FEMS Microbiol Lett, 1995 Feb 15, 126(2), 165 - 9 Heterologous expression of an endoglucanase gene (endA) from the ruminal anaerobe Ruminococcus flavefaciens 17 in Streptococcus bovis and Streptococcus sanguis; Whitehead TR et al.; The heterologous expression of a cloned endoglucanase gene (endA) from the ruminal bacterium Ruminococcus flavefaciens 17 was demonstrated in the Streptococcus species S . bovis JB1 and S . sanguis DL1 . The endA gene was introduced into S . bovis and S . sanguis using the Escherichia coli/Streptococcus shuttle vector pVA838 . Expression of the gene was detected by clearing zones around the recombinant colonies on agar plates containing carboxymethylcellulose stained with Congo red . S . bovis JB1 containing the endA gene was capable of utilizing cellotetraose at a faster rate than the parent strain . This is the first demonstration that Streptococcus species can express a gene from a Ruminococcus flavefaciens strain. Mol Gen Genet, 1995 Feb 6, 246(3), 374 - 80 Transcription termination of the streptokinase gene of Streptococcus equisimilis H46A: bidirectionality and efficiency in homologous and heterologous hosts; Steiner K et al.; In Streptococcus equisimilis H46A, a hypersymmetrical transcription terminator with bidirectional activity was localized between the translational termination codons of the streptokinase gene, skc, and the rel-orf1 genes . These two transcription units are oriented towards each other, and under normal conditions the skc mRNA level exceeds that of the rel-orf1 genes by a factor of at least 1000 . Reporter vectors based on the promoterless cat gene were constructed by transcriptional fusion of skc to cat, such that the region between the two genes contained the terminator in skc orientation or in rel-orf1 orientation . Additionally, skc and cat were fused directly, with deletion of the terminator . The reporter vectors were designed to be capable of being studied either as multicopy plasmids in Escherichia coli or in single copy following integration, via skc, into the S . equisimilis chromosome . Chloramphenicol acetyl transferase (CAT) activity assays in conjunction with determination of chloramphenicol resistance levels and Northern hybridization analysis showed that the terminator is active in either host and orientation . However, termination efficiency was host dependent, with high terminator strength being observed in the homologous streptococcal background and appreciable readthrough occurring in E . coli . The extent of transcriptional readthrough was dependent upon terminator orientation, with termination being more efficient in rel-orf1 polarity . The results suggest that, in S . equisimilis, transcription of both skc and rel-orf1 is efficiently terminated by a common signal, and that these genes are largely protected from convergent transcription, which otherwise would seem to be particularly detrimental to the weakly expressed rel-orf1 genes. J Infect Dis, 1995 Feb, 171(2), 479 - 82 Diagnosis of bacteremic pneumococcal pneumonia by amplification of pneumolysin gene fragment in serum; Salo P et al.; A polymerase chain reaction (PCR) assay based on the amplification of pneumolysin gene fragments in patient sera was developed for the etiologic diagnosis of acute pneumococcal pneumonia . Two pairs of oligonucleotide primers were designed to amplify a 348-bp and a 208-bp fragment of the pneumolysin gene . Amplified products were analyzed by agarose gel electrophoresis and hybridization using a 24-mer probe internal to the amplified DNA . The nested PCR could detect 10 organisms as determined by serial dilutions of DNA from Streptococcus pneumoniae . All 20 serum samples from patients with acute pneumococcal pneumonia (confirmed by blood culture) were positive . Among 100 serum samples from healthy elderly controls, 94 were negative and 6 were positive by PCR . Thus, PCR may be a novel diagnostic method for pneumococcal pneumonia. J Infect Dis, 1995 Feb, 171(2), 350 - 5 Phagocytosis of Streptococcus pneumoniae measured in vitro and in vivo in a rat model of carbon tetrachloride-induced liver cirrhosis; Gentry MJ et al.; Both humans and rats with liver cirrhosis have increased morbidity and mortality from pneumococcal pneumonia . By use of a rat model of carbon tetrachloride-induced liver cirrhosis, uptake of fluorochrome-labeled Streptococcus pneumoniae by polymorphonuclear leukocytes (PMNL) and alveolar macrophages (AM) was examined by flow cytometry . Peripheral blood PMNL from cirrhotic rats showed no defect in phagocytic or bactericidal capacity for type 10A S . pneumoniae in vitro . However, in vivo, fewer type 3 S . pneumoniae were engulfed by PMNL in the lungs of cirrhotic rats with a concomitant increase in the number of organisms taken up by their AM in comparison with controls . These studies indicate the importance of using more relevant in vivo methodologies for assessing bacterial phagocytosis . In addition, the reduction in uptake of type 3 pneumococci by PMNL within the microenvironment of the cirrhotic rat lung could help to explain the increased susceptibility of cirrhotic rats to pneumococcal pneumonia. Chest, 1995 Feb, 107(2), 511 - 6 Prognostic factors of pneumonia requiring admission to the intensive care unit; Almirall J et al.; All patients with severe pneumonias (community-acquired and nosocomial) who required treatment in the intensive care unit (ICU) were included in a 3-year prospective study . Predictive factors for a fatal outcome were analyzed in 127 patients . An etiologic diagnosis was made in 70 (55.1%) patients . Culture of sputum or tracheobronchial secretions were used only as criteria for microbiologic diagnosis of Legionella pneumophila . The pathogens most frequently identified were L pneumophila, Streptococcus pneumoniae, and Pseudomonas aeruginosa . Viruses were not detected as causative agents . A total of 54 patients died (mortality rate, 42.5%) . The univariate analysis showed the following factors associated with mortality: advanced age (> or = 70 years); presence of septic shock, requirement of mechanical ventilation, and Simplified Acute Physiology Score {SAPS} index > 12 at the time of admission to the ICU or when symptoms appeared in patients already admitted to the ICU; development of any complication during ICU hospitalization; and P aeruginosa as the etiologic agent of the pneumonia . When all variables were introduced by a stepwise method, the final model included advanced age (> or = 70 years), SAPS index > 12, presence of septic shock, requirement of mechanical ventilation, bilateral pulmonary involvement, and P aeruginosa as the etiologic agent of pneumonia as prognostic factors associated with a fatal outcome. J Exp Med, 1995 Feb 1, 181(2), 747 - 53 Bacterial superantigens induce T cell expression of the skin-selective homing receptor, the cutaneous lymphocyte-associated antigen, via stimulation of interleukin 12 production; Leung DY et al.; T lymphocyte infiltration is a prominent feature of the skin inflammation associated with infections by toxin (superantigen)-secreting Staphylococcus aureus or Streptococcus bacteria . The cutaneous lymphocyte-associated antigen (CLA) has been hypothesized to be a homing receptor (HR) involved in selective migration of memory/effector T cells to the skin . Since the expression of this putative skin-selective HR is known to be under strict microenvironmental control, we sought to determine the effect of staphylococcal and streptococcal toxins on T cell expression of CLA . After in vitro stimulation of peripheral blood mononuclear cells with staphylococcal enterotoxin B, toxic shock syndrome toxin-1, and streptococcal pyrogenic exotoxins A and C, there was a significant increase in the numbers of CLA+ T cell blasts (p < 0.01), but not blasts bearing the mucosa-associated adhesion molecule alpha e beta 7-integrin, compared with T cells stimulated with phytohemaglutinin (PHA) or anti-CD3 . Bacterial toxins were also found to specifically induce interleukin (IL) 12 production . More importantly, induction of toxin-induced CLA expression was blocked by anti-IL-12, and the addition of IL-12 to PHA-stimulated T cells induced CLA, but not alpha e beta 7-integrin, expression . These data suggest that bacterial toxins induce the expansion of skin-homing CLA+ T cells in an IL-12-dependent manner, and thus may contribute to the development of skin rashes in superantigen-mediated diseases. Clin Immunol Immunopathol, 1995 Feb, 74(2), 143 - 50 Immunological function in post-traumatic splenosis; Hathaway JM et al.; A 28-year-old male medical student underwent splenectomy at 8 years of age due to traumatic rupture of the spleen sustained in a motor vehicle accident . Eighteen years later the patient had major abdominal surgery performed for an unrelated condition and, at the time of surgery, over 100 splenic nodules were found embedded throughout the patient's omentum, small bowel, and mesentery . An extensive study of immunological functions was carried out during the following 2 years . Through the course of this investigation, it was determined that the patient's peripheral blood smear lacked Howell-Jolly bodies and deformed or damaged erythrocytes, indicating that the splenotic tissue had the capacity to remove intranuclear inclusions from circulating red cells and to phagocytose old erythrocytes . The patient's levels of complement, serum immunoglobulins and the numbers of circulating T and B lymphocytes, helper T cells, and cytotoxic/suppressor T cells all were within the normal range . The response to Streptococcus pneumoniae polysaccharides was also normal, with increased levels of specific antibodies to all serotypes included in the vaccine 4 months after immunization . Finally, histological examination of his biopsied splenotic nodules revealed tissue that was indistinguishable from normal spleen. Infect Immun, 1995 Feb, 63(2), 733 - 5 Identity of Streptococcus mutans surface protein antigen III and wall-associated protein antigen A; Russell MW et al.; Preparations of Streptococcus mutans surface proteins AgIII and antigen A from different laboratories were compared with regard to amino acid composition, N-terminal amino acid sequence, electrophoretic mobility, and antigenic similarity . Despite previous observations of differences in physical properties, data indicate that these two preparations represent the same protein. Infect Immun, 1995 Feb, 63(2), 609 - 21 Streptococcus salivarius ATCC 25975 possesses at least two genes coding for primer-independent glucosyltransferases; Simpson CL et al.; Fractionation of the culture medium showed that Streptococcus salivarius ATCC 25975 secreted a glucosyltransferase (Gtf) that was primer independent . On the basis of this observation, a gene library of S . salivarius chromosomal DNA cloned into lambda L47.1 was screened for a gene(s) coding for such an activity . As a result of this screening process, two new gtf genes, gtfL and gtfM, both of which coded for primer-independent Gtf activities, were isolated . GtfL produced an insoluble glucan that was refractory to digestion by the endo-(1-->6)-alpha-D-glucanase . of Chaetonium gracile, while GtfM produced a soluble glucan that was readily degraded by the glucanase . Comparison of the deduced amino acid sequences of gtfL and gtfM with 10 other available Gtf sequences allowed the relatedness of the conserved catalytic regions to be assessed . This analysis showed that the 12 enzymes did not form clusters based on their primer dependencies or on their product solubilities . Further analysis of the YG repeats in the C-terminal glucan-binding domains of GtfJ, GtfK, GtfL, and GtfM from S . salivarius showed that there was strong homology between a block of contiguous triplet YG repeats present in the four alleles . These blocks of YG repeats were coded for by a region of each gene that appeared to have arisen as a result of a recent duplication event(s). Infect Immun, 1995 Feb, 63(2), 448 - 55 A pneumolysin-negative mutant of Streptococcus pneumoniae causes chronic bacteremia rather than acute sepsis in mice; Benton KA et al.; Pneumolysin is a cytoplasmic virulence factor of Streptococcus pneumoniae that can interfere with phagocyte function in vitro . We have examined the effects of pneumolysin in vitro and in vivo and have found that it protects intravenously injected pneumococci against infection-induced host resistance . We employed a virulent capsular type 2 pneumococcal strain, D39, and its isogenic pneumolysin-negative mutant, PLN . Strain D39 exhibited exponential net growth in mice (doubling time, 1.4 h); 24 to 28 h after infection with 10(4) CFU, the numbers of pneumococci reached 10(9) to 10(10) CFU/ml and the mice died . Strain PLN yielded identical net growth in mice until reaching 10(6) to 10(7) CFU/ml at 12 to 18 h postinfection . At this time, the increase in the level of PLN CFU per milliliter ceased and remained constant for several days . PLN exhibited wild-type growth kinetics in mice when coinfected simultaneously with strain D39 . This observation suggests that pneumolysin exerts its effects at a distance . By 12 to 18 h postinfection with PLN, mice exhibited the following evidence of an induced inflammatory response: (i) elevated plasma interleukin-6, (ii) a halt in the net growth of PLN, and (iii) control of the net growth of pneumolysin-producing D39 pneumococci upon subsequent challenge . Our data suggest that pneumolysin plays a critical role in sepsis during the first few hours after infection by enabling pneumococci to cause acute sepsis rather than a chronic bacteremia . However, once chronic bacteremia was established, it appeared that pneumolysin was no longer able to act as a virulence factor. Infect Immun, 1995 Feb, 63(2), 442 - 7 Interaction