Infect Immun, 2003 Sep, 71(9), 5376 - 80 Intracellular survival of Streptococcus pyogenes in polymorphonuclear cells results in increased bacterial virulence; Medina E et al.; It has recently been shown that survival within phagocytic cells constitutes an additional strategy used by Streptococcus pyogenes to evade the host defenses . Here we provide evidence that S . pyogenes can escape from the phagosome into the cytoplasm of phagocytic cells . Furthermore, intracellular bacteria seem to undergo phenotypic switching that results in much more virulent microorganisms. Infect Immun, 2003 Sep, 71(9), 5169 - 77 Insertional inactivation of pac and rmlB genes reduces the release of tumor necrosis factor alpha, interleukin-6, and interleukin-8 induced by Streptococcus mutans in monocytic, dental pulp, and periodontal ligament cells; Engels-Deutsch M et al.; Streptococcus mutans possesses different cell wall molecules, such as protein of the I/II family, the serotype f polysaccharide rhamnose glucose polymer (RGP), and lipoteichoic acid (LTA), which act as adhesins and modulins, allowing S . mutans to colonize teeth and cause dental caries and pulpitis . We tested several isogenic mutants of S . mutans defective in protein I/II and/or RGP, as well as purified modulins such as protein I/II, RGP, and LTA, for their binding and activation abilities on monocytic, dental pulp (DP), and periodontal ligament (PDL) cells . Our results demonstrate that both protein I/II and RGP play important roles in streptococcal adherence to human monocytic and fibroblastic cells, whereas LTA is only a minor adhesin . In the activation process, the cytokine response elicited is polarized toward a Th1 response which seems principally due to protein I/II and RGP . Even if protein I/II seems to be more efficient in its purified form in triggering cells to release interleukin-8 (IL-8), RGP is the most efficient cytokine-stimulating component in intact bacteria, while LTA plays only a minor role . In cell activation, we showed, by using either cytochalasin D or coated ligands, that internalization of either S . mutans, S . mutans isogenic mutants, or purified ligands is not necessary to trigger cells to release IL-8 . We also showed that, besides the implication of monocytes in pulpal inflammation, fibroblast-like cells such as DP and PDL cells are also actively implicated in local inflammation and in the generation of a Th1 response after stimulation with S . mutans cells or antigens. Infect Immun, 2003 Sep, 71(9), 5056 - 64 Analysis of RogB-controlled virulence mechanisms and gene repression in Streptococcus agalactiae; Gutekunst H et al.; Streptococcus agalactiae is the leading cause of bacterial sepsis and meningitis in neonates and also the causative agent of different serious infections in immunocompromised adults . The wide range of diseases that are caused by S . agalactiae suggests regulatory mechanisms that control the formation of specific virulence factors in these bacteria . The present study describes a gene from S . agalactiae, designated rogB, encoding a protein with significant similarity to members of the RofA-like protein (RALP) family of transcriptional regulators . Disruption of the rogB gene in the genome of S . agalactiae resulted in mutant strain RGB1, which was impaired in its ability to bind to fibrinogen and fibronectin . Mutant RGB1 also exhibited a reduced adherence to human epithelial cells but did not show an altered invasion of eukaryotic cells . By real-time PCR analysis, mutant RGB1 revealed an increased expression of the cpsA gene, encoding a regulator of capsule gene expression . However, strain RGB1 exhibited a reduced expression of the rogB gene and of two adjacent genes, encoding putative virulence factors in S . agalactiae . Furthermore, mutant RGB1 was impaired in the expression of the fbsA gene, coding for a fibrinogen receptor from S . agalactiae . The altered gene expression in mutant RGB1 could be restored by plasmid-mediated expression of rogB, confirming a RogB deficiency as the cause for the observed changes in virulence gene expression in S . agalactiae . Reporter gene studies with a promotorless luciferase gene fused to fbsA allowed a growth-dependent analysis of fbsA expression in S . agalactiae . These reporter gene studies also suggest that RogB exerts a positive effect on fbsA expression in S . agalactiae. Infect Immun, 2003 Sep, 71(9), 5033 - 41 An Enterococcus faecium secreted antigen, SagA, exhibits broad-spectrum binding to extracellular matrix proteins and appears essential for E . faecium growth; Teng F et al.; A gene encoding a major secreted antigen, SagA, was identified in Enterococcus faecium by screening an E . faecium genomic expression library with sera from patients with E . faecium-associated endocarditis . Recombinant SagA protein showed broad-spectrum binding to extracellular matrix (ECM) proteins, including fibrinogen, collagen type I, collagen type IV, fibronectin, and laminin . A fibrinogen-binding protein, purified from culture supernatants of an E . faecium clinical isolate, was found to match the N-terminal sequence of the predicted SagA protein and to react with the anti-SagA antibody, confirming that it was the SagA protein; this protein appeared as an 80- to 90-kDa smear on a Western blot that was sensitive to proteinase K and resistant to periodate treatment and glycoprotein staining . When overexpressed in E . faecium and Escherichia coli, the native and recombinant SagA proteins formed stable oligomers, apparently via their C-terminal domains . The SagA protein is composed of three domains: (i) a putative coiled-coil N-terminal domain that shows homology to the N-terminal domain of Streptococcus mutans SagA protein (42% similarity), previously shown to be involved in cell wall integrity and cell shape maintenance, and to the P45 protein of Listeria monocytogenes (41% similarity); (ii) a central domain containing direct repeats; and (iii) a C-terminal domain that is similar to that found in various proteins, including P45 (50% similarity) and P60 (52% similarity) of L . monocytogenes . The P45 and P60 proteins both have cell wall hydrolase activity, and the latter has also been shown to be involved in virulence, whereas cell wall hydrolase activity was not detected for SagA protein . The E . faecium sagA gene, like the S . mutans homologue, is located in a cluster of genes encoding proteins that appear to be involved in cell wall metabolism and could not be disrupted unless it was first transcomplemented, suggesting that the sagA gene is essential for E . faecium growth and may be involved in cell wall metabolism . In conclusion, the extracelluar E . faecium SagA protein is apparently essential for growth, shows broad-spectrum binding to ECM proteins, forms oligomers, and is antigenic during infection. Infect Immun, 2003 Sep, 71(9), 4925 - 35 ZmpB, a novel virulence factor of Streptococcus pneumoniae that induces tumor necrosis factor alpha production in the respiratory tract; Blue CE et al.; Inflammation is a prominent feature of Streptococcus pneumoniae infection in both humans and animal models . Indeed, an intense host immune response to infection is thought to contribute significantly to the pathology of pneumococcal pneumonia and meningitis . Previously, induction of the inflammatory response following infection with S . pneumoniae has been attributed to certain cell wall constituents and the toxin pneumolysin . Here we present data implicating a putative zinc metalloprotease, ZmpB, as having a role in inflammation . Null mutations were created in the zmpB gene of the virulent serotype 2 strain D39 and analyzed in a murine model of infection . Isogenic mutants were attenuated in pneumonia and septicemia models of infection, as determined by levels of bacteremia and murine survival . Mutants were not attenuated in colonization of murine airways or lung tissue . Examination of cytokine profiles within the lung tissue revealed significantly lower levels of the proinflammatory cytokine tumor necrosis factor alpha following challenge with the Delta zmpB mutant (Delta 739) . These data identify ZmpB as a novel virulence factor capable of inducing inflammation in the lower respiratory tract . The possibility that ZmpB was involved in inhibition of complement activity was examined, but the data indicated that ZmpB does not have a significant effect on this important host defense . The regulation of ZmpB by a two-component system (TCS09) located immediately upstream of the zmpB gene was examined . TCS09 was not required for the expression of zmpB during exponential growth in vitro. Infect Immun, 2003 Sep, 71(9), 4842 - 9 MtuA, a lipoprotein receptor antigen from Streptococcus uberis, is responsible for acquisition of manganese during growth in milk and is essential for infection of the lactating bovine mammary gland; Smith AJ et al.; A mutant strain of Streptococcus uberis (AJS001) that was unable to grow in bovine milk was isolated following random insertional mutagenesis . The level of growth in milk was restored to that of the parental strain (strain 0140J) following addition of MnSO(4) but not following addition of other metal ions . The mutant contained a single insertion within mtuA, a homologue of mtsA and psaA, which encode metal-binding proteins in Streptococcus pyogenes and Streptococcus pneumoniae, respectively . Strain AJS001 was unable to infect any of eight quarters on four dairy cows following intramammary challenge with 10(5) CFU . Bacteria were never recovered directly from milk of these animals but were detected following enrichment in Todd-Hewitt broth in three of eight milk samples obtained within 24 h of challenge . The animals showed no inflammatory response and no signs of mastitis . Three mammary quarters on two different animals simultaneously challenged with 600 CFU of the parental strain, strain 0140J, became colonized, shed high numbers of S . uberis organisms in milk, displayed a marked inflammatory response to infection, and showed overt signs of mastitis . These data indicate that mtuA was required for efficient uptake of Mn(2+) during growth in bovine milk and infection of the lactating bovine mammary gland. Kansenshogaku Zasshi, 2003 Jul, 77(7), 510 - 5 {Hospital-acquired Streptococcus pneumoniae infection}; Nagata K et al.; Three elderly patients were consecutively found to harbor or to become infected with intermediate-level penicillin-resistant Streptococcus pneumoniae in a hospital respiratory ward . All the isolates from the respective patients produced mucoid-type colonies on sheep blood agar plates and were found to have an identical antibiogram, indicating that those were resistant against erythromycin, clarithromycin, clindamycin and minocycline . Pulse-field gel electrophoresis of genomic DNA digested Sma I and Apa I demonstrated homology among the isolates, which may suggest person-to-person spread in a hospital setting . With this, it is an urgent to establish the institution-based infection control precautions against S . pneumoniae. Ginekol Pol, 2003 Jun, 74(6), 463 - 7 {Significance of group B streptococcus (GBS) infections in parturient women}; Wilk K et al.; OBJECTIVES: Maternal infections of group B streptococcus (GBS) has recently been associated with preterm labor and early onset of neonatal infections . DESIGN: The aim of this study was to determine the incidence of GBS infections in parturient women, as well as, GBS infections influence on the pregnancy duration, cesarean section rate, birth weight and Apgar score . MATERIALS AND METHODS: A total of 701 cervical swabs were taken and cultured from pregnant women, who came to delivered to Department of Obstetrics and Gynaecology of Silesian Medical School from 1st of January to 30th of September 2002 . Results of cervical swabs cultures were clinically analyzed . Mann Whitney test was used to perform statistical analysis . RESULTS: In 23 of 701 women (3.3%) who were admitted to our department GBS infections were detected . In women with GBS, preterm birth and low birth weight, as well as, low Apgar score were more frequently observed . CONCLUSIONS: Positive--GBS infection cervical swabs was found in 23 of 701 parturient women (3.3%) who were admitted to our department . In women with GBS, higher preterm birth rate, as well as, higher cesarean section rate performed because of intrauterine infection were observed, but the differences were not statistically significant. Oral Microbiol Immunol, 2003 Oct, 18(5), 333 - 7 Coaggregation of Streptococcus salivarius with periodontopathogens: evidence for involvement of fimbriae in the interaction with Prevotella intermedia; Levesque C et al.; Streptococcus salivarius is divided into two serological subgroups that carry either fibrils or fimbriae . Although fimbriae have been observed on up to 50% of S . salivarius strains in the human oral cavity, no function has yet been assigned to them . To determine whether S . salivarius fimbriae have a role in adhesion, we examined the ability of S . salivarius to coaggregate with selected microorganisms involved in periodontal diseases . Our results show that S . salivarius coaggregated with Fusobacterium nucleatum, Porphyromonas gingivalis, and Prevotella intermedia . However, only fimbriated S . salivarius cells were able to coaggregate with P . intermedia, suggesting a specific role for these structures in the interaction . Heat treatment, sensitivity to sugars, amino acids, and EDTA, as well as protease treatment were also used to further characterize coaggregation between S . salivarius and periodontopathogens. Oral Microbiol Immunol, 2003 Oct, 18(5), 293 - 7 Biochemical and functional properties of a pyruvate formate-lyase (PFL)-activating system in Streptococcus mutans; Takahashi-Abbe S et al.; Streptococcus mutans has an oxygen-sensitive enzyme, pyruvate formate-lyase (PFL), which is a key enzyme in anaerobic sugar fermentation . We have shown that S . mutans has an activating system, including a PFL-activating enzyme (PFL-activase) and an electron transport system; the latter transfers an electron from NADPH to PFL-activase, as occurs in Escherichia coli . NADPH was a physiological electron donor for the electron transport system and as little as 0.02 mM NADPH activated over 80% of PFL of S . mutans . The optimum pH of the PFL-activating system was around 6.8, whereas the optimum of the E . coli system is at alkaline pH . In addition, small dialyzable molecules in cell-free extracts participated in keeping PFL active in S . mutans . These results suggest that, in dental plaque under anaerobic conditions where sugar supply is often limited or pH frequently falls below neutrality, S . mutans always keeps PFL active through the activating system. Oral Microbiol Immunol, 2003 Oct, 18(5), 271 - 7 Intranasal immunization of humans with Streptococcus mutans antigens; Li F et al.; To evaluate the effectiveness of a low dose of soluble or liposomal (L) glucosyltransferase-enriched preparation (E-GTF) in inducing mucosal immune responses after intranasal immunization, 12 adults were immunized on days 0 and 7 by the IN route with 62.5 microg of soluble E-GTF or L-E-GTF . An increase in the mean salivary IgA anti-E-GTF response (P < 0.03) was seen in the L-E-GTF but not the soluble E-GTF group . A significant increase (P < 0.05) in the mean specific IgA antibody activity was also seen in nasal wash from both groups . Although the nasal wash responses were higher in the L-E-GTF than in the soluble E-GTF group, they were not significantly different . The soluble E-GTF immunized group showed a higher serum IgG response than the L-E-GTF immunized group on day 90 (P < 0.05) . These results indicate that as little as 62.5 microg of E-GTF, when given by the intranasal route, induced an IgA response in secretions. J Immunol, 2003 Sep 1, 171(5), 2354 - 65 Two distinct mechanisms for induction of dendritic cell apoptosis in response to intact Streptococcus pneumoniae; Colino J et al.; Apoptotic dendritic cells (DCs) are ineffective at inducing immunity . Thus, parameters that regulate DC viability during a primary infection will help to determine the outcome of the subsequent immune response . In this regard, pathogens have developed strategies to promote DC apoptosis to counterbalance the nascent primary immune response . We demonstrate, using cultured bone marrow-derived DCs, that Streptococcus pneumoniae can induce DC apoptosis through two distinct mechanisms: 1) a rapid, caspase-independent mechanism of apoptosis induction, critically dependent on bacterial expression of pneumolysin, and 2) a delayed-onset, caspase-dependent mechanism of apoptosis induction associated with terminal DC maturation . Delayed-onset apoptosis does not require bacterial internalization, but rather is triggered by the interaction of bacterial subcapsular components and bone marrow-derived DC (likely Toll-like) receptors acting in a myeloid differentiation factor 88-dependent manner . In this regard, heavy polysaccharide encapsulation interferes with both DC maturation and apoptosis induction . In contrast, neither CD95/CD95 ligand interactions nor TNF-alpha appear to play a role in the delayed onset of apoptosis . These data are the first to define two mechanistically distinct pathways of DC apoptosis induction in response to an extracellular bacterium that likely have important consequences for the establishment of antibacterial immunity. Br J Ophthalmol, 2003 Sep, 87(9), 1103 - 8 Severe infective keratitis leading to hospital admission in New Zealand; Wong T et al.; AIM: To identify key risk factors and the management and outcome of severe infective keratitis leading to public hospital admission in New Zealand . METHODS: Over a 2 year period, all admissions of presumed infective keratitis to Auckland Hospital were identified . The clinical records of all 103 cases were retrospectively reviewed with respect to clinical features, risk factors, management, and outcomes . RESULTS: The mean time from first symptoms or signs and presentation to hospital was 8.9 (SD 15.5) days . The majority of subjects, 88%, had at least one of the risk factors commonly associated with infective keratitis including previous ocular surgery (30%), contact lens wear (26%), topical corticosteroid use (25%), and ocular trauma (24%) . Corneal scraping was performed in 92% and of a total of 105 scrapes, 71% were positive . Bacteria were isolated in all these cases, the majority being Gram positive organisms (72%) . The most common isolates identified were coagulase negative Staphylococcus (16%), Propionibacterium acnes (14%), Staphylococcus epidermidis (11%), and Streptococcus pneumoniae (9%) . In addition, yeasts were isolated in 5%, fungi in 4%, virus in 2%, and chlamydia in 1% . Importantly, polymicrobial infection accounted for 33% of culture positive cases . Antimicrobial treatment was changed on the basis of culture results in 17 cases (16.5%) . Median initial visual and final best corrected visual acuity was 6/36-6/48 (logMAR 0.86) (IQR 0.39-2.00) and 6/12-6/15 (logMAR 0.360) (IQR 0.15-1.70), respectively . Previous ocular surgery and topical corticosteroid use were significantly associated with poorer visual acuity . The mean hospital stay was 5.8 days and the median 4.0 (IQR 2.0-8.0) days . Longer duration of stay was associated with the presence of hypopyon, larger ulcers, previous ocular surgery, and poor visual acuity . CONCLUSIONS: Infectious keratitis is an important cause of ocular morbidity . A significant proportion of cases have potentially modifiable risk factors . Previous ocular surgery and topical corticosteroid use, in particular, were associated with poorer visual outcomes . Many cases of severe keratitis might be avoided, or their severity reduced, by appropriate education of patients and ophthalmologists. Int J Antimicrob Agents, 2003 Aug, 22(2), 140 - 6 Alterations in penicillin binding protein gene of Streptococcus pneumoniae and their correlation with susceptibility patterns; Ohsaki Y et al.; Penicillin binding protein (pbp) gene alterations of 328 clinical isolates of Streptococcus pneumoniae were examined for a correlation with their antibiotic-resistance . The frequency of penicillin G (PEN-G) resistance was determined to clarify susceptibility to several antibiotics, namely PEN-G, ampicillin, sulbactam/ampicillin, cefozopram, panipenem (PAPM), clarithromycin (CLR), azithromycin (AZM) and levofloxacin (LVX) . Oligonucleotide primers for three pbp genes (pbp1a, pbp2x and pbp2b) were used to detect mutations in pbp . Of the strains, 25.9% were classified as Pen-Gs, 68.0% as Pen-Gir and 6.1% as Pen-Gr . The polymerase chain reaction product for wild-type pbp1a was found in 185 isolates, that for wild-type pbp2x was found in 66 isolates and that for wild-type pbp2b was found in 213 isolates . None of these three genes was detectable in 100 isolates while all of them were detected in 64 isolates (1aw/2xw/2bw) . Of those 64 isolates with 1aw/2xw/2bw, the minimum inhibitory concentration (MIC) of PEN-G was < or =0.06 mg/l for 54 isolates and 0.12 mg/l for 10 isolates . Of the 272 strains for which the MIC of PAPM was < or =0.03 mg/l, there were 85 Pen-Gs, 184 Pen-Gir and three Pen-Gr isolates . Three strains for which the MIC of LVX was > or =4.0 mg/l included one Pen-Gs and two Pen-Gir isolates . The MICs of CLR correlated significantly with those of AZM . The MIC of CLR was > or =1 mg/l for 216 isolates, and the MIC of AZM was > or =1 mg/l for 244 of them . These data suggested that PAPM may be effective against S . pneumoniae infection, although acquisition of resistance should be considered . LVX also seemed to be effective against S . pneumoniae. Am J Vet Res, 2003 Aug, 64(8), 976 - 81 Identification of variations in SzP proteins of Streptococcus equi subspecies zooepidemicus and the relationship between protein variants and clinical signs of infection in horses; Walker RL et al.; OBJECTIVE: To determine whether previously unidentified variations of the SzP protein of Streptococcus equi subsp zooepidemicus were present in horses with various clinical signs of infection and whether any relationship could be identified between SzP protein variants and naturally occurring clinical conditions . SAMPLE POPULATION: 23 isolates of S equi subsp zooepidemicus were recovered from specimens of horses with various clinical conditions and used as a representative population of isolates for evaluation of different SzP protein variants . PROCEDURE: Genetic heterogeneity of the isolates was demonstrated by repetitive extragenic palindromic-polymerase chain reaction analysis . The SzP gene was sequenced and the presumed protein sequence determined for each isolate . Characteristics of the SzP proteins were compared among the isolates and in relation to the clinical conditions of horses from which they were recovered . RESULTS: The signal peptide types, number of proline-glutamic acid-proline-lysine repeats, and anchor sequences were consistent with those previously described for the SzP protein . Many of the isolates clustered with 5 previously described types on the basis of the hypervariable region of the SzP protein . One additional variant, which represented 8 of the isolates, was identified . Particular motifs in the hypervariable region accounted for many of the differences among hypervariable types . CONCLUSIONS AND CLINICAL RELEVANCE: The SzP protein appears to be limited to a selected number of types . Variations in the SzP protein are frequently determined on the basis of different motifs rather than random amino acid substitutions . There does not appear to be any association of SzP protein variations and clinical manifestations of infection in horses. Mamm Genome, 2003 Jul, 14(7), 448 - 53 A major locus conferring susceptibility to infection by Streptococcus pneumoniae in mice; Denny P et al.; We have studied the genetics of susceptibility to infection by Streptococcus pneumoniae in mice . Linkage analysis of the F(2) generation from a cross between resistant BALB/cO1aHsd and susceptible CBA/CaO1aHsd strains allowed us to map a major locus controlling the development of bacteremia and survival after intranasal infection. Caries Res, 2003 Sep-Oct, 37(5), 374 - 80 Detection of Streptococcus mutans and Streptococcus sobrinus on the permanent first molars of the Mosuo people in China; Wu H et al.; Streptococcus mutans and Streptococcus sobrinus are associated with the development of dental caries . The purpose of this study was to differentiate these bacteria by morphology, biochemical characteristics and PCR, and to compare their occurrence with the prevalence of dental caries in the Mosuo people . Plaque samples were collected from the permanent first molar in 126 Mosuo people (83 females, 43 males, aged 25-55 years, average age 36.1 +/- 7.73) . Dental status was recorded as DMFT by WHO caries diagnostic criteria . Males had a significantly lower prevalence of caries and DMFT than females: 11.4 vs . 86.9% and 1.65 vs . 6.95, respectively (p<0.001) . Morphological and biochemical tests gave unreliable results . The prevalence of S . mutans and S . sobrinus was 75.4 and 57.1%, respectively . 26.5% of females and 53.5% of males were positive for S . mutans alone, 18.1% of females and 16.3% of males were positive for S . sobrinus alone, while 50.6% of females and 18.6% of males were positive for both S . mutans and S . sobrinus and 4.8% of females and 11.6% of males were negative for both species . The DMFT scores of subjects positive for both S . mutans and S . sobrinus were significantly higher than of those positive for either S . mutans or S . sobrinus alone . These results indicate that subjects harboring both S . mutans and S . sobrinus have a significantly higher prevalence of dental caries than those with S . mutans or S . sobrinus alone . Clin Microbiol Infect, 2003 Jul, 9(7), 741 - 5 Activity of telithromycin compared with seven other agents against 1039 Streptococcus pyogenes pediatric isolates from ten centers in central and eastern Europe; Bozdogan B et al.; In total, 1039 pediatric Streptococcus pyogenes isolates from Bulgaria, Croatia, the Czech Republic, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia and Slovenia were studied . All strains were susceptible to penicillin G, levofloxacin, and quinupristin-dalfopristin, 91-100% to telithromycin, and 82-100% to erythromycin, azithromycin, and clarithromycin, and 90-100% to clindamycin . Macrolide resistance occurred mainly in Slovakia (25%), the Czech Republic (17.3%), and Croatia (15.8%) . Overall, 9.7% of S . pyogenes isolates were erythromycin resistant due to erm(B)- or erm(A)-encoded methylases (72.3%) or to a mef(A)-encoded efflux pump (25.7%) . One strain had alterations of both 23S rRNA (A2058G Escherichia coli numbering) and ribosomal protein L22 (G95D). Clin Microbiol Infect, 2003 Jul, 9(7), 738 - 40 A five-year survey of pneumococcal peritonitis in two Danish counties--incidence, diagnosis and clinical entities; Nielsen KR et al.; Eighteen patients with pneumococcal peritonitis were hospitalized in a five-year survey period from a Danish catchment population of 730 000 (0.5/100 000/year) . They were naturally divided into three groups: (1) six children with appendicitis; (2) eight women of childbearing age with pelvic inflammatory disease (PID); and (3) four elderly patients with ulcerating gastric diseases . Complications were observed in six patients . All infections were community-acquired, but the pneumococcal etiology was not suspected before the organism was isolated in the laboratory . A classification of peritonitis caused by Streptococcus pneumoniae is discussed. Clin Microbiol Infect, 2003 Jul, 9(7), 704 - 7 In vitro