetation edge; scanning electron microscopy showed large and small leukocytes . One and six hours after infection, there were more polymorphonuclear leukocytes inside the vegetation but few superficially . Bacteria were first seen at six hours as microcolonies inside the vegetation . Twenty-four-hour sections showed large bacterial colonies inside with few bacteria at the edges . Despite the smooth appearance of the vegetation edges, all electron microscopic views revealed very rough surfaces. Health Lab Sci, 1978 Oct, 15(4), 189 - 91 Evaluation of primary plating media for the isolation of group A streptococcus from delayed throat cultures; Pien FD et al.; Sulfamethoxazole-trimethoprim blood agar (SXT-BA), neomycin blood agar (NEO-BA) and plain sheep blood agar plates (SBA) were compared for isolating group A streptococci in 1,954 throat cultures . SBA and SXT-BA had similar isolation rates (approximately 75% of all positive isolates) . NEO-BA was significantly better (87% recovery) . A combination of any two media gave 92-95% recovery of group A streptococci from throat specimens. Zh Mikrobiol Epidemiol Immunobiol, 1978 Oct, (10), 66 - 9 {Selection of phage-resistent clones of streptococcus group A and their properties}; Totolian AA; In studying the effects induced by virulent phage CAI in the sensitive cultures of streptococcus, group A, a possibility was shown of selection of phage-resistant clones with the altered enzymatic activity . These clones lost their capacity to produce proteinase and retained residual lipoproteinase activity . This evidence correlates with literature data indicating that phage-resistant streptococci served as good producers of M-protein--the main virulence factor . Infection of the culture producing streptokinase with phage CAI with a definite infection multiplicity led to an increase of the enzyme activity in the culture fluid . This process was accompanied by selection of the resistant strains characterized by greater streptokinase production and greater enzyme stability . As suggested, the latter could result from the absence of proteolytic activity in the phage-resistant clone. Infect Immun, 1978 Oct, 22(1), 171 - 5 Genetic separation of serum opacity factor from M protein of group A streptococci; Cleary PP; Mutagenized cultures of three strains of group A streptococci which were M positive and produced the extracellular serum opacity factor (OF) were screened for mutants which failed to exhibit OF activity on serum agar plates . All cell fractions from three mutants studied in detail, including culture supernatants, protoplast membranes, and cytoplasmic fractions, were completely devoid of activity . Two OF- isolates also lacked OF antigen, whereas the third continued to produce cross-reacting antigen . All three mutants were resistant to phagocytosis and yielded acid-extractable M antigen, indicating that the M protein of each strain was unaltered by the mutations . The separation of the OF+ and M+ phenotypes by mutation establishes that genes which code for the M protein and OF are distinct; therefore, the activities and antigenic determinants of each must be associated with separate, distinct protein molecules. J Clin Microbiol, 1978 Oct, 8(4), 410 - 2 Rapid isolation and identification of group B streptococci from selective broth medium by slide co-agglutination test; Szilagyi G et al.; Direct identification of group B streptococci from a selective broth medium was performed with the Phadebact streptococcus test to determine the feasibility of this technique for early detection of streptococcal colonization . Of 124 clinical isolates, 122 (98.4%) were correctly identified in less than 24 h from the selective broth medium, whereas standard cultures from blood agar plates identified, after 48 h, only 66 (53.2%) . The presence of group B streptococci in mixed cultures was always detected by the Phadebact test, and no false-positive co-agglutination tests were observed in 372 cultures from which organisms other than group B streptococci were isolated. Pediatrics, 1978 Oct, 62(4), 504 - 9 Maternal ABO blood group type B: a risk factor in the developement of neonatal group B streptococcal disease; Regan JA et al.; In a prospective study of maternal genital colonization with group B streptococci (GBS) at the time of delivery, epidemiological data, including blood type (ABO group), were recorded for the 1,062 patients studied . Blood type B was found in a statistically significant higher proportion of patients colonized with GBS (28%) compared with the total population (16.4%) (P less than .005, X2 = 8.43) . Women with blood type B were twice as likely to be colonized as those with types O or A . Hypotheses to explain this observation include the possibilities that GBS possess a B-like antigen, rendering parturients who lack anti-B antibody at increased risk for GBS colonization, or that GBS possess a receptor site for B surface antigens . One may speculate that a mutation toward an affinity for the human ABO blood group type B accounts for the advent of the group B Streptococcus as a significant perinatal pathogen. Br J Obstet Gynaecol, 1978 Oct, 85(10), 783 - 6 Group B beta haemolytic streptococci in the female genital tract: a study of four clinic populations; Embil JA et al.; The carrier rate of group B beta-haemolytic streptococci (GBS) was assessed in pregnant and non-pregnant women attending four clinics . Multiple sites were sampled and standard methods were used to isolate GBS . Colonization rates were highest in patients attending a venereal disease clinic but were not associated with other sexually transmitted diseases . Higher colonization rates were detected when multiple sites were sampled . Serotypes II and III occurred most frequently. Antibiotiki, 1978 Oct, 23(10), 867 - 71 {Lysis of the cellular walls of Streptococcus group A by enzymes produced by actinomycetes}; Savel'ev EP et al.; More than 80 cultures of actinomycetes belonging to different taxanomic groups were studied with a purpose of screening actinomycetes actively producing enzymes lyzing the cell walls of group A streptococci . 31 strains of the actinomycetes producing enzymes which lyzed the cell walls by 20-50 and 60-80 per cent within 1 and 4 hours respectively were selected . The proteolytic activity of the enzymes produced by these strains was also studied . It was shown that 4 cultures, i.e . Actinomyces albus, strains 6 and 9, Actinomyces levoris, strain 29 and Actinomyces gibsonii, strain 42 were of interest as organisms producing enzymes which lyzed the streptococcal cell wall without impairing its antigenic components. Am J Clin Pathol, 1978 Oct, 70(4), 689 - 90 Pyridoxine inhibition of a symbiotic streptococcus; Sherman SP et al.; A symbiotic, alpha-hemolytic streptococcus that showed satellitism about a Staphylococcus aureus was recovered from blood cultures of a patient with endocarditis . Previously reported as being required for growth of symbiotic streptococci, pyridoxine hydrochloride was found to inhibit the growth of this organism. J Fam Pract, 1978 Oct, 7(4), 697 - 700 Treatment of impetigo and ecthyma; Linder CW; A comparison of the treatment of superficial skin infections using intramuscular benzathine penicillin G alone or combined with hexachlorophene scrubbing was conducted in 127 children . Of 72 children treated with benzathine penicillin alone, 94.4 percent had a good result . Of the 55 children receiving hexachlorophene scrubbing in addition to penicillin, 85.5 percent had a good result . The healing rate was higher (93 percent) in those children whose skin cultures grew Group A beta hemolytic streptococci.When staphylococcus aureus was the only pathogen isolated, the healing rate was 86 percent . Regardless of the pathogens isolated, the healing rate was not increased with scrubbing . Since scrubbing with hexachlorophene offered no improvement in the healing rate and since it adds to the expense and discomfort of treatment, it should be eliminated as part of the treatment. Infect Immun, 1978 Oct, 22(1), 136 - 42 Binding of aggregated human beta2-microglobulin to surface protein structure in group A, C, and G streptococci; Kronvall G et al.; A novel mammalian-microbial "short circuit" has been demonstrated between aggregated human beta2-microglobulin and group A, C, and G streptococci . Bacteria belonging to nine gram-positive and three gram-negative species were tested for binding of radiolabeled beta2-microglobulin . All 10 individual strains of group A streptococci showed a high degree of reactivity with aggregated human beta2-microglobulin . Among 27 group C and 28 group G streptococci, 9 and 6 strains, respectively, were highly reactive, whereas the remaining strains showed a lower, but definite level of beta2-microglobulin binding . Of 11 group B streptococci, 4 were slightly positive . All strains among the other eight species were completely negative . Simultaneous testing of A, C, and G streptococci for immunoglobulin binding showed a lack of correlation between type II and III Fc reactivity and beta2-microglobulin binding . There was no inhibition of uptake of aggregated beta2-microglobulin to reactive strains when excess amounts of human immunoglobulin were added . The beta2-microglobulin-binding surface structure was found to be markedly sensitive to trypsin digestion . The relative trypsin resistance of the immunoglobulin-binding protein in the digestion experiments further demonstrated the dissociation between these two reactivities. J Dairy Sci, 1978 Oct, 61(10), 1483 - 97 Complete versus selective dry cow therapy for mastitis control; Rindsig RB et al.; Two hundred and thirty-two cows were assigned alternately to complete dry cow therapy (infusion in all quarters on the day of drying off) or selective therapy (infusion in all quarters if a history of mastitis, California Mastitis Test score of +2 or +3 in any quarter, or if cell counts from bucket milk samples as determined by the membrane filter-deoxyribonucleic acid procedure were above 500,000 cells/ml) . A dry cow product containing 10(6) units of procaine penicillin G and 1 g of dihydrostreptomycin in a slow release base was used . A 1% iodophor teat dip was used throughout the experiment . Infections of Staphylococcus aureus, Streptococcus agalactiae, other streptococci, and gram negative rods were eliminated from 85.4% of the infected quarters with complete therapy and 88.2% of the infected quarters with selective therapy . New infections occurred in 3.1% of quarters with complete therapy and in 6.5% of the quarters with selective therapy . Incidence of mastitis following the dry period was less with complete therapy compared to selective therapy (4.6% vs . 