of pneumolysin-sufficient and -deficient isogenic variants of Streptococcus pneumoniae with human respiratory mucosa; Rayner CF et al.; Streptococcus pneumoniae is the most common cause of community-acquired pneumonia, and pneumolysin, a hemolytic toxin, is thought to be an important virulence factor . We have studied the interaction of a pneumolysin-sufficient type II S . pneumoniae strain (PL+) and an otherwise identical pneumolysin-deficient derivative (PL-) with human respiratory mucosa in an organ culture with an air interface for up to 48 h . Ciliary beat frequency (CBF) was measured by a photometric technique, and adherence to and invasion of the epithelium were assessed by scanning and transmission electron microscopy . PL+ and PL- caused a progressive fall in CBF compared with the control which became significant (P < 0.01) at 24 h for PL+ and at 48 h for PL- . At 24 h, there was a significant increase in the percentage of the mucosa of the organ culture that was damaged for PL+ compared with the control (P < 0.01) and PL- (P < 0.02) . At 48 h, there was a significant increase in mucosal damage for both PL+ (P < 0.005) and PL- (P < 0.05) compared with the control . At 24 and 48 h, PL+ and PL- adhered predominantly to mucus and damaged cells . PL+ infection alone caused separation of tight junctions between epithelial cells, and at 48 h PL+ cells were adherent to the separated edges of otherwise healthy unciliated cells . PL+ and PL- both caused damage to the epithelial cell ultrastructure . S . pneumoniae infection caused patchy damage to the respiratory mucosa and a lowered CBF . These changes were more severe and occurred earlier with the pneumolysin-sufficient variant. Glycobiology, 1995 Feb, 5(1), 97 - 104 A 23 kDa membrane glycoprotein bearing NeuNAc alpha 2-3Gal beta 1-3GalNAc O-linked carbohydrate chains acts as a receptor for Streptococcus sanguis OMZ 9 on human buccal epithelial cells; Neeser JR et al.; Streptococcus sanguis colonizes several human oral surfaces, including both hard and soft tissues . Large salivary mucin-like glycoproteins bearing sialic acid residues are known to bind various S.sanguis strains . However, the molecular basis for the adhesion of S.sanguis to human buccal epithelial cells (HBEC) has not been established . The present study shows that S.sanguis OMZ 9 binds to exfoliated HBEC in a sialic acid-sensitive manner . The desialylation of such cells invariably abolishes adhesion of S.sanguis OMZ 9 to the cell surface . A soluble glycopeptide bearing short sialylated O-linked carbohydrate chains behaves as a potent inhibitor of the attachment of S.sanguis OMZ 9 to exfoliated HBEC . The resialylation of desialylated HBEC with CMP-sialic acid and Gal beta 1,3GalNAc alpha 2,3-sialyltransferase specific for O-glycans restores the receptor function for S.sanguis OMZ 9, whereas a similar cell resialylation with the Gal beta 1,4GlcNAc alpha 2,6-sialyltransferase specific for N-glycans is without effect . Finally, the same resialylation reaction carried out with CMP-9-fluoresceinyl-sialic acid as a substrate yields exfoliated HBEC bearing fluorescence on a single 23 kDa protein, when using the alpha 2,3-sialyltransferase as the catalyst . The latter finding demonstrates that this 23 kDa cell surface glycoprotein bears NeuNAc alpha 2-3Gal beta 1-3GalNAc O-linked sugar chains, a carbohydrate sequence which is recognized by S.sanguis OMZ 9 on exfoliated HBEC . In similar experiments carried out with a buccal carcinoma cell line termed SqCC/Y1, S.sanguis OMZ 9 did not attach in great numbers to such cultured cells, and these cells were shown to not express membrane glycoprotein bearing alpha 2,3-sialylated O-linked carbohydrate chains. Zhonghua Liu Xing Bing Xue Za Zhi, 1995 Feb, 16(1), 36 - 9 {Perinatal colonization of group B streptococcus: a study in 600 cases in Beijing Tiantan Hospital}; Zhang JH et al.; An epidemiologic study of perinatal colonization of group B streptococcus (GBS) was carried out . Six hundred mother-infant pairs were studied at Beijing Tiantan Hospital . Maternal carriage rate of GBS was 8% with a neonatal colonization rate of 6.7% . Overall perinatal carriage rate was 13% . Women with perinatal colonization showed prone to have more premature and low birth weight babies . We did not find that perinatal colonization was associated with prolonged rupture of membranes and IUGR in our study group . Serotypical study showed that most frequent GBS type isolated from the carriers was III, followed by I a . Antibiotic sensitivity study showed that more than half of the GBS strains were resistant to the antibiotics a severe problem which might have caused by abuse in this country. Australas J Dermatol, 1995 Feb, 36(1), 29 - 31 Necrotizing fasciitis: the role of Staphylococcus epidermidis, immune status and intravascular coagulation; Leibowitz MR et al.; An 83 year old Caucasian woman with necrotizing fasciitis (NF) of the right hand is described . Staphylococcus epidermidis was the only organism cultured . Serology failed to demonstrate Streptococcus pyogenes, the common pathogen of NF . Despite antibiotic therapy, gangrene supervened, necessitating digital amputation . Staphylococcus epidermidis is usually non-pathogenic, but review of the literature indicates that it is relatively commonly found with other pathogens in NF . Accordingly, studies of immune status were undertaken . Apart from reduced myeloperoxidase production (30-50% of normal levels), all humoral, cell-mediated and neutrophil function tests were normal . This is the first report of Staphylococcus epidermidis as the sole isolate in NF and also the only study of immune status of NF patients . It is concluded that a non-virulent organism (e.g . Staphylococcus epidermidis) may be pathogenic in the face of advanced age alone . Elevated fibrin degradation productions were also demonstrated in the patient, consistent with lysis of localized intravascular thrombus . The role of anticoagulation in NF is discussed. J Appl Physiol, 1995 Feb, 78(2), 491 - 8 Diaphragmatic failure during group B streptococcal sepsis in piglets: the role of thromboxane A2; Murphy TD et al.; Group B Streptococcus (GBS) causes an impairment of diaphragmatic pressure generation (Pdi) in 2-wk-old piglets, whereas 4-wk-old piglets are unaffected . In this study, we examined the effect on 4-wk-old piglets of a higher dose of GBS than previously utilized . We sought to determine whether an eicosanoid product of arachidonic acid metabolism accounted for the decrease in Pdi during GBS infusion and whether thromboxane A2 (TxA2) is the putative eicosanoid mediator of decreased Pdi during GBS infusion . Measuring Pdi during phrenic nerve stimulation, we studied four groups of anesthetized spontaneously breathing 4-wk-old piglets . Group 1 (GBS) was infused with live GBS, which caused a decrease in Pdi by 1 h at 20-, 30-, 50-, and 100-Hz stimulation frequencies . Group 2 {GBS + indomethacin (Indo)} was pretreated with Indo before GBS infusion . In the GBS + Indo group, Pdi did not decrease throughout 4 h of GBS infusion . Because Indo proved to be protective of Pdi during GBS infusion, we examined the role of TxA2, the only eicosanoid present at 1 h in the serum of GBS-infused piglets . Group 3 was infused with the TxA2 analogue U-46619 only for 1 h . Group 4 was treated with the TxA2-receptor antagonist SQ-29548 before and concomitant with GBS infusion for 1 h; the SQ-29548 was then discontinued, and GBS was continued for 1 h more . In the U-46619-infused group, Pdi decreased at 1 h, and in the SQ-29548-treated group, Pdi did not decrease during GBS infusion.(ABSTRACT TRUNCATED AT 250 WORDS) J Antimicrob Chemother, 1995 Feb, 35(2), 317 - 26 Concentrations of OPC-17116, a new fluoroquinolone antibacterial, in serum and lung compartments; Cook PJ et al.; The efficacy of an antibiotic is usually predicted from serum concentration and MICs for likely pathogens, but in the lung, tissue concentrations may be more relevant . This study compares concentrations of a new fluoroquinolone, OPC-17116, in serum, epithelial lining fluid (ELF), alveolar macrophages and bronchial mucosa, in 24 adults . OPC-17116 400 mg was given daily for 4 days, and diagnostic bronchoscopy was performed up to 13 h after the final dose . Mucosal biopsies were taken from macroscopically normal sites, alveolar macrophages were harvested by lavage, and ELF volume was derived from urea concentrations in bronchial lavage fluid and blood . A microbiological assay, using Escherichia coli, was used to assay OPC-17116 concentration in serum, bronchial mucosa, ELF and alveolar macrophages . The mean concentration of OPC-17116 in serum was 1.2 mg/L . Serum concentrations were significantly exceeded in bronchial mucosa (mean ratio 3.13) in ELF (mean ratio 12.21) and in macrophages (mean ratio 194.52) . Penetrations of these compartments considerably exceeded those reported for other fluoroquinolones, and concentrations in all tissues were substantially higher than previously reported MIC90 levels for a variety of bacteria, including Streptococcus pneumoniae . A clinical role for OPC-17116 is suggested in a wide range of respiratory infections, including those due to intracellular bacteria. Vet Immunol Immunopathol, 1995 Feb, 44(3-4), 329 - 46 Influence of recombinant bovine interleukin-1 beta and interleukin-2 in pigs vaccinated and challenged with Streptococcus suis; Blecha F et al.; An experiment was conducted to determine the adjuvanticity of recombinant bovine IL-1 beta (rBoIL-1 beta) and recombinant bovine IL-2 (rBoIL-2) administered in conjunction with a single Streptococcus suis vaccination in pigs . Sixty 4-week-old pigs were allotted to eight groups: nonvaccinated controls; vaccinated controls; rBoIL-beta at 0.1, 1, and 10 micrograms kg-1; rBoIL-2 at 2.5, 25, and 250 micrograms kg-1 . All pigs (except nonvaccinated controls) were vaccinated on Day 0 with a commercial Streptococcus suis vaccine (serotypes 1 and 2) . At vaccination, pigs were injected intramuscularly with their respective cytokine treatments . Pigs received additional cytokine injections on 2 consecutive days . On Day 21, all pigs were challenged intravenously with 3.2 x 10(9) colony forming units of a log phase culture of S . suis (serotype 2) . The highest dose of rBoIL-1 beta exceeded the maximum tolerable dose for the cytokine; however, this dose of rBoIL-1 beta protected pigs from the S . suis challenge . Pigs administered rBoIL-1 beta at 10 micrograms kg-1 had higher antibody responses to S . suis, less severe clinical signs of the disease after challenge, better growth performance during the infection, and less severe gross pathological lesions caused by the bacteria . No pigs in this treatment group died from the bacterial challenge . These data suggest that rBoIL-1 beta (10 micrograms kg-1), administered intramuscularly for 3 consecutive days at vaccination, is more effective than a single S . suis vaccination alone in protecting pigs against a S . suis challenge. Pediatr Infect Dis J, 1995 Feb, 14(2), 93 - 6 The impact of dexamethasone on hearing loss in experimental pneumococcal meningitis; Bhatt SM et al.; Bacterial meningitis, particularly that resulting from Streptococcus pneumoniae, is a common cause of acquired profound sensorineural deafness in children . The pathogenesis of meningogenic hearing loss has been investigated in an experimental rabbit model . In this study significant deafness was documented within the first 15 hours of infection . Initiation of antibiotic therapy at this time diminished the severity of hearing loss in most animals . The addition of dexamethasone to antibiotic therapy prevented the development of profound deafness . These results suggest this model will be useful in developing antiinflammatory strategies to improve the outcome of bacterial meningitis. Pediatr Infect Dis J, 1995 Feb, 14(2), 123 - 8 Risk factors for invasive disease caused by Streptococcus pneumoniae among Alaska native children younger than two years of age; Gessner BD et al.; Streptococcus pneumoniae causes a significant amount of illness and death from pneumonia, bacteremia and meningitis among children < 2 years of age . No currently available effective vaccine exists to prevent pneumococcal disease in this age group . To identify modifiable risk factors we conducted a retrospective case-control study of 29 Alaska Native residents of Bethel, AK, < 2 years of age who had invasive pneumococcal illness from 1983 to 1992 and 85 controls matched for race, city of residence and date of birth . Data were collected through reviews of medical records and telephone interviews . In matched univariate analysis the following variables were associated with illness at P < or = 0.25 and were included in the multivariate model: at least one prior episode of pneumonia; at least one prior hospitalization; group child care center attendance; at least one tobacco smoker in the household; at least one tobacco chewer in the household; and lack of breast-feeding . Using a conditional multiple logistic regression analysis, we found that group child care center attendance (odds ratio, 98.6; 95% confidence interval, 5.1 to 1920.6) and the presence in the household of at least one person who chewed tobacco (odds ratio, 20.6; 95% confidence interval, 1.4 to 294.5) were independently associated with illness while breast-feeding was protective (odds ratio, 0.1; 95% confidence interval, 0.0 to 1.0) . These data suggest that breast-feeding may prevent invasive pneumococcal disease and that strategies for decreasing risks should target children in group child care settings . Further studies are needed to evaluate the interaction of tobacco and pneumococcal illness. Clin Infect Dis, 1995 Feb, 20(2), 286 - 90 Pneumococcal