activity of telithromycin (HMR 3647) against Greek Streptococcus pyogenes and Streptococcus pneumoniae clinical isolates with different macrolide susceptibilities; Ioannidou S et al.; The susceptibilities to macrolides and telithromycin of 161 Streptococcus pyogenes and 145 Streptococcus pyogenes strains, consecutively isolated from five Greek hospitals, were determined by Etest . Moreover, mechanisms of resistance to macrolides were phenotypically and genetically determined by double disk induction test and PCR, respectively . Of the S . pneumoniae and S . pyogenes isolates, 42.8% and 30.8%, respectively, were found to be resistant to erythromycin . Of the erythromycin-resistant S . pneumoniae and S . pyogenes isolates, 57.5% and 59.5%, respectively, displayed the M phenotype and harbored the mefA/E gene . Telithromycin was found to be more active than both erythromycin and clarithromycin against both species, with considerably lower MIC50 and MIC90 values. Clin Microbiol Infect, 2003 Jul, 9(7), 653 - 61 Activity of telithromycin and seven other agents against 1034 pediatric Streptococcus pneumoniae isolates from ten central and eastern European centers; Bozdogan B et al.; OBJECTIVE: To test the activity of telithromycin against 1034 Streptococcus pneumoniae isolates from pediatric patients in ten centers from ten central and eastern European countries during 2000-2001, and to compare it with the activities of erythromycin A, azithromycin, clarithromycin, clindamycin, and quinupristin-dalfopristin . METHODS: The minimum inhibitory concentrations (MICs) of telithromycin, erythromycin A, azithromycin, clarithromycin, clindamycin, levofloxacin, quinupristin-dalfopristin and penicillin G were tested by the agar dilution method with incubation in air, and mechanisms of resistance to macrolides and quinolones were investigated . RESULTS: Strains were isolated from sputum, tracheal aspirates, ear, eye, blood, and cerebrospinal fluid . Among S . pneumoniae strains tested, 36% had raised penicillin G MICs (>/= 0.12 mg/L) . Susceptibilities were as follows: telithromycin, quinupristin-dalfopristin and levofloxacin, >/= 99%; clindamycin, 83%; and erythromycin A, azithromycin and clarithromycin, 78% . Of 230 (22.3%) erythromycin A-resistant S . pneumoniae strains, 176 (79.6%) had erm(B), 38 (16.1%) had mef(A), and 10 (4.3%) had mutations in 23S ribosomal RNA or in ribosomal protein L4 . The rates of drug-resistant S . pneumoniae are high in all centers except Kaunas, Riga, and Prague . CONCLUSION: Telithromycin had low MICs against all strains, irrespective of macrolide, azalide or clindamycin resistance . Ribosomal methylation was the most prevalent resistance mechanism among all resistant strains, except in Sofia, where the prevalence of the efflux mechanism was higher. Clin Microbiol Infect, 2003 Jul, 9(7), 614 - 8 Invasive pneumococcal infections: a clinical and microbiological analysis of 53 patients in Taiwan; Lee CY et al.; OBJECTIVE: To track penicillin susceptibility among Streptococcus pneumoniae causing invasive diseases and to evaluate risk factors for antibiotic resistance . METHODS: A retrospective study was performed in a medical center of all patients with invasive pneumococcal infections based on positive microbiological findings, confirmed by appropriate clinical and laboratory findings . MICs of penicillin and ceftriaxone were determined and interpreted by NCCLS methodology . RESULTS: Fifty-three episodes of invasive S . pneumoniae infections (ISPI) among 22 children and 31 adults were identified . The disease patterns of ISPI were similar between children and adults, and the most common modes were pneumonia (70%) and primary bacteremia (23%) . The rate of penicillin-nonsusceptible S . pneumoniae (PNSP) isolated from pediatric patients was higher than that in adult patients (95.5% vs . 54.8%, P < 0.001) . This finding was correlated to prior antibiotic use that was more common in children (36.4%) than in adults (18.9%) . The rate of penicillin-resistance among S . pneumoniae isolates (PRSP) was extremely high in this area: 45.5% from pediatric patients and 41.9% from adult patients . More adults (90.3%) with ISPI had major underlying diseases than children (4.5%) . This may explain why adult patients tended to run an unfavorable outcome (mortality rate, 51.6% and 4.5% in adults and children, respectively), although most of the cases with empyema were children . None of the patients enrolled in this study received pneumococcal vaccination . CONCLUSION: We suggest that vaccines be administered for young children and the elderly with major underlying diseases to prevent ISPI. Intern Med, 2003 Aug, 42(8), 723 - 5 Lung abscess caused by Actinomyces odontolyticus; Takiguchi Y et al.; A 64-year-old woman with periodontal disease was admitted because of fever, right chest pain, and bloody sputum . Her chest radiograph revealed a nodular shadow in the right middle lung fields . From the results of a needle aspiration biopsy, she was diagnosed with a lung abscess due to Actinomyces odontolyticus (A . odontolyticus) and Streptococcus spp . The patient improved quickly with antibiotics . To our knowledge, only nine cases of pulmonary infection due to A . odontolyticus have been reported, and we report the first case in Japan . Although respiratory disease caused by A . odontolyticus is rare, the association of this organism should be considered even in healthy individuals. J Biol Chem, 2003 Nov 7, 278(45), 44448 - 56 Epub 2003 Aug 15. The structural modifications induced by the M339F substitution in PBP2x from Streptococcus pneumoniae further decreases the susceptibility to beta-lactams of resistant strains; Chesnel L et al.; PBP2x is a primary determinant of beta-lactams resistance in Streptococcus pneumoniae . Altered PBP2x with multiple mutations have a reduced "affinity" for the antibiotics . An important polymorphism is found in PBP2x sequences from clinical resistant strains . To understand the mechanism of resistance, it is necessary to identify and characterize the relevant substitutions . Many similar PBP2x sequences from resistant isolates have the previously studied T338A mutation, adjacent to the active site Ser337 . We report here the structural and functional analysis of the M339F substitution that is found in a subset of these sequences, originating from highly resistant strains . The M339F mutation causes a 4-10-fold reduction of the reaction rate with beta-lactams, depending on the molecular context . In addition, release of the inactivated antibiotic from the active site is up to 3-fold faster as a result from the M339F mutation . These effects measured in vitro are correlated with the level of beta-lactam resistance in vivo conferred by several PBP2x variants . Thus, a single amino acid difference between similar PBP2x from clinical isolates can strongly modulate the degree of beta-lactam resistance . The crystal structure of the double mutant T338A/M339F solved to a resolution of 2.4 A shows a distortion of the active site and a reorientation of the hydroxyl group of the active site Ser337, which can explain the kinetic effects of the mutations. J Bacteriol, 2003 Sep, 185(17), 5210 - 9 Identification of a differentially expressed oligopeptide binding protein (OppA2) in Streptococcus uberis by representational difference analysis of cDNA; Taylor DL et al.; Streptococcus uberis is an increasingly significant cause of intramammary infection in the dairy cow, presently responsible for approximately 33% of all cases of bovine mastitis in the United Kingdom . Following experimentally induced infection of the lactating mammary gland, S . uberis is found predominantly in the luminal areas of secretory alveoli and ductular tissue, indicating that much of the bacterial growth occurs in residual and newly synthesized milk . With the objective of identifying potential virulence determinants in a clinical isolate of S . uberis, we have used representational difference analysis of cDNA to identify genes that show modified expression in milk . We have identified a number of differentially expressed genes that may contribute to the overall pathogenicity of the organism . Of these, a transcript encoding a putative oligopeptide binding protein (OppA) was further characterized . We have found that S . uberis possesses two oppA-like open reading frames, oppA1 and oppA2, which are up-regulated to different degrees following growth in milk . Mutants lacking either oppA1 or oppA2 are viable and have an increased resistance to the toxic peptide derivative aminopterin; however, only mutants lacking oppA1 display a lower rate of growth in milk . In addition, expression of the oppA genes appears to be coordinated by different mechanisms . We conclude that the oppA genes encode oligopeptide binding proteins, possibly displaying different specificities, required for the efficient growth of S . uberis in milk. J Bacteriol, 2003 Sep, 185(17), 5166 - 74 Role of RopB in growth phase expression of the SpeB cysteine protease of Streptococcus pyogenes; Neely MN et al.; The Rgg family of transcription regulators is widely distributed among gram-positive bacteria; however, how the members of this family control transcription is poorly understood . In the pathogen Streptococcus pyogenes, the Rgg family member RopB is required for transcription of the gene that encodes the secreted SpeB cysteine protease . Expression of the protease follows distinct kinetics that involves control of transcription in response to the growth phase . In this study, the contribution of RopB to growth phase control was examined . The gene encoding the protease (speB) and ropB are transcribed divergently from a 940-bp intergenic region . Primer extension analyses, in conjunction with reporter fusion studies, revealed that the major region controlling the transcription of both speB and ropB is adjacent to ropB and that the promoters for the two genes likely overlap . Furthermore, it was found that RopB is a DNA-binding protein that specifically binds to sequences in this control region . The interrelationship between ropB and speB expression was further reflected in the observation that transcription of ropB itself is subject to growth phase control . However, while expression of ropB from a promoter expressed during the early logarithmic phase of growth could complement a ropB deletion mutant, ectopic expression of ropB did not uncouple the expression of speB from its growth phase signal . These data implicate other factors in growth phase control and suggest that regulation of ropB expression itself is not the central mechanism of control. Vaccine, 2003 Sep 8, 21(25-26), 3608 - 13 Anti-PsaA and the risk of pneumococcal AOM and carriage; Rapola S et al.; Pneumococcal surface adhesin A (PsaA) is one of the common protein antigens of Streptococcus pneumoniae investigated as a possible vaccine candidate on the basis of studies in experimental animal models . The relation between the serum anti-PsaA concentration collected at 6, 12 and 18 months of age and the risk of pneumococcal carriage and acute otitis media (AOM) in the following 6 months was evaluated in 329 children of the Finnish Otitis Media (FinOM) Cohort Study . A higher anti-PsaA concentration at all three time points studied was found to predict a higher risk of pneumococcal carriage 6 months later . A higher anti-PsaA concentration at 6 months also predicted a higher risk of pneumococcal AOM during the following 6 months (RR 1.51, 95% CI 1.24-1.83), whereas a higher anti-PsaA concentration at 12 or 18 months seemed to decrease the risk of pneumococcal AOM (RR 0.94 {95% CI 0.80-1.09} and RR 0.88 {95% CI 0.73-1.07}, respectively) . These relations remained the same when concomitant risk factors for pneumococcal AOM were included in the models . Previous pneumococcal AOM was the most important risk factor for a subsequent pneumococcal AOM (RR 5.93 {95% CI 2.87-12.3}, RR 2.2 {95% CI 1.21-4.00}, and RR 3.3 {95% CI 1.72-6.32} during the three periods). Indian J Pediatr, 2003 Jun, 70(6), 509 - 11 Group B streptococcal meningitis in a 5-year-old boy; Managoli S et al.; Group B Streptococcus (Streptococcus agalactiae) is a well-known cause of early and late onset infections in neonates and very young infants . Recently attention has focused on the changing spectrum of invasive Group B Streptococcus (GBS) disease, including children beyond early infancy and non-pregnant adults . There is very little information available on invasive GBS infection especially meningitis in pediatric population older than three months of age . We report a case of uncomplicated meningitis due to GBS in a previously healthy 5-year-old boy . The literature on infection especially meningitis caused by Group B Streptococcus beyond infancy is reviewed. Int J Clin Pract, 2003 Jul-Aug, 57(6), 519 - 29 Telithromycin: the first ketolide antibacterial for the treatment of community-acquired respiratory tract infections; Lorenz J; Telithromycin is the first ketolide antibacterial to be approved for clinical use . The ketolides represent a novel class of antibacterial agents structurally related to the macrolides, which has been developed specifically to offer an optimal spectrum for the treatment of upper and lower respiratory tract infections (RTIs) caused by common and atypical pathogens, including strains that are resistant to currently used antibiotics . The innovative structural changes that distinguish telithromycin from macrolides contribute to its unique microbiological profile . Its well-balanced spectrum of antibacterial activity is highly appropriate for the empirical treatment of upper and lower community-acquired RTIs, offering activity against common, including resistant, and atypical/intracellular pathogens . Furthermore, telithromycin demonstrates a low propensity to select for or induce resistance to