7.8% of the quarters) . Selective therapy was as effective as complete therapy in eliminating existing infections . Complete therapy would be the choice in situations where new infections in dry period are of concern. Science, 1978 Sep 8, 201(4359), 918 - 20 Absence of glycerol teichoic acids in certain oral streptococci; Rosan B; Glycerol teichoic acids were not detected immunochemically or chemically in phenol-water, hot saline (Rantz and Randall), or supernatant fluids of disrupted cells of Streptococcus mitis . Thus teichoic acids do not appear to be found in most Gram-positive bacteria, as has been suggested. J Clin Microbiol, 1978 Sep, 8(3), 299 - 301 Comparison of three blood culture media with tryptic soy broth; Hall MM et al.; Four consecutive studies comparing commercially prepared bottles that contained brain heart infusion, brucella (vented and unvented), and Trypticase soy broths with Tryptic soy broth failed to demonstrate significant differences in rates of isolation of organisms from blood . Statistically significant differences between bottles were limited to the average times required to detect growth of viridans streptococci in one study and of all organisms in another. Z Rheumatol, 1978 Sep-Oct, 37(9-10), 304 - 8 Epidemiological studies on rheumatic heart disease and streptococcal carriers among school-children in Addis-Ababa, Ethiopia . Preliminary communication; Yazov L et al.; The results of the first part of epidemiological follow-up studies on rheumatic heart disease and streptococcal carriers in Addis-Ababa are presented . In 1012 school-children relatively low morbidity of rheumatic heart disease (0.49%) and relatively small percentage of carriers of A-beta-hemolytic streptococci (4.24%) were found . There was no statistically significant difference in the morbidity of rheumatic heart disease as well as in the percentage of streptococcal carriers between the two basic social groups--children of well-to-do and of poor parents . No correlations with overcrowding were found . Serological types 5/12/27 and 3/13/B3164 of group A-beta-hemolytic streptococci were isolated most frequently. Zentralbl Bakteriol {Orig A}, 1978 Sep, 241(3), 294 - 300 Chemotactic activity of polymorphonuclear leukocytes to Streptococcus pyogenes; Tylewska S et al.; Influence of two different streptococcal group A type 12 strains on chemotactic activity of polymorphonuclear leukocytes (PMN) was investigated in vitro and in vivo . The strains differed only in presence of M protein . In both conditions, the inhibition of the chemotaxis of the PMN after their treatment with M positive strains was observed . These results suggest that M protein of streptococci inhibits chemotaxis of PMN and therefore they can weaken defensive mechanisms of infected organism. Infect Immun, 1978 Sep, 21(3), 738 - 46 Association of elevated levels of extracellular neuraminidase with clinical isolates of type III group B streptococci; Milligan TW et al.; The level of total extracellular neuraminidase produced by 74 clinical isolates of group B streptococci isolated from diseased or asymptomatically colonized infants was assayed . Extracellular neuraminidase was obtained from concentrated filtrates of exponentially growing cultures of group B streptococci grown in a chemically defined medium (FMC) containing supplemental protein . The total activity of extracellular enzyme produced by these clinical isolates ranged from less than 10 to 360 nmol of sialic acid released per min per mg of cell dry weight . Strains were arbitrarily classified as either nonproducers (less than 10 nmol/min per mg of cell dry weight), low producers (greater than 10 to less than or equal 140 nmol/min per mg of cell dry weight), or high producers (greater than 140 to 360 nmol/min per mg of cell dry weight) . Type III isolates from diseased infants were significantly more often classified as high producers than strains of group B streptococci of other serotypes from diseased infants (P less than 0.001) . Furthermore, the serotype III strains isolated from neonatal infections were more often high producers than those of the same serotype from asymptomatically colonized infants (P less than 0.025) . These results suggest that the ability to produce elevated levels of neuraminidase may be related to the frequent association of type III strains with disease among neonates. J Infect Dis, 1978 Sep, 138(3), 287 - 92 Wound infections due to group A streptococcus traced to a vaginal carrier; Stamm WE et al.; An epidemic of surgical wound infections caused by group A Streptococcus affecting 18 patients in a community hospital was studied . Onset of symptoms shortly after surgery (median time, 16 hr) in 17 patients suggested acquisition of infection in the operating room, and a case-control investigation linked the presence during surgery of one particular nurse with postoperative streptococcal infection . During the first month of the epidemic, the nurse had streptococcal cellulitis of the finger and may thus have directly contaminated wounds or dressings . However, the last six wound infections occurred after her skin lesions had resolved and after nasopharyngeal and skin cultures were repeatedly negative for group A streptococci . Subsequent investigation showed that the nurse was colonized vaginally with group A streptococci of the same M and T types found in the infected patients and that this organism was disseminated into her immediate environment by airborne or droplet spread . Vaginal as well as rectal carriers of streptococci should be sought whenever outbreaks of streptococcal wound infection in which a cutaneous or nasopharyngeal carrier cannot be readily identified. J Infect Dis, 1978 Sep, 138(3), 281 - 6 Transfer of erythromycin resistance from clinically isolated lysogenic strains of Streptococcus pyogenes via their endogenous phage; Hyder SL et al.; Endogenous bacteriophage from clinically isolated, erythromycin-resistant strains of Streptococcus pyogenes, upon induction by treatment with mitomycin C, were demonstrated to cause transduction of antibiotic resistance yielding transductants resistant to relatively high concentrations of erythromycin . Transduction of resistance to erythromycin via endogenous phage may play a significant role in the emergence of streptococci with multiple resistance in the clinical environment. J Clin Microbiol, 1978 Sep, 8(3), 326 - 8 Rapid grouping of beta-hemolytic streptococci by latex agglutination; Lue YA et al.; Latex agglutination was compared with fluorescent-antibody staining with group A conjugate and Lancefield precipitation for grouping of beta-hemolytic streptococci . Latex agglutination correctly grouped 98.8% of 82 group A streptococci and more than 95% of 187 group B, C, or G streptococci . Occasional cross-reactions occurred between groups A and C and groups B and G. Monatsschr Kinderheilkd, 1978 Sep, 126(9), 540 - 8 {Group B streptococcus infections during the neonatal period (author's transl)}; Roos R; Nowadays, in severe infections during the neonatal period new bacteria--group B streptococci--have to be taken into account, since in some clinics they already predominate over gramnegative rods . Septicemia and meningitis may be caused by group B streptococci . The septicemia which especially threatents prematures starts with apnoeic spells in the very first hours after birth and may be easily misdiagnosed as an idiopathic respiratory distress syndrome . The mortality is very high (about 60%) . Meningitis starts later, normally during the 3rd to 4th week . Seizures are typical at the onset . Group B streptococci may be identified in the CSF by counterimmunoelectrophoresis within one hour . The prognosis is more favourable in meningitis than in septicemia (mortality about 20%) . Survivors have little neurological sequelae . Penicillin G or ampicillin combination with an aminoglycoside is recommended as chemotherapy . Exchange transfusion should be considered early . Group B streptococci causing the septic form may be transfered during labour since up to 25% of pregnant women are colonized . Nosocomial transmission of group B streptococci may be the reason for meningitis . Prophylactic penicillin does not seem to help in preventing the disease, but it is possible, that meningitis of the newborn may be prevented by immunizing the mother during pregnancy. Am J Med, 1978 Sep, 65(3), 411 - 5 Vancomycin therapy of bacterial endocarditis; Hook EW 3rd et al.; Fifteen patients with bacterial endocarditis were treated with vancomycin between 1967 and 1976 . The indications for vancomycin therapy were penicillin-cephalosporin allergy in six patients, antibiotic resistant bacteria in six, initial therapy in one and culture-negative endocarditis in two . The causative microorganisms were Staph . epidermidis (four patients), Staph . aureus (two patients), diphtheroids (four patients), viridans streptococci (two patients) and enterococci (one patient) . Minimum inhibitory concentrations of vancomycin for these organisms ranged from 0.8 to 3.1 micrograms/ml . The patients received vancomycin for two to 10 weeks (mean five weeks) . Cure was achieved in 13 patients, including six with prosthetic valve endocarditis (PVE) . Two patients had a relapse of PVE and cultures of blood or heart valve were positive within two months of vancomycin therapy . Vancomycin serum levels did not exceed 50 micrograms/ml, and no serious drug toxicity was encountered in any patient . Three patients had minimal audiogram changes beyond the social hearing range . One patient had mild phlebitis and a rash, and one patient had a transient leukopenia . Vancomycin is an effective nontoxic antibiotic in patients with endocarditis when penicillin or cephalosporin therapy is not appropriate. Parazitologiia, 1978 Sep-Oct, 12(5), 400 - 5 {Comparative study of the bactericidal action of the body of Ornithodoros papillipes ticks}; Podboronov VM et al.; Experiments in vivo have shown that the ticks of Ornithodoros papillipes inhibit both Gram-positive and Gram-negative bacteria . On Gram-positive microorganisms most sensitive to bactericidal effect of ticks have turned to be micrococci, staphylococci, streptococci and bacteria of diphtheria, of Gram-negative ones--Bacillus coli . Of Gram-positive microorganisms less sensitive were Listeria, of Gram-negative ones--salmonellae, agents of tularemia and pseudotuberculosis . At the infection with bacteria the organism of the tick produces a bactericidal substance which causes the dying off of the microbal population . The ability of the bactericidal substance to lyse the inhibited cells of Micrococcus lysodeiktickus as well as the coincidence of data on sensibility to the tick bactericidal substance obtained experimentally in vitro and in vivo have shown that lysozyme is an active antibacterial substance in the tick's organism. Aktuelle Gerontol, 1978 Sep, 8(9), 493 - 502 {A meaningful antibiotic therapy of diseases of the ear, nose and throat in old age (author's transl)}; Glaninger J; Each stage of life is characterized by the prevalence of certain affections; among others, inflammatory diseases of the ear, nose and throat are frequent in old age . Therefore, specific problems of chemotherapy in old age are dealt with in general terms in the introduction, with special stress being placed on the functions of individual organs, mainly of the kidneys, and on questions of disturbed absorption . Inflammations caused by streptococci, requiring at least ten days of antibiotic treatment, always deserve particular attention, and so do staphyloccocal diseases, requiring the selective administration of semi-synthetic pencillines (sioxazol preparations) . Penicillin is still the first choice among all antibiotics, penicillin substitutes, to be used in case of allergies, are listed according to their order of value . As anaerobic germs may also be present in the ENT area, the effective modern therapy by means of special antibiotics is also referred to . Finally, due consideration is given to local antibiotic therapy, with an emphasis on the ototoxicity of chemotherapeutical agents, such as amino-glycosides. J Exp Med, 1978 Sep 1, 148(3), 776 - 86 Demonstration of opsonic activity and in vivo protection against group B streptococci type III by Streptococcus pneumoniae type 14 antisera; Fischer GW et al.; The present studies demonstrate that antisera directed against Streptococcus pneumoniae type 14 is opsonic for group B streptococci type III in a neutrophile-mediated bactericidal assay . Specificity was demonstrated by the observations that group B streptococci