vertebral osteomyelitis; Kutas LM et al.; Vertebral osteomyelitis is an unusual complication of pneumococcal infection . This report describes a patient who presented with back pain and lower extremity weakness after bacteremic pneumococcal pneumonia . Magnetic resonance imaging showed destruction of the L-4-L-5 vertebral bodies and thecal sac compression, and Streptococcus pneumoniae was isolated from an aspirate of the disk space . We found only 10 other cases of pneumococcal vertebral osteomyelitis in a review of the literature . In these 11 cases the presentations were usually subacute, and the onset of back pain was insidious . Elevated erythrocyte sedimentation rates were commonly noted . Computed tomography and magnetic resonance imaging were most helpful in delineating the extent of involvement in patients seen in the last decade . Successful treatment included surgery alone in 2 cases that occurred before the antibiotic era, surgery plus 6 weeks of antibiotic therapy in 1, and antibiotics alone for 4 weeks to 7 months in 5 . Two patients seen in the preantibiotic era died. Vet Microbiol, 1995 Feb, 43(2-3), 209 - 18 Equine strangles modelled in mice; Chanter N et al.; Small animal models of Streptococcus equi infection have been confined to parenteral injection of mice which subsequently develop a septicaemia . To devise a model of infection more closely resembling strangles, 4.9 x 10(6) cfu of S . equi were placed on the nares of C3H and Balb/c mice (fifteen of each) . Compared with ten uninfected controls, infected mice sneezed more often and their daily weight gain was significantly reduced . Histopathological examination seven days after infection revealed varying degrees of nasopharyngeal and regional lymphoid pathology in twenty two mice . Eleven mice had an early or mild rhinitis in which the nasal epithelium presented microabscesses containing polymorphonuclear leucocytes . Another eleven mice had a suppurative rhinitis or pharyngitis associated in most with regional lymphadenitis; in two mice, abscessated lymph nodes had erupted into perinodal connective tissues . Two mice had a vestibular abscess . The suppurative rhinitis was associated with extensive necrosis of nasal propria which occasionally extended to conchal bone, resulting in osteomyelitis . Multiple bacterial abscesses were seen in the spleen of one mouse . Histological lesions were not detected in control mice or in eight infected mice . S . equi was re-isolated from the nares of fourteen of the twenty two affected mice but not from the eight unaffected challenged mice or control mice . The close resemblance of this model to strangles in horses may justify its further use for the investigation of pathogenesis and protective immunity. J R Coll Surg Edinb, 1995 Feb, 40(1), 25 - 7 Breast abscesses in Nigeria: lactational versus non-lactational; Efem SE; This review of 299 cases of breast abscesses seen over a 10-year period (1981-1990) at the University of Calabar Teaching Hospital in Nigeria seeks to establish the current status of breast abscesses in the tropics . Lactational breast abscess constitutes 95% of breast abscesses while non-lactational breast abscess constitutes only 5% in this review . The commonest pathogen cultured from lactational breast abscess is Staphylococcus aureus and the disease responds to incision and drainage and systemic antibiotics, while non-lactational breast abscess is caused mostly by anaerobic organisms, usually with underlying mammary duct ectasia . The low incidence of non-lactational breast abscess corresponds to the low incidence of cigarette smoking and mammary duct ectasia in Nigerian women . While the high incidence of lactational breast abscess corresponds to the high rate of breast feeding and low level of personal hygiene in the low income group Nigerian women in which the disease is commonest . Economic recession has also reduced patronage of artificial feeds thus intensifying breast feeding and consequent lactational breast abscessPIP: A consultant surgeon analyzed data on 299 women aged 18-56 treated for breast abscess during 1981-1990 at the University of Calabar Teaching Hospital in Nigeria to examine the differences and similarities in the etiology, presentation, management, and prognosis of lactational and nonlactational breast abscess . This hospital treats an average of 30 cases annually . Only 14 women (5%) were not lactating at the time of presentation . The lactating group comprised younger women than the nonlactating group (median age, 25 vs . 42) . 85% of all lactational breast abscesses submitted for culture grew Staphylococcus aureus . 5% grew coliforms and 10% grew no organisms . 9 nonlactational breast abscesses were submitted for culture: 4 grew anaerobic organisms (3 Bacteroides sp . and 1 Streptococcus), 1 grew coliforms, and 2 grew nothing . All the women with lactational breast abscess improved with treatment: incision and drainage followed by daily packing with gauze soaked in magnesium sulfate solution (135 cases), Eusol (100 cases), and honey (50 cases) and systemic antibiotic with erythromycin, ampiclox, or amoxicillin/clavulanic acid . Only 4 of the women with nonlactational breast abscess improved with this treatment . The other 10 women experienced recurrence of breast abscess . Excision biopsy was required to treat them . They had acute or chronic inflammation with duct ectasia . All the women in the lactational breast abscess group were poor, while 6 of the 14 women with nonlactational breast abscess were from the high income group . No one from either group smoked cigarettes, probably explaining the low incidence of nonlactational breast abscess in Nigeria . The continual high incidence of lactational breast abscess coincides with the high incidence of breast feeding and with poor personal hygiene in the low income group in Nigeria . Can Fam Physician, 1995 Feb, 41, 273 - 8, 281-5 Group B streptococcus . Is it time for a screening program? Paes BA. Group B streptococcal infection often causes perinatal sepsis . Early diagnosis is based on a high index of suspicion and laboratory tests . Proposed interventions targeted at the antepartum, intrapartum, and postpartum periods have met with limited success . Screening has not been widely adopted. J Periodontol, 1995 Feb, 66(2), 139 - 44 Bacterial-stimulated cytokine production of peripheral mononuclear cells from patients of various periodontitis categories; Kjeldsen M et al.; Periodontitis is a general term for disease categories, including juvenile periodontitis (JP), rapidly progressive periodontitis (RPP), and adult periodontitis (AP), which may or may not share a common etiology and pathogenesis . These disease categories are characterized by differences in progression of tissue destruction and differences in age group susceptibility, but not, to our knowledge, by differences in cytokine responses of inflammatory cells . The present study examined blood cell counts and interindividual variation in the ability of PBMC of patients in three different categories of periodontitis to produce cytokines after stimulation with different oral bacterial species in vitro . The AP group had a significantly lower production of IL-1ra when stimulated with Porphyromonas gingivalis (P.g.) and Actinobacillus actinomycetemcomitans (A.a.) (P < 0.05) . Streptococcus sanguis (S.s.), which is associated with normal periodontal conditions, induced extremely high levels of IL-1 alpha and TNF alpha production in all groups . The RPP group had a significantly higher number of monocytes (MC) than the AP group (P < 0.05) . Additionally, JP patients had a significantly higher concentration of polymorphonuclear granulocytes compared to juvenile controls (P < 0.05) . In conclusion, IL-1 alpha, TNF alpha, or IL-6 production by peripheral blood MC after in vitro stimulation with oral bacterial type stains may not distinguish different categories of periodontitis . The results support the hypothesis that the cytokine IL-1ra is produced in different concentrations in the two groups: RPP and AP . Furthermore, elevated MC concentration in the RPP group compared to the AP group may be an important pathogenic feature in RPP. Curr Opin Pediatr, 1995 Feb, 7(1), 107 - 25 Fever without apparent source on clinical examination, lower respiratory infections in children, bacterial infections, and acute gastroenteritis and diarrhea of infancy and early childhood; McCarthy PL et al.; This section focuses on issues in infectious disease that are commonly encountered in pediatric office practice . Paul McCarthy discusses recent literature regarding the evaluation and management of acute fevers without apparent source on clinical examination in infants and children and the evaluation of children with prolonged fevers of unknown origin . David Bachman reviews recent literature about lower respiratory tract infection in children and focuses on community-acquired lower respiratory infections and respiratory syncytial virus . Eugene Shapiro discusses literature concerning several infectious diseases commonly seen in office settings and concerning which recent developments are of interest: the hemolytic-uremic syndrome and enterohemorrhagic Escherichia coli . Streptococcus pneumoniae resistant to penicillin, infections in day care centers, and new antimicrobial drugs . Michael Baron reviews recent literature about gastroenteritis and diarrhea of infancy and early childhood and discusses diagnosis, complications, pathogenesis and physiology, epidemiology, and treatment. Antimicrob Agents Chemother, 1995 Feb, 39(2), 329 - 33 Influence of pulmonary surfactant on in vitro bactericidal activities of amoxicillin, ceftazidime, and tobramycin; van 't Veen A et al.; The influence of a natural pulmonary surfactant on antibiotic activity was investigated to assess the possible use of exogenous surfactant as a vehicle for antibiotic delivery to the lung . The influence of surfactant on the bactericidal activity of amoxicillin was tested against Staphylococcus aureus and Streptococcus pneumoniae, and the influence of surfactant on the activities of ceftazidime and tobramycin was tested against Klebsiella pneumoniae, Pseudomonas aeruginosa, S . aureus, and S . pneumoniae . In vitro antibiotic activity was determined by killing curve studies in media with and without surfactant . Amoxicillin and ceftazidime activities were not changed in the presence of surfactant, except for a decreased killing rate of S . pneumoniae by ceftazidime in medium with additional rabbit serum . In contrast, killing curves with low concentrations of tobramycin (0.25x and 1x the MIC) showed a decreased level of activity of tobramycin against all pathogens tested in the presence of surfactant . With higher tobramycin concentrations (4x the MIC) killing rates were decreased less or were unchanged in the presence of surfactant . Concluding from the results of the study, both amoxicillin and ceftazidime can be combined with surfactant without the loss of activity . For mixing surfactant with tobramycin, dosages should be adjusted to overcome the partial inactivation of tobramycin by surfactant. Burns, 1995 Feb, 21(1), 54 - 6 Hot water burns in Cape Town; Hudson DA et al.; Scalds are common in South Africa and accounted for 21.6 per cent of the admissions to the Burns Unit of the University of Cape Town . Two hundred and forty adult patients (160 males, 80 females) with a mean age of 34.2 years were admitted for treatment of scalds between 1985 and June 1992 . One hundred and thirteen sustained their scalds accidentally while 127 patients were assaulted with hot water . Epilepsy accounted for 11 per cent of the accidental burns . The head and neck was involved in 16.8 per cent of accidental burns and in 84.9 per cent of assaults . A quarter of the scalds to the trunk and limbs were caused by assault compared with 75 per cent caused by accidents . Beta haemolytic streptococcus was the second commonest organism isolated from the burn wound (57 patients) . In 19 per cent of these patients a weekly course of penicillin and erythromycin did not eradicate the streptococcus and clindamycin was required . Accidental scalds usually affect the lower body and limbs whereas assault with hot water commonly involves the head and neck . Streptococcus is a common organism in the Burns Unit and is becoming more difficult to eradicate. J Clin Microbiol, 1995 Feb, 33(2), 385 - 8 Identification of Streptococcus porcinus from human sources; Facklam R et al.; Streptococcus porcinus is normally associated with infections in swine . Cultures of this streptococcal species are rarely reported from human infections . In the past 10 years, we have identified 13 cultures of S . porcinus from human sources from persons living in the United States and Canada . Seven of the strains were identified in the past 15 months . Nine of the strains were of a single serogroup, provisionally called C1 . In addition, nine of the strains were isolated from the genitourinary tract of reproductive-age female patients, some with delivery problems . S . porcinus strains could be identified by hemolytic, serologic, and physiologic characteristics . All strains were susceptible to penicillin, erythromycin, and other antimicrobial agents . Fifty-four percent of the strains were resistant to tetracycline . These findings suggest that we may be seeing a change in the flora of the genitourinary tract of humans . Whether these isolates are significant pathogens is unknown at this time. Enferm Infecc Microbiol Clin, 1995 Feb, 13(2), 99 - 103 {Osteoarticular infections caused by Streptococcus agalactiae . Report of 4 cases}; Gomez-Rodriguez N et al.; BACKGROUND: Streptococcus agalactiae (group B streptococcus) is a rare etiology of osteoarticular infection in