macrolide-lincosamide-streptogramin antibacterials . A once-daily dose of telithromycin 800 mg rapidly achieves high concentrations in both plasma and respiratory tissues and fluids and is maintained at effective levels throughout the 24-hour dosing period . In clinical trials, telithromycin has demonstrated high clinical and bacteriological efficacy in the treatment of community-acquired pneumonia, acute exacerbations of chronic bronchitis, acute sinusitis and group A beta-haemolytic streptococcal tonsillitis/pharyngitis . High efficacy was maintained in those patient groups considered to be at high risk of complications and those with infections caused by penicillin and/or macrolide (erythromycin) resistant Streptococcus pneumoniae . Together with its favourable tolerability profile and short course of once-daily therapy, these properties indicate that telithromycin will be a valuable new antibacterial for the empirical treatment of community-acquired RTIs. J Antimicrob Chemother, 2003 Sep, 52(3), 345 - 53 Epub 2003 Aug 13. High-level telithromycin resistance in laboratory-generated mutants of Streptococcus pneumoniae; Walsh F et al.; Resistance to macrolides in Streptococcus pneumoniae is usually mediated by methylation of 23S ribosomal RNA, encoded by the erm(B) methylation gene, or by efflux mediated by the mef(A) gene . Changes in the L4 and L22 ribosomal proteins have also been associated with macrolide resistance and reduced telithromycin activity . This study generated in vitro mutants from three parent strains of S . pneumoniae: 02J1175 {mef(A) +}, 02J1095 {erm(B) +} and NCTC 13593 (macrolide susceptible) . The erm(B) and the erm(B) upstream region, the mef(A) genes and the mef(A) upstream and downstream regions, the 23S rRNA genes encoding domains II and V and the L4 and L22 genes of the telithromycin-resistant strains were all amplified by PCR and all, except the mef(A) upstream and downstream regions, were sequenced . No changes were present in any of the genes of the mef(A) + mutants . No changes were found in the erm(B) genes, the 23S rRNA genes or the L4 protein genes of the erm(B) + mutants . However, a Lys-94 to Gln-94 amino acid mutation did occur in a mutant derived from erm(B) + with a telithromycin MIC of >32 mg/L . A 210 base pair deletion in the erm(B) upstream region was also present in this strain . We believe this is the first incidence of a Lys-94 to Gln-94 change in L22 associated with telithromycin resistance and also the first time that such a large deletion in the erm(B) upstream region has been identified in S . pneumoniae. J Antimicrob Chemother, 2003 Sep, 52(3), 435 - 40 Epub 2003 Aug 13. Gatifloxacin and the elderly: pharmacokinetic-pharmacodynamic rationale for a potential age-related dose reduction; Ambrose PG et al.; OBJECTIVES: Recently, anecdotal reports via the FDA's MedWatch reporting system have documented rare but serious hyperglycaemia in elderly patients receiving gatifloxacin . One possible factor contributing to these events may be gatifloxacin overexposure, resulting from age-related decreases in renal function in elderly patients predisposed to glycaemic alterations . These analyses examine gatifloxacin exposure in 10 patients with severe hyperglycaemia, provide a pharmacokinetic-pharmacodynamic (PK-PD) rationale for a potential age-related dose reduction to avoid high exposures, and evaluate the likely impact of such a dose reduction on clinical efficacy in this specific patient population . METHODS: First, a previously derived population pharmacokinetic model, with patient demographics, was used to estimate gatifloxacin AUC0-24 following a dosage regimen of 400 mg/24 h in 10 index patients with severe hyperglycaemia . Second, the population pharmacokinetic model and patient demographic data from 2696 patients aged > or =65 years from two New Drug Application (NDA) databases were used to estimate AUC0-24 following dosage regimens for gatifloxacin of 200 and 400 mg/24 h . Finally, Monte Carlo simulation was utilized to assess the probability of achieving PK-PD target exposures against Streptococcus pneumoniae in elderly patients using these regimens . RESULTS: The mean estimated AUC0-24 among severe hyperglycaemia cases was 74 mg.h/L (range 57-100) . Gatifloxacin AUC0-24 exposures for the 400 mg regimen were predicted to be higher in patients aged > or =65 years and similar to the severe hyperglycaemia cases . The probability of AUC0-24 > or =60 and > or =70 in patients aged > or =65 years for the 200 mg regimen was 0.03 and <0.01, respectively, versus 0.51 and 0.35 for the 400 mg regimen, respectively . The probability of achieving PK-PD target exposures against S . pneumoniae in patients aged > or =65 years receiving the 200 mg regimen was 0.99 . CONCLUSIONS: The probability of a patient aged > or =65 years having an AUC0-24 > or =60-70 mg.h/L is markedly lower following a 200 mg regimen relative to a 400 mg regimen, suggesting a decreased risk of severe hyperglycaemia in a predisposed patient . Moreover, a dose reduction does not appear to significantly modify the likelihood of achieving the PK-PD target of gatifloxacin against S . pneumoniae. J Antimicrob Chemother, 2003 Sep, 52(3), 503 - 6 Epub 2003 Aug 13. Comparative antimicrobial activity of levofloxacin and ciprofloxacin against Streptococcus pneumoniae; Garrison MW; OBJECTIVES: Levofloxacin has good coverage against both Gram-positive and Gram-negative pathogens . Recent reports demonstrate enhanced activity associated with a higher 750 mg dosage of levofloxacin . The objective of this study was to comparatively evaluate the activity of common regimens of levofloxacin (500 mg) and ciprofloxacin (500 mg), and a higher 750 mg levofloxacin regimen against penicillin susceptible and non-susceptible strains of S . pneumoniae . MATERIALS AND METHODS: An in vitro pharmacodynamic modelling apparatus (PDMA) characterized specific bacterial kill profiles for simulated regimens of levofloxacin and ciprofloxacin against four strains of S . pneumoniae . Total log reduction, time for 3-log reduction and AUC/MIC were determined . RESULTS: Ciprofloxacin was less effective than the levofloxacin regimens against all four study isolates . Ciprofloxacin produced 3-log reduction in only one isolate compared with all four isolates with the levofloxacin regimens . Bacterial regrowth did not occur over 12 h with levofloxacin; however, three of four isolates demonstrated bacterial regrowth with ciprofloxacin . None of the isolates were cleared from the PDMA by ciprofloxacin . The 500 mg levofloxacin regimen cleared two of four isolates and the 750 mg dose of levofloxacin cleared all study isolates . Respective AUC/MIC values for levofloxacin (500 and 750 mg) and ciprofloxacin were 44-89, 63-126 and < or =13, which correlated well with bacterial kill data . CONCLUSIONS: Both levofloxacin regimens were more effective than ciprofloxacin against the study isolates tested . The 750 mg levofloxacin regimen generated more favourable bacterial killing compared with the 500 mg levofloxacin regimen . In addition to using the 750 mg levofloxacin dose for nosocomial infections, this dose may also prove useful for the management of resistant pneumococcal infections. J Vet Med B Infect Dis Vet Public Health, 2003 May, 50(4), 161 - 5 Identification of Streptococcus dysgalactiae strains of Lancefield's group C, G and L by polymerase chain reaction; Hassan AA et al.; Streptococcus dysgalactiae serogroup C, G and L strains were investigated by polymerase chain reaction (PCR) using oligonucleotide primers designed according to species-specific parts of the 16S-23S rDNA intergenic spacer region . The oligonucleotide primers with specificity for the 16S-23S rDNA intergenic spacer region allowed a correct identification of all S . dysgalactiae serogroups C, G and L strains investigated . No cross-reactivities could be observed with any of the control strains indicating the usefulness of PCR-technology to identify the serologically heterogeneous species S . dysgalactiae. Ukr Biokhim Zh, 2002 May-Jun, 74(3), 31 - 41 {Metabolism of rumen microbial populations formed on biosubstrates with different assimilation under the effect of pentachlorophenol}; Kalachniuk LH et al.; It has been established that metabolism of mixed microbial population formed on easy assimilated sources of energy and nitrogen (concentrate diet) progressed on higher level . There is increase of amilolytic activity, formation of lactate, ammonia, low molecular carbonic acids with predomination of propionate molar fraction . The increased resistance to effect of pentachlorophenol (PCP) is characteristic nature of the latter . The role of the most resistant synthrophic bacteria to PCP increases . The pure strains of Streptococcus bovis and Megasphaera elsdenii do not stop metabolism at 100 microM of PCP . Mixed population of microorganisms formed on hard accessible biosubstrates (cellulose) and Butyrivibrio fibrisolvens have the increased cellulosolytic activity and while the high sensibility even to low doses of PCP (10-40 microM) is observed . It has been supposed that mechanism of PCP effect is ambiguous for various species of microbial complex of rumen . It's effect strength on all main chains of metabolism (membrane transport, energetic exchange, protein biosynthesis, etc.) significantly depends on capacity of pool of metabolic intermediates formed as a result of definite program of biotechnology of nurture, but significantly decreases the harmful effect of biocides. Sex Transm Dis, 2003 May, 30(5), 405 - 10 Risk factors for infection with herpes simplex virus type 2: role of smoking, douching, uncircumcised males, and vaginal flora; Cherpes TL et al.; BACKGROUND: Herpes simplex virus type 2 (HSV-2), the primary cause of genital herpes, is one of the most prevalent sexually transmitted diseases worldwide . Epidemiologic serosurveys suggest that infections occur more frequently in women than in men . GOAL: The goal of the study was to identify unique correlates of HSV-2 infection in women that might contribute to their increased susceptibility of infection or suggest opportunities for decreasing the incidence of disease . STUDY DESIGN: We enrolled 1207 women aged 18 to 30 years from three Pittsburgh health clinics in a cross-sectional study . Each woman provided demographic and behavioral information, vaginal swab specimens for bacterial culture, a vaginal smear for Gram stain diagnosis of bacterial vaginosis, and blood for HSV-1 and HSV-2 serology . RESULTS: Black race, older age, cigarette smoking, douching, a greater number of lifetime sex partners, a history of intercourse with an uncircumcised partner, the presence of vaginal group B Streptococcus, and abnormal vaginal flora were among the independent predictors of HSV-2 infection . CONCLUSION: HSV-2 infection may be occur more often in women who douche, smoke, have sex with uncircumcised partners, or have bacterial vaginosis; these represent alterable risk factors. Pediatr Infect Dis J, 2003 Aug, 22(8), 739 - 42 Serotype distribution and antimicrobial resistance patterns in Streptococcus pneumoniae isolates from hospitalized pediatric patients with respiratory infections in Shanghai, China; Zhao GM et al.; BACKGROUND: Surveillance for pneumococcal respiratory illness was conducted in children hospitalized at Affiliated Pediatric Hospital of Fudan University in Shanghai from August 2000 to August 2001 . METHODS: Sputum cultures were obtained from pediatric patients admitted with pneumonia or respiratory distress by tracheal aspirate . Blood cultures were also performed on a subset of patients . All pneumococcal isolates were serotyped and tested for antibiotic susceptibility . In addition clinical information on the patients including prior antibiotic history was abstracted . Streptococcus pneumoniae tracheal isolations were attempted in a total of 1013 pediatric patients hospitalized during this period . Among these samples 112 specimens were S . pneumoniae-positive . These positive isolates underwent serotyping and antibiotic susceptibility testing . RESULTS: Five serotypes (19F, 23F, 6A, 14, 6B) of S . pneumonia accounted for 81% (91 of 112 cases) . Other serotypes accounted only for 12% (13 of 112 cases), and 7% (8 of 112 cases) of isolates could not be typed by quelling test . Only one blood culture isolate was positive, probably reflecting the frequent use of antibiotic treatment before hospitalization . Fifty-one and 8.0% of isolates had intermediate and high level penicillin resistance, respectively . Fifty-eight percent were resistant to ampicillin, 6.6% to cefazolin, 25.0% to cefaclor, 6.6% to ceftriaxone, 85.7% to erythromycin, 66.7% to clindamycin and 28.2% to chloramphenicol . Among 66 isolates that were not susceptible to penicillin, serotype 19F was the most common, followed by 23F and 14 . CONCLUSION: S . pneumoniae is a common cause of respiratory illness requiring hospitalization in young children in Shanghai, with antibiotic resistance increasingly common . Five serotypes account for most disease. Pediatr Infect Dis J, 2003 Aug, 22(8), 726 - 31 Extrapharyngeal group A Streptococcus infection: diagnostic accuracy and utility of rapid antigen testing; Clegg HW et al.; BACKGROUND: Antigen tests have been well-studied and are widely used in pediatric practice for rapid detection of group A Streptococcus (GAS) infections in the throat, but they have not been examined sufficiently for the detection of infection of skin sites, such as the perineal region or impetiginous lesions . METHODS: During the 3-year period 1999 to 2002, we evaluated 239 patients with suspected GAS skin infection, in 5 pediatric practices, using 3 Dacron swabs for each site . The first swab was tested in the pediatric office laboratory with an antigen detection kit . For the first 91 patients, the Abbott Test Pack Plus antigen detection test (ADT) was used . The Abbott Signify Strep A ADT was used to test subsequent patients . The second swab was tested with BD Directigen 1-2-3 ADT in the hospital laboratory . The third swab was placed in modified Stuart's transport medium for comparison of recovery of GAS from culture in broth or on agar . A positive culture served as the reference standard . Test performance and test accuracy were determined for each ADT . RESULTS: Of the 247 ADTs and cultures performed on 239 patients, 91 with suspected skin infection were tested with the Test Pack Plus test, 149 with the Signify Strep A test and 247 with the Directigen test . Eighty-six (35%) cultures were positive, 73 from perineal sites (54 rectal, 13 vaginal, 6 penile) and 13 from impetiginous lesions . There was 100% concordance for the 86 cultures positive for GAS in a comparison between dry Dacron swabs and swabs that had been placed in modified Stuart's transport medium . Test Pack Plus and Signify Strep A ADTs had similar performance characteristics for skin infections: sensitivity, 92 and 88%; specificity, 99 and 97%; positive predictive value, 96 and 94%; and negative predictive value, 97 and 93% . Directigen ADT had sensitivity 78%, specificity 100%, positive predictive value 100% and negative predictive value 89% . Accuracy for the tests varied from 92 to 97% . CONCLUSION: Tests designed to detect GAS carbohydrate antigen in patients with pharyngitis can be used rapidly and accurately to detect GAS antigen in patients with cutaneous lesions suspected of GAS infection. J Appl Microbiol, 2003, 95(3), 621 - 30 Establishing populations of Megasphaera elsdenii YE 34 and Butyrivibrio fibrisolvens YE 44 in the rumen of cattle fed high grain diets; Klieve AV et al.; AIM: To determine whether Megasphaera elsdenii YE34 (lactic acid degrader) and Butyrivibrio fibrisolvens YE44 (alternative starch utilizer to Streptococcus bovis) establish viable populations in the rumen of beef cattle rapidly changed from a forage-based to a grain-based diet . METHODS AND RESULTS: Five steers were inoculated with the two bacterial strains (YE34 and YE44) and five served as uninoculated controls . With the exception of one animal in the control group, which developed acidosis, all steers rapidly adapted to the grain-based diet without signs of acidosis (pH decline and accumulation of lactic acid) . Bacterial populations of S . bovis, B . fibrisolvens and M . elsdenii were enumerated using real-time Taq nuclease assays . Populations of S . bovis remained constant (except in the acidotic animal) at ca 10(7) cell equivalents (CE) ml-1 throughout the study . Megasphaera elsdenii YE34, was not detectable in animals without grain in the diet, but immediately established in inoculated animals, at 10(6) CE ml-1, and increased 100-fold in the first 4 days following inoculation . Butyrivibrio fibrisolvens, initially present at 10(8) CE ml-1, declined rapidly with the introduction of grain into the diet and was not detectable 8 days after grain introduction . CONCLUSION: Megasphaera elsdenii rapidly establishes a lactic acid-utilizing bacterial population in the rumen of grain-fed cattle 7-10 days earlier than in uninoculated cattle . SIGNIFICANCE AND IMPACT OF THE STUDY: The study has demonstrated that rumen bacterial populations, and in particular the establishment of bacteria inoculated into the rumen for probiotic use, can be monitored by real-time PCR. Sichuan Da Xue Xue Bao Yi Xue Ban, 2003 Jul, 34(3), 494 - 6 {The influence of gene vaccines pcDNA3-pac and pcDNA3-gtfB of Streptococcus mutans on plaque index and S . mutans score in rats}; Yang D et al.; OBJECTIVE: This study was aimed at using the gene vaccines pcDNA3-pac and pcDNA3-gtfB which were constructed on PAc and GTF-B gene vaccinating gnotobiotic rats by submandibular gland-target injection to observe the level of salivary S . mutans and dental plaque inhabitation . METHODS: Thirty-six 28-day-old Wistar rats were divided into 6 groups, including those vaccinated with pcDNA3-pac, pcDNA3-gtfB, pcDNA3-pac combined with pcDNA3-gtfB, inactive whole cell of S . mutans JBP, and those injected with pcDNA3 and 0.1 mol/L PBS buffer respectively . Each rat was administrated with 100 micrograms vaccines or controlled materials by submandibular gland-target injection, vaccinated three times at 1-2 weeks interval . Then the gnotobiotic rat model was constructed, following that all rats were fed with cariogenic diet 2000# for 3 months . Rat saliva was collected to assay the level of S . mutans in saliva and evaluate the dental plaque index . RESULTS: The level of S . mutans in saliva and the dental plaque index of the group vaccinated with pcDNA3-pac combined with pcDNA3-gtfB and the group with inactive S . mutans cell were lower than those of other groups . And they were the highest in the groups injected with pcDNA3 or PBS buffer (P < 0.01 or P < 0.05) . No statistically significant differences were observed between the group vaccinated with pcDNA3-pac and the group vaccinated with pcDNA3-gtfB, between the group vaccinated with pcDNA3-pac combined with pcDNA3-gtfB and the group for positive control, and between the pcDNA3 group and PBS buffer group (P > 0.05) . CONCLUSION: The two gene anticaries vaccines induce the specific antibodies and thus produce effects on the level of S . mutans in saliva and dental plaque index . Therefore gene vaccines pcDNA3-pac and pcDNA3-gtfB are effective, and joint gene vaccines inoculation is optimal. Gene, 2003 Jul 17, 312, 305 - 12 An inserted DNA fragment with plasmid features is uniquely associated with the presence of the GBSi1 group II intron in Streptococcus agalactiae; Luan SL et al.; The group II intron (GBSi1) identified downstream of the C5a-peptidase gene (scpB) in a subpopulation of Streptococcus agalactiae isolates is a suggested marker for a separate genetic lineage of serotype III isolates . In the present study two additional copies of GBSi1, one of which not previously described, were identified among serotype III isolates . All intron copies shared a common target site motif . A single copy of GBSi1 was found in a subgroup of serotype II and V isolates . In these isolates, the intron had inserted downstream of scpB, which suggests that this is the primary insertion site for GBSi1 . Most bacterial group II introns described to date reside in transposable elements . The scpB locus was found to be flanked by insertion sequences similar to what has been described in an intronless serotype Ia isolate . However, this region contained an additional 2.1 kb DNA fragment present only in intron carrying isolates . This DNA fragment contained a partial transposase and putative plasmid related proteins . This may suggest that GBSi1 once was brought into the S . agalactiae genome by an integrated plasmid. Recenti Prog Med, 2003 Feb, 94(2), 66 - 8 {Primary plasma cell leukemia . A fulminant case}; Famularo G et al.; Primary plasma cell leukemia is a rare variant of malignant monoclonal gammapathies with de novo presentation in the leukemic phase . Only few series enrolling more than 20 patients have been reported in the literature . The authors deal with a patient who had a fulminant presentation of primary plasma cell leukemia with fatal outcome . Diagnosis of primary plasma cell leukemia was established based on Kyle's criteria, which include an absolute plasma cell count greater than 2 x 10(9)/L or a relative plasma cell number comprising greater than 20% of peripheral blood cells . The patient died within three days of diagnosis because of Streptococcus pneumoniae septic shock and multiple organ failure . This case report is worth of note due to the rarity of primary plasma cell leukemia and also because fulminant presentation is not commonly recognized among patients with malignant gammapathies. J Clin Microbiol, 2003 Aug, 41(8), 3970 - 2 Genetic relationship between Streptococcus pneumoniae isolates from nasopharyngeal and cerebrospinal fluid of two infants with Pneumococcal Meningitis; de Andrade AL et al.; The molecular epidemiology of Streptococcus pneumoniae isolates from carriage and cerebrospinal fluid (CSF) concurrently recovered from the same individual has not yet been reported . By using pulsed-field gel electrophoresis, we demonstrated the genetic linkage among strains from CSF and nasopharynges of two children with pneumococcal meningitis. J Clin Microbiol, 2003 Aug, 41(8), 3951 - 4 Ability of lysozyme and 2-deoxyglucose to differentiate human and bovine Streptococcus bovis strains; Kurtovic A et al.; Human and bovine Streptococcus bovis strains had the same 16S ribosomal DNA restriction fragment length polymorphism and often had the same patterns of starch, mannitol, lactose, and raffinose utilization . PCRs of BOX sequences differed, but numerical analyses indicated that some human strains clustered with bovine strains . However, human and bovine strains had distinctly different sensitivities to lysozyme and 2-deoxyglucose. J Clin Microbiol, 2003 Aug, 41(8), 3936 - 8 Strains of Streptococcus pyogenes from severe invasive infections bind HEp2 and HaCaT cells more avidly than strains from uncomplicated infections; Edwards ML et al.; Epidemiologically unrelated Streptococcus pyogenes strains isolated from blood, throat, and skin were assayed for adherence to HEp2 and HaCaT cells . Invasive isolates showed significantly higher avidity for these cell lines than isolates from skin and throat . In general, S . pyogenes showed greater binding to HaCaT cells than to HEp2 cells. J Clin Microbiol, 2003 Aug, 41(8), 3521 - 5 Comparison of five genotypic techniques for identification of optochin-resistant pneumococcus-like isolates; Verhelst R et al.; Three PCR techniques (amplification of the psaA, ply, and lytA genes) and a commercial kit (AccuProbe {GenProbe, San Diego, Calif.}, based on hybridization with the 16S rRNA gene), all four of which claimed to be specific for Streptococcus pneumoniae, were used to identify 49 alpha-hemolytic streptococcal isolates suspected of being pneumococci . The definite phenotypic identification of these organisms as S . pneumoniae was difficult when optochin susceptibility and the presence of a capsule were taken as markers . Furthermore, RsaI digestion of the amplified 16S rRNA gene was applied . All 49 strains were optochin resistant . Eleven of these were encapsulated and were identified as pneumococci by all tests . Twenty of the 38 unencapsulated strains were unambiguously identified as nonpneumococci by all tests . The identities of another 18 unencapsulated strains remained inconclusive due to highly variable reactions for all phenotypic and genotypic techniques applied . The AccuProbe test was positive for seven strains for which the results of the other tests were inconclusive . RsaI restriction of the amplified 16S rRNA gene confirmed the AccuProbe result for all strains, while the result of the psaA-specific PCR was in concordance with encapsulation for all strains . The results presented here indicate that identification problems continue to exist for some strains, despite the application of genotypic and phenotypic tests in combination . We found the psaA-specific PCR to be the genotypic technique best suited for the identification of genuine pneumococci and optochin-resistant pneumococci. J Clin Microbiol, 2003 Aug, 41(8), 3481 - 6 Identification of Streptococcus sanguinis with a PCR-generated species-specific DNA probe; Li Y et al.; The objective of the present study was to design a PCR-generated DNA probe and determine the specificity of the probe for the identification of clinical isolates of Streptococcus sanguinis . To do this, we examined over 200 arbitrarily primed PCR (AP-PCR) amplicon patterns obtained with DNA from clinical isolates of S . sanguinis . A 1.6-kb DNA amplicon that was common to all AP-PCR profiles was extracted from agarose gels and then cloned and sequenced . A search for a similar sequence in the GenBank database with the BLASTN program revealed that the 1.6-kb DNA fragment comprised an intergenic region between two housekeeping genes, uncC (proton-translocating ATPase) and murA (UDP-N-acetylglucosamine enolpyruvyl transferase) . Three digoxigenin-labeled DNA probes were synthesized on the basis of the sequence of the 1.6-kb fragment: the sequence of probe SSA-1 contained the proton-translocating ATPase (uncC) and the entire intergenic region, the sequence of probe SSA-2 contained only the intergenic region, and the sequence of probe SSA-3 contained an internal region of the murA gene . Dot blot hybridization showed that the three probes displayed signals for hybridization to both S . sanguinis strain ATCC 10556 and the S . sanguinis clinical isolates . Probe SSA-1, however, hybridized to DNA from S . oralis and S . mitis . Probe SSA-3 hybridized to DNA from S . gordonii, S . mitis, S . oralis, S . parasanguinis, and S . vestibularis . The probe SSA-2-specific intergenic region appeared to be specific for S . sanguinis . The results from this study suggest that probe SSA-2 may serve as a species-specific DNA probe for the identification of clinical isolates of S . sanguinis. J Med Chem, 2003 Aug 14, 46(17), 3655 - 61 Discovery of (3S)-amino-(4R)-ethylpiperidinyl quinolones as potent antibacterial agents with a broad spectrum of activity and activity against resistant pathogens; Hu XE et al.; Novel quinolone antibacterial agents bearing (3S)-amino-(4R)-ethylpiperidines were designed by using low energy conformation analysis and synthesized by applying a conventional coupling reaction of the quinolone nuclei with new piperidine side chains . These compounds were tested in MIC assays and found to be highly potent against Gram-positive and Gram-negative organisms . In particular, the new compounds exhibited high activity against the resistant pathogens Staphylococcus aureus (MRCR) and Streptococcus pneumoniae (PR) . Importantly, when the (3S)-amino-(4R)-ethylpiperidinyl quinolones were compared with marketed quinolones sharing the same quinolone nuclei but different side chains at the C-7 position, the new quinolones showed superior activity against Gram-positive organisms, including resistant pathogens. Appl Environ Microbiol, 2003 Aug, 69(8), 4595 - 603 A newly discovered Bacteroides conjugative transposon, CTnGERM1, contains genes also found in gram-positive bacteria; Wang Y et al.; Results of a recent study of antibiotic resistance genes in human colonic Bacteroides strains suggested that gene transfer events between members of this genus are fairly common . The identification of Bacteroides isolates that carried an erythromycin resistance gene, ermG, whose DNA sequence was 99% identical to that of an ermG gene found previously only in gram-positive bacteria raised the further possibility that conjugal elements were moving into Bacteroides species from other genera . Six of seven ermG-containing Bacteroides strains tested were able to transfer ermG by conjugation . One of these strains was chosen for further investigation . Results of pulsed-field gel electrophoresis experiments showed that the conjugal element carrying ermG in this strain is an integrated element about 75 kb in size . Thus, the element appears to be a conjugative transposon (CTn) and was designated CTnGERM1 . CTnGERM1 proved to be unrelated to the predominant type of CTn found in Bacteroides isolates-CTns of the CTnERL/CTnDOT family-which sometimes carry another type of erm gene, ermF . A 19-kbp segment of DNA from CTnGERM1 was cloned and sequenced . A 10-kbp portion of this segment hybridized not only to DNA from all the ermG-containing strains but also to DNA from strains that did not carry ermG . Thus, CTnGERM1 seems to be part of a family of CTns, some of which have acquired ermG . The percentage of G+C content of the ermG region was significantly lower than that of the chromosome of Bacteroides species-an indication that CTnGERM1 may have entered Bacteroides strains from some other bacterial genus . A survey of strains isolated before 1970 and after 1990 suggests that the CTnGERM1 type of CTn entered Bacteroides species relatively recently . One of the genes located upstream of ermG encoded a protein that had 85% amino acid sequence identity with a macrolide efflux pump, MefA, from Streptococcus pyogenes . Our having found >90% sequence identity of two upstream genes, including mefA, and the remnants of two transposon-carried genes downstream of ermG with genes found previously only in gram-positive bacteria raises the possibility that gram-positive bacteria could have been the origin of CTnGERM1. Appl Environ Microbiol, 2003 Aug, 69(8), 4482 - 8 Production and properties of bacteriocin-like inhibitory substances from the swine pathogen Streptococcus suis serotype 2; Melancon D et al.; Streptococcus suis serotype 2 is a major pathogen found in the upper respiratory tract of swine . In this study, isolates of this bacterial species were tested for the production of bacteriocin-like inhibitory substances (BLIS) . Of the 38 strains tested, four inhibited the growth of other S . suis isolates according to a deferred-antagonism plate assay . Interestingly, three of the strains were originally isolated from healthy carrier pigs and were considered nonvirulent . Three isolates (94-623, 90-1330, and AAH4) that produced BLIS in liquid broth were selected for further characterization . None of the inhibitory activities was related to the production of either organic acids or hydrogen peroxide . The BLIS produced by these strains were heat stable and proteinase K, pronase, and elastase sensitive but were trypsin and chymotrypsin resistant . They were stable at pH 2 and 12 and had molecular masses in the range of 14 to 30 kDa . Maximum production was observed during the mid-log phase . Following a curing procedure with novobiocin, only 90-1330 lost the ability to produce BLIS, suggesting that the BLIS might be plasmid encoded . Analysis of the inhibitory spectra revealed that the BLIS-producing strains also inhibited the growth of Actinobacillus minor, Actinobacillus porcinus, Enterococcus durans, Micrococcus luteus, Streptococcus agalactiae, Streptococcus dysgalactiae subsp . dysgalactiae, Streptococcus equi subsp . zooepidemicus, and S . dysgalactiae subsp . equisimilis . This study reports for the first time the ability of the swine pathogen S . suis serotype 2 to produce BLIS with the characteristics of classic bacteriocins . Further studies are required to investigate the possibility of using bacteriocin-producing strains to prevent swine infections caused by virulent strains of S . suis serotype 2. Microb Pathog, 2003 Aug, 35(2), 63 - 72 Influence of group A streptococcal acid glycoprotein on expression of major virulence factors and internalization by epithelial cells; Marouni MJ et al.; A single transposon insertion upstream to the open-reading-frame identified as the streptococcal acid glycoprotein (sagp) gene rendered a Tn916 isolate of Streptococcus pyogenes with elevated susceptibility to internalization by the epithelial cells . The role of SAGP in S . pyogenes internalization was further studied using isogenic mutant containing an in-frame deletion within the sagp gene . The sagp mutant displayed slower growth-rate and showed 5-fold higher internalization efficiency than the parent strain . Transcription of sagp at the logarithmic phase, but not at the stationary phase of the growth was repressed by csrR, the global regulator gene . At the same time, mutation of the sagp gene partially decreased the transcription of hasA, a gene that is required for capsule synthesis . The mutation had no effect on transcription of the emm3 gene, encoding for the M protein . The most striking effect of the sagp mutation was a down-regulation of the streptococcal pyrogenic exotoxin B (SpeB) at both translational and transcriptional level . Treatment of the SAGP mutant cells with the exogenous mSpeB (mature protease) only partially reduced their susceptibility to internalization . The exogenous mSpeB was more effective in reducing the internalization efficiency of a speB mutant and brought it to the level observed for the parent strain . In overall, results show that CsrR, directly or indirectly, affects the expression of SAGP, and that the SAGP modulates expression of not only SpeB, but also other genes that facilitate S . pyogenes internalization. CMAJ, 2003 Aug 5, 169(3), 198 - 203 Risk factors for early-onset group B streptococcal disease in neonates: a population-based case-control study; Adair CE et al.; BACKGROUND: Infection with group B streptococcus (GBS) is a major cause of neonatal illness and death . We examined the antenatal and perinatal risk factors for early-onset GBS disease among neonates . METHODS: We identified cases by population-based surveillance in all microbiology laboratories serving Alberta . A case was defined as any instance of a positive sterile-site GBS culture in an infant born between 1993 and 1997 who was either less than 7 days old or stillborn after 20 weeks' gestation . We randomly selected controls from a computer-compiled list of all hospital births, including stillbirths after 20 weeks' gestation, in Alberta during the study period . To increase power, we chose 5 or 6 control infants born in the same year as each case infant . We reviewed hospital, prenatal clinic and physician health records and, between 1997 and 1999, conducted maternal interviews by telephone . RESULTS: There were no differences between the 90 cases and 489 controls in sociodemographic variables or in many reproductive and behavioural variables . Case infants were more likely than control infants to be of low birth weight (odds ratio {OR} 3.60, 95% confidence interval {CI} 1.68-7.65), to have been delivered preterm (OR 3.89, 95% CI 2.08-7.27), or to have a mother with amnionitis (OR 15.03, 95% CI 5.58-41.89), intrapartum fever (OR 4.65, 95% CI 2.48-8.69) or premature rupture of the membranes (OR 2.39, 95% CI 1.38-4.14) . After adjustment for potential confounders, intrauterine fetal monitoring was associated with a more than 2-fold increase in the risk of neonatal GBS disease (OR 2.24, 95% CI 1.22-4.13) . INTERPRETATION: Intrauterine fetal monitoring should be added to the list of risk factors in risk-based screening . Since many of the cases had no identifiable maternal risk factors, universal screening for GBS may be appropriate. FEMS Immunol Med Microbiol, 2003 Aug 18, 38(1), 1 - 7 Novel vaccine strategies with protein antigens of Streptococcus pneumoniae; Swiatlo E et al.; Infections caused by Streptococcus pneumoniae (pneumococcus) are a major cause of mortality throughout the world . This organism is primarily a commensal in the upper respiratory tract of humans, but can cause pneumonia in high-risk persons and disseminate from the lungs by invasion of the bloodstream . Currently, prevention of pneumococcal infections is by immunization with vaccines which contain capsular polysaccharides from the most common serotypes causing invasive disease . However, there are more than 90 antigenically distinct serotypes and there is concern that serotypes not included in the vaccines may become more prevalent in the face of continued use of polysaccharide vaccines . Also, certain high-risk groups have poor immunological responses to some of the polysaccharides in the vaccine formulations . Protein antigens that are conserved across all capsular serotypes would induce more effective and durable humoral immune responses and could potentially protect against all clinically relevant pneumococcal capsular types . This review provides a summary of work on pneumococcal proteins that are being investigated as components for future generations of improved pneumococcal vaccines. Life Sci, 2003 Sep 5, 73(16), 2101 - 11 Effects of IgM from rheumatic fever patients on intracellular calcium levels of neonatal rat cardiac myocytes; Bick RJ et al.; Rheumatic fever (RF), a potential sequela of Streptococcus pyogenes pharyngitis, sometimes results in myocarditis and heart failure . Antibodies have been implicated in the pathogenesis of RF and anti-cardiac myosin antibody levels are elevated in RF patients . Since myocarditis is associated with altered cardiomyocyte calcium transients it was of interest to determine the direct effects of RF patient antibodies on calcium transients in cultured myocytes . RF patient polyclonal IgM treatment caused increased calcium retention by neonatal rat heart cells in vitro as determined with isotopically labeled calcium . Therefore, to further characterize this finding, calcium transients were evaluated by real time fluorescence spectroscopy and deconvolution imaging . RF patient polyclonal IgM produced increased calcium retention during the relaxation stage of the contraction cycle leading to a slowing of contraction rate, disorganized calcium transients, and eventual tetany . In contrast, calcium transient studies of cardiomyocytes following treatment with monoclonal anti-myosin antibodies revealed declining intracellular calcium levels, accompanied by disorganized transients and tetany . Treatment with both antibodies led to myocyte dysfunction and these novel findings suggest a role for antibodies in the pathogenesis of the myocarditis associated with rheumatic carditis. J Fam Pract, 2003 Aug, 52(8), 592 - 3 Steroids ineffective for pain in children with pharyngitis; Via RM; In children with acute pharyngitis, oral dexamethasone does not provide clinically significant reductions in time to initial or complete pain relief . Reserve its use for children with group A beta-hemolytic streptococcus pharyngitis who have moderate to severe pain, realizing that the benefit is of questionable significance. Ann Univ Mariae Curie Sklodowska {Med}, 2002, 57(1), 400 - 6 The activity of dental caries in students of the Faculty of Dentistry, the study with the use of microbiological and biochemical tests (Dentocult SM); Kiernicka M et al.; The aim of the paper is to answer the question whether the Dentocult SM tests could be used to study dental caries activity in the 20-25 age group . 66 students of the Faculty of Dentistry, Medical University of Lublin, were included in the study . In all cases dental state was assessed by using average numbers of DMF and DMFs Ds . In the microbiological examinations a ready-made medium from Dentocult SM set was used . The results revealed that the risk of dental caries in the population studied cannot be determined only on the basis of Streptococcus mutans values. Hua Xi Kou Qiang Yi Xue Za Zhi, 2003 Jun, 21(3), 228 - 30 {Study on potential anti-caries DNA vaccine pcDNA3-gtfB integration into host cell genome}; Yang J et al.; OBJECTIVE: Gene vaccine security is of concern because of the possibility of insertion mutagenesis resulting in inactivation of tumor suppressor or activation of oncogene . The purpose of this study was to examine the potential of anti-caries DNA vaccine pcDNA3-gtfB integrating into the host cell genome . METHODS: Anti-caries DNA vaccine pcDNA3-gtfB was constructed by the previous study . The gtfB gene(904-4,578 bp, genebank M17361) was cloned from Streptococcus mutans GS-5 . 