type III and S . pneumoniae type 14 adsorbed the opsonic activity of anti-S . pneumoniae type 14 antisera . Group B streptococci strain 090R (devoid of type antigens) and S . pneumoniae type 3, did not remove the opsonic activity of anti-S . pneumoniae type 14 serum . In vivo studies using a suckling rat model of neonatal group B streptococcal type III sepsis demonstrated that antisera directed against S . pneumoniae type 14 was highly protective. Schweiz Med Wochenschr, 1978 Aug 5, 108(31), 1197 - 202 {Colonization of the pregnant woman and the newborn by group B streptococcus: therapeutic and preventive implications}; Carrel J; In a search for group B streptococci, vagina and urethra of 196 pregnant women entering the delivery room were cultured using a selective medium . Sixteen (8.2%) were positive . Fifteen (15%) of 101 nonpregnant women cultured similarly during a clinical consultation were positive . Esogastric aspiration fluid of 199 neonates from the former group of women was also cultured: 8 (4.0%) were positive . Thus, maternal genital colonization was accompanied by neonatal contamination in 7 of 16 cases (43%) . Typing of the streptococci revealed identity between all maternal and neonatal isolates tested . These values are comparable with those obtained in other countries . Their epidemiological implications and the prophylaxis and therapy of the neonatal disease are discussed. Science, 1978 Aug 4, 201(4354), 455 - 7 Adherence of group A streptococci to pharyngeal cells: a role in the pathogenesis of rheumatic fever; Selinger DS et al.; We used an assay in vitro to investigate the possible role of streptococcal adherence to human pharyngeal cells in the pathogenesis of acute rheumatic fever . There was no difference in adherence of rheumatic fever-associated and non-associated strains of group A streptococci to pooled pharyngeal cells of normal people . Likewise, streptococci not associated with rheumatic fever adhered equally well to cells taken from normal people and from patients with rheumatic heart disease . However, the pharyngeal cells of all nine rheumatic heart disease patients tested had increased avidity for adherence for a rheumatic fever-associated strain of streptococcus compared to the pharyngeal cells obtained from age- and sex-matched controls . Increased streptococcal adherence to pharyngeal cells of rheumatic fever-prone patients may play a role in the pathogenesis of rheumatic fever. Mayo Clin Proc, 1978 Aug, 53(8), 529 - 32 Meningitis due to group C streptococci in an adult; Mohr DN et al.; Group C streptococci are generally considered to be a rare cause of infection in man . Infections due to these microorganisms, however, are common in several animal species . To our knowledge, the literature contains only two previous cases of meningitis in man which were due to group C streptococci . In one of these cases meningitis developed as a complication of endocarditis due to group C streptococci . Our recent clinical experience with a patient with severe acute meningitis caused by group C streptococci is reported and the pertinent literature is reviewed . The illness manifested itself as a severe form of acute meningitis, with slow but statisfactory response to therapy with penicillin. J Hyg (Lond), 1978 Aug, 81(1), 49 - 66 A study of acute respiratory disease in the community of Port Chalmers . I . Illnesses within a group of selected families and the relative incidence of respiratory pathogens in the whole community; Jennings LC et al.; A study of respiratory diseases in the semi-isolated community of Port Chamlers, New Zealand, began in April 1973 . The intensive surveillance of a selected group fo 26 families involved the weekly reporting of illness, the collection of specimens for virus, Group A streptococci and Mycoplasma pneumoniae isolation and the collection of sera at 6-month intervals . A total of 956 illnesses were reported during 32 months . The median number of illnesses per year were: infants 4.4, children 2.5, female adults 2.4 and male adults 2.0 . Of all these illnesses, 57% were upper respiratory, 31% were lower respiratory and 9% were enteric . The severity of these illnesses was not greater than would be expected in open communities . Surveillance by pathogen isolation only of the whole community through the patients in the general practice was carried out concurrently . A total of 640 nasopharyngeal swab specimens were collected from which 161 viruses, 47 Group A streptococci and 2 M . pneumoniae were isolated . The overall isolation rate was 33% . The similarities between the epidemiological patterns of respiratory disease in the open community and the isolated community are discussed. J Infect Dis, 1978 Aug, 138(2), 152 - 9 Type distribution of beta-hemolytic streptococci in Israel: a 10-year study; Bergner-Rabinowitz S et al.; A survey was carried out over 10 years on the distribution of beta-hemolytic streptococci, their identification, and the clinical implications . Curtures were typed by the conventional agglutination and precipitation methods and by enzyme production . The present survey indicates the changes in streptococcal ecology of the various serotypes . Epidemics of acute pharyngitis with complete absence of rheumatic fever provided suggestive evidence that not all group A types are associated with rheumatic fever . The survey also emphasizes the occurence of non-group A streptococci in human infection. Ann Rheum Dis, 1978 Aug, 37(4), 339 - 42 Immunodiffusion studies on synovial fluid from patients with rheumatoid arthritis: the reaction of fibrinogen with a streptococcal extract; Rylance HJ; Synovial fluids (83.3%) from patients with rheumatoid arthritis gave a positive reaction when examined by immunodiffusion against a Lancefield extract of Group A Type 12 streptococci . None of the patients with osteoarthrosis reacted positively . An antiserum was prepared to the material in synovial fluid reacting with the streptococcal extract . This antiserum reacted positively with all synovial fluids tested including the osteoarthrosis patients . It also reacted with all plasma samples tested but only with a few (18.2%) of serum samples . Immunodiffusion and absorption experiments demonstrated that the material reacting with the streptococcal extract was fibrinogen . Of 12 other streptococci examined only one, a Group C organism, gave a similar positive reaction with synovial fluids. J Infect Dis, 1978 Aug, 138(2), 174 - 80 Solid-phase radioimmunoassay for detection of staphylococcal antigen in serum of rabbits with endocraditis due to Staphylococcus aureus; Wheat LJ et al.; To aid in the rapid diagnosis of staphylococcal infection, a solid-phase radioimmunoassay for Staphylococcus aureus antigen was developed and evaluated in rabbits with staphylococcal endocarditis . Test specimens containing antigen were added to polystyrene tubes coated with antibody to S . aureus . Antigens immobilized on the tube were detected by adding radiolabeled antibody to S . aureus . Sensitivity for antigen was 0.312 microgram/ml in buffer and 1.25 microgram/ml in 50% rabbit serum . Cross-reactions were not observed with antigens extracted from streptococci; however, antigen extracted from Staphylococcus epidermidis (which contained ribitol-teichoic acid) could also be detected at low concentrations . Antigen was detected in each of 12 rabbits with S . aureus endocarditis but not in control rabbits . This assay is sensitive, specific, reproducible, and capable of detecting antigens in the serum of rabbits with endocarditis. Med Microbiol Immunol (Berl), 1978 Jul 4, 165(2), 129 - 37 The cervical lymph nodes in Streptococcus pyogenes, group A, type 50, infection in mice; Wildfeuer A et al.; Streptococcus pyogenes, group A, type 50, one of the few group A streptococcal types naturally occuring in mice, proved highly virulent in this species after experimental infection . Intranasal infection of 96 mice (Swiss albino, NMRI, and CBA) with this microorganism induced profound reactions in the cervical lymph nodes of 69% of the animals . Histologically, two different forms of reaction were distinguishable . In 61 mice, the lymph nodes exhibited follicular and lymphoplasmacellular hyperplasia and in 9 animals suppurative lymphadenitis was present . The ability of type 50 streptococci to persist in the pharynx of mice, and the similarity of the morphological changes induced by this organism appear to make intranasal murine group A, type 50, streptococcal infection a suitable model for human streptococcal pharyngitis. Medicine (Baltimore), 1978 Jul, 57(4), 329 - 43 Neurologic complications of bacterial endocarditis; Pruitt AA et al.; (1) Neurologic complications remain a significant problem in bacterial endocarditis . Of 218 patients with endocarditis, 84 (39%) had a neurologic complication and 58% of these 84 patients died . In contrast, the mortality rate was only 20% among those endocarditis patients without neurologic complications . (2) Of the neurologic complications, cerebral embolism is the most frequent and important . An embolic stroke occurred in 37 (17%) of our patients, with 30 of these patients dying . Emboli are important not only in terms of the direct morbidity and mortality they cause via cerebral infarction, but also because of their role in the causation of mycotic aneurysms, brain abscesses, and abnormal CSF formulae . (3) Cerebral emboli are particularly common in patients with mitral valve infection, and in patients with infection due to virulent organisms, particularly S . aureus and enteric gram-negative bacilli . (4) Mycotic aneurysms occur more frequently in the course of acute endocarditis rather than late in the course of subacute disease . Management of angiographically demonstrated mycotic aneurysms is dependent upon the presence or absence of hemorrhage, the anatomic location of the aneurysm, and the clinical course of the patient . Healing of mycotic aneurysms can occur during the course of effective antimicrobial therapy, thus obviating the need for neurosurgical intervention in all such patients . (5) Macroscopic brain abscess is a rare complication of bacterial endocarditis . Miliary microscopic abscesses are more common than larger abscesses, particularly in patients with acute disease and miliary infection in other organs of the body . (6) Focal seizures occur most commonly in endocarditis patients with acute embolic disease; generalized seizures are of diverse etiologies, with metabolic factors being most important . Penicillin neurotoxicity should be considered in patients with impaired renal function who are receiving high dose penicillin . (7) With the exception of hemorrhagic complications, lumbar puncture results tend to reflect the nature of the infecting organism rather than the nature of the neurologic complication . Endocarditis due to virulent organisms such as S . aureus is usually associated with a purulent CSF formula while nonvirulent organisms, such as viridans streptococci, susually have aseptic or normal CSF formulae. Arch Dis Child, 1978 Jul, 53(7), 540 - 4 Group B streptococci in pharyngeal aspirates at birth and the early detection of neonatal sepsis; Slack MP et al.; The pharyngeal aspirates collected from 400 babies at the time of delivery were examined for the presence of bacteria, especially group B streptococci . Aspirates from 79 babies were found to contain viable bacteria, including 4 with group B streptococci; one of these 4 babies developed streptococcal meningitis within 24 hours . The group B streptococci were seen on a Gram-stained film of the aspirate, and were detectable by coagglutination and