adults . In a literature review (Medline-Embase plus) up until may 1994, we have found only 51 cases . In most patients, diabetes mellitus, liver disease or long-term steroid therapy were documented . METHODS: Four adult patients with osteoarticular infection due to S . agalactiae from two Galician hospitals were studied from January 1988 to October 1994: prepatellar bursitis (one case), septic monoarthritis (2 cases) and psoas abscess associated to cervical spondylodiscitis and oligoarthritis (left sternoclavicular and left hip joints) . RESULTS: In the first patient, a young woman with prepatellar bursitis, a previous local trauma was recorded . The second case, a man with septic arthritis of right knee, had degenerative disease of the knees and a prostatic adenocarcinoma . In the third patient, a diabetic woman with septic arthritis of the left shoulder, vulvovaginitis due to Candida albicans was found . The last patient suffered vertebral osteomyelitis of the cervical spine (C3-C4), arthritis of the left sternoclavicular and hip joints and abscess of the ipsilateral psoas . The evolution was favourable in the four cases . CONCLUSIONS: Although uncommon, osteomyelitis and arthritis caused by group B streptococcus should be considered as opportunistic pathogen in adults with debilitating conditions . Early recognition and prompt institution of adequate therapy can help avoid joint destruction and severe complications. Enferm Infecc Microbiol Clin, 1995 Feb, 13(2), 85 - 9 {Importance of anaerobic bacteria in recurrent childhood non-streptococcal tonsillitis}; de Miguel I et al.; BACKGROUND: The presence of anaerobes in the oropharyngeal flora was already known, but they were infrequently involved in infections, except for specific diseases (abscesses, Vincent's angina) . The involvement of anaerobes in more frequent by observed oropharyngeal diseases has been recently proposed . METHODS: We analyzed the tonsillar flora of 22 healthy children (control group) and 54 children diagnosed of recurrent tonsillitis . We compare the clinical response of children with recurrent tonsillitis to two treatments: penicillin, and penicillin plus metronidazole . RESULTS: We isolated Streptococcus pyogenes from 22.2% of children with tonsillitis, and did not isolate it from any healthy children . The rest of tonsillar flora was qualitatively similar in both groups . Both populations showed a high proportion of beta-lactamase-producer bacteria . In children from whom S . pyogenes was isolated, the response to the treatment was similar for both treatments . In those cases where S . pyogenes was not isolated, penicillin + metronidazole cured the 77.2% of children treated, but penicillin cured only 30% of cases . CONCLUSIONS: These results suggest that anaerobes might be involved, at least, in recurrent tonsillitis when S . pyogenes is not found, and justify further studies about the etiology and treatment of this disease. J Appl Bacteriol, 1995 Feb, 78(2), 116 - 24 The in vitro uptake and metabolism of peptides and amino acids by five species of rumen bacteria; Ling JR et al.; Streptococcus bovis JB1, Prevotella ruminicola B(1)4, Selenomonas ruminantium Z108, Fibrobacter succinogenes S85 and Anaerovibrio lipolytica 5S were incubated with either 14C-peptides (mol . wt, 200-1000) or 14C-amino acids to compare their rates of uptake and metabolism . In experiment 1, the bacteria were grown and incubated in a complex medium, but no uptake of 14C-labelled substrates occurred . When casein digest was omitted, uptake rates of 14C-peptides were different (P < 0.01) with each species, but nil for 14C-amino acids . In experiment 2, to minimize the effects of non-radiolabelled peptides and amino acids, defined and semi-defined media were used . Patterns of 14C-peptide uptake resembled those of experiment 1 . The 5-min rate for Strep . bovis JB1 was almost twice that of P . ruminicola B(1)4, though by 15 min they were similar and threefold greater than other species; that of A . lipolytica 5S was especially low . Incubations with 14C-amino acids resulted in a wide range (P < 0.01) of uptake rates; after 5 min P . ruminicola B(1)4 possessed the lowest and Strep . bovis JB1 the highest, but after 15 min, that of Sel . ruminantium Z108 was even higher . All bacteria, with the exception of P . ruminicola B(1)4, assimilated 14C-amino acids faster (P < 0.01) than 14C-peptides . Only Strep . bovis JB1 and P . ruminicola B(1)4 were capable of extensively metabolizing 14C-peptides, but all five species metabolized 14C-amino acids; there was evidence of substantial degradation and some synthesis . Calculations suggest that peptides could supply up to 43%, and amino acids 62% of the N requirements of rumen bacteria. Adv Dent Res, 1995 Feb, 9(1), 55 - 62 Characteristics of Actinobacillus actinomycetemcomitans invasion of and adhesion to cultured epithelial cells; Fives-Taylor P et al.; Actinobacillus actinomycetemcomitans (A.a.) is highly implicated in periodontitis . We have developed several in vitro models using the KB oral cell line to examine A.a.-epithelial cell interactions . In support of the use of KB cell line model systems is our finding that A.a . invaded KB and primary gingival cells to the same extent . Invasion is an active event which requires new protein synthesis by both KB and A.a . Like many other intracellular parasites, A.a . invade by receptor-mediated endocytosis . We observed that internalized A.a . were surrounded by foci of actin which had been transported from the periphery of the KB cell . Adhesion of A.a . to KB cells occurred rapidly and stimulated the formation of microvilli . Adhesion is affected by both host factors (saliva, serum, {NaCl}) and culture conditions . Multiple determinants {fimbriae, outer membrane proteins, vesicles, and/or an extracellular amorphous material (ExAmMat)} which are either associated with the A.a . surface or are released into the milieu are involved . We determined that ExAmMat can convey adhesiveness to weakly adherent A.a . and to at least one other oral species (Streptococcus parasanguis). Oral Microbiol Immunol, 1995 Feb, 10(1), 47 - 53 Inhibition of streptococcal growth, F-ATPase and pyrophosphatase by diphosphonates; Hsu MT et al.; 1-Hydroxyethane-1,1-diphosphonate (EHDP) and a variety of other diphosphonates, and also pyrophosphate, at millimolar levels were found to inhibit the growth of Streptococcus mutans GS-5 . Inhibition appeared to be due mainly to chelation of Mg2+ and could be readily reversed through addition of Mg2+, or less effectively, by other divalent cations . The trianionic forms of the diphosphonates or pyrophosphate were more effective inhibitors than the dianionic forms . Diphosphonates and pyrophosphate did not inhibit glycolysis by S . mutans, assayed in terms of glucose utilization, or arginolysis by Streptococcus rattus FA-1, assayed in terms of ammonia production . However, they did act as buffers to moderate pH changes . Diphosphonates also were inhibitors of the F-ATPase of S . mutans by complex mechanisms only partly reversible with divalent cations . They also were inhibitors of the pyrophosphatase of the organism . However, intact cells were impermeable to the compounds, and inhibition of cytoplasmic or membrane enzymes did not appear to be involved in growth inhibition. Microb Pathog, 1995 Feb, 18(2), 141 - 52 Virulence of Streptococcus pneumoniae in mice: a standardized method for preparation and frozen storage of the experimental bacterial inoculum; Aaberge IS et al.; Animal models of pneumococcal infection are important to evaluate the protective capacity of new vaccine candidates . We have established a method to prepare and store the experimental inoculum without loss of virulence or number of bacteria . This allows a standardized inoculum from the same culture batch to be used in several experiments . Pneumococci were cultured to mid-logarithmic growth phase in Todd-Hewitt broth with 17% fetal calf serum . The bacterial broth was distributed into smaller volumes and immediately frozen on liquid nitrogen and stored at -70 degrees C . We have tested the virulence of five different pneumococcal serotypes in BALB/c, C57BL/6, and NIHS mice using inocula prepared by this method and stored without loss of virulence for up to 4 years . Serotypes 1, 4, 5 and 8 were highly virulent for the strains of mice tested whereas type 6B showed lower virulence and a peculiar, protracted course of infection . There were no clear differences in virulence between the different strains of mice with the exception of serotype 6B, which showed higher virulence in BALB/c and NIHS mice than in C57BL/6 mice. Diagn Microbiol Infect Dis, 1995 Feb, 21(2), 65 - 8 Increased recovery of group B Streptococcus by the inclusion of rectal culturing and enrichment; Platt MW et al.; Detection of intrapartum carriage of group B streptococcus (GBS) and subsequent antibiotic prophylaxis may prevent GBS infections in neonates . Because the gastrointestinal tract is the primary source of this organism, detection of carrier status requires both rectal and vaginal swabs . Vaginal swabs from 651 obstetric outpatients were plated onto 5% sheep blood agar . A second vaginal and a rectal swab were collected and incubated overnight in an enrichment medium of Todd-Hewitt broth containing antibiotics . By at least one method, 110 (16.9%) patients were positive for GBS . Only 31.8% of these positive patients were detected by direct culture of vaginal swabs . The use of vaginal swabs directly plated onto blood agar identified only three carriers not detected by another method . Inoculation of an enrichment broth with the vaginal swab and subsequent subculture detected 70.9% of the total . The use of both vaginal and rectal swabs with enrichment detected 97.3% of total GBS carriers . A subset of enrichment broths inoculated with vaginal and rectal specimens from 279 patients was tested for GBS by direct latex agglutination (Streptex; Murex Diagnostics, Inc., Norcross, GA, USA) . Of the 90 broths that grew GBS on subculture, only 59 (65.6%) were positive by the direct agglutination method . The use of this method, although reducing processing time by 1 day, gave false-negative results for one-third of the GBS-positive broths . An accurate detection of the GBS carrier state can only be achieved by a combination of vaginal and rectal swabs incubated in enrichment broth and subcultured on blood agar. Diagn Microbiol Infect Dis, 1995 Feb, 21(2), 61 - 4 Superiority of conventional culture technique over rapid detection of group A Streptococcus by optical immunoassay; Baker DM et al.; An optical immunoassay (OIA) has been reported to be more sensitive than conventional culture for the detection of Group A Streptococcus, eliminating the need for culture . We attempted to confirm the sensitivity and specificity through a laboratory quantitation study and a clinical trial . OIA did not detect Group A Streptococcus below 10(5) colony forming units (CFU) . Culture detected Streptococcus to 10(2) CFU from the inoculated swab . In the clinical study, throat swabs were obtained from 77 patients in an outpatient clinic . Compared with culture, the sensitivity of OIA was 78% and the specificity was 90% . These results demonstrate that OIA was less sensitive than culture in seeded experiments and missed 22% of positives in clinical practice . Our study, contrary to previous reports, suggests that OIA is not sensitive enough to be used as the sole assay for Group A Streptococcus pharyngitis. Eur J Oral Sci, 1995 Feb, 103(1), 32 - 5 Susceptibility of Streptococcus mutans and Streptococcus sobrinus to antimicrobial agents after short-term oral chlorhexidine treatments; Jarvinen H et al.; Effects of three different types of short-term applications (1-3 times during 1 week) of chlorhexidine (1 or 40%) on the susceptibility of 863 clinical isolates of Streptococcus mutans and 53 isolates of Streptococcus sobrinus from 58 subjects were studied . Chlorhexidine-resistant isolates were not found either before or after the treatment . The minimum inhibitory concentrations (MICs) to chlorhexidine of all isolates of S . mutans were < or = 1 microgram/ml, and of S . sobrinus < or = 2 micrograms/ml . S . mutans and S . sobrinus were also susceptible to ampicillin, penicillin, cefuroxime, and tetracycline . In conclusion, different short-term chlorhexidine regimens do not induce resistance in S . mutans or S . sobrinus and, furthermore, these species have so far retained their susceptibility to common antibiotics. MMWR Morb Mortal Wkly Rep, 1995 Jan 6, 43(51-52), 949 - 52 Hemorrhage and shock associated with invasive pneumococcal infection in healthy infants and children--New Mexico, 1993-1994; Location of the alpha-amylase gene in rumen Streptococcus bovis strains distinguished by unstable amylase activity; Institute of Animal Physiology, Slovak Academy of Sciences, KosiceGenetic stability of amylase activity after serial subcultivation experiments with amylolytic ruminal Streptococcus bovis strains was investigated . Two strains Amy+ and Amy- were obtained . Loss of amylase activity connected with the loss of plasmid DNA was not found in these strains . The presence of the gene responsible for the amylase activity in the chromosome of these strains was revealed by hybridization of the alpha-amylase gene on pJK108 against chromosomal DNA of S . bovis and Bacillus subtilis after a complete restriction with EcoRI. J Gynecol Obstet Biol Reprod (Paris), 1995, 24(6), 644 - 50 {Early, severe, neonatal infections due to streptococcus group B . Multicenter retrospective study on the incidence and risk factors}; Lejeune C et al.; Streptococcus group B is often the causal agent in maternofetal infections occurring early . The prevention of fatal