36 Wistar rats were divided into 2 groups: submandibular gland-targeted injection(SGT) group and control group . Rats in SGT group were injected with 100 micrograms of plasmid pcDNA3-gtfB, rats in control group with PBS solution . Genomes from submandibular gland, kidney, heart, liver, lung, and brain tissues were isolated later in 12 weeks . Genomes from different tissues were purified by low-melting agarose electrophoresis . Using the purified genomes as template, plasmid integration were examined by PCR(upper primer: 5'-ATATGGTACCATGACCGAAGCGACATCTAAGCAAGA-3', lower primer: 5'-ACTACTCGAGTTAGAACCATTGACCCTG AGCATTGC-3') . The sensitivity level of PCR was determined by adding gradient plasmid copies into genomes in control group . RESULTS: The examination of 6 tissues failed in revealing any evidence of integration at the sensitivity level that could detect 1 copy integration in 10,000 nuclei . CONCLUSION: The potential frequency of plasmid pcDNA3-gtfB integration into host cell genome would not exceed that of the spontaneous mutation . It was indicated that pcDNA3-gtfB was genetically safe as a promising anti-carious DNA vaccine. Hua Xi Kou Qiang Yi Xue Za Zhi, 2003 Jun, 21(3), 174 - 6 {Construction and expression of traceable DNA vaccine for prevention of caries}; Liu L et al.; OBJECTIVE: Streptococcus mutans has been proved as a causative bacteria of human dental caries . The surface protein antigen is one of the important pathogenic factors . The A region of the surface protein antigen pac gene (pacA) can enrich T-cells and B-cells epitope . In this study, a DNA vaccine carrying pacA and gfp gene (a reporter gene) for caries prevention was constructed . The DNA vaccine was liable to be traced in vitro and in vivo . METHODS: The fragment of pacA (1.3 kb) was amplified by PCR with the plasmid pPC41 as template, and inserted into a pEGFP-C1 vector . The recombinant plasmid produced was named as pEGFPC1-pacA . After the COS1 cell line was transfected by the recombinant plasmid, the expression of gfp was detected by observing the green fluorescence and measuring the fluorescence intensity, and the expression of pacA was detected by RT-PCR . RESULTS: Restricted analyzing, sequencing and PCR technique were employed to identify the recombinant plasmid . The phase and orientation of the pacA gene inserted into the vector pEGFPC1 were correct and no changes of their open reading frames were discovered . The transfected COS1 carrying green fluorescent protein (GFP) was observed; the GFP expression level of transfected cells was higher than that of controlled cell . The transcript of pacA gene was confirmed by RT-PCR . CONCLUSION: Construction of the recombinant plasmid was successful . The gfp gene and pacA gene in the plasmid was transcribed and expressed simultaneously in the transfected cells . Moreover, detection of GFP is simple, safe and effective for living cells. J Neurosci Res, 2003 Aug 15, 73(4), 441 - 6 Increased neurogenesis after experimental Streptococcus pneumoniae meningitis; Gerber J et al.; Neuronal damage in the hippocampal formation is a common feature in animal models of bacterial meningitis and human disease . In mouse and rabbit models of Streptococcus pneumoniae meningitis, proliferation of neural progenitor cells quantified by bromodeoxyuridine (BrdU) incorporation was enhanced in the subgranular layer of the dentate gyrus . In mice, the density of BrdU-labeled cells was maximal on Day 2 after infection . Approximately 60% of the cells labeled by BrdU between Days 7 and 10 after infection that remained present 28 days later had migrated into deeper layers of the dentate gyrus and differentiated into neurons, as evidenced by immunohistochemical staining for TUC-4, MAP-2 and beta-tubulin . This suggests that endogenous repair mechanisms may limit consequences of neuronal destruction after meningitis . Planta Med, 2003 Jul, 69(7), 623 - 7 Antimicrobial constituents from goldenseal (the Rhizomes of Hydrastis canadensis) against selected oral pathogens; Hwang BY et al.; Two new C-methyl flavonoids, 6,8-di- C-methylluteolin 7-methyl ether (1) and 6- C-methylluteolin 7-methyl ether (2), were isolated from a commercially available sample of the roots of Hydrastis canadensis, along with seven known compounds, berberine (3), beta-hydrastine (4), canadine (5), canadaline (6), isocorypalmine (7), canadinic acid (8), and beta-sitosterol 3- O-beta- D-glucoside (9) . The structures of the new compounds 1 and 2 were elucidated on the basis of their spectral data including 1D and 2D NMR techniques . Of these isolates, berberine (3) and, to a lesser extent, 1 and 2, showed antimicrobial activity when evaluated against the oral pathogens Streptococcus mutans and Fusobacterium nucleatum . Berberine (3) exhibited an additive antimicrobial effect when tested against S . mutans in combination with 1. Clin Nucl Med, 2003 Aug, 28(8), 694 - 5 Positive leukocyte and negative bone scintigraphy in extensive arthroplasty infection; Shin Lee T et al.; An 85-year-old male resident of a nursing home presented after a fall with a painful left hip, confusion, and fever . He had multiple medical problems including severe vascular disease and poor vision as a result of macular degeneration . An Austin Moore left hip prosthesis had been inserted for a fractured femoral neck several years before . A septic workup showed a raised leukocyte count but no other focal abnormality . Plain radiography showed a periprosthetic fracture of the left hip . Blood cultures grew beta-hemolytic group A Streptococcus sensitive to penicillin . Bone scintigraphy was thought to be consistent with loosening of the prosthesis without evidence of a recent fracture . Tc-99m leukocyte scintigraphy was markedly abnormal, with extensive soft-tissue uptake suggestive of a large periprosthetic infective collection . This was confirmed at surgery with drainage of 200 mL pus from the left hip, and deep and superficial soft tissues of the thigh . The trochanteric fracture was well granulated and thought to be of long standing . The prosthesis was removed and the patient was treated with appropriate antibiotics with good effect. Acta Microbiol Immunol Hung, 2003, 50(2-3), 119 - 24 In vitro activity of cefditoren against a special collection of clinical isolates of Streptococcus pneumoniae from Hungary; Nagy E et al.; Cefditoren is the active form of cefditoren pivoxil, a new, broad-spectrum oral cephalosporin with strong in vitro activity against penicillin-susceptible and resistant Streptococcus pneumoniae . In this study, the minimum inhibitory concentrations (MICs) of cefditoren were determined for a special selection of S . pneumoniae isolates known to be susceptible, moderately susceptible or fully resistant to penicillin; these isolates originated from the lower respiratory tract of adults with pneumonia or the upper respiratory tract of children with or without symptoms of infection . Some of this latter group of isolates exhibited extremely high MICs to penicillin (> or = 32 mg/l), whereas the MICs of cefditoren did not exceed 2 mg/l . The MIC50 and MIC90 of cefditoren proved to be 0.25 and 1.0 mg/l, respectively, with a range of MICs < or = 0.015-2.0 mg/l for all the tested S . pneumoniae isolates . Its good activity suggests that cefditoren is expected to be a potent drug in infections caused by penicillin-resistant and multidrug-resistant S . pneumoniae. N Engl J Med, 2003 Jul 31, 349(5), 435 - 45 Risk of bacterial meningitis in children with cochlear implants; Reefhuis J et al.; BACKGROUND: In June 2002, the Food and Drug Administration received reports of bacterial meningitis in patients with cochlear implants for treatment of hearing loss . Implants that included a positioner (a wedge inserted next to the implanted electrode to facilitate transmission of the electrical signal by pushing the electrode against the medial wall of the cochlea) were voluntarily recalled in the United States in July 2002 . METHODS: We identified patients with meningitis and conducted a cohort study and a nested case-control investigation involving 4264 children who had received cochlear implants in the United States between January 1, 1997, and August 6, 2002, and who were less than six years of age when they received the implants . We calculated the incidence of meningitis in the cohort and assessed risk factors for meningitis among patients and among 199 controls, using data from interviews with parents and abstracted from medical records . RESULTS: We identified 26 children with bacterial meningitis . The incidence of meningitis caused by Streptococcus pneumoniae was 138.2 cases per 100,000 person-years--more than 30 times the incidence in a cohort of the same age in the general U.S . population . Postimplantation bacterial meningitis was strongly associated with the use of an implant with a positioner (odds ratio, 4.5 {95 percent confidence interval, 1.3 to 17.9}, with adjustment for medical, surgical, and environmental factors) and with the joint presence of radiographic evidence of a malformation of the inner ear and a cerebrospinal fluid leak (adjusted odds ratio, 9.3 {95 percent confidence interval, 1.2 to 94.5}) . The incidence of meningitis among patients who had received an implant with a positioner remained higher than the incidence among those whose implants did not have a positioner for the duration of follow-up (24 months from the time of implantation) . CONCLUSIONS: Parents and health care providers should ensure that all children who receive cochlear implants are appropriately vaccinated and are then monitored and treated promptly for any bacterial infections after receiving the implant . Emerg Infect Dis, 2003 Jul, 9(7), 833 - 7 Antimicrobial susceptibility breakpoints and first-step parC mutations in Streptococcus pneumoniae: redefining fluoroquinolone resistance; Lim S et al.; Clinical antimicrobial susceptibility breakpoints are used to predict the clinical outcome of antimicrobial treatment . In contrast, microbiologic breakpoints are used to identify isolates that may be categorized as susceptible when applying clinical breakpoints but harbor resistance mechanisms that result in their reduced susceptibility to the agent being tested . Currently, the National Committee for Clinical Laboratory Standards (NCCLS) guidelines utilize clinical breakpoints to characterize the activity of the fluoroquinolones against Streptococcus pneumoniae . To determine whether levofloxacin breakpoints can identify isolates that harbor recognized resistance mechanisms, we examined 115 S . pneumoniae isolates with a levofloxacin MIC of >2 mg/mL for first-step parC mutations . A total of 48 (59%) of 82 isolates with a levofloxacin MIC of 2 mg/mL, a level considered susceptible by NCCLS criteria, had a first-step mutation in parC . Whether surveillance programs that use levofloxacin data can effectively detect emerging resistance and whether fluoroquinolones can effectively treat infections caused by such isolates should be evaluated. Can J Vet Res, 2003 Jul, 67(3), 225 - 8 Comparison of experimental models for Streptococcus suis infection of conventional pigs; Pallares FJ et al.; Four different experimental models for Streptococcus suis-induced disease were compared to find a model that closely mimics naturally occurring disease in conventional pigs . Fourteen, 2-week old pigs free of S . suis type 2 were used in 2 experiments . In experiment 1, 3 pigs were inoculated intravenously (IV) and 3 pigs intranasally (IN) with S . suis . Two out of 3 of the IV-inoculated pigs exhibited signs of severe central nervous system disease (CNS) and were euthanized . Streptococcus suis type 2 was isolated from whole blood, joints, and serosal surfaces of both pigs . No clinical signs and no growth of S . suis were detected in the IN-inoculated pigs . In experiment 2, 4 pigs were inoculated IV and another 4 were inoculated IN with the same isolate as in experiment 1 . One hour before inoculation the IN-inoculated pigs were given 5 mL of 1% acetic acid intranasally (IN-AA) . All the IV-inoculated pigs showed CNS disease and lameness, and 2 of the pigs became severely affected and were euthanized . All the IN-AA inoculated pigs exhibited roughened hair coats and 2 pigs developed severe CNS disease and were euthanized . Streptococcus suis was isolated from the joints and blood of 3 pigs in the IV-inoculated group . Streptococcus suis was isolated from blood of 2 pigs, meninges of 3 pigs, and joints of 1 pig in the IN-AA inoculated group . Natural exposure to S . suis most likely occurs by the intranasal route . The IN-AA model should serve as a good model for S . suis-induced disease, because the natural route of exposure is intranasal and the IN-AA model was effective in inducing disease that mimics what is observed in the field. Pediatr Dent, 2003 May-Jun, 25(3), 215 - 22 The effects of chlorhexidine gel on Streptococcus mutans infection in 10-month-old infants: a longitudinal, placebo-controlled, double-blind trial; Wan AK et al.; PURPOSE: This study investigated the long-term effects of 0.2% chlorhexidine gel, used as a weekly brush-on gel, on Streptoccocus mutans infection in 10-month-old infants . METHODS: The investigation followed the criteria of a placebo-controlled, double-blind, longitudinal clinical trial . Infants were recruited at birth and oral microbiological swabs were taken at 3 monthly intervals, together with medical, dental, dietary and brushing histories . Children who were found to be colonized with S . mutans were randomly assigned to either the chlorhexidine-gel group (N = 50) or placebo gel group (N = 46), and parents were instructed to brush the gel on the teeth once per week for 12 weeks . In another control group (N = 210), infants did not use either chlorhexidine or placebo gels . Saliva samples were cultured using S . mutans-selective tryptone-yeast extract-cysteine-sucrose-bacitracin (TYCSB) agar . The mean age of the children was 10.2 +/- 2.6 months at the start of the trial and subjects were followed until the ages of 18 months . RESULTS: In the children with initial low S . mutans counts of < 300 CFU/mL, there was a significant percentage reduction in S . mutans counts in the chlorhexidine-gel group compared to the placebo gel and no-gel control groups after 3 months of weekly gel brushing . However, no significant differences with the placebo group were observed after 15 months of follow-up . There were 39 children (41%) who achieved reduction of their S . mutans to 0 CFU/mL . Compared to those who remained infected with S . mutans, these children had higher toothbrushing frequencies (P < .001) and toothpaste use (P < .001), as well as lower frequencies of daily feeds (P < .01), and lesser weekly frequencies of sweet solids and liquids (P < .001) . CONCLUSIONS: Children with relatively low initial S . mutans counts (< 300 CFU/mL) showed a reduction in S . mutans counts in the first 3 months when 0.2% chlorhexidine gel was brushed on the teeth weekly . No differences were observed when compared with the placebo and no-treatment groups at later follow-up periods. J Antimicrob Chemother, 2003 Sep, 52(3), 511 - 3 Epub 2003 Jul 29. Pharmacodynamics of linezolid in a clinical isolate of Streptococcus pneumoniae genetically modified to express lux genes; Alloush HM et al.; A bioluminescent clinical isolate of Streptococcus pneumoniae was used to test the real-time effects of the oxazolidinone antibiotic, linezolid, on metabolism compared with effects on cell replication . Viable counts and bioluminescence measurements showed that linezolid has little bactericidal effect, which was similar at minimum (6 mg/L), intermediate (13 mg/L) and maximum (20 mg/L) serum concentrations . The post-antibiotic effect, however, was shorter when measured by light output than by viable counts . The results demonstrate that bioluminescence provides a rapid and sensitive means of measuring the effect of antimicrobials on bacterial metabolism, and that the latter recovers earlier than commencement of cell replication after linezolid exposure. Zhonghua Kou Qiang Yi Xue Za Zhi, 2003 May, 38(3), 223 - 6 {Rapid detection of Streptococcus mutans and streptococcus sobrinus in human saliva by nested polymerase chain reaction}; Tian HP et al.; OBJECTIVE: To establish a simple and rapid method to detect Streptococcus mutans and streptococcus sobrinus simultaneously in human saliva . METHODS: Chromosomal DNA from the bacteria was obtained by the extraction method with phenol-chloroform . A nested PCR method with two sets of primers specific for portions of the glucosyltransferase genes (gtfB of S . mutans and gtfI of S . sobrinus), was optimized to detect S . mutans and S . sobrinus from standard strains, clinical strains and directly in human saliva . RESULTS: The first process of nested PCR was capable of amplifying DNA fragments specific for these species from chromosomal DNA extracted from 10(5) CFU cells of standard and clinical strains, or from 1 ml clinical saliva samples containing 10(5) CFU cells of either species . a second process of nested PCR, using the first PCR product as a template with new internal primers to detect 10(3) CFU of either streptococcal species in 1ml saliva samples . CONCLUSION: Nested PCR could detect S . mutans and S . sobrinus rapidly and simply in human saliva . This finding would be important to studies of elucidation the role of these two streptococcal species in the etiology of dental caries. Cell Mol Biol (Noisy-le-grand), 2003 Mar, 49(2), 245 - 54 Peptide mimotopes as prototypic templates of broad-spectrum surrogates of carbohydrate antigens; Cunto-Amesty G et al.; Peptide mimetics of carbohydrate antigens can function as templates to exploit immune mechanisms to augment vaccine design strategies as they are T cell dependent antigens . In this study we evaluate a peptide mimetic (peptide 105) of the Pneumococcal capsular polysaccharide type 14 (Pn14) as a model antigen to explore differences in antigenicity and immunogenicity of peptide mimotopes . The multiple antigenic peptide (MAP) form, by ELISA, competes with native Pn14 in a concentration-dependent manner for binding to an anti-Pn14 monoclonal antibody . It was observed that peptide priming with a conjugated form (105-BSA) and boosting with Pn14 produced higher levels of Pn14-reactive IgG1, IgG2a, IgG2b and IgG3 than priming and boosting with Pn14 . This serum also displayed reactivity with multiple serotypes, as assessed by ELISA . However, when compared with serum from humans immunized with the 23-valent pneumococcal vaccines, mimetic-induced mouse serum did not display a significant ability to mediate opsonophagocytic killing of pneumococci . These results suggest the feasibility of designing mimotopes to render effective humoral responses not only to a single serotype of Streptococcus pneumoniae, but to multiple serotypes at once . Such peptides would simplify currently available vaccine approaches, yet highlights the requirement of more extensive polymerization to fully emulate native antigen. Cardiol Young, 2003 Apr, 13(2), 168 - 72 Echocardiographic presentations of endocarditis, and risk factors for rupture of a sinus of Valsalva in childhood; McMahon CJ et al.; BACKGROUND: In recent years, the diagnosis of infective endocarditis has been enhanced by the use of echocardiography . We sought, therefore, to review its effect on the management of endocarditis in children . METHODS: We reviewed all the patients presenting to our institution for evaluation for infective endocarditis from May 1994 to January 2002 . The patients were stratified according to whether or not they had congenitally malformed hearts . RESULTS: Of the 90 referred patients identified, 46 (51%) had positive ultrasonic findings . Of these, we excluded 26 patients because of the presence of indwelling lines . The remaining 20 patients with features of endocarditis had a median age of 6.5 years, and a range from 0.14 to 8.5 years . There were 4 patients with normal hearts, and 16 with congenital cardiac malformations . We identified rupture of a sinus of Valsalva in four patients, with rupture into the left ventricle in two, and into the right ventricle and right atrium in one each . The mitral valve was involved in six patients, the aortic valve in another six, including all four with rupture of the sinus of Valsalva, both mitral and aortic valves in three, the pulmonary trunk in three patients, and the tricuspid valve and a Blalock-Taussig shunt in one patient each . Organisms isolated included Streptococcus mitis in 4 patients, Streptococcus pneumoniae in 2 patients, Streptococcus sanguis in 1, Staphylococcus aureus in 3, Staphylococcus epidermidis in 1, and Enteroccocus in 2 . Cultures proved negative in 7 patients . Surgical intervention was needed in 12 patients, and one died (5%) . Only the left-sided chambers were involved in those with normal hearts . Both patients infected with Streptococcus pneumoniae had rupture of a sinus of Valsalva . CONCLUSION: Involvement of the left-sided chambers is more likely in structurally normal hearts, and in cases with rupture of a sinus of Valsalva, in which case infection with Streptococcus pneumonia should be suspected. J Microbiol Immunol Infect, 2003 Jun, 36(2), 129 - 36 Brain abscess: clinical analysis of 53 cases; Kao PT et al.; Fifty-three cases of brain abscess were treated at Mackay Memorial Hospital from January 1991 through December 2001 . The ages ranged from 2 weeks to 84 years, with a peak at 40 to 50 years (11/53, 21%) . The male to female ratio was 1.8:1 (34 males, 19 females) . The most common presenting symptoms were fever (30/53, 57%), headache (29/53, 55%), and changed mental status (24/53, 45%) . The duration of symptoms before hospitalization ranged from several hours to 2 months . A shorter duration of symptoms was associated with poor outcome . The common predisposing factors were otic infection (10/53, 19%), penetrating head trauma and neurosurgery (10/53, 19%), and bacterial endocarditis (5/53, 9%) . The leading underlying diseases were diabetes mellitus (12/53, 23%) and/or liver cirrhosis (6/53, 11%), and both were independently associated with increased risk of mortality . Computed tomographic scanning and magnetic resonance imaging facilitated early diagnosis and proper management . Surgical intervention was used together with antibiotics in 33 (62%) of 53 patients in whom the average abscesses diameter was 3.75 cm (range, 2-6 cm) . The remaining 20 (38%) patients whose average abscesses diameter was 2.3 cm (range, 1-3.5 cm) were treated with antibiotics only . Culture of material drained from abscesses isolated 27 microorganisms from 19 (58%) of the 33 patients, 81% (22/27) of which were aerobic and 19% (5/27) anaerobic bacteria . The most common pathogen was alpha-hemolytic Streptococcus spp . (6/27, 22%) . Most of the patients with Klebsiella pneumoniae isolated from brain abscess, cerebrospinal fluid, and blood cultures were diabetic . A high mortality rate (9/20, 45%) was found in patients with medical treatment . A high index of suspicion is needed for the early diagnosis of brain abscess, particularly in patients with predisposing factors . In this series, early diagnosis using computed tomography and/or magnetic resonance scanning, optimal timing of surgery, and appropriate use of antibiotics were associated with improved outcome. Rinsho Shinkeigaku, 2003 Apr, 43(4), 176 - 9 {A Japanese case of Streptococcus suis meningitis associated with lumbar epidural abscess}; Ibaraki M et al.; A 47-year-old man working at a meat processing factory was admitted to our hospital after suffering high fever and severe headache for a 2-day period . He was alert and showed no neurological symptoms apart from neck stiffness . The CSF was turbid, with 701/microliter of polymorphnuclear leukocytes, a protein concentration of 218 mg/ml, and a sugar concentration of 33 mg/dl . He was diagnosed as suffering from Streptococcus suis (S . suis) serotype 2 meningitis based on CSF culture . Severe headache and high fever subsided after the treatment with intravenous antibiotics and immunoglobin . He developed, however, severe lumbargo on the third day, which was proven to be caused by the lumbar epidural abscess . Also, on the 8th day he developed hearing loss . These symptoms were treated and ameliorated with the administration of dexamethasone . On the 73rd day, the patient was discharged in good clinical condition, although he still suffered from a decrease in hearing perception . S . suis, found as a commensal in the nasopharynx of swine, is responsible for meningitis in the people who are in close contact with swine or unprocessed pork . S . suis meningitis seems to be the result of a preventable occupational infection . Although most of the patients come from other countries in Asia, our patient is the first documented case occurring in Japan . Those who have an occupational exposure to swine and pork are strongly recommended to use protective gloves . Prevention through public health surveillance is important. Rinsho Ketsueki, 2003 Jun, 44(6), 381 - 5 {Fatal septic shock and rhabdomyolysis following transfusion of platelet concentrates contaminated with Streptococcus pneumoniae}; Katayama T et al.; We report on a 58-year-old male diagnosed as having primary myelofibrosis with thrombocytopenia, who died of fatal septic shock and rhabdomyolysis after platelet concentrates (PCs) transfusion . The initial diagnosis of primary myelofibrosis was established by splenomegaly, leukoerythroblastosis and bone marrow fibrosis . PCs were transfused because of thrombocytopenia with marked bleeding tendency . Soon after the PCs transfusion in March 2000, he had attacks of chest pain, back pain and myalgia, then went into shock and died of unknown causes . PCs were suspected as being the cause of death, because Streptococcus pneumoniae was found in the culture of PCs in the WBC-reduction in-line filter and fresh frozen plasma from the same donor preserved in the Japan Red Cross Center . Rhabdomyolysis, neutrophil infiltration and phagocytosed bacteria were found from the autopsy materials, which were identified by DNA analysis as the same species found in the PCs . PCs are kept at room temperature because platelet function is lost in the cold . When PCs are contaminated with bacteria, marked multiplication induces fatal bacteremia . This is a rare report in Japan of fatal septic shock caused by PCs with bacterial contamination . We must pay strict attention to bacterial contamination in blood components. Clin Infect Dis, 2003 Aug 1, 37(3), 376 - 81 Epub 2003 Jul 14. Emergence of levofloxacin-resistant pneumococci in immunocompromised adults after therapy for community-acquired pneumonia; Anderson KB et al.; We describe 4 patients infected with levofloxacin-resistant pneumococci after therapy for community-acquired pneumonia (CAP) . The 4 patients had 15 episodes of CAP; Streptococcus pneumoniae was isolated from blood or sputum samples obtained during 14 of the episodes . The underlying medical condition was Bruton agammaglobulinemia in 3 patients and chronic lymphoid leukemia in the other . The initial episode of CAP in each patient was due to a levofloxacin-susceptible strain . One of 4 reinfections and 5 of 6 relapses were due to levofloxacin-resistant strains . All of these strains had amino acid substitutions in the quinolone-resistance-determining region of the genes parC and gyrA . The time between episodes of pneumonia varied from 1 to 4 months . In immunocompromised patients with suspected or proven pneumococcal infection, it may be prudent not to use fluoroquinolone monotherapy empirically when the patient has a history of fluoroquinolone therapy in at least the past 4 months. Biomed Mater Eng, 2003, 13(3), 281 - 95 Electrochemical study on microbiology-related corrosion of metallic dental materials; Chang JC et al.; Microbiology-related corrosion has been noted in industry for many years . It is widely recognized that microorganisms affect the corrosion of metal and alloys immersed in aqueous environments . Under similar conditions, the effect of bacteria in the oral environment on the corrosion of dental metallic materials remains unknown . The purpose of this study is to investigate the corrosion behavior of dental metallic materials in the presence of Streptococcus