countercurrent immunoelectrophoresis within 4 hours and by culture after 24 hours . Examination of pharyngeal aspirates may be of value as a screening test for neonatal sepsis. Br J Obstet Gynaecol, 1978 Jul, 85(7), 541 - 5 Group B streptococcal infection in a maternity unit; Cowen J et al.; Neonatal infection due to Group B streptococci is described in a maternity unit . Six babies were affected and two died . Three of the babies were born at term, and weighed more than 2.5 kg . Tachypnoea was the earliest clinical sign in each case, and we suggest that newborn infants with persistent tachypnoea and evidence of maternal or infant colonization with Group B streptococci should receive antibiotics . Alternative approaches to the diagnosis and management of infection with Group B streptococci are discussed and rejected. J Clin Microbiol, 1978 Jul, 8(1), 105 - 7 Characterization and incidence of pigment production by human clinical group B streptococci; Merritt K et al.; Pigment was produced in stab cultures by 97% of 297 group B streptococci isolated from human clinical specimens . The pigment, which was associated with a membranous cell fraction, showed a four-banded absorption spectrum similar to that of a carotenoid, with maxima at 435, 566, 485, and 525 nm . Addition of glucose to the growth medium suppressed pigment production in most strains . Only 37% of strains from bovine sources produced pigment. Medicine (Baltimore), 1978 Jul, 57(4), 279 - 305 Bone infections involving anaerobic bacteria; Lewis RP et al.; Over 700 cases of anaerobic osteomyelitis have been reported in the literature . Nonetheless, most reviews of osteomyelitis have paid little attention to the potential role of anaerobes in bone infections . There have, as yet, been no prospective studies of osteomyelitis utlizing optimal anaerobic transport and culture techniques . In a retrospective study of osteomyelitis at Wadsworth VA Hospital from 1973--1975, 39 percent of 58 patients with osteomyelitis had an infection involving anaerobes . Anaerobes were isolated from 81 percent of 27 patients whose specimens were cultured anaerobically . Anaerobes were isolated from nine of ten samples of bone . Anaerobic bacteria were part of a mixed flora involving facultative bacteria in all but two cases . All of the patients with anaerobic infection had non-hematogenous osteomyelitis . Non-hematogenous disease comprises 80--90 percent of the osteomyelitis seen in adults . Our experience at Wadsworth VA Hospital and a review of the literature lead us to believe that anaerobes play a much larger role in osteomyelitis than has been appreciated previously . Infections of the calvarium, mastoid, mandible, maxilla and the extremities are most likely to involve anaerobes . Predisposing conditions include paranasal sinusitis, otitis media, periodontal disease, trauma, peripheral vascular disease, peripheral neuropathy and/or chronic osteomyelitis . The presence of a foul odor is a valuable clinical clue to the presence of anaerobes . Bacteroides, fusobacteria and anaerobic cocci have been reported with almost equal frequency from anaerobic bone infections . While Bacteroides fragilis is the most common anaerobe isolated in infections of other organ systems, it does not appear to be a common pathogen in anaerobic bone infections . The role of anaerobes in osteomyelitis is not yet resolved . They have been isolated in pure culture from infected bone, and under those circumstances are clearly pathogenic . Anaerobes are found more frequently as part of a mixed flora with facultative streptococci, gram-negative bacilli, and less often with S . aureus . In this setting it is unclear which organism or organisms are the primary invaders, or whether there is a synergistic mechanism of infection . The reliability of sinus drainage cultures also remains to be determined . Our retrospective study suggests that certain anaerobes isolated from sinus drainage are not present in infected bone . Cultures of bone or an abscess adjacent to bone would be expected to give more reliable data . The majority of anaerobes other than B . fragilis are susceptible to levels of penicillin achievable with parenteral administration of the antibiotic . Anaerobic pathogens should be sought in the situations noted above . We feel that parenteral penicillin should be part of the initial antibiotic regimen in patients with suspected or documented anaerobic bone infection... Infect Immun, 1978 Jul, 21(1), 34 - 40 Role of antibody and complement in opsonization of group B streptococci; Shigeoka AO et al.; A requirement for the classic complement pathway in opsonization of group B streptococci was observed by using both a chemiluminescence and a radiolabeled bacterial uptake technique . The classic pathway increased levels of opsonization for types Ia and II stock and wild strains and for some type III wild strains . In contrast, other type III wild strains and the type III stock strain had accelerated kinetics of uptake in the presence of an intact classic pathway, but the level of opsonization was unchanged from that with antibody alone . We could not demonstrate a significant role for the alternative pathway in opsonizing stock or wild strains of group B streptococci . Futhermore, electrophoretic and complement consumption analysis by hemolytic titration failed to reveal alternative pathway activation by the majority of strains of this group . Therapy aimed at supplying opsonins for these organisms will require the presence of type-specific antibody. Am J Clin Pathol, 1978 Jul, 70(1), 108 - 11 Group G streptococcal endocarditis; Bouza E et al.; The group G streptococcus may be a more common human pathogen than previously recognized . A case of group G streptococcal endocarditis is reported and the 11 cases reported previously are reviewed . Group G endocarditis may have significant clinical and prognostic differences from endocarditis caused by the more commonly identified viridans or group D streptococci . Routine serologic grouping of beta-hemolytic streptococcal isolates from serious infections is warranted. J Clin Microbiol, 1978 Jul, 8(1), 50 - 3 Discrepancy between results of the Streptozyme test and those of the antideoxyribonulcease B and antihyaluronidase tests; Hederstedt B et al.; Comparison of the serum titers obtained with the Streptozyme, the antistreptolysin O, the antideoxyribonuclease B, and the antistreptohyaluronidase tests suggested that the Streptozyme test had failed to detect antibodies against streptococcal deoxyribonuclease B and hyaluronidase . Moreover, sera that were negative in the Streptozyme test could be shown by immunodiffusion to possess significant numbers of precipitins against extracellular factors produced by group A streptococci . Follow-up studies on patients with diagnosed streptococcal infections revealed elevated antideoxyribonuclease and streptohyaluronidase titers and increased numbers of precipitation lines without simultaneous increased titers by the Streptozyme test . There is thus a need for stricter control of possible batch-to-batch variations and more careful standardization of the antigen content of the Streptozyme test. Proc Natl Acad Sci U S A, 1978 Jul, 75(7), 3163 - 7 Repeating covalent structure of streptococcal M protein; Beachey EH et al.; We have attempted to identify the covalent structure of the M protein molecule of group A streptococci that is responsible for inducing type-specific, protective immunity . M protein was extracted from type 24 streptococci, purified, and cleaved with cyanogen bromide . Seven cyanogen bromide peptides were purified and further characterized . Together, the peptides account for the entire amino acid content of the M protein molecule . Each of the purified peptides possessed the type-specific determinant that inhibits opsonic antibodies for group A streptococci . The primary structures of the amino-terminal regions of each of the purified peptides was studied by automated Edman degradation . The partial sequences of two of the peptides were found to be identical to each other and to that of the uncleaved M protein molecule through at least the first 27 residues . The amino-terminal sequences of the remaining five peptides were identical to each other through the twentieth residue but completely different from the amino-terminal region of the other two peptides . However, the type-specific immunoreactivity and the incomplete analysis of the primary structure of the seven peptides suggest that the antiphagocytic determinant resides in a repeating amino acid sequence in the M protein molecule. J Clin Pathol, 1978 Jun, 31(6), 531 - 5 Determination of antibiotic sensitivities by the Sensititre system; Phillips I et al.; The Sensititre system provides antibiotics dried in microtitre trays in appropriate concentrations for the determination of minimum inhibitory concentrations (MIC) when organisms are added in liquid culture medium and incubated overnight . Results with a variety of media--for Gram-negative bacilli tested with ampicillin, carbenicillin, cephaloridine, and gentamicin, staphylococci with penicillin, cloxacillin, fusidic acid, and gentamicin, and streptococci with penicillin, ampicillin, cephaloridine, and erythromycin--were usually very similar to those of agar dilution tests . Discrepant results are found in a few situations, and in some cases, especially those involving borderline resistance to fusidic acid and gentamicin among staphylococci and Gram-negative bacilli, we have been unable to suggest modfication to produce the right results . Despite these problems, fortunately few and identifiable, we recommend the system especially for use in laboratories that determine the MICs infrequently. Circulation, 1978 Jun, 57(6), 1158 - 61 Short-term intramuscular therapy with procaine penicillin plus streptomycin for infective endocarditis due to viridans streptococci; Wilson WR et al.; Thirty-three patients with viridans streptococcal infective endocarditis were treated for two weeks with intramuscular procaine pencillin, 1.2 million units every 6 hours, plus streptomycin, 500 mg intramuscularly every 12 hours . Nine patients (27%) had infections with relatively penicillin-resistant microorganisms (MIC greater than 0.1 microgram/ml or MBC greater than or equal 3.12 microgram/ml) . Follow-up ranged from 2 months to 3.5 years . There were no relapses; Mild vestibular toxicity developed in one patient . One patient died two months after completion of antimicrobial therapy from sudden onset of severe congestive heart failure; Seven patients required cardiac valve replacement after completion of antimicrobial therapy . None died . We believe that this therapeutic regimen is effective antimicrobial therapy for infective endocarditis caused by viridans streptococci, irrespective of in vitro microbiologic data. Antibiotiki, 1978 Jun, 23(6), 549 - 52 {Sensitivity of beta-hemolytic streptococci to antibiotics}; Liashenko IuI et al.; Susceptibility of 64 beta-hemolytic streptococcal strains isolated from the patients with sore throat was studied by the method of serial dilutions in fluid nutrient medium (Konikov broth) . Heterogenecity with respect to the sensitivity was investigated in 34 strains among separate populations of the microbes (10 to 15 in every strain) . The MIC of benzylpenicillin, oxacillin and erythromycin ranged within 0.007--0.24 U/ml, 0.02--0.36 gamma/ml and 0.005--0.1 gamma/ml respectively . The MIC of benzylpenicillin with respect to separate populations most sensitive to it was 0.007--0.015 U/ml, while that with respect to the lease sensitive populations ranged from 0.015 to 0.24 U/ml . The respective values for oxacillin were 0.02--0.12 and 0.18--0.36 gamma/ml and those for erythromycin were 0.005--0.025 and 0.05--0.1 gamma/ml . Therefore, the beta-hemolytic streptococci isolated from the patients with sore throat were characterized by a rather high sensitivity to the antibiotics which was important precondition for their efficiency in treatment of the patients with the above disease. J Infect Dis, 1978 Jun, 137(6), 795 - 801 Pathogenesis of bacteremia due to Pseudomonas aeruginosa in cyclophosphamide-treated mice and potentiation of virulence of endogenous streptococci; Brownstein DG; Mice treated with cyclophosphamide on day 0 were killed at sequential intervals during subsequent administration of Pseudomonas aeruginosa in drinking water and were examined for sites of bacterial colonization and multiplication with use of peroxidase-labeled antibody and culture techniques . These studies were coordinated with those of clinical and histopathologic changes . Bacterial antigen was first detected on day 4 on the surface of nasal squamocolumnar junctions and the stratum corneum of gingival sulci and crests . Invasion of tissue by P . aeruginosa proceeded rapidly from these sites and led to bacteremia . There was no invasion of the lower alimentary canal . Endogenous group B beta-hemolytic streptococci colonized and penetrated ulcers created by previous pseudomonas invasion . These results suggest that epithelial colonization is the critical event in the pathogenesis of bacteremia due to P . aeruginosa in the immunosuppressed host . The resulting infection may provide a conduit for invasion and enhancement of the virulence of endogenous streptococci. J Clin Microbiol, 1978 Jun, 7(6), 599 - 600 Modified method for serological identification of group B streptococci; Dillon HC Jr et al.; Extracts from 10- and 40-ml cultures compared favorably for serological identification of group B streptococci . Typing by gel diffusion proved reliable and efficient . These modifications save time, media, and antisera. JACEP, 1978 Jun, 7(6), 229 - 32 Pharyngeal gram stains in the treatment of sore throats; Hedges JR et al.; The use of the direct pharyngeal Gram stain for diagnosis of group A beta-hemolytic streptococcal pharyngitis was evaluated . Seventy-five consecutive out-patients presented with pharyngitis (or high fever in infants) were studied with pharyngeal cultures and Gram stains . Gram stains were read as either positive, negative, or indeterminate for streptococcal pharyngitis . When these predictions were correlated with the resulting culture growth of group A beta-hemolytic streptococci, the predictive value of a throat smear Gram stain was found to be significant (p less than 0.005) . There were two false positives and three false negatives . Approximately one third of the smears were in the indeterminate category . Although the Gram stain of a pharyngeal smear was found to be less sensitive than the routine throat culture, the ability to obtain inexpensive rapid microbiological information suggests that the Gram stain can be used as a quick screening procedure. J Med Microbiol, 1978 May, 11(2), 111 - 6 A study of carbon dioxide-dependent strains of Streptococcus milleri; Sisson PR et al.; Forty-four strains of non-haemolytic streptococci, from a variety of sites, that required CO2 for aerobic growth were identified as Streptococcus milleri . Of these strains, 40 (90%) possessed the Lancefield group-F antigen, the remainder being non-groupable with antisera to the group antigens A, C, F and G. J Clin Invest, 1978 May, 61(5), 1394 - 404 Bacterial adherence in the pathogenesis of endocarditis . Interaction of bacterial dextran, platelets, and fibrin; Scheld WM et al.; The role of dextran in the pathogenesis of bacterial endocarditis was investigated by studying the adherence of dextran producing oral streptococci to the constituents of nonbacterial thrombotic endocarditis (NBTE) in vitro and in vivo . The adherence of Streptococcus sanguis to fibrin and platelets was determined in an in vitro assay system simulating nonbacterial thrombotic endocarditis . Adherence was increased when the organisms were grown in sucrose-supplemented media (adherence ratio X 10(4), 177 +/- 6 in 5% sucrose vs . 140 +/- 7 in 0.5% sucrose, P less than 0.001), and decreased by incubating the organisms in dextranase (adherence ratio X 10(4), 117 +/- 16, P less than 0.001), an effect which was nullified by heat inactivating this enzyme (adherence ratio X 10(4), 192 +/- 7, P less than 0.001) . The amount of dextran produced in broth by three different oral streptococci correlated directly with the adherence observed to fibrin and a fibrin-platelet matrix in vitro (P less than 0.001) . These organisms adhered more readily to a fibrin-platelet matrix than to fibrin alone (adherence ratio X 10(4), 455 +/- 30 vs . 177 +/- 6, respectively, P less than 0.001) . The role of dextran formation was also examined in vivo in rabbits with preexisting NBTE . After injection of 10(7) S . sanguis, 12 of 17 animals developed endocarditis . In contrast, when the organisms were pretreated with dextranase (an enzyme that removes dextran from the bacterial cell surface), the same inoculum resulted in endocarditis in only 5 of 19 animals (P less than 0.05) . In addition, a fresh strain of S . sanguis that produced high levels of dextran (1,220 +/- 50 microgram/ml) and adhered avidly to fibrin (adherence ratio X 10(4), 220 +/- 11) produced endocarditis in 12 of 18 rabbits after injection of 10(7) organisms . Another isolate of the same strain that had been passed repeatedly in the laboratory produced less dextran (400 +/- 30 microgram/ml), adhered poorly to fibrin (adherence ratio X 10(4), 140 +/- 7), and produced endocarditis in only 3 of 14 rabbits under identical conditions (P less than 0.05) . This study demonstrates that dextran production is important in the adherence of oral streptococci to the constituents of NBTE and may play a role in the pathogenesis of bacterial endocarditis by oral streptococci. Zentralbl Bakteriol {Orig B}, 1978 May, 166(4-5), 353 - 60 {Analysis of the germ content of the air in university lecture rooms (author's transl)}; Nikodemusz I et al.; The microflora of the air in university lecture rooms was examined with the sedimentation method . For this purpose blood agar (20 degrees C and 37 degrees C), saline agar and Endo plates were used . The germ counts identified correlate to the size and utilization of the rooms . The lowest germ count was determined in the room used for practical work, which was followed by the lecture room . The newly built lecture room contained the highest colony count . The floor ventilation furnishes an explanation for this . Most of the colonies were Gram-positive cocci (micrococci, indifferent streptococci, sarcins) . Aerobic spore-forming organisms were found to be present in smaller quantities than cocci . Fungi, mainly, moulds grew better at a temperature of 20 centigrade . The microbiological monitoring of air forms an important part of environmental protection . Great importance can be attached to a stardization of the air germ count in the prevention of airborne infections. Am J Med, 1978 May, 64(5), 759 - 64 Serious infections caused by Streptococcus milleri; Murray HW et al.; Viridans streptococci continue to be the most common etiologic agents in bacterial endocarditis . The spectrum of diseases other than endocarditis caused by these organisms, however, has received sparse attention . Moreover, little clinical information is available concerning the individual viridans streptococcal species . During the 16 months of this study, one species of viridans streptococci, Streptococcus milleri, caused a surprising number of clinically significant suppurative infections . Clinical syndromes included the following: abscesses, 10 cases; peritonitis, four cases; endocarditis, three cases; cholangitis, empyema and cellulitis, one case each . A gastrointestinal source was apparent in eight of these 20 cases . Review of 58 cases of viridans streptococcal endocarditis demonstrated that although Strep . milleri was an infrequent cause of endocarditis, this species was associated with an unusual frequency of suppurative complications . Our experience suggests that Strep . milleri may be more commonly associated with serious suppurative infections than other viridans streptococci and that species identification may be a clinically useful procedure. J Infect Dis, 1978 May, 137(5), 524 - 30 Epidemiology of group B Streptococcus: longitudinal observations during pregnancy; Anthony BF et al.; A longitudinal, three-year study of the epidemiology of group B Streptococcus was conducted with repeated (four to 11) observations of 382 patients followed through pregnancy, delivery, and the postpartum period . Group B streptococci (2.3% of which were nonhemolytic) were isolated from the birth canal at first visit from 15% of the patients and from 28% with repeated cultures . Overall, group B streptococci were isolated at 12% of culture visits . Streptococcal carriage was significantly less common among patients who were Mexican-American, 20 years old or older, or in a fourth or later pregnancy . Multivariate analysis indicated that each of these three factors had a significant, independent bearing upon carriage of group B streptococci . Of 108 patients harboring these organisms in the birth canal, 36% could be classified as chronic, 20% as transient, and 15% as intermittent carriers . The relationship of infant colonization to the presence of streptococci in the birth canal at delivery and not to previous or subsequent carriage by the mother was consistent with the observation that maternal colonization was often inconstant. J Clin Microbiol, 1978 May, 7(5), 463 - 6 Bacitracin and coagglutination for grouping of beta-hemolytic streptococci; Stoner RA; Bacitracin may be used for presumptive differentiation of group A from other beta-hemolytic streptococci . Whatever criteria are used for the test, a small number of erroneous results will be obtained . With the 1,161 strains studied in this laboratory, using a zone of 10 mm or greater as indicative of group A was better than using Maxted's original criterion of any zone of inhibition for group A . Co-agglutination is a preferable alternative to bacitracin testing, providing a grouping result as quickly as the bacitracin test but with the advantage of giving a definite grouping result . With the 247 strains studied so far, coagglutination results have correlated exactly with results of conventional grouping by a precipitin method. J Bacteriol, 1978 May, 134(2), 578 - 84 Temperature-dependent variation in the synthesis of streptococcal group-specific carbohydrate . II . Biosynthetic studies in group A and variant strains; Ayoub EM; The biosynthesis of the cell wall polysaccharide and peptidoglycan of group A and A-486-Var streptococci was studied with N-acetyl-{14C}glucosamine, UDP-N-acetyl-{14C}glucosamine, and {14C}glucose . The incorporation of N-acetyl-{14C}-glucosamine into the cell wall four times greater in the A-486-Var cells than in the group A cells . However, the percentage of the total label incorporated into the cell wall polysaccharide at 37 degrees C by the A-486-Var strain was 12%, compared with 66% for the group A cells . When the A-486-Var was grown at 22 degrees C, the proportion of the label incorporated into the cell wall polysaccharide increased to 41% . At 37 degrees C, N-acetyl-{14C}glucosamine was incorporated preferentially into the peptidoglycan of the A-486-Var; almost three times as much of the label was incorporated into the