fulminant forms is much controversial . POPULATION AND METHODS: A retrospective multicentric study (10 maternity wards, 5 years, 96.243 live births) was conducted . All cases of early (<48 th) infection due to Streptococcus group B were collected and divided into two groups for comparison: group 1: infant death, and group 2: surviving infants requiring ventilatory assistance for > or = 12 hours . The aim of this study was to determine the incidence of fatal infections and to ascertain he clinical features and laboratory data correlated with death . RESULTS: The incidence of fatal early maternofetal infection due to Streptococcus group B (group 1) was 14 cases in 96,243 live births (0.14%) or 1 case in 7,143 live births . All newborns who died were symptomatic at 8 hours of life . The factors significantly correlated with death were: lack of antibiotics per partum, which did not {correction of no} altogether prevent severe forms (2/14 deaths and 14/28 survivals had had antibiotic per partum); prematurity; impaired adaptation to birth, early clinical signs and sudden aggravation; lack of an inflammatory syndrome at first work-up; a chest X-ray suggesting hyalin membrane disease; and major non-infectious associated disease . CONCLUSION: These findings underscore the importance of antibiotic prophylaxy per partum and the need for immediate paediatric care in case of risk factors. Acta Otolaryngol Suppl, 1995, 520 Pt 2, 405 - 7 Recovery from bilateral vestibular failure: implications for visual and cervico-ocular function; Bronstein AM et al.; We report a patient who sustained severe bilateral labyrinthine lesions during Streptococcus suis meningitis but considerably recovered vestibular function over a 7 month period . This unique case allowed us to examine the cervico-ocular reflex (COR) and visual function at various levels of activity of his vestibular system . The slow phase COR, elicited by trunk oscillation (0.2 Hz) with the head earth-stationary, was negligible immediately after the acute vestibular loss but rose to a gain of 0.51 one month after . Seven months later, when vestibular function was improved, COR gain dropped to a gain of 0.15 . Measurements of spatial visual function during whole body oscillation in the acute stage and after 6 months showed marked improvement which correlated entirely with VOR measurements in the dark and during optic fixation . This patient also showed the unique feature that, in the acute stage, eye movement gain and visual function were poorer during whole body motion than during identical visual target motion . These findings suggest that: i) the COR may be inhibited by the presence of vestibular signals, ii) spatial vision measurements provide accurate assessment of the patient's visual blur during head motion, and iii) the severe oscillopsia experienced by patients in the acute stage of vestibular loss may not only be due to the absence of the VOR; additional degradation in eye movements during head motion, perhaps arising from acutely distorted labyrinthine signals, may also play a part. DNA Seq, 1995, 6(1), 33 - 6 Cloning and sequencing of the streptokinase gene from streptococcus pyogenes (CIP 56.57); Ball MM et al.; The streptokinase gene of the Streptococcus pyogenes strain CIP 56.57 was cloned and sequenced . This sequence coding for a 441 amino acid protein is well conserved among streptococcus species: there are two very conserved domains separated by a more variable region. Medicina (B Aires), 1995, 55(6), 681 - 4 Characterization of clinical isolates of Streptococcus agalactiae by random amplified polymorphic DNA using degenerate oligonucleotides; Limansky AS et al.; Epidemiological studies of Streptococcus agalactiae strains have been limited by the lack of sensitive and discriminatory methods for comparing clinical isolates . Serotyping, albeit a widely used methodology, has been shown to possess low capability to distinguish between epidemiologically related and unrelated isolates . We have employed here a random amplification of polymorphic DNA (RAPD) assay, using degenerate oligonucleotides as primers, to characterize S . agalactiae isolates from related or unrelated clinical samples . Epidemiologically-related isolates (mother-infant pairs) showed identical profiles by this methodology . On the contrary, 12 epidemiologically-unrelated isolates (classified into 5 different serotypes) resulted in 11 distinct RAPD patterns . This suggests that the proposed modified RAPD assay provides a highly discriminatory tool for the analysis of genomic diversity among isolates from pathogenic organisms. J Oral Implantol, 1995, 21(3), 207 - 13 Oral bacterial attachment to titanium surfaces: a scanning electron microscopy study; Wu-Yuan CD et al.; Despite the wide use of dental implants, the understanding of the mechanism(s) of bacterial attachment to implant surfaces and of the factors that affect such attachment is limited . In this study, the attachment of oral bacteria--including Streptococcus sanguis, Actinomyces viscosus, and Porphyromonas gingivalis--to titanium (Ti) discs with different surface morphology (smooth, grooved, or rough) was examined by scanning electron microscopy (SEM) . The most bacterial attachment was observed on the rough BSA-coated Ti surfaces . The smooth surfaces promoted poor attachment for S . sanguis and A . viscosus . However, P . gingivalis attached equally well to both the smooth and grooved coated Ti surfaces, based on direct cell quantitation and examination with SEM . Cell-surface fimbriae (which may play a role in adhesion) of both A . viscosus and P . gingivalis observed were associated with the Ti surfaces . Ti implant surface characteristics appeared to influence oral bacterial attachment in vitro . The in vitro attachment system has proven its usefulness for future bacterial attachment studies with model implant surfaces. Acta Vet Scand, 1995, 36(4), 475 - 87 Staphylococcal and other bacterial species associated with intramammary infections in Danish dairy herds; Aarestrup FM et al.; Four thousand six hundred forty-five quarter milk samples from 1179 cows from 20 commercial dairy herds were examined in order to determine the prevalence of bacterial species . A total of 859 isolates from 839 (18.1%) culture positive samples could be assigned to 34 different species and subspecies . Diagnostics of staphylococcal species was based on conventional procedures able to differentiate between all 36 species and subspecies presently acknowledged . Staphylococcus aureus was found in 10.2% of the samples and was the most common species isolated . Streptococcus dysgalactiae (1.6%) and Streptococcus uberis (1.4%) were the second and third most common species isolated . Seventeen different coagulase negative staphylococcal species (CNS) were found in 4.1% of the samples . The most frequently isolated CNS were S . epidermidis (1.3%), S . chromogenes (1.0%) and S . simulans (0.7%) . Isolates of S . aureus were phage typed, and isolates of S . epidermidis were investigated by phage typing, antibiogram typing, and biotyping . A total of 378 (79.9%) isolates of S . aureus could be typed by phages, assigning them to 18 different phage types . However, 6 phage types accounted for 92.1% of the typable isolates . One to 2 phage types predominated within each herd . Eleven (18%) isolates of S . epidermidis could be typed by phages, assigning the isolates to 3 different types . Biotyping of S . epidermidis produced a total of 8 different types, the most common accounting for 29.5% of the isolates . A total of 6 different antibiogram types were observed among all isolates of S . epidermidis . Resistance towards penicillin (36.1%), tetracycline (9.8%) and streptomycin (9.8%), were recorded in the isolates of S . epidermidis . However, 35 (57.4%) of the isolates were susceptible to all 12 antibiotics tested. Acta Vet Scand, 1995, 36(4), 423 - 31 Relations between udder infection and somatic cells in camel (camelus dromedarius) milk; Abdurahman OA et al.; Quarter milk samples (n = 391) from 101 camels were examined to study the occurrence and causes of mastitis in traditionally managed camels in eastern Sudan and to evaluate the value of the California Mastitis Test (CMT), somatic cell count (SCC) and adenosine triphosphate (ATP) in the detection of subclinical mastitis in the camel . One hundred and seventy (43.5%) of the quarter milk samples yielded pathogenic bacteria . Streptococcus agalactiae, other Streptococcus spp., Staphylococcus aureus, coagulase-negative staphylococci, and Escherichia coli were isolated from milk . Thirty-two (8.2%) quarter milk samples yielded mixed cultures, and 189 (48.3%) yielded no growth . Mean values for CMT, SCC and ATP were higher for quarters infected with major pathogens . However, a significant number of quarter milk samples had elevated values in these tests but were from quarters from which no bacteria were isolated . The ability of the tests to predict a positive bacteriology increased slightly when 2 or 3 tests were combined. Scand J Infect Dis, 1995, 27(4), 399 - 400 Atypical cellulitis due to group B streptococcus; Doedens RA et al.; In a minority of late-onset Group B streptococcal (GBS) cases in neonates, facial or buccal cellulitis has been described . We report a case of sepsis with GBS, in which an atypical cellulitis in the inguinal area was seen as presenting symptom. Med Pregl, 1995, 48(3-4), 103 - 7 {Bacterial study in patients with chronic disease of the palatine tonsils}; Udovicki J et al.; At the Otorhinolaryngology Clinic in Novi Sad, 58 patients, from 2 to 53 years of age, with chronic palatine tonsillitis were bacteriologically examined . Staphylococcus aureus was isolated in most patients and was detected in 21 patients on the surface of the tonsil and in 25 patients at the place of a cut . Streptococcus pyogenes group A occurred only in 3 patients, group B in 1 patient which amounts to 5.17%, and 1.72% . The percentage of patients in whom rheumatism occurred was similar . The author points out the fact that there is a great disproportion between the number of patients who undergo surgery and number of complications at distant organs and appeals to reduction of indications for tonsillectomy to a reasonable level. J Clin Dent, 1995, 6(2), 131 - 4 Effect of an antibacterial varnish and amine-fluoride/stannous fluoride (AmF/SnF2) toothpaste on Streptococcus mutans counts in saliva and dental plaque of children; Banoczy J et al.; The purpose of this study was to evaluate the effect of the simultaneous application of a chlorhexidine and thymol-containing varnish (Cervitec) and an amine fluoride/stannous fluoride containing toothpaste (Meridol) on Streptococcus mutans counts in saliva and dental plaque of school children 12-14 years of age, during a six-week period . The children were separated into group 1 (Cervitec varnish + fluoride-containing toothpaste), group 2 (Cervitec varnish + Meridol toothpaste), and group 3 (Meridol toothpaste alone) . Over the six weeks the greatest improvement in salivary Streptococcus mutans count occurred in group 2 . Overall, a statistically significant decrease in total microbiological count, and Streptococcus mutans was found in all three groups. Stomatologiia (Mosk), 1995, 74(5), 62 - 4 {The local immunity of the oral cavity in dental caries}; Khazanova VV et al.; Functional activity of local immunity with regard to dental caries in children is liable to appreciable individual fluctuations which depend on sex, age, and season . In children aged 4 to 5 no association between the titer of antibodies to cariogenic Streptococcus and number of carious lesions was observed, whereas in those aged 9 to 19 these parameters were in inverse relationship . In children aged 11-12 and 14-16 this association is inverse . Regression analysis of nonspecific and specific characteristics of local immunity of the oral cavity in children aged under 12 suffering from caries revealed functional insufficiency of the mechanisms regulating the local immunity, which disappears after fluoroprophylaxis . Test system for screening of mutant Streptococcus cannot be recommended for wide use to detect subjects sensitive to caries, because it has certain limitations as regards the age of examinees. J Clin Dent, 1995, 6 Spec No, 97 - 104 Microbiological assessment of an improved stannous fluoride dentifrice; Weber DA et al.; Recently, a new stabilized stannous fluoride (SnF2) dentifrice (SSF) has been developed . The aim of the present work was to examine the antimicrobial activity of SnF2, and to assess the long-term microbial safety of this dentifrice in a series of in vitro and clinical evaluations . Results of in vitro time-kill experiments with representative oral bacteria demonstrated that SnF2 exerts broad antimicrobial activity against both Gram-positives and Gram-negatives and, in particular, has potent activity against Streptococcus mutans . Sixty-eight subjects participated in a nine-day plaque regrowth clinical study to assess the short-term antiplaque effect of SSF . The results revealed no significant differences from the negative control, suggesting that SnF2 does not detectably or directly alter plaque microbial viability or composition . Separately, evaluation of microbial safety in a subgroup of 120 subjects participating in a six-month clinical efficacy and safety trial found no significant ecological shifts between SSF and the negative (NaF dentifrice) control among 11 supragingival microbial populations examined . The potential for development of bacterial resistance to SnF2 was assessed under both in vitro and clinical conditions . In a rigorous assessment of the ability of bacterial populations to develop either phenotypic or genotypic resistance to SnF2, representative