peptidoglycan at 37 degrees C as was incorporated at 22 degrees C . Studies with protoplast membranes of these organisms showed similar differences, with a fourfold greater uptake of UDP-N-acetyl-{14C}glucosamine by the A-486-Var membranes at both incubation temperatures . These studies suggest that a defect in the incorporation of N-acetylglucosamine into the side chain of the polysaccharide is present in the A-486-Var strain at a step following the synthesis of UDP-N-acetylglucosamine . This defect, which may involve the UDP-N-acetylglucosamine transferase, is temperature dependent in the A-486-Var strain. Ann Microbiol (Paris), 1978 May-Jun, 129(4), 447 - 72 {Assay of human anti-exoproteins to group A streptococci by microhaemagglutination: correlation with anti-streptolysin O and various anti-enzymes (author's transl)}; Alouf JE et al.; A microhaemagglutination test in disposable U plates has been devised for rapid, quantitative evaluation in antistreptococcal antibodies in human sera . Fresh or freeze-dried glutaraldehyde-treated sheep erythrocytes sensitized with over fifteen extracellular proteins released by group A Streptococcus pyogenes including streptolysin O, deoxyribonucleases, hyaluronatelyase, streptokinase and nicotinamide dinucleotide glycohydrolase were used . Haemagglutination and anti-streptolysin O (ASLO) titers were determined in parallel on 434 serum specimens from 123 healthy subjects ("controls") and 311 patients with a history of supposed or evident streptococcal infection . The titration of the four above-mentioned anti-enzyme antibodies has also been made on about 100 sera from both groups . Haemagglutination titre (HT) was less than 800 in control sera . By contrast it was greater than 800 up to 12 800 in patients specimens . Very good correlation was found between HT on the one hand and ASLO or anti-SK, anti-HA and anti-NADase antibodies on the other hand . HT and anti-DNase B antibodies were less correlated . Haemagglutination titres appear to rise earlier than serological titres of conventional streptococcal antibodies . The haemagglutination test described may be particularly helpful as a rapid serologic indicator of streptococcal infections and more reliable than the titration of ASLO alone, or of any one of anti-enzyme antibodies. J Gen Microbiol, 1978 Apr, 105(2), 219 - 26 A study of the interaction between oral streptococci and hard surfaces; Rutter PR et al.; A rotating disc method was used to compare the tendencies of two oral streptococci to deposit on to glass and polystyrene surfaces from electrolyte solutions of varying ionic strength . Streptococcus salivarius had a greater tendency to deposit than had Streptococcus mitior under these condition . In addition to the balance of van der Waals' forces of attraction and electrostatic forces of repulsion, it is suggested that the adsorption to the glass and polystyrene surfaces of material present in the outer layers of the cell wall could play a significant part in the deposition of S . salivarius. Acta Pathol Microbiol Scand {B}, 1978 Apr, 86(2), 107 - 11 Rapid identification of group A, B, C and G beta-haemolytic Streptococci by a modification of the co-agglutination technique . Comparison of results obtained by co-agglutination, fluorescent antibody test, counterimmunoelectrophoresis, and precipitin technique; Arvilommi H et al.; A rapid modification of the co-agglutination (COA) technique for grouping A, B, C and G beta-haemolytic streptococci was developed . The results are obtained within three hours after inoculation from primary plates of 0.5 ml broth . This method was compared to the fluorescent antibody test (FA) and counterimmunoelectrophoresis (CIE), two other rapid methods available for serological grouping of streptococci . Of 71 recently isolated streptococcal strains from clinical sources, 70 were correctly grouped in COA, 63 in FA and 68 in CIE . With commercial reagents COA compared favourably in accuracy to the other methods and can be recommended for routine serological grouping of beta-haemolytic streptococci in the clinical laboratory. Zh Mikrobiol Epidemiol Immunobiol, 1978 Apr, (4), 97 - 101 {Relationship between bacteriocinogenic and non-bacteriocinogenic streptococcal cultures in experiments in vivo}; Kolesnichenko TG et al.; The data obtained pointed to a possible role of the phenomenon of bacteriocinogenia of streptococci, group A, in the formation of biocenoses in vivo, since in the present investigations it served as the principal and the leading factor determining the character and the result of interaction of the bacteriocinogenic and bacteriosensitive streptoccoci under conditions of combined infection of mice . Realization of the bacteriocinogenia phenomenon in vivo occurred as soon as the first hours of the infectious process development in the animals; for its manifestation definite quantitative correlations of bacteriocinogenic and bacteriocinosensitive strains were required. Zh Mikrobiol Epidemiol Immunobiol, 1978 Apr, (4), 119 - 25 {Further study of the L forms of Streptococci in blood cultures from the patients with rheumatic fever depending on the course of the disease and the methods of cultivation}; Klodnitskaia SN; Cultures of blood from patients with rheumatism during the active and inactive phases of the disease, treated and untreated with antibiotics were studied . The following results were obtained in blood cultures (on Klodnisky's medium with a 0.01% cystine) of 105 patients with rheumatism: L-forms of streptococcus were isolated in the 88 cases, irrespective of the severity of the disease or the treatment, streptococcus--in 8, and the result proved to be negative in 9 cases . Hemoculture on broth with a 1% glucose solution proved to be positive (streptococcus) in one patient only . The constancy with which the L-forms of streptococcus were isolated in hemocultures from the patients with rheumatism and also the peculiarity of their pathogenic properties modelling the rheumatism under experimental conditions pointed to their role in the pathogenesis of rheumatism . A method of isolation of hemocultures on Klodnitsky's medium with a 0.01% cystine can be recommended for the diagnosis of a septic condition caused by the L-forms of streptococcus in patients suffering from rheumatism. Zentralbl Bakteriol {Orig A}, 1978 Apr, 240(3), 302 - 12 The use of lysozyme-peroxidase-conjugates for the electron microscopic detection of peptidoglycan in the cell wall of streptococci; Wagner M et al.; Conjugation of lysozyme with horse radish peroxidase by means of glutaraldehyde results in a complex which retains the activities of both enzymes . The incubation of peptidoglycan with lysozyme-peroxidase followed by the reaction with 3,3'-diaminobenzidine and H2O2 results in a strong labelling of both sides . In contrast, after treatment with peroxidase alone no reaction was observed . Thus, the specific binding of lysozyme-peroxidase can be used for the electron microscopic localization of this component in the bacterial cell wall . Isolated peptidoglycane as well as trypsinized cell walls of group A and C streptococci were labelled both on the inner and the outer surface . The surface of intact cells of group A- and C-streptococci was labelled only sparsely . In contrast, by means of the indirect immunoferritin technique strong labelling of intact cells was effected with specific anti-peptidoglycan antibodies . The specificity of these antibodies are mainly directed to the peptide side chains . From this we suggest that in the cell wall of group A and C streptococci the lysozyme-sensitive part of the peptidoglycan is not so superficially localized as the peptides. Oral Surg Oral Med Oral Pathol, 1978 Apr, 45(4), 549 - 59 Experimental endocarditis induced by dental manipulation and oral streptococci; Bahn SL et al.; Circumstantial evidence has strongly implicated dental manipulation as an etiologic factor in the development of infective endocarditis . The introduction of human oral streptococci via the oral cavity in rabbits with vegetative cardiac lesions yields a 94 per cent incidence of infective endocarditis, if the number of inoculated organisms is above a threshold level of 10(7). Infect Immun, 1978 Apr, 20(1), 194 - 9 Filamentous capsulated streptococci from the human respiratory tract: chemical and immunochemical characterization of the polysaccharide capsular antigen of provisional binary capsular type 87; Venkateswaran PS et al.; The polysaccharide capsular antigen of the filamentous binary capsulated streptococcus of provisional type 87 and the polysaccharide capsular antigens of two pneumoccal strains transformed with deoxyribonucleic acid of streptococus type 87 have been purified and analyzed with regard to their component monosaccharides . The purified polysaccharides from the three strains were immunochemically identical . Each was found to contain rhamnose, glucose, galactose, galactosamine, and phosphate . Rhamnose was the immunodominant sugar. J Bacteriol, 1978 Apr, 134(1), 221 - 8 Purification and characterization of a hyaluronidase associated with a temperate bacteriophage of group A, type 49 streptococci; Benchetrit LC et al.; Urea treatment of a temperate bacteriophage from a type 49 strain of group A streptococcus (Streptococcus pyogenes) followed by ammonium sulfate fractionation, ion exchange, and affinity chromatography of solubilized proteins provided for the recovery (12%) and purification (44-fold) of the phage-associated hyaluronidase . The molecular weight of the homogeneous, purified enzyme was estimated to be 71,000 by polyacrylamide gel electrophoresis (in the presence of sodium dodecyl sulfate) and 75,000 by gel filtration with Sephacryl S-200 . The enzyme has a pH optimum of 5.5, a Vmax of 0.1 absorbance unit/min per microgram of protein, and a Km of 4.8 X 10(-2) mg/ml with umbilical cord hyaluronic acid as substrate . Of the cations tested, calcium and magnesium were the only effectors of the enzyme . The enzyme is a glycoprotein (7.25% carbohydrate) containing glucose, galactose, and glucosamine . Analysis of the amino acid composition revealed a predominance of acidic amino acids and a relatively high content of cysteine . The partial specific volume, estimated from the amino acid and sugar analyses, was 0.725 cm3/g. J Am Vet Med Assoc, 1978 Mar 15, 172(6), 676 - 80 Epizootic of concurrent cutaneous streptococcal abscesses and swinepox in a herd of swine; Miller RB et al.; Concurrent cutaneous abscesses and swinepox were observed in a herd of swine . An ungroupable hemolytic streptococcus was isolated from the abscesses . Tests indicated that streptococci isolated from different swine were similar if not identical . Swinepox lesions were observed on swine only after weaning . Lice (Haematopinus suis) were numerous on the suckling and weaned swine and appeared to be resistant to lindane . Abscesses, swinepox, and lice were eliminated after the swine were treated with an organic phosphate insecticide and antibacterial agents were added to the rations. J Pediatr, 1978 Mar, 92(3), 485 - 90 Oral antibiotic therapy for skeletal infections of children . II . Therapy of osteomyelitis and suppurative arthritis; Tetzlaff TR et al.; Antimicrobial regimens consisting of a brief initial period of parenteral therapy followed by oral therapy were investigated in infants and children with suppurative bone and joint disease . There were 30 patients with acute hematogenous disease (19 osteomyelitis; three osteoarthritis; eight arthritis) and five with subacute or chronic osteomyelitis . Disease was due to Staphylococcus aureus in 26, Hemophilus influenzae in