bacteria were exposed to continuous sub-lethal concentrations of SnF2 in a laboratory chemostat for at least 9 days . Results of time-kill experiments on exposed populations revealed no significant changes in susceptibility despite exposure of over 10(12) bacteria . Based on typical spontaneous mutation rates of 10(-6) to 10(-8), these results suggested that the potential for bacteria to develop resistance to SnF2 is low . Evaluation of susceptibility to SnF2 to over 800 bacterial isolates obtained over the course of the six-month clinical trial corroborate the in vitro findings, revealing no changes in susceptibility suggestive of development of resistance to SnF2 is a microbiologically safe agent for oral use and support separate clinical observations demonstrating the safety and efficacy of this stabilized SnF2 dentifrice. Dev Biol Stand, 1995, 85, 303 - 7 Analysis of glucan synthesis by Streptococcus mutans; Kuramitsu HK et al.; Glucan synthesis by Streptococcus mutans GS-5 has been analyzed by examining the regulation of expression and structure-function relationships of the glucosyltransferases . Primer extension analysis of the gtf genes has identified the putative promoter sequences for these genes and indicated that the -10 sequences are similar to the Escherichia coli consensus sequence . Site-directed mutagenesis as well as deletion analysis of the enzymes have identified amino acid residues as well as functional domains which play important roles in glucan synthesis. Dev Biol Stand, 1995, 85, 19 - 25 Transformation of naturally competent Streptococcus mutans with replicative and non-replicative Tn916-containing plasmids: implications for a mechanism of transposition; Caufield PW et al.; Based on the observations reported here and what is known concerning transformation of naturally competent strains of S . mutans and other streptococcal species such as S . gordonii, we propose the model shown in Figure 2 . The Tn916-intermediate transforms S . mutans as originally proposed for B . subtilis by Scott and coworkers {8} . It is not clear in either system (B . subtilis or S . mutans) whether the Tn916 intermediate enters the cell as ds-DNA or ss-DNA . Because it is likely that transformation of B . subtilis via formation of protoplasts involves a mechanism quite different from natural transformation in S . mutans, it would be unwise to extrapolate findings from their studies . If Tn916 enters S . mutans in a manner similar to plasmid or chromosomal DNA, we would assume that Tn916 binds to a cell receptor and as one strand enters, the other is degraded {9} . This leaves open the question of whether Tn916 recircularizes as ds-DNA before it inserts into the chromosome or whether it remains as ss-DNA, if, indeed, it enters as ss-DNA . The transformation efficiency for the Tn916 intermediate (approximately 10(-7) precluded kinetics studies such as those performed with pAM118 . Poyart-Salmeron and coworkers {11} however, described a model in which Tn1545 inserts into the target site as a ds-DNA circular molecule, similar to that seen with lambda phage . Perhaps the most interesting finding presented here is that the predominant mechanism of insertion of Tn916 into the chromosome of the recipient occurs after Tn916 enters the cell . The replicative plasmid pAM118 evidently forms by two-hit kinetics followed by intracellular excision and transposition of Tn916 . The helper-rescue experiment shows that in this system, the formation of Tcr transformants, and hence the integration of Tn916, was a function of the transformation efficacy of plasmid pAM118 . Since intracellular excision of Tn916 probably follows the re-formation of the plasmid pAM118, the rate-limiting step in this system would be the formation of the transient, intracellular plasmid pAM118 . (The transient white colony phenotype probably denotes the slower growth rate of transformants that acquire the large replicative plasmid pAM118) . Our findings demonstrate that a practical way of promoting Tn916 insertions into chromosomal DNA for the purpose of obtaining mutations is to use a helper-rescue system . Our model supports the concept that the majority of Tn916 inserts arise from a mechanism similar to 'zygotic induction' as proposed for S . sanguis (gordonii) {1} . However, the frequencies for the co-establishment of the replicative plasmid (Emr) and Tn916 inserts (Tcr) in their paper (10(-6)) differ from our observations for S . mutans . We found nearly 100% of Tcr white colonies to be Emr whereas in S . gordonii, only a fraction (approximately 1%) exhibited the TcrEmr phenotype . If both phenotypes arose independently, the frequency of the TcrEmr phenotype would be 10(-8) rather than 10(-6) survivors/recipients as observed . It was surmised that both Tcr and Emr transformants arise dependently {1} where both the Tn916 intermediate and pAM118 contribute to the formation of Tn916 inserts . We conclude from their data, however, that most Tcr arose from the Tn916-intermediate formed in the donor, in agreement with the explanation of these data by Scott {12} . Support for the contention that the Tcr arose in S . gordonii from transformation by the Tn916-intermediate as in S . mutans (yellows), and not from intracellular excision from pAM118, comes from the observation that so few Tcr are Ems and because pAM150 (rep-) yields Tcr at the same frequency as the rep+ pAM118 in their experiments . In summary, the Tn916 intermediate is capable of transforming S . mutans . In contrast to the hypothesis of Scott {12}, however, the Tn916 intermediate is not the only form involved in the transformat++t Dev Biol Stand, 1995, 85, 183 - 93 The streptokinase gene: allelic variation, genomic environment and expression control; Malke H et al.; The genes for streptokinase, the most important prokaryotic plasmingoen activator, exhibit allelic variation predominantly due to the polymorphism of an internal 220-base pair fragment that divides the phylogenetic tree of their products into two primary branches . Current molecular genetic research seeks functional correlates of the allelic variation, aims at analyzing the genomic environment of the streptokinase gene, skc, and focuses on understanding its expression . Of the six genes cloned and sequenced in the skc region of Streptococcus equisimilis H46A, skc is expressed most abundantly in a fashion that involves two overlapping core promoters and upstream sequences rich of AT tracts . Transcription of skc is terminated at a hypersymmetrical site that functions bidirectionally and prevents convergent transcription of the oppositely oriented skc and rel-orf1 genes whose mRNA abundance differs by a factor of at least three orders of magnitude. Dev Biol Stand, 1995, 85, 149 - 52 Insertional inactivation of virR in Streptococcus pyogenes M49 demonstrates that VirR functions as a positive regulator of streptococcal C5a peptidase and M protein in OF+ strains; McLandsborough LA et al.; Mutational analysis confirms the presence of a positively controlled virulence regulon in the OF+ lineage of S . pyogenes . Although there are differences in the organization of the virR regulon in OF+ and OF- strains, expression of these surface proteins is dependent on a VirR protein . In addition, it appears that production of OF is dependent on virR . The contribution of OF to the pathogenesis of S . pyogenes is unknown . The greater association of OF+ strains with impetigo compared to the greater association of OF- strains with pharyngitis {2} may indicate that production of apoproteinase is a contributing factor to skin infections. Dev Biol Stand, 1995, 85, 137 - 44 Regulation of host cell recognition in Streptococcus pyogenes; Gibson C et al.; Protein F, a fibronectin-binding protein, and the M protein of Streptococcus pyogenes both play important roles in directing adherence to different populations of host cells in the skin . Expression of both proteins is regulated in response to alterations in atmosphere . Transcriptional control of mry, a positive-acting regulator of expression of the gene which encodes the M protein (emm) in response, to elevated levels of CO2, is a mechanism for control of emm expression in response to atmosphere . Expression of protein F is controlled at the level of transcription in response to the concentration of O2, and its expression is stimulated in the presence of superoxide . Further support for a role of superoxide in regulation of prtF expression comes from the observation that an S . pyogenes mutant which contains an insertionally inactivated gene for superoxide dismutase (sod) becomes hypersensitive to superoxide and will express prtF constitutively . A second strain also demonstrates constitutive expression of prtF but contains a functional sod . Complementation analyses in this strain using a prtF allele cloned from a regulating host and a novel method for shuttle mutagenesis which utilized the transposon mini-gamma delta have been used to identify rofA, a positive-acting regulator of prtF expression . A model for the role of the surface proteins, F and M and their regulatory genes mry and rofA in streptococcal infections of the skin will be discussed. Arch Tierernahr, 1995, 48(3), 231 - 43 Rumen fermentation and metabolic profile in conventional and gnotobiotic lambs; Bomba A et al.; Observations were carried out of actual acidity, volatile fatty acid (VFA) concentrations, enzyme activity in the rumen, total protein, urea, total lipid and glucose in the serum of conventional (CL) and gnotobiotic lambs (GL) in the period of milk nutrition . The inoculum of gnotobiotic lambs contained Streptococcus bovis, Prevoxella ruminicola, Butyrivibrio fibrisolvens and Selenomonas ruminantium at a concentration of 1.10(6) each . Throughout the observation period the pH of the rumen contents of gnotobiotic lambs ranged within 6.5-6.8 with a significant difference at an age of 7 weeks . Total VFA concentrations in the rumen contents were increased in the CL throughout milk nutrition: the differences at 4 and 5 weeks of age were significant . Total VFA in the conventional lambs revealed an increasing tendency between weeks 4 and 7, reaching higher levels at 7 weeks of age (57.1 mmol.l-1), whereas in the gnotobiotic animals the range (24.3-30.1 mmol.l-1) was narrow and the peak occurred at 6 weeks of age . In GL significantly increased molar proportions of acetic acid were observed whereas in CL the molar proportions of propionic acid proved to be significant increased . The molar proportions of butyric and valeric acids were increased in CL but the group differences were not significant . In GL no isoacids were found . Alpha amylase (E.C.3.2.1.1.) activity of the rumen contents was significantly increased in GL between weeks 2 and 6 of age whereas cellulase (endoglucanase E.C.3.2.1.4 . and cellobiohydrolase E.C.3.2.1.91.) activity was significantly increased in 4-week-old CL . Over the whole period of milk nutrition no significant differences were observed in urease (E.C.3.5.1.5.) activity of the rumen contents in the examined groups . At 5 weeks of age significantly increased total protein levels were observed in the conventional animals with maximum levels occurring at 4 weeks of age (CL-59.5 g.l-1 GL-55.3 g.l-1) . Urea levels in 6-week old conventional lambs were significantly higher than in the gnotobiotic animals (CL-6.4 mmol.l-1 vs . GL-1.9 mmol.l-1) . As to glycaemia no significant group differences were recorded . In the conventional animals total lipid levels were significantly increased at 1 and 6 weeks of age with a peak occurring in the first week of life (7.5 g.l-1) whereas in the gnotobiotic lambs a significant increase was observed at 3 weeks of age, the peak being recorded in 4 week-old animals (4.3 g.l-1) . Throughout the period of interest the mean daily weight gains in the conventional and gnotobiotic lambs presented 0.164 and 0.162 kg, respectively.