five, streptococci in three, and S . aureus plus Streptococcus pyogenes in one patient . Pus was removed by surgical drainage or needle aspiration . Oral therapy was monitored by assay of antibiotic concentration and bactericidal activity in serum . Adjustments in dosage were made when necessary to assure a peak serum bactericidal titer of at least 1:8 . One patient progressed to chronic osteomyelitis but all other patients with acute disease responded well . Oral therapy provides increased patient comfort and decreases the risk of nosocomial infection associated with prolonged intravenous therapy . It should be carried out only under carefully monitored conditions in hospital to assure compliance and adequacy of serum bactericidal activity. Appl Environ Microbiol, 1978 Mar, 35(3), 592 - 600 Improved lysis of group N streptococci for isolation and rapid characterization of plasmid deoxyribonucleic acid; Klaenhammer TR et al.; Procedures for effective cellular lysis and plasmid deoxyribonucleic acid (DNA) isolation from group N streptococci were developed . Cells were grown at 32 degrees C for 4 h in a modified Elliker broth containing 20 mM DL-threonine . After cellular digestion with 2 mg of lysozyme per ml for 7 min at 37 degrees C, 1% sodium dodecyl sulfate exposure resulted in complete and immediate lysis . Lactose (Lac) plasmid species in Streptococcus lactis C2 and S . cremoris B1 (30 and 37 megadaltons, respectively) were demonstrated upon examination of DNA from the cleared lysates by agarose gel electrophoresis . Increasing the lysozyme treatment to 20 min or more resulted in loss of the Lac plasmid, whereas other resident plasmids were unaffected and demonstrable in agarose gels . Diethylpyrocarbonate added before lysis prevented Lac plasmid loss in 20-min lysozyme-treated cells, but was not effective after 40 min of lysozyme treatment . The results suggested that endogenous nuclease activity during the lysozyme treatment period initiated Lac plasmid DNA loss . The development of an efficient lysis procedure for the group N streptococci allowed rapid identification and characterization of plasmid DNA by agarose gel electrophoresis . The plasmid composition of S . lactis C2 and S . cremoris B1, as determined by agarose gel electrophoresis, compared favorably to previous electron microscopic observations. J Gen Microbiol, 1978 Mar, 105(1), 113 - 8 Peptide utilization by group N streptococci; Law BA; The rate of glycylleucine uptake by Group N streptococci varied widely . One strain of Streptococcus cremoris did not transport the dipeptide or utilize tripeptides . In peptide-utilizing strains, amino acid, dipeptide and tripeptide transport were distinct, although dipeptides inhibited tripeptide utilization . Specificity determinants for peptide transport and utilization were similar to those reported in Gram-negative bacteria . Peptide utilization in S . lactis was not completely dependent on the transport of intact peptides. Antimicrob Agents Chemother, 1978 Mar, 13(3), 399 - 404 Stepwise acquisition of multiple drug resistance by beta-hemolytic streptococci and difference in resistance pattern by type; Miyamoto Y et al.; We collected 1,353 strains of beta-hemolytic streptococci of groups A, B, C, and G (1,176 strains of which were group A) isolated in 26 institutions throughout Japan in 1972-1974 . The strains were grouped and T-typed by our specific group-and T-factor sera, and the minimal inhibitory concentrations of 10 antibiotics were assayed by the standard method . Resistant strains from the above collection were classified according to group, T-type, and drug resistance pattern . Our data on T-types for 1964-1971 and on drug resistance for 1966-1971 were used to interpret the detected long-term variations in T-type and drug resistance . The stepwise acquisition of multiple drug resistance, the difference in resistance pattern between predominant T-types, and the rarity of single-macrolide resistance were demonstrated. South Med J, 1978 Mar, 71(3), 242 - 6 Significance of hemolytic streptococci for Nashville school children: clinical and serologic observations; Quinn RW et al.; The results of this study (1969-1971 confirm previous findings that incidence rates for hemolytic and group A streptococci in Nashville school children fluctuate sporadically . During these two years, there was a significant decrease in streptococcal incidence and in typability of group A streptococci . A positive throat culture was not associated significantly more often with symptoms of an infection of the upper respiratory tract than when symptoms were absent . The larger the number of group A streptococci present in the throat culture, the more likely was a streptococcal antibody increase to occur . Nevertheless, some children with small numbers of group A streptococci had an antibody increase, and the degree of positivity of the throat culture was not a very accurate indication of whether an antibody response would occur . Epidemiologic factors such as age, sex, race, or crowding in the home did not seem to play a highly significant role in rates . Seasonal influences were marked in 1969-1970 but not in 1970-1971 . Regarding socioeconomic background, the rates were consistently lower in Clemons school, which serves a predominantly black neighborhood of higher socioeconomic level, than in the other two schools . Our findings confirm that the incidence of acquisition of the hemolytic streptococcus is a continually changing, dynamic process among school children. Antimicrob Agents Chemother, 1978 Mar, 13(3), 405 - 11 Treatment of osteomyelitis and septic arthritis with cefazolin; Fass RJ; Sixteen cases of severe osteomyelitis and septic arthritis caused by staphylococci, streptococci, gonococci, and a variety of gram-negative bacilli were treated with 4 to 8 g of parenteral cefazolin per day; nine received subsequent therapy with oral cephalexin or ampicillin . Of 16 infections, 15 were apparently cured . Cefazolin concentrations in those patients were: serum (peak), 25 to 216 micrograms/ml; synovial fluid, 24 to 46 micrograms/ml; and bone, 3.2 to 10.6 micrograms/g . Bacterial pathogens had minimal inhibitory concentrations of cefazolin of 2 micrograms or less per ml and seemed to be eradicated from foci of infection during therapy . One infection in a diabetic patient did not respond; despite high concentrations of cefazolin in serum, no detectable antibiotic was present in her infected metatarsal, and the infecting Escherichia coli (minimal inhibitory concentration, 16 micrograms/ml) was not eradicated during therapy . Concentrations of cefazolin in bone in 10 uninfected patients who received 1-g intramuscular doses prophylactically before surgery were also measured . Concentrations in bones from those who had normal renal function ranged from less than 0.6 to 2.8 micrograms/g. J Epidemiol Community Health, 1978 Mar, 32(1), 68 - 71 An epidemiological study of rheumatic fever and rheumatic heart disease in Lagos; Ogunbi O et al.; In Lagos 12 755 schoolchildren aged between six and 12 years were screened for evidence of rheumatic heart disease and showed a prevalence rate of 0.03% . Group C (27.7%) and group G (47.3%) predominated in the throat and in cases of pharyngitis, while group A predominated on the skin . Two hundred and sixty-six cases of pharyngitis were recorded, 70 (26.4%) were positive for beta-haemolytic streptococci . Half of the cases of streptococci while 28.2% and 21.1% were caused by groups C and G respectively . A diversity of serotypes of group A streptococci, which included types 49 and 55, and C and G streptococci were isolated from impetiginous skin lesions . The main point of interest is the association of group C and G streptococci with sore throat and skin infections . The pathogenicity of C and G in such circumstances merits further investigation . The present study also showed that prophylactic benzathine penicillin (Penadur) given to patients with rheumatic heart disease or rheumatic fever had been effective with no recurrent attack of acute rheumatic fever. Scand J Dent Res, 1978 Mar, 86(2), 108 - 17 Effect of inorganic ions and surface active organic compounds on the adherence of oral streptococci; Olsson J et al.; A reduction in the adherence of oral streptococci was observed after topical application of aluminum ions to standardized dentin test pieces whereas pyrophosphate and tripolyphosphate seemed to inhibit the adherence after incorporation in the incubation solution . A pronounced effect was recorded after topical application of surfactants with the positively charged primary amino group as end group . Hydrofluorides of several such aliphatic amines effectively reduced the number of colony-forming units washed off from the test pieces . Also the free base of hexadecylamine showed a similar effect . Inhibition of adherence was also obtained with long chain esters of lysine, with an optimum at 16 carbon atoms in the alcohol group . These compounds have the advantage of being built up from molecules known to the body. Tsitol Genet . 1978 Mar-Apr;12(2):10914. {Heterologous transformation: search for an explantation of the high effectiveness of Bacillus subtilis transformation achieved by using Bacillus natto DNA}; Cherepenko EI et al.; A higher efficiency of B . subtilis cells transformation by B . natto DNA is true for every concentration of DNA and is not due to the helping effect known for streptococci, strain Challis . In competition experiments for DNA uptake unlabelled B . natto and B . subtilis DNAs when added to transforming H3-DNA reduced the radioactivity of the samples by a factor of three and two, respectively . A conclusion is drawn that a higher rate of B . natto DNA penetration to the B . subtilis cells results in a higher efficiency of their transformation. Infect Immun, 1978 Mar, 19(3), 983 - 91 Existence of multiple immunodeterminants in the type-specific capsular substance of group B type Ia streptococci; Kane JA et al.; Rabbits immunized with group B, type Ia streptococci produce two distinct populations of protective antibodies . Evidence is presented indicating that these antibodies are directed against two major immunodeterminants which coexist in the specific type Ia antigen . Immunochemical data, using purified antibody preparations, indicate that the type substance, a sialic acid polymer consisting of galactose, glucose, glucosamine, and sialic acid, possesses two distinct immunodominant determinants, terminal sialic acid residues and a galactosyl oligosaccharide . Antibodies directed against either of these determinants were shown to possess in vivo and in vitro opsonic capabilities. Infect Immun, 1978 Mar, 19(3), 961 - 5 Immunodiffusion method for identification of group A streptococci; Lyampert IM et al.; The development of a method suitable for identification of group A streptococci by microprecipitation in gels is described . The method is based on preparation of specific sera containing high antibody levels agains the antigenic determinant characteristic of group A streptococcal polysaccharide . In a comparative study with a counterimmunoelectrophoresis method, the proposed test proved to be specific, easily read, and less complicated . Results were obtained in 2 h. J Infect Dis, 1978 Mar, 137(3), 274 - 91 Changing ecology of acute bacterial empyema: occurrence and mortality at Boston City Hospital during 12 selected years from 1935 to 1972; Finland M et al.; The occurrence, etiology, and demography of acute bacterial empyema are presented to reflect the widespread use of sulfonamides, penicillin, and other active antibiotics . In community-acquired (C-A) cases Streptococcus pneumoniae, hemolytic streptococci, and Staphylococcus aureus were the most frequent single organisms identified in initial positive cultures of pleural fluid during 1935 . S . pneumoniae declined steadily until 1953 but continued to occur frequently in C-A cases . Hemolytic streptococci became infrequent . S . aureus increased and became the most frequent organism in 1955 and declined to original levels after 1965 while gram-negative rods increased . S . aureus, aerobic gram-negative rods, and enterococci were most frequent in originally mixed infections, hospital-acquired cases, and superinfections . Anaerobes with or without aerobes were mostly seen in C-A cases and did not vary in incidence . Mortality increased with age . Overall mortality was greater during the 10 antibiotic years, associated with a marked decrease in the proportion of patients younger than 50 years and increase in those over 60 years old, and was greater in patients with serious underlying diseases subjected to more complicated surgical procedures. Ann Immunol (Paris), 1978 Feb-Mar, 129(2-3), 389 - 400 The isolation of thirteen cloned hybrid cell lines secreting mouse strain A derived antibodies with specificity for group A streptococcal carbohydrate; Rajewsky K et al.; Thirteen hybrid cell lines originating from the fusion of a BALB/c myeloma with strain A spleen cells were isolated each of which secreted an antibody with specificity for the carbohydrate of group A streptococci . The cell lines were stable over many in vivo passages in (BALB/c X A/J)F1 mice and secreted large amounts of antibodies into the serum and ascitic fluid of their hosts . Seven of the hybrid cell antibodies belonged to the IgM class, five were typed as IgG2a and one as an IgA immunoglobulin. Acta Pathol Microbiol Scand {B}, 1978 Feb, 86(1), 29 - 33 Binding of aggregated IgG in the presence of fresh serum by group A streptococci producing pharyngeal infection: possible connection with types frequently involved in acute nephritis; Christensen P et al.; 109 streptococcal strains, belonging to diverse serological groups and types, were investigated as regards their capacity to bind IgG aggregates in the presence of fresh serum . Strains capable of such binding were not found in groups B,C,D,E,G,L,M or N . Such binding was restricted to a few types of group A streptococci: the potentially nephritogenic types 2, 6 and 12, and four strains belonging to type M 39, M 46 and M 22 or M 62, the nephritogenic capacity of which is unknown . Two of five strains isolated from patients with acute post-stretococcal glomerulonephritis (AGN) and 19/28 type T 12, SOR-strains, isolated during an epidemic in a kindergarten with associated cases of AGN, were found to bind aggregates . The findings suggest a possible association between capacity to bind aggregates in the presence of serum and the serological types of group A streptococci involved in acute nephritis following pharyngeal infection. Zh Mikrobiol Epidemiol Immunobiol, 1978 Feb, (2), 120 - 5 {Specific experimental therapy in sensitization to group A streptococci}; Nugmanova ZhS et al.; A model of delayed hypersensitivity to Streptococcus hemolyticus, group A, were obtained in guinea pigs and rabbits . Studies of spontaneous changes of the immuno-allergic reactivity revealed that after a month of sensitization there developed delayed hypersensitivity only; according to the results of late skin tests it lasted not less than 6 months (the duration of investigation) . The delayed hypersensitivity component began to manifest itself in 2 1/2 to 3 months and increased later on . Specific hyposensitization was performed with streptococcus allergens differing by physico-chemical conditions, i.e . the corpuscula allergen, the one that was lysed by ultrasonic waves, and Ando-Verzhikovsky's allergen . The latter had the most intensive hyposensitizing features . Specific hyposensitization was more demonstrative after the intracutaneous long-term course injections of threshold doses . Administration of subthreshold doses, as well as subcutaneous or intravenous injections of the allergen, was ineffective. J Clin Microbiol . 1978 Feb;7(2):238. Rapid sodium chloride tolerance test for presumptive identification of enterococci; Qadri SM et al.; A rapid test is described which distinguishes enterococci from other group D streptococci in 8 to 24 h by use of a medium containing brain heart infusion agar, NaCl, dextrose, and bromocresol purple. J Clin Microbiol, 1978 Feb, 7(2), 194 - 201 Detection of group B streptococcal antibodies in human sera by radioimmunoassay: concentrations of type-specific antibodies in sera of adults and infants infected with group B streptococci; Wilkinson HW; Current interest in determining the possible protective role of antibodies against group B streptococcal disease prompted this study of the feasibility of using a radioimmunoassay to measure type-specific immunity in humans . The radioimmunoassay was standardized as a quantitative test for antibodies against the carbohydrate (CHO) antigens of all five group B types . The data showed that the CHO antigens extracted by a cold trichloroacetic acid-sonification method measure more antibodies than do the corresponding CHO antigens extracted by hot hydrochloric acid; that the Ia CHOs extracted from two different types, Ia and Ic, measure the same quantity of Ia antibodies; and that human sera contain antibodies reactive with all five type-specific CHOs . No evidence of "protective" antibody was found in the serum samples studied, although there was evidence of and antibody response in adults to prolonged colonization by group B streptococci . The wide ranges of antibody concentration in a serum bank collection, the broad reactivity of all human sera tested, and the mixed populations of antibodies in human sera that react with different determinants on the same type-specific CHO antigen (type III) indicate that further studies must be done to better define normal and susceptible populations and to determine antigenic components important in protection. J Clin Microbiol, 1978 Feb, 7(2), 176 - 9 Analysis of group B streptococcal types associated with disease in human infants and adults; Wilkinson HW; It is important to resolve existing differences of opinion regarding group B streptococcal type distribution in human disease because of the relevance of type prevalence to future programs of prevention . This report compares data obtained from typing 392 group B streptococci isolated from systemic infections in both infants and adults in the United States from 1972 through 1975 . The data showed a substantial predominance of type III among strains isolated from cases of infant meningitis and from "late-onset" septicemia but did not confirm a prior report that type Ia causes most cases of "early-onset" infant septicemia . Type II was the predominant serotype among 11 cerebrospinal fluid isolates from adults . The fact that over one-fourth of the isolates were types other than Ia or III means that future epidemiological studies, including definition of immunological factors, must include all five group B types. Infect Immun, 1978 Feb, 19(2), 741 - 4 Adult mice as a model for early onset group B streptococcal disease; Wennerstrom DE et al.; The intravenous inoculation of adult mice with virulent group B streptococci serotype Ia resulted in fulminating sepsis with extensive colonization of the lungs and kidneys . The time course of the infection lasting 24 to 40 h, extensive pulmonary colonization, and resistance of the type Ia organism to phagocytosis in the absence of specific antibody suggest that mice are an appropriate model for the study of early onset streptococcal infection of human neonates. Infect Immun, 1978 Feb, 19(2), 481 - 5 Chicken embryo model for type III group B beta-hemolytic streptococcal septicemia; Tieffenberg J et al.; A lethal septicemia was induced in 11- and 12-day-old chicken embryos with intravenous inoculation of relatively small numbers of a clinical isolate (GBBHS-III-Bell) or a reference strain (GBBHS-III-D136-C) of group B beta-hemolytic streptococci (GBBHS) . GBBHS-III-Bell was more virulent than GBBHS-III-D136-C, and 11-day-old chicken embryos were more susceptible than 12-day-old chicken embryos . Type-specific rabbit antisera protected the embryos from bacterial challenge, and this protective effect was absorbed with homologous but not heterologous GBBHS strains . A heterologous antiserum and normal rabbit sera provided some protection, which could be absorbed with either homologous or heterologous GBBHS strains . The chicken embryo is a suitable animal model for the study of infection and immunity with GBBHS type III. Johns Hopkins Med J, 1978 Feb, 142(2), 39 - 45 Serious group B beta-hemolytic streptococcal infections in adults: report of two cases and review of the literature; Nicklas JM; Adult infections with group B beta-hemolytic streptococci have been infrequently reported in the past . Two patients described herein, one with meningitis and the other with suppurative arthritis, emphasize that the organism is a potential pathogen and cause of serious infections in adults . The literature pertinent to these group B streptococcal infections is reviewed. J Pediatr, 1978 Feb, 92(2), 325 - 33 Tropical acute rheumatic fever and associated streptococcal infections compared with concurrent acute glomerulonephritis; Potter EV et al.; Ninety-three patients with acute rheumatic fever and 195 patients with acute glomerulonephritis were observed in Trinidad during an outbreak of scabies with a high incidence of secondary streptococcal infections . Clinical and laboratory manifestations of ARF were the same as those seen in temperate zones, except that antistreptolysin O titers were less markedly increased . The patients with ARF were similar to those with AGN in respect to sex, race, location of residence, and living conditions, but were older and had markedly fewer skin infections . Currently prevalent nephritogenic streptococcal strains never were isolated from patients with ARF even when M55 streptococci appeared and led to an epidemic of AGN. Acta Pathol Microbiol Scand {C}, 1978 Feb, 86(1), 41 - 3 Lancefield extract of group A streptococci type 15 acts like an anti-human IgG with restricted specificity; Schalen C et al.; Lancefield extract of streptococci group A type 15 precipitates certain human sera and agglutinates red cells coated with some IgG anti-Rh antibodies . The frequency of precipitation varies between populations . The serum component in the precipitate is IgG . The results indicate that an iso-allotypic marker is detected by the extract. J Clin Microbiol, 1978 Feb, 7(2), 111 - 3 Efficacy of direct Gram stain in differentiating staphylococci from streptococci in blood cultures positive for gram-positive cocci; Agger WA et al.; A preponderance of clusters seen on direct Gram stain of blood cultures positive for gram-positive cocci was 98% sensitive and 100% specific for identification of staphylococcal species or of Peptococcus . A preponderance of chains, pairs, or both was 100% sensitive and 98% specific for identifying streptococci . Further presumptive identification of either staphylococci or streptococci based on microscopic morphology was unreliable . The direct Gram stain is highly reliable for differentiating staphylococci from streptococci and should be of considerable value to clinicians selecting initial antimicrobial therapy. Immun Infekt, 1978 Feb, 6(1), 28 - 32 {Correlation of growth-phase and streptodornase-production of beta-hemolytic streptococci group A (author's transl)}; Ti