(ABSTRACT TRUNCATED AT 400 WORDS) Microbiol Immunol, 1995, 39(9), 729 - 32 Characterization of Streptococcus sanguis isolated from patients with Behçet's disease; Yokota K et al.; The DNA homology and cell wall sugar constituents of eight Streptococcus sanguis(-like) strains, three isolated from the patients with Behcet's disease (BD114-23, BD113-20, BD118-1), two from patients with Kawasaki disease (MCLS-1, MCLS-2), and three type and reference strains of ATCC (ATCC10556T: S . sanguis, ATCC10557: S . oralis, and ATCC10558T: S . gordonii) were analyzed . Strains BD114-23 and BD118-1 showed high DNA homology to ATCC10556T, and their cell wall constituents were identical . Conversely, BD113-20, MCLS-1, MCLS-2, and ATCC10557 showed little DNA homology to ATCC10556T and ATCC10558T, but showed approximately 50 to 60% homology to each other . The cell wall constituents of BD113-20, MCLS-1, MCLS-2, and ATCC10557, however, were somewhat different, indicating that some of the clinical isolates have different characters from those of the three ATCC strains. Ter Arkh, 1995, 67(11), 69 - 71 {The diagnostic and prognostic significance of the indices of the immune response to streptococcal group A antigens in rheumatism}; Miasoedova SE et al.; Serum samples obtained from 33 patients with acute rheumatic fever (ARF), 60 patients with rheumatic heart disease (RHD) and 30 adult healthy persons have been studied . Antibodies to streptococcal A polysaccharide (SAP) and lypoteichoic acid (LTA) were examined by ELISA, to streptolysin O by standard technique . SAP antibodies in high titers persisted from 5 to 12 months in ARF and rheumatic carditis patients especially when RHD was developing . High titers of antibodies to LTA and SLO persisted for 3 months since ARF onset, then fell (p < 0.05) . ELISA proved sensitive in determination of antibodies to SAP and LTA . Its combination with determination of the titers to SLO antigens confirmed Streptococcus A infection involvement in emergence of ARF in all the cases including insidious or late-onset carditis and chorea . High levels of antibodies to SAP and LTA were more frequently detected in patients with RHD than in healthy persons (p < 0.001) . Correlation between frequency of high levels of antibodies to SAP and bicillin 5 or erythromycin administration, duration of RHD was not established. Microbiol Immunol, 1995, 39(7), 521 - 4 Effect of Porphyromonas gingivalis ATCC 33277 vesicle on adherence of Streptococcus mutans OMZ 70 to the experimental pellicle; Kamaguchi A et al.; The vesicles of Porphyromonas gingivalis ATCC 33277 strongly aggregated Streptococcus cricetus, S . rattus, and S . mutans, but poorly aggregated S . sobrinus . The adherence of S . mutans OMZ 70 to hydroxyapatite (HA) coated with whole saliva was increased in parallel with the quantity of the vesicles . The significant increase of adherence of S . mutans OMZ 70 by the vesicles was also observed on the HA coated with parotid saliva, submandibular saliva, serum, and type I collagen . These findings suggest that the vesicles may act as a bridge between mutans streptococcus and the tooth surface. Caries Res, 1995, 29(6), 507 - 12 Adherence of microorganisms to rat salivary pellicles; Kopec LK et al.; Numerous studies, using models to mimic the formation of the acquired pellicle, have concentrated on human saliva-coated hydroxyapatite; in contrast, although the rat is frequently used as an animal model, the information concerning the formation of pellicles from rat saliva is sparse . We compared the ability of Streptococcus and Actinomyces species to adhere to hydroxyapatite coated by rat saliva (rsHA) and human saliva (sHA) . We also explored the influence of glucan synthesized in situ on the adherence of organisms . We show that each strain of organism has a distinct binding pattern, which was essentially the same with surfaces coated with either rat or human saliva . Dissolved rsHA beads revealed a major protein band (35-49 kD), identified as glutamine/glutamic-acid-rich protein; acidic proline-rich protein (31-45 kD and alpha-amylase (66 kD) were also identified . Overall, these in vitro data strongly suggest that the principles of bacterial adhesion to rsHA are similar to those observed with sHA. Microbiol Immunol, 1995, 39(6), 387 - 91 Characterization of the dextranase gene (dex) of Streptococcus mutans and its recombinant product in an Escherichia coli host; Igarashi T et al.; The gene (dex), which encodes the Streptococcus mutans dextranase (Dex), was cloned in Escherichia coli . The E . coli host harboring a recombinant plasmid (pSD2) containing an 8-kb BamHI insert produced a Dex protein of 133 kDa as well as smaller enzymes of 118, 104, and 88 kDa . The Dex produced by the recombinant E . coli was apparently located in the cytoplasmic fraction, not in the periplasmic nor the extracellular fractions . Subcloning and deletion analysis of pSD2 showed that the structural gene of Dex was encoded by a 4-kb BamHI-SalI fragment . The fragment also contained the dex promoter which was effective in the E . coli cell. Drugs, 1995, 49 Suppl 2, 48 - 57 In vitro activity of fluoroquinolones against gram-positive bacteria; Eliopoulos GM; This paper reviews the in vitro activities of several newer fluoroquinolone antimicrobials that exhibit enhanced potency against Gram-positive bacteria . Several of these agents demonstrate 10-fold greater activity than older members of this class against Staphylococcus aureus and inhibit {minimum inhibitory concentration (MIC90) values < or = 2 mg/L} many isolates resistant to ciprofloxacin or ofloxacin . Markedly enhanced activity is also noted against Streptococcus pneumoniae, 90% of isolates being inhibited at concentrations 10- to 100-fold lower than those of the older agents . Enterococci also exhibit greater susceptibility to several of the newer fluoroquinolones, although relative cross-resistance with the earlier drugs is noted . As determined by dilution techniques, the new fluoroquinolones generally demonstrate bactericidal activity at concentrations at or near their MIC values . The activities of the new compounds described here are decreased at low pH, but are not affected by the addition of up to 50% human serum to the test medium . Resistance is rarely detected (frequency < 10(-9)) when high density bacterial suspensions are plated in the presence of 4 times the MIC of these compounds . However, colonies displaying relative resistance to the new agents can be selected by serial passage in incremental antimicrobial concentrations. Scand J Infect Dis, 1995, 27(3), 201 - 6 Severe community-acquired pneumococcal pneumonia . The French Study Group of Community-Acquired Pneumonia in ICU; Moine P et al.; Streptococcus pneumoniae is the most frequent pathogen of severe community-acquired pneumonia (CAP) necessitating hospitalization . The main objective of this multicentre prospective study was to determine the value of clinical, biological, and radiological features for predicting pneumococcal etiology and to define prognostic factors . Streptococcus pneumoniae was isolated in 43/132 patients (33%) with CAP requiring ICU treatment . The mean age of the patients with pneumococcal pneumonia was 55 +/- 17 (SD) yrs and 34 were male . On admission, 14 patients with pneumococcal pneumonia were in shock, 24 were mentally confused, and 27 required mechanical ventilation during their hospitalization . Among the clinical, biological, and radiological features, fever > 39 degrees C, pleuritic chest pain, lobar distribution or alveolar consolidation, and an increase in immature granulocytes > or = 5% of WBC were more frequent in pneumococcal pneumonia than in other etiologies . Mortality was 35% . Fatal outcome was significantly related to the presence of impaired alertness, septic shock, mechanical ventilation, acute renal failure, and bacteremic pneumonia. Infection, 1995, 23 Suppl 2, S91 - 4 Assessment of the use of cefixime for switch therapy; Low DE; Switch therapy, the switch from a parenteral to an oral antimicrobial agent, has been used successfully in the treatment of many serious infections . Several studies have found that significant cost savings can be achieved by switch therapy . Moreover, it has the further advantages of shortening hospital stay and reducing nosocomial bacteremia . With the exception of Staphylococcus aureus and penicillin-resistant Streptococcus pneumoniae, cefixime has similar in vitro activity to cefotaxime and ceftriaxone . It has a prolonged half-life, allowing for once-a-day dosing, and has excellent tissue penetration (132%) . These characteristics support the use of cefixime for switch therapy when a susceptible pathogen has been identified. Caries Res, 1995, 29(5), 413 - 7 Interaction of chlorhexidine with cytoplasmic membranes of Streptococcus mutans GS-5; Koontongkaew S et al.; Cytoplasmic membranes of Streptococcus mutans GS-5 were extracted by incubating cells with 1% sodium lauroyl sarcosinate for 20 min at room temperature . The profiles of membrane proteins were determined by SDS-PAGE and isoelectric focusing . The effect of chlorhexidine digluconate on cell membranes was studied after treating the extracted proteins for 30 min with the drug at final concentrations of 0.05 and 0.2% . Chlorhexidine caused selective reduction in the intensity of the membrane proteins . Five densely staining bands with molecular weights of 24.2, 19.6, 18.1, 17.6 and 16.4 kD were obviously diminished . Isoelectric focusing indicated that chlorhexidine preferably precipitated acidic cytoplasmic proteins (pI 4.0-4.92) . Our results are consistent with the hypothesis that the mode of action of this drug is mainly attributed to its hydrophilic property . Chlorhexidine, being cationic, may interact with bacteria by attraction to negative-charge membrane components. Caries Res, 1995, 29(5), 407 - 12 Identification and genetic characterisation of melibiose-negative isolates of Streptococcus mutans; Colby SM et al.; Streptococcus mutans is frequently identified on the basis of phenotypic characteristics such as the ability to ferment carbohydrates . The usefulness of some of these identification tests may be limited in the case of isolates which are atypical with regard to their fermentation properties . We previously identified isolates of S . mutans which were unable to ferment melibiose, a characteristic which is included in some typing schemes . In all of these isolates there was a large chromosomal deletion which included the multiple sugar metabolism (msm) operon which encodes several genes involved in the uptake and metabolism of a number of sugars including melibiose . In the present study, sugar fermentation tests, ribotyping, colony hybridisation with DNA probes and polymerase chain reaction (PCR) were used to investigate the relatedness of these atypical isolates . The PCR and colony hybridisation procedures were based on amplification and detection of two genes: the wapA gene which encodes a surface protein found in all S . mutans strains and the gtfA gene which lies within the msm operon . The colony hybridisation and PCR results confirmed loss of the gtfA gene in the melibiose-negative isolates . Three new melibiose-negative isolates were also identified, but in only 2 of these was the gtfA gene absent, the third did not appear to have lost this region of the chromosome . Biotyping, as well as ribotyping based on an EcoRI digest of chromosomal DNA, revealed that the melibiose-negative isolates fell into a number of distinct groups.(ABSTRACT TRUNCATED AT 250 WORDS) Caries Res, 1995, 29(5), 402 - 6 Acid production by human strains of Streptococcus mutans and Streptococcus sobrinus; Kohler B et al.; Acid production by washed suspensions of human strains of Streptococcus mutans (n = 18) and Streptococcus sobrinus (n = 12) was measured . The strains were isolated from infants and adolescents with varying caries experience . Some of these strains and two laboratory strains (1 S . mutans and 1 S . sobrinus) had been tested in an earlier study for their cariogenicity in hamsters . Further, 3 Streptococcus sanguis strains and 1 S . sobrinus laboratory strain were included . Acid production was determined in repeated titration experiments at a constant pH of 5.5 . Higher mean acid production activities (p < 0.05) were obtained by S . sobrinus compared with both S . mutans and S . sanguis . However, large variations among the strains were found both between and within the species . No clear relationship was found between the glycolytic activity of strains and the caries prevalence of the children from whom the strains had been isolated or the caries scores in a hamster model . In conclusion, although both S . mutans and S . sobrinus have aciduric and acidogenic properties, it is difficult to relate the acid production activity of pure cultures in vitro to the caries process in vivo. J Immunol, 1995 Jan 1, 154(1), 375 - 86 Ig-binding surface proteins of Streptococcus pyogenes also bind human C4b-binding protein (C4BP), a regulatory component of the complement system; Thern A et al.; Streptococcus pyogenes, an important human pathogen, expresses several proteins that interact with the immune system of the host . Among the proteins isolated from different bacterial strains are antiphagocytic M proteins, Ig Fc-binding proteins and exotoxins that act as superantigens . Here we report a novel interaction between S . pyogenes and the human immune system, the ability of most S . pyogenes strains to bind human C4BP (C4b-binding protein), a 570-kDa serum protein that inhibits the classical pathway of complement activation . Molecular analysis of three different streptococcal strains demonstrated that C4BP binds to protein Arp or protein Sir, two Ig-binding cell surface molecules that are members of the M protein family . These bacterial proteins have separate high affinity binding sites for Ig and for C4BP, as demonstrated by inhibition tests and binding assays with purified components . A single streptococcal cell surface molecule, Arp or Sir, therefore combines the abilities to bind Ig and C4BP, two high m.w . components of the immune system . Two bacterial strains expressing Arp or Sir were shown to selectively bind C4BP in whole human serum, suggesting that S . pyogenes also binds C4BP in the infected host . When bound to streptococcal cells, C4BP retained its ability to act as a cofactor in the degradation of C4b by factor I . These results indicate that many strains of S . pyogenes interfere with the classical pathway of complement activation by binding C4BP to the bacterial cell surface. Clin Immunol Immunopathol, 1995 Jan, 74(1), 77 - 83 Macrophage inflammatory protein-1 alpha expression in vivo and in vitro: the role of lipoteichoic acid; Danforth JM et al.; Lipoteichoic acid (LTA), a component of the cell wall of most gram-positive bacteria, has been shown to play a significant role in the initiation and progression of bacterial infection . However, little is known of its position in the cytokine network involved in the induction and perpetuation of inflammation . In this study, we assessed whether the macrophage activating and chemotactic cytokine macrophage inflammatory protein-1 alpha (MIP-1 alpha) was expressed in the setting of localized gram-positive infection . Furthermore, we determined whether LTA purified from either Staphylococcus aureus or Streptococcus pyogenes could induce the expression of MIP-1 alpha mRNA and protein from human blood monocytes . Immunohistochemical staining of human endocardial samples obtained from patients with acute S . aureus endocarditis revealed cell-associated MIP-1 alpha expression by neutrophils, macrophages, and fibroblasts . Treatment of human peripheral blood monocytes in vitro with LTA isolated from either S . aureus or S . pyogenes resulted in both the time- and dose-dependent expression of MIP-1 alpha mRNA . Similarly, staphylococcal and streptococcal LTA induced the dose-dependent production of MIP-1 alpha protein after 24 h in culture . These studies suggest that LTA may play an important role in triggering the recruitment and activation of leukocytes that characterizes the host response to gram-positive bacterial invasion. Med Pediatr Oncol, 1995 Jan, 24(1), 67 - 8 Streptococcus sanguis bacteremia and colorectal cancer: a case report; Kampe CE et al.; Streptococcus sanguis, usually considered a nonpathogen of the oral cavity, was isolated from blood cultures from a patient who was subsequently found to have a cecal adenocarcinoma . Further studies are needed to determine if Streptococcus sanguis infections have diagnostic implications similar to those of Streptococcus bovis. Infect Control Hosp Epidemiol, 1995 Jan, 16(1), 18 - 24 Influenza and pneumococcal vaccination and tuberculin skin testing programs in long-term care facilities: where do we stand? McArthur MA, Simor AE, Campbell B, McGeer A. OBJECTIVE: 1) To compare policies and procedures for distribution of influenza and pneumococcal vaccines to long-term care facilities for the elderly in Canada, 2) to determine vaccination rates of residents and staff, and 3) to describe vaccination and tuberculin skin testing programs in these facilities . DESIGN: A cross-sectional survey consisting of telephone interviews and a mailed questionnaire was conducted in the spring of 1991 . Telephone interviews were conducted with provincial/territorial epidemiologists . The questionnaire was sent to all (N = 1.520) Canadian long-term care facilities for the elderly with > or = 25 beds . RESULTS: There were 1,270 responding facilities (84%) . The mean overall influenza vaccination rate for residents was 78.5% . The mean vaccination rate was higher in those provinces in which the vaccine was paid for by the government (79% versus 71%; P = 0.002) . Only 19% of facilities reported staff vaccination rates > 25%; rates again were higher in those provinces in which vaccine for staff was provided by the government . Pneumococcal vaccine was offered to residents in 12% of the facilities . The proportions of facilities with > 10% and > 75% of residents vaccinated were significantly higher in the provinces where the pneumococcal vaccine was recommended and paid for as compared with those where it was not (P < 0.001 for both) . Tuberculin skin testing programs for residents existed in 360 long-term care facilities (28%) across the country . CONCLUSION: In 1990, the number of residents living in Canadian long-term care facilities who were vaccinated against influenza and Streptococcus pneumoniae was suboptimal . Staff influenza vaccination rates were very low across the country . Most facilities did not have a baseline tuberculin skin test status for their residents . Vaccination rates are higher in jurisdictions in which governments provide the vaccine without charge. QJM, 1995 Jan, 88(1), 39 - 47 Streptococcus suis infection in Hong Kong; Kay R et al.; Twenty-five patients were admitted to two hospitals in Hong Kong for Streptococcus suis infection between 1984 and 1993 . Among them, 15 (60%) had an occupational exposure to pigs or pork, and four had a clear history of skin injury up to 16 days before admission . Examination of the cerebrospinal fluid of 21 patients confirmed the presence of meningitis in every case; the remaining four patients who did not have lumbar punctures had each presented with arthritis, bronchopneumonia, endocarditis and pyrexia without neck stiffness . The only fatality was a patient admitted in septicaemic shock with evidence of meningitis and disseminated intravascular coagulation . Of the 24 survivors, 16 (67%) acquired varying degrees of hearing loss as a result of meningitic involvement . All the isolates of S . suis were sensitive to penicillin or ampicillin, which was used alone or in combination with other antibiotics for every patient . Two patients had a relapse of symptoms when penicillin was stopped, but were successfully treated after the antibiotic was resumed for a total of 6 weeks . Over 100 cases of S . suis infection have been described previously, with a geographic distribution heavily biased towards Northern Europe and Southeast Asia . Lack of awareness of this unique zoonosis may be a reason why it is not diagnosed more readily elsewhere. Microbiology, 1995 Jan, 141 ( Pt 1), 189 - 95 Characterization of Streptococcus suis capsular type 2 haemolysin; Gottschalk MG et al.; The production of a haemolysin by Streptococcus suis capsular type 2 was investigated . Human group O erythrocytes were the most susceptible, followed by horse, sheep, cow and pig red blood cells, which exhibited similar susceptibilities; rabbit erythrocytes were the least susceptible . The haemolysin was produced at the end of the exponential growth phase . The toxin described in this paper was purified by affinity chromatography using a thiopropyl-Sepharose 6B column . It is an extracellular protein with a molecular mass of 65 kDa . The haemolysin belongs to the family of toxins known as antigenically related cholesterol-binding cytolytic toxins, since it shares common characteristics with other members of this family, such as sensitivity to oxygen and oxidizing agents, activation by reducing agents, inhibition by low concentrations of cholesterol, formation of transmembrane pores and a 'multihit' mechanism of action . In addition, anti-streptolysin antibodies inhibited the haemolytic activity caused by the S . suis haemolysin . Antibodies against the haemolysin could not be detected in pigs experimentally infected with a haemolytic positive strain of S . suis capsular type 2 . To our knowledge, this is the only Lancefield group D Streptococcus producing a haemolysin with these characteristics . The role of this haemolysin in the pathogenesis of S . suis infections remains to be investigated. Microbiology, 1995 Jan, 141 ( Pt 1), 181 - 8 High-efficiency transformation and gene inactivation in Streptococcus suis type 2; Smith HE et al.; An efficient electrotransformation system for Streptococcus suis type 2 is described . It is demonstrated that vectors based on the broad-host-range plasmid pWVO1 replicate in S . suis type 2 . Transformation efficiencies of about 10(7) transformants per micrograms of plasmid DNA could be obtained . Derivatives of plasmid pBR322 containing S . suis chromosomal DNA did not replicate but integrated into the chromosome . Southern hybridization analysis revealed that double as well as single cross-over integration events had occurred . Double cross-over events occurred at a frequency of about 15% . With these transformation and integration systems, recombinant DNA technology can now be applied to this important pathogenic species. Comp Immunol Microbiol Infect Dis, 1995 Jan, 18(1), 17 - 26 Detection of aerolysin gene in Aeromonas strains isolated from drinking water, fish and foods by the polymerase chain reaction; Baloda SB et al.; A polymerase chain reaction (PCR) technique was used to assay the presence of the aerolysin gene in a total of 89 Aeromonas hydrophila and A . sobria strains isolated from drinking water, fish and foods . These strains were also characterized for the production of virulence factors such as haemolysin, protease and cytotoxin . The primers used in the PCR targeted a 209-bp fragment of the aer gene coding for the beta-haemolysin and detected template DNA only in haemolytic A . hydrophila strains . The cell-free culture supernatants of these aerolysin-positive A . hydrophila strains were also cytotoxic to the HeLa and McCoy cells . The haemolytic A . sobria and non-haemolytic A . hydrophila were consistently negative in the PCR assay . Primer specificity was determined in the PCR by using a control haemolytic Escherichia coli, Streptococcus pyogenes and a restriction endonuclease assay . The PCR clearly identified the aerolysin-producing strains of A . hydrophila and may have application as a rapid species-specific virulence test. Br Heart J, 1995 Jan, 73(1), 20 - 4 Infections after cardioverter-defibrillator implantation: observations in 335 patients over 10 years; Trappe HJ et al.; OBJECTIVE--To determine the incidence of infection after implantation of a cardioverter-defibrillator and the management of this complication . SUBJECTS--335 consecutive patients who had a cardioverter-defibrillator implanted between January 1984 and December 1993 . MAIN OUTCOME MEASURES--Incidence of infection within the first month after implantation (early infection) and after the first month (late infection) . RESULTS--Infections associated with cardioverter-defibrillator devices occurred in 13 patients (3.9%) during a mean follow up of 22 (11) months . All patients had general signs of inflammation, fever (> 37.5 degrees C), and leucocytosis (> 10,000/ml) with or without purulent drainage . Five patients (38%) had infections during the first implantation, whereas eight patients (62%) had infections after replacement of the pulse generator . Early infection was observed in four patients (31%) and late infection in nine (69%) . Incidence of infection was higher in patients who underwent epicardial cardioverter-defibrillator implantation (12/207 patients, 5.8%) than in those who received nonthoracotomy lead systems (1/125 patients, 0.8%) (P < 0.05) . Infections were caused by staphyloccocus in 10 patients, pseudomonas in two patients, and streptococcus in one patient . The whole device had to be removed in all patients . During a mean follow up of 39 (29) months seven patients died: six of congestive heart failure and one of myocardial reinfarction . CONCLUSIONS--Infection, one of the most serious complications after cardioverter-defibrillator implantation, is associated with increased morbidity and mortality . When infection occurs the system must be removed to avoid a fatal outcome. Klin Padiatr, 1995 Jan-Feb, 207(1), 1 - 3 {Recurrent subacute endocarditis caused by Streptococcus mutans in a child}; Hunkert F et al.; Bacterial endocarditis belongs to the rare diseases in childhood . It occurs usually as a single episode and almost exclusively in children with congenital heart disease . In recent years, however, an increased number of renewed endocarditis after the first episode were reported, especially in drug addicts . We present a case of renewed subacute infective endocarditis 3 years and 9 months after complete recovery from the first one . Furthermore, using the available literatures, the role of risk factors, the change in spectrum of the infecting organisms, the diagnostic and therapeutic approach in cases with renewed infection are discussed. J Dent Res, 1995 Jan, 74(1), 351 - 7 Binding of human high-molecular-weight salivary mucins (MG1) to Hemophilus parainfluenzae; Veerman EC et al.; In human saliva, two different mucin populations can be distinguished, viz., high-molecular-weight mucins (MG1, mol . wt > 1 x 10(6)) and low-molecular-weight mucins (MG2, mol . wt approximately 125 kD) . The carbohydrate moiety of MG1 displays a wide spectrum of oligosaccharide structures, varying in composition, length, branching, and acidity . The biological significance of the heterogeneity in carbohydrate structures of mucins is unclear . The present investigation focused on the question whether MG1, because of its diverse carbohydrate side-chain population, can bind to a large variety of oral micro-organisms . A replica plate technique, in combination with immunochemical detection with monoclonal antibodies against MG1, was used to screen in vivo human oral microflora for the presence of micro-organisms which could bind the high-molecular-weight salivary mucin MG1 . Binding to purified MG1 was established for Hemophilus (para)influenzae species, whereas other species, including Streptococcus and Staphylococcus, were negative . MG1 binding to Hemophilus parainfluenzae could be abolished by protease treatment of MG1 . In contrast, periodate acid treatment, partial deglycosylation, or addition of monosaccharides did not affect MG1 binding to H . parainfluenzae, indicating that MG1 carbohydrate side-chains were not directly involved in the binding . The binding was pH-dependent, showing an increase when the pH was lowered from 8.0 to 4.0 . These data indicate that MG1 can be bound in a selective manner by Hemophilus spp . and suggest that the 'naked' unglycosylated polypeptide moiety of MG1 is involved in its binding to Hemophilus parainfluenzae. Nord Med, 1995, 110(2), 50 - 2 {Infection with group A Streptococcus}; Solberg CO et al.; In the last 8-10 years, the prevalence of severe group A streptococcus (GAS) infections such as bacteremia, erysipelas, necrotizing fasciitis and puerperal fever has increased significantly in industrialized countries . Shock, acute respiratory distress syndrome and multiorgan failure have been common features, and the attributable mortality has been as high as 30 per cent . The majority of infections have occurred in otherwise healthy adolescents and adults, and the GAS strains have been predominantly M types 1 and 3, which produce pyrogenic exotoxins, indicating an increased virulence of these strains . The article reports on the prevalence, pathogenesis, clinical features and treatment of severe GAS infections. Am J Physiol, 1995 Jan, 268(1 Pt 1), L27 - 32 Effect of pentoxifylline on changes in neutrophil sequestration and emigration in the lungs; Andres DW et al.; The response of neutrophils to inflammatory stimuli includes sequestration, adhesion, and